REQUIRES TWO-THIRDS MAJORITY VOTE (§ 20)               

                                                 (Reprinted with amendments adopted on April 21, 2003)

 

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.

 

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 the sale and purchase of prescription drugs by a wholesaler; 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; reducing the fees for the initial registration and renewal of a registration of supportive personnel; authorizing persons enrolled in certain training programs to administer controlled substances and certain drugs and medicines; 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, 3 and 3.5 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.

2-1  Sec. 3.  “Pharmaceutical technician in training” means a

2-2  person who is:

2-3  1.  Registered with the Board in order to obtain the training

2-4  and experience required to be a pharmaceutical technician; or

2-5  2.  Enrolled in a program of training for pharmaceutical

2-6  technicians that is approved by the Board.

2-7  Sec. 3.5. 1.  A wholesaler may sell a prescription drug only

2-8  to:

2-9  (a) A pharmacy or practitioner; or

2-10      (b) Another wholesaler if:

2-11          (1) The wholesaler who purchases the drug is licensed by

2-12  the Board; and

2-13          (2) The sale is a bona fide transaction.

2-14      2.  A wholesaler may purchase a prescription drug only from:

2-15      (a) A manufacturer; or

2-16      (b) Another wholesaler if:

2-17          (1) The wholesaler who sells the drug is licensed by the

2-18  Board; and

2-19          (2) The sale is a bona fide transaction.

2-20      3.  The Board shall not limit the quantity of prescription drugs

2-21  a wholesaler may purchase, sell, distribute or otherwise provide to

2-22  another wholesaler, distributor or manufacturer.

2-23      4.  For the purposes of this section:

2-24      (a) A purchase shall be deemed a bona fide transaction if:

2-25          (1) The wholesaler purchased the drug:

2-26             (I) Directly from the manufacturer of the drug; or

2-27             (II) With a reasonable belief that the drug was

2-28  originally purchased directly from the manufacturer of the drug;

2-29          (2) The circumstances of the purchase reasonably indicate

2-30  that the drug was not purchased from a source prohibited by law;

2-31          (3) Unless the drug is purchased by the wholesaler from the

2-32  manufacturer, before the wholesaler sells the drug to another

2-33  wholesaler, the wholesaler who sells the drug conducts a

2-34  reasonable visual examination of the drug to ensure that the drug

2-35  is not:

2-36             (I) Counterfeit;

2-37             (II) Deemed to be adulterated or misbranded in

2-38  accordance with the provisions of chapter 585 of NRS;

2-39             (III) Mislabeled;

2-40             (IV) Damaged or compromised by improper handling,

2-41  storage or temperature control;

2-42             (V) From a foreign or unlawful source; or

2-43             (VI) Manufactured, packaged, labeled or shipped in

2-44  violation of any state or federal law relating to prescription drugs;

3-1       (4) The drug is shipped directly from the wholesaler who

3-2  sells the drug to the wholesaler who purchases the drug; and

3-3       (5) The documents of the shipping company concerning the

3-4  shipping of the drug are attached to the invoice for the drug and

3-5  are maintained in the records of the wholesaler.

3-6  (b) A sale shall be deemed a bona fide transaction if there is a

3-7  reasonable assurance by the wholesaler that purchases the drug

3-8  that the wholesaler will sell the drug directly and only to a

3-9  pharmacy or practitioner.

3-10      (c) The purchase or sale of a prescription drug includes,

3-11  without limitation, the distribution, transfer, trading, bartering or

3-12  any other provision of a prescription drug to another person by a

3-13  wholesaler. A transfer of a prescription drug from a wholesale

3-14  facility of a wholesaler to another wholesale facility of the

3-15  wholesaler shall not be deemed a purchase or sale of a

3-16  prescription drug pursuant to this section if the wholesaler is a

3-17  corporation whose securities are publicly traded and regulated by

3-18  the Securities Exchange Act of 1934.

3-19      Sec. 4.  NRS 639.001 is hereby amended to read as follows:

3-20      639.001  As used in this chapter, unless the context otherwise

3-21  requires, the words and terms defined in NRS 639.0015 to 639.016,

3-22  inclusive, and sections 2 and 3 of this act have the meanings

3-23  ascribed to them in those sections.

3-24      Sec. 5.  NRS 639.0124 is hereby amended to read as follows:

3-25      639.0124  “Practice of pharmacy” includes, but is not limited

3-26  to, the:

3-27      1.  Performance or supervision of activities associated with

3-28  manufacturing, compounding, labeling, dispensing and distributing

3-29  of a drug[.] , including the receipt, handling and storage of

3-30  prescriptions and other confidential information relating to

3-31  patients.

3-32      2.  Interpretation and evaluation of prescriptions or orders for

3-33  medicine.

3-34      3.  Participation in drug evaluation and drug research.

3-35      4.  Advising of the therapeutic value, reaction, drug interaction,

3-36  hazard and use of a drug.

3-37      5.  Selection of the source, storage and distribution of a drug.

3-38      6.  Maintenance of proper documentation of the source, storage

3-39  and distribution of a drug.

3-40      7.  Interpretation of clinical data contained in a person’s record

3-41  of medication.

3-42      8.  Development of written guidelines and protocols in

3-43  collaboration with a practitioner which are intended for a patient in a

3-44  licensed medical facility and authorize the implementation,

3-45  monitoring and modification of drug therapy. The written

4-1  guidelines and protocols may authorize a pharmacist to order and

4-2  use the findings of laboratory tests and examinations.

4-3  9.  Implementation and modification of drug therapy in

4-4  accordance with the authorization of the prescribing practitioner for

4-5  a patient in a pharmacy in which drugs, controlled substances,

4-6  poisons, medicines or chemicals are sold at retail.

4-7  The term does not include the changing of a prescription by a

4-8  pharmacist or practitioner without the consent of the prescribing

4-9  practitioner, except as otherwise provided in NRS 639.2583.

4-10      Sec. 6.  NRS 639.015 is hereby amended to read as follows:

4-11      639.015  “Registered pharmacist” means:

4-12      1.  A person registered in this state as such on July 1, 1947;

4-13      2.  A person registered in this state as such in compliance with

4-14  the provisions of paragraph (c) of section 3 of chapter 195, Statutes

4-15  of Nevada 1951; or

4-16      3.  A person who has complied with the provisions of NRS

4-17  639.120 [and 639.133] and whose name has been entered in the

4-18  registry of pharmacists of this state by the Executive Secretary of

4-19  the Board and to whom a valid certificate as a registered pharmacist

4-20  or valid renewal thereof has been issued by the Board.

4-21      Sec. 7.  NRS 639.0152 is hereby amended to read as follows:

4-22      639.0152  “Supportive personnel” means [persons who perform

4-23  technical services in a pharmacy that do not require the judgment of

4-24  a pharmacist but which are related to the preparation and

4-25  distribution of drugs under the direct supervision of the pharmacist

4-26  who is responsible for all of the work performed in the pharmacy.]

4-27  any person, other than a pharmacist, intern pharmacist,

4-28  pharmaceutical technician or pharmaceutical technician in

4-29  training, who is employed by a pharmacy and has access to the

4-30  secured premises of the pharmacy.

4-31      Sec. 8.  NRS 639.040 is hereby amended to read as follows:

4-32      639.040  1.  The Board shall elect a President and a Treasurer

4-33  from among its members.

4-34      2.  The Board shall employ [a] an Executive Secretary, who

4-35  must not be a member of the Board. The Executive Secretary shall

4-36  keep a complete record of all proceedings of the Board and of all

4-37  certificates issued, and shall perform such other duties as the Board

4-38  may require, for which services he is entitled to receive a salary to

4-39  be determined by the Board.

4-40      Sec. 9.  NRS 639.070 is hereby amended to read as follows:

4-41      639.070  1.  The Board may:

4-42      (a) Adopt such regulations, not inconsistent with the laws of this

4-43  state, as are necessary for the protection of the public, appertaining

4-44  to the practice of pharmacy and the lawful performance of its duties.

5-1  (b) Adopt regulations requiring that prices charged by retail

5-2  pharmacies for drugs and medicines which are obtained by

5-3  prescription be posted in the pharmacies and be given on the

5-4  telephone to persons requesting such information.

5-5  (c) Adopt regulations, not inconsistent with the laws of this

5-6  state, authorizing the Executive Secretary of the Board to issue

5-7  certificates, licenses and permits required by this chapter and

5-8  chapters 453 and 454 of NRS.

5-9  (d) Adopt regulations governing the dispensing of poisons,

5-10  drugs, chemicals and medicines.

5-11      (e) Regulate the practice of pharmacy.

5-12      (f) Regulate the sale and dispensing of poisons, drugs, chemicals

5-13  and medicines.

5-14      (g) Regulate the means of recordkeeping and storage, handling,

5-15  sanitation and security of drugs, poisons, medicines, chemicals and

5-16  devices, including, but not limited to, requirements relating to:

5-17          (1) Pharmacies, institutional pharmacies and pharmacies in

5-18  correctional institutions;

5-19          (2) Drugs stored in hospitals; and

5-20          (3) Drugs stored for the purpose of wholesale distribution.

5-21      (h) Examine and register, upon application, pharmacists and

5-22  other persons who dispense or distribute medications whom it

5-23  deems qualified.

5-24      (i) Charge and collect necessary and reasonable fees for its

5-25  services, other than those specifically set forth in this chapter.

5-26      (j) Maintain offices in as many localities in the State as it finds

5-27  necessary to carry out the provisions of this chapter.

5-28      (k) Employ an attorney, inspectors, investigators and other

5-29  professional consultants and clerical personnel necessary to the

5-30  discharge of its duties.

5-31      (l) Enforce the provisions of NRS 453.011 to 453.552, inclusive,

5-32  and enforce the provisions of this chapter and chapter 454 of NRS.

5-33      (m) Adopt regulations concerning the information required to be

5-34  submitted in connection with an application for any license,

5-35  certificate or permit required by this chapter or chapter 453 or 454

5-36  of NRS.

5-37      (n) Adopt regulations concerning the education, experience and

5-38  background of a person who is employed by the holder of a license

5-39  or permit issued pursuant to this chapter and who has access to

5-40  drugs and devices.

5-41      (o) Adopt regulations concerning the use of computerized

5-42  mechanical equipment for the filling of prescriptions.

5-43      (p) Participate in and expend money for programs that enhance

5-44  the practice of pharmacy.

6-1  2.  This section does not authorize the Board to prohibit open-

6-2  market competition in the advertising and sale of prescription drugs

6-3  and pharmaceutical services.

6-4  Sec. 10.  NRS 639.081 is hereby amended to read as follows:

6-5  639.081  1.  Except as otherwise provided in subsection 3, all

6-6  money coming into the possession of the Board must be kept or

6-7  deposited by the Executive Secretary of the Board in banks, credit

6-8  unions or savings and loan associations in the State of Nevada, or

6-9  invested in United States treasury bills or notes, to be expended for

6-10  payment of compensation and expenses of members of the Board

6-11  and for other necessary or proper purposes in the administration of

6-12  this chapter.

6-13      2.  The Board may delegate to a hearing officer or panel its

6-14  authority to take any disciplinary action pursuant to this chapter,

6-15  impose and collect fines therefor and deposit the money therefrom

6-16  in banks, credit unions or savings and loan associations in this state.

6-17      3.  If a hearing officer or panel is not authorized to take

6-18  disciplinary action pursuant to subsection 2 and the Board deposits

6-19  the money collected from the imposition of fines with the State

6-20  Treasurer for credit to the State General Fund, it may present a

6-21  claim to the State Board of Examiners for recommendation to the

6-22  Interim Finance Committee if money is needed to pay attorney’s

6-23  fees or the costs of an investigation, or both.

6-24      Sec. 11.  NRS 639.120 is hereby amended to read as follows:

6-25      639.120  1.  An applicant to become a registered pharmacist in

6-26  this state must:

6-27      (a) Be of good moral character.

6-28      (b) Be a graduate of a college of pharmacy or department of

6-29  pharmacy of a university accredited by the American Council on

6-30  Pharmaceutical Education or Canadian Council for Accreditation

6-31  of Pharmacy Programs and approved by the Board or a graduate of

6-32  a foreign school who has passed an examination for foreign

6-33  graduates approved by the Board to demonstrate that his education

6-34  is equivalent.

6-35      (c) Pass an examination approved and given by the Board with a

6-36  grade of at least 75 on the examination as a whole and a grade of at

6-37  least 75 on the examination on law. An applicant for registration by

6-38  reciprocity must pass the examination on law with at least a grade

6-39  of 75.

6-40      (d) Complete not less than 1,500 hours of practical

6-41  pharmaceutical experience as an intern pharmacist under the direct

6-42  and immediate supervision of a registered pharmacist.

6-43      2.  The practical pharmaceutical experience required pursuant

6-44  to paragraph (d) of subsection 1 must relate primarily to the selling

6-45  of drugs, poisons and devices, the compounding and dispensing of

7-1  prescriptions, preparing prescriptions , and keeping records and

7-2  preparing reports required by state and federal statutes.

7-3  3.  The Board may accept evidence of compliance with the

7-4  requirements set forth in paragraph (d) of subsection 1 from boards

7-5  of pharmacy of other states in which the experience requirement is

7-6  equivalent to the requirements in this state.

7-7  Sec. 12.  NRS 639.127 is hereby amended to read as follows:

7-8  639.127  1.  An applicant for registration as a pharmacist in

7-9  this state must submit an application to the Executive Secretary of

7-10  the Board on a form furnished by the Board and must pay the fee

7-11  fixed by the Board. The fee must be paid at the time the application

7-12  is submitted and is compensation to the Board for the investigation

7-13  and the examination of the applicant. Under no circumstances may

7-14  the fee be refunded.

7-15      2.  Proof of the qualifications of any applicant must be made to

7-16  the satisfaction of the Board and must be substantiated by affidavits,

7-17  records or such other evidence as the Board may require.

7-18      3.  An application is only valid for 1 year after the date it is

7-19  received by the Board unless the Board extends its period of

7-20  validity.

7-21      4.  A certificate of registration as a pharmacist must be issued to

7-22  each person who the Board determines is qualified pursuant to the

7-23  provisions of NRS 639.120[, 639.133] and 639.134. The certificate

7-24  entitles the person to whom it is issued to practice pharmacy in this

7-25  state.

7-26      Sec. 13.  NRS 639.128 is hereby amended to read as follows:

7-27      639.128  The application of a natural person who applies for the

7-28  issuance of a certificate of registration as a pharmacist, [an]

7-29  intern pharmacist , pharmaceutical technician, pharmaceutical

7-30  technician in training or supportive personnel or a license issued

7-31  pursuant to NRS 639.233 must include the social security number of

7-32  the applicant.

7-33      Sec. 14.  NRS 639.129 is hereby amended to read as follows:

7-34      639.129  1.  A natural person who applies for the issuance or

7-35  renewal of a certificate of registration as a pharmacist, [an]

7-36  intern pharmacist , pharmaceutical technician, pharmaceutical

7-37  technician in training or supportive personnel or a license issued

7-38  pursuant to NRS 639.233 shall submit to the Board the statement

7-39  prescribed by the Welfare Division of the Department of Human

7-40  Resources pursuant to NRS 425. 520. The statement must be

7-41  completed and signed by the applicant.

7-42      2.  The Board shall include the statement required pursuant to

7-43  subsection 1 in:

7-44      (a) The application or any other forms that must be submitted

7-45  for the issuance or renewal of the certificate or license; or

8-1  (b) A separate form prescribed by the Board.

8-2  3.  A certificate of registration as a pharmacist, [an]

8-3  intern pharmacist , pharmaceutical technician, pharmaceutical

8-4  technician in training or supportive personnel or a license issued

8-5  pursuant to NRS 639.233 may not be issued or renewed by the

8-6  Board if the applicant is a natural person who:

8-7  (a) Fails to submit the statement required pursuant to subsection

8-8  1; or

8-9  (b) Indicates on the statement submitted pursuant to subsection

8-10  1 that he is subject to a court order for the support of a child and is

8-11  not in compliance with the order or a plan approved by the district

8-12  attorney or other public agency enforcing the order for the

8-13  repayment of the amount owed pursuant to the order.

8-14      4.  If an applicant indicates on the statement submitted pursuant

8-15  to subsection 1 that he is subject to a court order for the support of a

8-16  child and is not in compliance with the order or a plan approved by

8-17  the district attorney or other public agency enforcing the order for

8-18  the repayment of the amount owed pursuant to the order, the Board

8-19  shall advise the applicant to contact the district attorney or other

8-20  public agency enforcing the order to determine the actions that the

8-21  applicant may take to satisfy the arrearage.

8-22      Sec. 15.  NRS 639.137 is hereby amended to read as follows:

8-23      639.137  1.  Any person who is not a registered pharmacist,

8-24  but who is employed in this state for the purpose of fulfilling the

8-25  requirements of paragraph (d) of subsection 1 of NRS 639.120 to

8-26  become eligible for registration as a pharmacist, shall register with

8-27  the Board as an intern pharmacist. An applicant, to be eligible for

8-28  registration as an intern pharmacist, must be enrolled in a college of

8-29  pharmacy or a department of pharmacy of a university approved by

8-30  the Board or be a graduate of a foreign school and pass an

8-31  examination for foreign graduates approved by the Board. The

8-32  application must be made on a form furnished by the Board.

8-33      2.  The Executive Secretary of the Board, upon approval of the

8-34  application, shall issue a certificate of registration authorizing

8-35  the applicant to undergo practical pharmaceutical training under the

8-36  direct and immediate supervision of a registered pharmacist. The

8-37  period of validity of the certificate of registration, including any

8-38  renewal, must not exceed 4 years after the date of issue. The

8-39  certificate of registration authorizes the holder, if acting under the

8-40  direct and immediate supervision of a registered pharmacist, to

8-41  perform:

8-42      (a) The duties of a registered pharmacist as authorized by

8-43  regulation of the Board; and

8-44      (b) Other activities as authorized by regulation of the Board.

9-1  3.  The certificate of registration must be posted as required by

9-2  NRS 639.150.

9-3  4.  Any certificate of registration issued pursuant to the

9-4  provisions of this section may be suspended, terminated or revoked

9-5  by the Board for:

9-6  (a) Any reason set forth in this chapter as grounds for the

9-7  suspension or revocation of any certificate, license or permit; or

9-8  (b) The failure of the registered pharmacist whose name appears

9-9  on the certificate of registration to provide adequate training and

9-10  supervision for the intern pharmacist in compliance with regulations

9-11  adopted by the Board.

9-12      Sec. 16.  NRS 639.1371 is hereby amended to read as follows:

9-13      639.1371  1.  The ratio of [supportive personnel]

9-14  pharmaceutical technicians to pharmacists must not allow more

9-15  than one [supportive personnel] pharmaceutical technician to each

9-16  pharmacist unless the Board by regulation expands the ratio.

9-17      2.  The Board shall adopt regulations concerning

9-18  pharmaceutical technicians and supportive personnel, including

9-19  requirements for:

9-20      (a) The qualifications, registration and supervision of

9-21  pharmaceutical technicians and supportive personnel; and

9-22      (b) [Services] The services which may be performed by

9-23  pharmaceutical technicians and supportive personnel,

9-24  to ensure the protection and safety of the public in the provision of

9-25  pharmaceutical care.

9-26      3.  The regulations adopted by the Board pursuant to this

9-27  section which prescribe:

9-28      (a) The qualifications for [supportive personnel]

9-29  pharmaceutical technicians must include:

9-30          (1) [At least 1 year of education at a postsecondary school

9-31  which is directly related to the duties performed by supportive

9-32  personnel;

9-33          (2)] The successful completion of a program for [supportive

9-34  personnel] pharmaceutical technicians which is approved by the

9-35  Board;

9-36          [(3)] (2) The completion of at least 1,500 hours of experience

9-37  in carrying out the duties of [supportive personnel; or

9-38          (4)] a pharmaceutical technician; or

9-39          (3) Any other experience or education deemed equivalent by

9-40  the Board.

9-41      (b) An expanded ratio of [supportive personnel] pharmaceutical

9-42  technicians to pharmacists must [not allow more than two

9-43  supportive personnel for each pharmacist in] be appropriate and

9-44  necessary for a particular category of pharmacy at any time.

10-1      (c) The services which may be performed by [supportive

10-2  personnel] pharmaceutical technicians must include, without

10-3  limitation, the:

10-4          (1) Removal of drugs from stock;

10-5          (2) Counting, pouring or mixing of drugs;

10-6          (3) Placing of drugs in containers;

10-7          (4) Affixing of labels to containers; and

10-8          (5) Packaging and repackaging of drugs.

10-9      4.  For the purposes of this chapter, and chapters 453 and 454 of

10-10  NRS, [supportive personnel] pharmaceutical technicians may

10-11  perform acts required to be performed by pharmacists , but only to

10-12  the extent provided in regulations.

10-13     Sec. 17.  NRS 639.138 is hereby amended to read as follows:

10-14     639.138  If the Board, after an investigation, denies any

10-15  application for a certificate, license or permit, the Executive

10-16  Secretary of the Board shall notify the applicant, within 10 days

10-17  after the denial is approved by the Board and entered in the official

10-18  minutes, by registered or certified mail, of the denial of the

10-19  application and the reasons therefor. The notice must inform the

10-20  applicant of his right to petition the Board for reconsideration and

10-21  his right to submit evidence to controvert the alleged violations on

10-22  which the denial was based.

10-23     Sec. 18.  NRS 639.139 is hereby amended to read as follows:

10-24     639.139  1.  At any time within 30 days after receipt of the

10-25  notice of denial of his application, an applicant may petition the

10-26  Board for reconsideration of the application. The petition must set

10-27  forth a denial, in whole or in part, of the violations alleged and a

10-28  statement that the applicant is prepared to submit evidence in

10-29  support of his denial of the allegations.

10-30     2.  Within 30 days after the petition is received by the Board,

10-31  the Executive Secretary of the Board shall notify the petitioner, by

10-32  registered or certified mail, of the Board’s decision [either] to grant

10-33  or deny the petition for reconsideration. If the petition is granted, the

10-34  notice [shall] must include the time and place set for reconsideration

10-35  of the application by the Board.

10-36     Sec. 19.  NRS 639.160 is hereby amended to read as follows:

10-37     639.160  Every registered pharmacist shall, within 10 days after

10-38  changing his place of practice as designated on the books of the

10-39  Executive Secretary of the Board, notify the Executive Secretary [of

10-40  the Board of such] of the change and of his new place of practice.

10-41  Upon receipt of [such] the notification , the Executive Secretary

10-42  shall make the necessary change in his register.

10-43     Sec. 20.  NRS 639.170 is hereby amended to read as follows:

10-44     639.170  1.  The Board shall charge and collect not more than

10-45  the following fees for the following services:

11-1                                                                        Actual cost

11-2  For the examination of an applicant for registration   of the

11-3  as a pharmacist......................... examination

11-4  For the investigation or registration of an

11-5  applicant as a registered pharmacist. $200

11-6  For the investigation, examination or registration

11-7  of an applicant as a registered pharmacist by

11-8  reciprocity............................................ 300

11-9  For the investigation or issuance of an original

11-10  license to conduct a retail pharmacy. 600

11-11  For the biennial renewal of a license to conduct a

11-12  retail pharmacy................................... 500

11-13  For the investigation or issuance of an original

11-14  license to conduct an institutional pharmacy  600

11-15  For the biennial renewal of a license to conduct an

11-16  institutional pharmacy........................ 500

11-17  For the issuance of an original or duplicate

11-18  certificate of registration as a registered

11-19  pharmacist............................................ 50

11-20  For the biennial renewal of registration as a

11-21  registered pharmacist......................... 200

11-22  For the reinstatement of a lapsed registration (in

11-23  addition to the fees for renewal for the period of

11-24  lapse)................................................... 100

11-25  For the initial registration of a pharmaceutical

11-26  technician or pharmaceutical technician in

11-27  training............................................... 50

11-28  For the biennial renewal of registration of a

11-29  pharmaceutical technician or pharmaceutical

11-30  technician in training....................... 50

11-31  For the initial registration of supportive personnel    [50] 20

11-32  For the biennial renewal of registration of

11-33  supportive personnel.................... [50] 20

11-34  For the investigation or registration of an intern

11-35  pharmacist............................................ 50

11-36  For the biennial renewal of registration as an

11-37  intern pharmacist................................. 40

11-38  For investigation or issuance of an original license

11-39  to a manufacturer or wholesaler........ 500

11-40  For the biennial renewal of a license for a

11-41  manufacturer or wholesaler.... [400] 500

 

 

 

12-1  For the reissuance of a license issued to a

12-2  pharmacy, when no change of ownership is

12-3  involved, but the license must be reissued because

12-4  of a change in the information required thereon  $100

12-5  [For the biennial renewal of registration issued to

12-6  a registered pharmacist placed on inactive status100]

12-7  For authorization of a practitioner to dispense

12-8  controlled substances or dangerous drugs, or both300

12-9  For the biennial renewal of authorization of a

12-10  practitioner to dispense controlled substances or

12-11  dangerous drugs, or both................... 300

 

12-12     2.  If a person requests a special service from the Board or

12-13  requests the Board to convene a special meeting, he must pay the

12-14  actual costs to the Board as a condition precedent to the rendition of

12-15  the special service or the convening of the special meeting.

12-16     3.  All fees are payable in advance and are not refundable.

12-17     4.  The Board may, by regulation, set the penalty for failure to

12-18  pay the fee for renewal for any license, permit, authorization or

12-19  certificate within the statutory period, at an amount not to exceed

12-20  100 percent of the fee for renewal for each year of delinquency in

12-21  addition to the fees for renewal for each year of delinquency.

12-22     Sec. 21.  NRS 639.180 is hereby amended to read as follows:

12-23     639.180  1.  Except as otherwise provided in this subsection, a

12-24  certificate, license or permit issued by the Board pursuant to this

12-25  chapter expires on October 31 of each even‑numbered year. A

12-26  certificate of registration as a pharmacist expires on October 31 of

12-27  each odd‑numbered year.

12-28     2.  Except as otherwise provided by NRS 639.137, 639.230 and

12-29  639.2328, each person to whom a certificate, license or permit has

12-30  been issued may, if the certificate, license or permit has not been

12-31  revoked, renew the certificate, license or permit biennially by:

12-32     (a) Filing an application for renewal;

12-33     (b) Paying the fee for renewal;

12-34     (c) Complying with the requirement of continuing professional

12-35  education, if applicable; and

12-36     (d) If the applicant is a natural person who is applying for the

12-37  renewal of a certificate of registration as a pharmacist, [an]

12-38  intern pharmacist , pharmaceutical technician, pharmaceutical

12-39  technician in training or supportive personnel or a license issued

12-40  pursuant to NRS 639.233, submitting the statement required

12-41  pursuant to NRS 639.129.

13-1      3.  The application for renewal, together with the fee for

13-2  renewal and, if applicable, the statement, must be delivered to the

13-3  Executive Secretary of the Board on or before the expiration date of

13-4  the certificate, license or permit, or the current renewal receipt

13-5  thereof.

13-6      4.  If a certificate, license or permit is renewed, it must be

13-7  delivered to the applicant within a reasonable time after receipt of

13-8  the application for renewal and the fee for renewal.

13-9      5.  The Board may refuse to renew a certificate, license or

13-10  permit if the applicant has committed any act proscribed by

13-11  NRS 639.210.

13-12     6.  If the application for renewal and the fee for renewal and, if

13-13  applicable, the statement[,] are not postmarked on or before the

13-14  expiration date of the certificate, license or permit, or the current

13-15  renewal receipt thereof, the registration is automatically forfeited.

13-16     Sec. 22.  NRS 639.2174 is hereby amended to read as follows:

13-17     639.2174  The Board shall not[:

13-18     1.  Issue a certificate as a registered pharmacist to any person

13-19  pursuant to NRS 639.133; or

13-20     2.  Renew] renew the certificate of any registered pharmacist[,]

13-21  until the applicant has submitted proof to the Board of the receipt of

13-22  the required number of continuing education units, obtained through

13-23  the satisfactory completion of an accredited program of continuing

13-24  professional education during the period for which the certificate

13-25  was issued.

13-26     Sec. 23.  NRS 639.230 is hereby amended to read as follows:

13-27     639.230  1.  A [pharmacy or a] person operating [as a

13-28  pharmacy] a business in this state shall not use the letters “Rx” or

13-29  “RX” or the word “drug” or “drugs,” “prescription” or “pharmacy,”

13-30  or similar words or words of similar import, without first having

13-31  secured a license from the Board.

13-32     2.  Each license must be issued to a specific person and for a

13-33  specific location and is not transferable. The original license must be

13-34  displayed on the licensed premises as provided in NRS 639.150.

13-35  The original license and the fee required for reissuance of a license

13-36  must be submitted to the Board before the reissuance of the license.

13-37     3.  If the owner of a pharmacy is a partnership or corporation,

13-38  any change of partners or corporate officers must be reported to the

13-39  Board at such a time as is required by a regulation of the Board.

13-40     4.  In addition to the requirements for renewal set forth in NRS

13-41  639.180, every person holding a license to operate a pharmacy must

13-42  satisfy the Board that the pharmacy is conducted according to law.

13-43     5.  Any violation of any of the provisions of this chapter by a

13-44  managing pharmacist or by personnel of the pharmacy under the

14-1  supervision of the managing pharmacist is cause for the suspension

14-2  or revocation of the license of the pharmacy by the Board.

14-3      Sec. 24.  NRS 639.231 is hereby amended to read as follows:

14-4      639.231  1.  An application to conduct a pharmacy must be

14-5  made on a form furnished by the Board and must state the name,

14-6  address, usual occupation and professional qualifications, if any, of

14-7  the applicant. If the applicant is other than a natural person, the

14-8  application must state such information as to each person

14-9  beneficially interested therein.

14-10     2.  As used in subsection 1, and subject to the provisions of

14-11  subsection 3, the term “person beneficially interested” means:

14-12     (a) If the applicant is a partnership or other unincorporated

14-13  association, each partner or member.

14-14     (b) If the applicant is a corporation, each of its officers, directors

14-15  and stockholders, provided that no natural person shall be deemed to

14-16  be beneficially interested in a nonprofit corporation.

14-17     3.  If the applicant is a partnership, unincorporated association

14-18  or corporation and the number of partners, members or stockholders,

14-19  as the case may be, exceeds four, the application must so state, and

14-20  must list each of the four partners, members or stockholders who

14-21  own the four largest interests in the applicant entity and state their

14-22  percentages of interest. Upon request of the Executive Secretary of

14-23  the Board, the applicant shall furnish the Board with information as

14-24  to partners, members or stockholders not named in the application or

14-25  shall refer the Board to an appropriate source of such information.

14-26     4.  The completed application form must be returned to the

14-27  Board with the fee prescribed by the Board, which may not be

14-28  refunded. Any application which is not complete as required by the

14-29  provisions of this section may not be presented to the Board for

14-30  consideration.

14-31     5.  Upon compliance with all the provisions of this section and

14-32  upon approval of the application by the Board, the Executive

14-33  Secretary shall issue a license to the applicant to conduct a

14-34  pharmacy. Any other provision of law notwithstanding, such a

14-35  license authorizes the holder to conduct a pharmacy and to sell and

14-36  dispense drugs and poisons and devices and appliances that are

14-37  restricted by federal law to sale by or on the order of a physician.

14-38     Sec. 24.5.  NRS 639.233 is hereby amended to read as follows:

14-39     639.233  1.  Any person, including a wholesaler or

14-40  manufacturer, who engages in the business of wholesale distribution

14-41  or furnishing controlled substances, poisons, drugs, devices or

14-42  appliances that are restricted by federal law to sale by or on the

14-43  order of a physician to any person located within this state shall

14-44  obtain a license pursuant to the provisions of this chapter.

15-1      2.  [The provisions of subsection 1 do not apply to a wholesaler

15-2  or manufacturer whose principal place of business is located in

15-3  another state and who ships controlled substances, drugs, poisons or

15-4  restricted devices or appliances to a wholesaler or manufacturer

15-5  located within this state and licensed by the Board.

15-6      3.] For the purpose of this section, a person is “engaged in the

15-7  business of furnishing” if he:

15-8      (a) Solicits or accepts orders for drugs or devices whose sale in

15-9  this state is restricted by this chapter or chapter 453 or 454 of NRS;

15-10  or

15-11     (b) Receives, stores or ships such drugs or devices.

15-12     Sec. 25.  NRS 639.234 is hereby amended to read as follows:

15-13     639.234  1.  The acceptance of a license issued pursuant to

15-14  NRS 639.233 constitutes a consent by the licensee to the inspection

15-15  , copying and removal for copying of his records maintained inside

15-16  and outside this state by any authorized representative of the Board.

15-17     2.  If such a licensee is not a resident of this state and does not

15-18  maintain records within this state of his shipments of controlled

15-19  substances, poisons or drugs or devices or appliances that are

15-20  restricted by federal law to sale by or on the order of a physician to

15-21  persons in this state , he shall, on receipt of a written demand from

15-22  the Executive Secretary of the Board, furnish a true copy of the

15-23  records to the Board.

15-24     3.  The Board may authorize as its representative any member

15-25  or representative of the Board of pharmacy or similar agency of the

15-26  state in which the records are located.

15-27     4.  [Failure] The intentional failure to furnish a true copy of

15-28  the required records or the intentional refusal to permit their

15-29  inspection is a ground for [the revocation or] summary suspension

15-30  of and disciplinary action relating to any license issued pursuant to

15-31  NRS 639.233.

15-32     Sec. 26.  NRS 639.235 is hereby amended to read as follows:

15-33     639.235  1.  No person other than a practitioner holding a

15-34  license to practice his profession in this state may prescribe or write

15-35  a prescription, except that a prescription written by a person who is

15-36  not licensed to practice in this state , but is authorized by the laws of

15-37  another state to prescribe , shall be deemed to be a legal prescription

15-38  unless the person prescribed or wrote the prescription in violation of

15-39  the provisions of NRS 453.3611 to 453.3648, inclusive.

15-40     2.  If a prescription that is prescribed by a person who is not

15-41  licensed to practice in this state, but is authorized by the laws of

15-42  another state to prescribe, calls for a controlled substance listed in:

15-43     (a) Schedule II, the registered pharmacist who is to fill the

15-44  prescription shall establish and document that the prescription is

15-45  authentic and that a bona fide relationship between the patient and

16-1  the person prescribing the controlled substance did exist when the

16-2  prescription was written.

16-3      (b) Schedule III or IV, the registered pharmacist who is to fill

16-4  the prescription shall establish[, in his professional judgment,] that

16-5  the prescription is authentic and that a bona fide relationship

16-6  between the patient and the person prescribing the controlled

16-7  substance did exist when the prescription was written. This

16-8  paragraph does not require the registered pharmacist to inquire into

16-9  such a relationship upon the receipt of [each such prescription.] a

16-10  similar prescription subsequently issued for that patient.

16-11     3.  A pharmacist who fills a prescription described in

16-12  subsection 2 shall record on the prescription or in the prescription

16-13  record in the pharmacy’s computer:

16-14     (a) The name of the person with whom he spoke concerning

16-15  the prescription;

16-16     (b) The date and time of the conversation; and

16-17     (c) The date and time the patient was physically examined by

16-18  the person prescribing the controlled substance for which the

16-19  prescription was issued.

16-20     4.  For the purposes of subsection 2, a bona fide relationship

16-21  between the patient and the person prescribing the controlled

16-22  substance shall be deemed to exist if the patient was physically

16-23  examined by the person prescribing the controlled substances

16-24  within the 6 months immediately preceding the date the

16-25  prescription was issued.

16-26     Sec. 27.  NRS 639.238 is hereby amended to read as follows:

16-27     639.238  1.  Prescriptions filled and on file in a pharmacy are

16-28  not a public record. A pharmacist shall not divulge the contents of

16-29  any prescription or provide a copy of any prescription, except to:

16-30     (a) The patient for whom the original prescription was issued;

16-31     (b) The practitioner who originally issued the prescription;

16-32     (c) A practitioner who is then treating the patient;

16-33     (d) A member, inspector or investigator of the Board or an

16-34  inspector of the Food and Drug Administration or an agent of the

16-35  Investigation Division of the Department of Public Safety;

16-36     (e) An agency of State Government charged with the

16-37  responsibility of providing medical care for the patient;

16-38     (f) An insurance carrier, on receipt of written authorization

16-39  signed by the patient or his legal guardian, authorizing the release of

16-40  such information;

16-41     (g) Any person authorized by an order of a district court;

16-42     (h) Any member, inspector or investigator of a professional

16-43  licensing board which licenses a practitioner who orders

16-44  prescriptions filled at the pharmacy; [or]

17-1      (i) Other registered pharmacists for the limited purpose of and to

17-2  the extent necessary for the exchange of information relating to

17-3  persons who are suspected of:

17-4          (1) Misusing prescriptions to obtain excessive amounts of

17-5  drugs[.] ; or

17-6          (2) Failing to use a drug in conformity with the directions for

17-7  its use or taking a drug in combination with other drugs in a manner

17-8  that could result in injury to that person[.] ; or

17-9      (j) A peace officer employed by a local government for the

17-10  limited purpose of and to the extent necessary:

17-11         (1) For the investigation of an alleged crime reported by an

17-12  employee of the pharmacy where the crime was committed; or

17-13         (2) To carry out a search warrant or subpoena issued

17-14  pursuant to a court order.

17-15     2.  Any copy of a prescription for a controlled substance or a

17-16  dangerous drug as defined in chapter 454 of NRS, issued to a person

17-17  authorized by this section to receive such a copy, must contain all of

17-18  the information appearing on the original prescription and be clearly

17-19  marked on its face[,] “Copy, Not Refillable—For Reference

17-20  Purposes Only.” The copy must bear the name or initials of the

17-21  registered pharmacist who prepared the copy.

17-22     3.  If a copy of a prescription for any controlled substance or a

17-23  dangerous drug as defined in chapter 454 of NRS is furnished to the

17-24  customer, the original prescription must be voided and notations

17-25  made thereon showing the date and the name of the person to whom

17-26  the copy was furnished.

17-27     4.  If, at the express request of a customer, a copy of a

17-28  prescription for any controlled substance or dangerous drug is

17-29  furnished to another pharmacist, the original prescription must be

17-30  voided and notations made thereon showing the date and the name

17-31  of the pharmacist to whom the copy was furnished. The pharmacist

17-32  receiving the copy shall call the prescribing practitioner for a new

17-33  prescription.

17-34     Sec. 28.  NRS 639.239 is hereby amended to read as follows:

17-35     639.239  Members, inspectors and investigators of the Board,

17-36  inspectors of the Food and Drug Administration , [and] agents of the

17-37  Investigation Division of the Department of Public Safety and peace

17-38  officers described in paragraph (j) of subsection 1 of NRS 639.238

17-39  may remove any record required to be retained by state or federal

17-40  law or regulation, including any prescription contained in the files of

17-41  a practitioner, if the record in question will be used as evidence in a

17-42  criminal action, civil action or an administrative proceeding, or

17-43  contemplated action or proceeding. The person who removes a

17-44  record pursuant to this section shall:

18-1      1.  Affix the name and address of the practitioner to the back of

18-2  the record;

18-3      2.  Affix his initials, cause an agent of the practitioner to affix

18-4  his initials and note the date of the removal of the record on the back

18-5  of the record;

18-6      3.  Affix the name of the agency for which he is removing the

18-7  record to the back of the record;

18-8      4.  Provide the practitioner with a receipt for the record; and

18-9      5.  Return a photostatic copy of both sides of the record to the

18-10  practitioner within 15 working days after the record is removed.

18-11     Sec. 29.  NRS 639.241 is hereby amended to read as follows:

18-12     639.241  1.  A hearing to determine whether the rights and

18-13  privileges granted by any certificate, certification, license or permit

18-14  issued by the Board should be revoked, suspended, limited or

18-15  conditioned must be initiated by the filing of an accusation by the

18-16  Board. The action must be entitled: The Nevada State Board of

18-17  Pharmacy v. (insert the name of the party whose certificate, license

18-18  or permit is involved), who must be designated “Respondent.”

18-19     2.  The accusation is a written statement of the charges alleged

18-20  and must set forth in ordinary and concise language the acts or

18-21  omissions with which the respondent is charged to the end that the

18-22  respondent will be able to prepare his defense. [It] The accusation

18-23  must specify the statutes and regulations which the respondent is

18-24  alleged to have violated, but must not consist merely of charges

18-25  phrased in language of the statute or regulation. The accusation must

18-26  be signed by the Executive Secretary of the Board acting in his

18-27  official capacity.

18-28     Sec. 30.  NRS 639.242 is hereby amended to read as follows:

18-29     639.242  1.  After filing the accusation, the Executive

18-30  Secretary of the Board shall cause a copy thereof, together with one

18-31  copy of the Statement to Respondent and three copies of the form of

18-32  the Notice of Defense, to be served on the respondent.

18-33     2.  Service may be [either] by personal service or by first-class

18-34  registered or certified mail addressed to the respondent at his last

18-35  address of record, or by mail to his attorney of record. Proof of

18-36  service [shall] must be retained and made a part of the case record.

18-37     Sec. 31.  NRS 639.244 is hereby amended to read as follows:

18-38     639.244  1.  The form for the Notice of Defense [shall] must

18-39  be prepared and furnished by the Board and [shall] permit the

18-40  respondent, by completing and signing the notice , to:

18-41     (a) [Request a hearing;

18-42     (b)] Object to the accusation as being incomplete and failing to

18-43  set forth clearly the charges; and

18-44     [(c)] (b) Deny or admit, in part or in whole, the violations

18-45  alleged.

19-1      2.  The Notice of Defense [shall] must be signed by the

19-2  respondent or [by] his attorney under penalty of perjury. Failure to

19-3  file a Notice of Defense [and request a hearing shall constitute]

19-4  constitutes a waiver of the respondent’s right to a hearing, but the

19-5  Board may[, in its discretion,] grant a hearing.

19-6      Sec. 32.  NRS 639.245 is hereby amended to read as follows:

19-7      639.245  Whenever a hearing has been granted by the Board,

19-8  the Executive Secretary of the Board shall serve notice on the

19-9  respondent of the time and place set for the hearing on the

19-10  accusation. If the Board receives a report pursuant to subsection 5 of

19-11  NRS 228.420, a hearing must be held within 30 days after receiving

19-12  the report. Service may be effected in the same manner as provided

19-13  in NRS 639.242.

19-14     Sec. 33.  NRS 639.246 is hereby amended to read as follows:

19-15     639.246  1.  The Executive Secretary of the Board shall issue

19-16  subpoenas for the production of witnesses, documents or papers, in

19-17  accordance with statutory provisions, at the request of any party to a

19-18  hearing or for purposes of an investigation or other matter under

19-19  inquiry by the Board.

19-20     2.  Witnesses appearing pursuant to a subpoena must receive

19-21  expenses and witness fees in the amounts and under the same

19-22  circumstances as prescribed by law for witnesses in civil actions.

19-23  The expenses and fees must be paid in full by the party at whose

19-24  request the witness is subpoenaed.

19-25     3.  Subpoenas must be served in the same manner as prescribed

19-26  by law for the service of subpoenas in civil actions. If any person

19-27  fails to comply with a subpoena within 10 days after its issuance, the

19-28  President of the Board, or the Executive Secretary of the Board at

19-29  the direction of the President, may petition the district court for an

19-30  order of the court compelling compliance with the subpoena.

19-31     4.  Upon such a petition, the court shall enter an order directing

19-32  the person subpoenaed to appear before the court at a time and place

19-33  to be fixed by the court in its order, the time to be not more than 10

19-34  days after the date of the order, and then and there to show cause

19-35  why he has not complied with the subpoena. A certified copy of the

19-36  order must be served upon the person.

19-37     5.  If it appears to the court that the subpoena was regularly

19-38  issued by the Board, the court shall enter an order compelling

19-39  compliance with the subpoena. Failure to obey the order constitutes

19-40  contempt of court.

19-41     Sec. 34.  NRS 639.247 is hereby amended to read as follows:

19-42     639.247  1.  Any hearing held for the purpose of suspending or

19-43  revoking any certificate, certification, license or permit must be

19-44  conducted publicly by the Board. The hearing must be presided over

19-45  by a member of the Board or his designee and three members

20-1  constitute a quorum. Any decision by the Board requires the

20-2  concurrence of at least three members. The proceedings of the

20-3  hearing must be reported or recorded by an electronic recording

20-4  device, an official court reporter or another qualified person.

20-5      2.  The member of the Board or his designee presiding at the

20-6  hearing or the Executive Secretary of the Board may administer

20-7  oaths or affirmations. Continuances and adjournments may be

20-8  ordered, or may be granted, by the member or his designee

20-9  presiding, for cause shown and by orally notifying those persons

20-10  present of the time and place at which the hearing will be continued.

20-11     Sec. 35.  NRS 639.252 is hereby amended to read as follows:

20-12     639.252  1.  If the respondent wishes to contest or appeal the

20-13  decision of the Board, the order or any part thereof, he may, [prior

20-14  to] not later than 10 days after the time the order becomes

20-15  effective, apply in writing to the Board for a rehearing. [Such

20-16  application shall] The application must set forth with particularity

20-17  the part or parts of the decision or order to which the respondent

20-18  objects and the basis of the objection.

20-19     2.  The Executive Secretary of the Board shall, within 10 days

20-20  after receipt of a written application for rehearing, notify the

20-21  respondent and his attorney of record in writing, by registered or

20-22  certified mail, of [its] his action, either granting or denying [such]

20-23  the application. If the application is granted, the notice [shall] must

20-24  contain the date, time and place of the rehearing . [, which date shall

20-25  not be less than 30 days after the date of the notice.] The rehearing

20-26  must be held at the next regularly scheduled meeting of the Board.

20-27  Granting of the application by the [Board shall serve] Executive

20-28  Secretary does not serve as an automatic stay of execution of the

20-29  order pending conclusion of the rehearing.

20-30     Sec. 36.  NRS 639.2555 is hereby amended to read as follows:

20-31     639.2555  1.  If the Board receives a copy of a court order

20-32  issued pursuant to NRS 425.540 that provides for the suspension of

20-33  all professional, occupational and recreational licenses, certificates

20-34  and permits issued to a person who is the holder of a certificate of

20-35  registration as a pharmacist, [an] intern pharmacist , pharmaceutical

20-36  technician, pharmaceutical technician in training or supportive

20-37  personnel or a license issued pursuant to NRS 639.233, the Board

20-38  shall deem the certificate of registration or license issued to that

20-39  person to be suspended at the end of the 30th day after the date on

20-40  which the court order was issued unless the Board receives a letter

20-41  issued to the holder of the certificate of registration or license by the

20-42  district attorney or other public agency pursuant to NRS 425.550

20-43  stating that the holder of the certificate of registration or license has

20-44  complied with the subpoena or warrant or has satisfied the arrearage

20-45  pursuant to NRS 425.560.

21-1      2.  The Board shall reinstate a certificate of registration as a

21-2  pharmacist, [an] intern pharmacist , pharmaceutical technician,

21-3  pharmaceutical technician in training or supportive personnel or a

21-4  license issued pursuant to NRS 639.233 that has been suspended by

21-5  a district court pursuant to NRS 425.540 if the Board receives a

21-6  letter issued by the district attorney or other public agency pursuant

21-7  to NRS 425.550 to the person whose certificate of registration or

21-8  license was suspended stating that the person whose certificate of

21-9  registration or license was suspended has complied with the

21-10  subpoena or warrant or has satisfied the arrearage pursuant to

21-11  NRS 425.560.

21-12     Sec. 37.  NRS 639.256 is hereby amended to read as follows:

21-13     639.256  A certificate, license or permit which has been

21-14  suspended for a specified period of time [shall] must automatically

21-15  be restored to good standing on the first day following the period of

21-16  suspension. The Executive Secretary[,] of the Board, when

21-17  notifying the respondent of the penalty imposed by the Board, shall

21-18  inform the respondent of the date on which the certificate, license or

21-19  permit will be so restored.

21-20     Sec. 38.  NRS 639.2585 is hereby amended to read as follows:

21-21     639.2585  1.  [Except where a substitution is required by

21-22  subsection 1 of NRS 639.2583:] If a prescription is purchased with

21-23  cash:

21-24     (a) Before he makes a substitution, a pharmacist shall advise the

21-25  person who presents the prescription of:

21-26         (1) The generic drug which he proposes to substitute; and

21-27         (2) The price difference between the drug under the brand

21-28  name prescribed and the drug which he proposes to substitute.

21-29     (b) The person presenting the prescription may refuse to accept

21-30  the proposed substitution.

21-31     2.  A pharmacist shall not make any substitution of drugs if the

21-32  drug to be substituted is higher in cost than the drug prescribed by

21-33  brand name.

21-34     Sec. 39.  NRS 639.2589 is hereby amended to read as follows:

21-35     639.2589  [1.] The form for any prescription which is issued

21-36  or intended to be filled in this state must contain a line for the

21-37  signature of the prescriber, the printed words “dispense only as

21-38  written” or “dispense as written” or the printed letters “DAW,”

21-39  and a box near that statement for the purpose of indicating that a

21-40  substitution may not be made.

21-41     [2.  Substitutions may be made in filling prescriptions contained

21-42  in the orders of a physician, or of an advanced practitioner of

21-43  nursing who is a practitioner, in a facility for skilled nursing or

21-44  facility for intermediate care. Each page of the document which

21-45  contains the order must be printed with the words: “The biological

22-1  equivalent of drugs ordered may be dispensed unless initialed by the

22-2  prescriber here” and a box must be provided near that statement for

22-3  the purpose of indicating that a substitution may not be made.

22-4      3.  Substitutions may be made in filling prescriptions ordered

22-5  on a patient’s chart in a hospital if the hospital’s medical staff has

22-6  approved a formulary for specific generic substitutions.]

22-7      Sec. 40.  NRS 453.1545 is hereby amended to read as follows:

22-8      453.1545  1.  The Board and the Division shall cooperatively

22-9  develop a computerized program to track each prescription for a

22-10  controlled substance listed in schedule II, III or IV that is filled by a

22-11  pharmacy that is registered with the Board[.] or that is dispensed by

22-12  a practitioner who is registered with the Board. The program must:

22-13     (a) Be designed to provide information regarding:

22-14         (1) The inappropriate use by a patient of controlled

22-15  substances listed in schedules II, III and IV to pharmacies,

22-16  practitioners and appropriate state agencies to prevent the improper

22-17  or illegal use of those controlled substances; and

22-18         (2) Statistical data relating to the use of those controlled

22-19  substances that is not specific to a particular patient.

22-20     (b) Be administered by the Board, the Division, the Health

22-21  Division of the Department of Human Resources and various

22-22  practitioners, representatives of professional associations for

22-23  practitioners, representatives of occupational licensing boards and

22-24  prosecuting attorneys selected by the Board and the Division.

22-25     (c) Not infringe on the legal use of a controlled substance for the

22-26  management of severe or intractable pain.

22-27     2.  The Board and the Division must have access to the program

22-28  established pursuant to subsection 1 to identify any suspected

22-29  fraudulent or illegal activity related to the dispensing of controlled

22-30  substances.

22-31     3.  The Board or the Division shall report any activity it

22-32  reasonably suspects may be fraudulent or illegal to the appropriate

22-33  law enforcement agency or occupational licensing board and

22-34  provide the law enforcement agency or occupational licensing board

22-35  with the relevant information obtained from the program for further

22-36  investigation.

22-37     4.  Information obtained from the program relating to a

22-38  practitioner or a patient is confidential and, except as otherwise

22-39  provided by this section, must not be disclosed to any person. That

22-40  information must be disclosed:

22-41     (a) Upon the request of a person about whom the information

22-42  requested concerns or upon the request on his behalf by his attorney;

22-43  or

22-44     (b) Upon the lawful order of a court of competent jurisdiction.

23-1      5.  The Board and the Division may apply for any available

23-2  grants and accept any gifts, grants or donations to assist in

23-3  developing and maintaining the program required by this section.

23-4      Sec. 40.5.  NRS 453.375 is hereby amended to read as follows:

23-5      453.375  A controlled substance may be possessed and

23-6  administered by the following persons:

23-7      1.  A practitioner.

23-8      2.  A registered nurse licensed to practice professional nursing

23-9  or licensed practical nurse, at the direction of a physician, physician

23-10  assistant, dentist, podiatric physician or advanced practitioner of

23-11  nursing, or pursuant to a chart order, for administration to a patient

23-12  at another location.

23-13     3.  An advanced emergency medical technician:

23-14     (a) As authorized by regulation of:

23-15         (1) The State Board of Health in a county whose population

23-16  is less than 100,000; or

23-17         (2) A county or district board of health in a county whose

23-18  population is 100,000 or more; and

23-19     (b) In accordance with any applicable regulations of:

23-20         (1) The State Board of Health in a county whose population

23-21  is less than 100,000;

23-22         (2) A county board of health in a county whose population is

23-23  100,000 or more; or

23-24         (3) A district board of health created pursuant to NRS

23-25  439.370 in any county.

23-26     4.  A respiratory therapist,at the direction of a physician or

23-27  physician assistant.

23-28     5.  A medical student, student in training to become a physician

23-29  assistant or student nurse in the course of his studies at an approved

23-30  college of medicine or school of professional or practical nursing, at

23-31  the direction of a physician or physician assistant and:

23-32     (a) In the presence of a physician, physician assistant or a

23-33  registered nurse; or

23-34     (b) Under the supervision of a physician, physician assistant or a

23-35  registered nurse if the student is authorized by the college or school

23-36  to administer the substance outside the presence of a physician,

23-37  physician assistant or nurse.

23-38  A medical student or student nurse may administer a controlled

23-39  substance in the presence or under the supervision of a registered

23-40  nurse alone only if the circumstances are such that the registered

23-41  nurse would be authorized to administer it personally.

23-42     6.  An ultimate user or any person whom the ultimate user

23-43  designates pursuant to a written agreement.

23-44     7.  Any person designated by the head of a correctional

23-45  institution.

24-1      8.  A veterinary technician at the direction of his supervising

24-2  veterinarian.

24-3      9.  In accordance with applicable regulations of the State Board

24-4  of Health, an employee of a residential facility for groups, as

24-5  defined in NRS 449.017, pursuant to a written agreement entered

24-6  into by the ultimate user.

24-7      10.  In accordance with applicable regulations of the State

24-8  Board of Pharmacy, an animal control officer, a wildlife biologist or

24-9  an employee designated by a federal, state or local governmental

24-10  agency whose duties include the control of domestic, wild and

24-11  predatory animals.

24-12     11.  A person who is enrolled in a training program to become

24-13  an advanced emergency medical technician, respiratory therapist

24-14  or veterinary technician if the person possesses and administers

24-15  the controlled substance in the same manner and under the same

24-16  conditions that apply, respectively, to an advanced emergency

24-17  medical technician, respiratory therapist or veterinary technician

24-18  who may possess and administer the controlled substance, and

24-19  under the direct supervision of a person licensed or registered to

24-20  perform the respective medical art or a supervisor of such a

24-21  person.

24-22     Sec. 41.  NRS 453.431 is hereby amended to read as follows:

24-23     453.431  1.  A pharmacist shall not knowingly fill or refill any

24-24  prescription for a controlled substance for use by a person other than

24-25  the person for whom the prescription was originally issued.

24-26     2.  A person shall not furnish a false name or address while

24-27  attempting to obtain a controlled substance or a prescription for a

24-28  controlled substance. A person prescribing, administering or

24-29  dispensing a controlled substance may request proper identification

24-30  from a person requesting controlled substances.

24-31     3.  A pharmacist shall not fill a prescription for a controlled

24-32  substance if the prescription shows evidence of alteration, erasure or

24-33  addition, unless he obtains approval of the practitioner who issued

24-34  the prescription.

24-35     4.  A pharmacist shall not fill a prescription for a controlled

24-36  substance classified in schedule II unless it is tendered on or before

24-37  the 14th day after the date of issue. This subsection does not

24-38  prohibit a practitioner from issuing a prescription on which he

24-39  indicates that the prescription may not be filled until the date

24-40  indicated on the prescription, which must not be later than 6

24-41  months after the date the prescription is issued.

24-42     5.  A person who violates this section is guilty of a category C

24-43  felony and shall be punished as provided in NRS 193.130.

 

 

25-1      Sec. 41.5.  NRS 454.213 is hereby amended to read as follows:

25-2      454.213  A drug or medicine referred to in NRS 454.181 to

25-3  454.371, inclusive, may be possessed and administered by:

25-4      1.  A practitioner.

25-5      2.  A physician assistant at the direction of his supervising

25-6  physician or a licensed dental hygienist acting in the office of and

25-7  under the supervision of a dentist.

25-8      3.  Except as otherwise provided in subsection 4, a registered

25-9  nurse licensed to practice professional nursing or licensed practical

25-10  nurse, at the direction of a prescribing physician, physician assistant,

25-11  dentist, podiatric physician or advanced practitioner of nursing, or

25-12  pursuant to a chart order, for administration to a patient at another

25-13  location.

25-14     4.  In accordance with applicable regulations of the Board, a

25-15  registered nurse licensed to practice professional nursing or licensed

25-16  practical nurse who is:

25-17     (a) Employed by a health care agency or health care facility that

25-18  is authorized to provide emergency care, or to respond to the

25-19  immediate needs of a patient, in the residence of the patient; and

25-20     (b) Acting under the direction of the medical director of that

25-21  agency or facility who works in this state.

25-22     5.  An intermediate emergency medical technician or an

25-23  advanced emergency medical technician, as authorized by

25-24  regulation of the State Board of Pharmacy and in accordance with

25-25  any applicable regulations of:

25-26     (a) The State Board of Health in a county whose population is

25-27  less than 100,000;

25-28     (b) A county board of health in a county whose population is

25-29  100,000 or more; or

25-30     (c) A district board of health created pursuant to NRS 439.370

25-31  in any county.

25-32     6.  A respiratory therapist employed in a health care facility.

25-33  The therapist may possess and administer respiratory products only

25-34  at the direction of a physician.

25-35     7.  A dialysis technician, under the direction or supervision of a

25-36  physician or registered nurse only if the drug or medicine is used for

25-37  the process of renal dialysis.

25-38     8.  A medical student or student nurse in the course of his

25-39  studies at an approved college of medicine or school of professional

25-40  or practical nursing, at the direction of a physician and:

25-41     (a) In the presence of a physician or a registered nurse; or

25-42     (b) Under the supervision of a physician or a registered nurse if

25-43  the student is authorized by the college or school to administer the

25-44  drug or medicine outside the presence of a physician or

25-45  nurse.

26-1  A medical student or student nurse may administer a dangerous drug

26-2  in the presence or under the supervision of a registered nurse alone

26-3  only if the circumstances are such that the registered nurse would be

26-4  authorized to administer it personally.

26-5      9.  Any person designated by the head of a correctional

26-6  institution.

26-7      10.  An ultimate user or any person designated by the ultimate

26-8  user pursuant to a written agreement.

26-9      11.  A nuclear medicine technologist, at the direction of a

26-10  physician and in accordance with any conditions established by

26-11  regulation of the Board.

26-12     12.  A radiologic technologist, at the direction of a physician

26-13  and in accordance with any conditions established by regulation of

26-14  the Board.

26-15     13.  A chiropractic physician, but only if the drug or medicine

26-16  is a topical drug used for cooling and stretching external tissue

26-17  during therapeutic treatments.

26-18     14.  A physical therapist, but only if the drug or medicine is a

26-19  topical drug which is:

26-20     (a) Used for cooling and stretching external tissue during

26-21  therapeutic treatments; and

26-22     (b) Prescribed by a licensed physician for:

26-23         (1) Iontophoresis; or

26-24         (2) The transmission of drugs through the skin using

26-25  ultrasound.

26-26     15.  In accordance with applicable regulations of the State

26-27  Board of Health, an employee of a residential facility for groups, as

26-28  defined in NRS 449.017, pursuant to a written agreement entered

26-29  into by the ultimate user.

26-30     16.  A veterinary technician at the direction of his supervising

26-31  veterinarian.

26-32     17.  In accordance with applicable regulations of the Board, a

26-33  registered pharmacist who:

26-34     (a) Is trained in and certified to carry out standards and practices

26-35  for immunization programs;

26-36     (b) Is authorized to administer immunizations pursuant to

26-37  written protocols from a physician; and

26-38     (c) Administers immunizations in compliance with the

26-39  “Standards of Immunization Practices” recommended and approved

26-40  by the United States Public Health Service Advisory Committee on

26-41  Immunization Practices.

26-42     18.  A person who is enrolled in a training program to become

26-43  a physician assistant, dental hygienist, intermediate emergency

26-44  medical technician, advanced emergency medical technician,

26-45  respiratory therapist, dialysis technician, nuclear medicine

27-1  technologist, radiologic technologist, physical therapist or

27-2  veterinary technician if the person possesses and administers the

27-3  drug or medicine in the same manner and under the same

27-4  conditions that apply, respectively, to a physician assistant, dental

27-5  hygienist, intermediate emergency medical technician, advanced

27-6  emergency medical technician, respiratory therapist, dialysis

27-7  technician, nuclear medicine technologist, radiologic technologist,

27-8  physical therapist or veterinary technician who may possess and

27-9  administer the drug or medicine, and under the direct supervision

27-10  of a person licensed or registered to perform the respective

27-11  medical art or a supervisor of such a person.

27-12     Sec. 42.  NRS 689A.04045 is hereby amended to read as

27-13  follows:

27-14     689A.04045  1.  Except as otherwise provided in this section,

27-15  a policy of health insurance which provides coverage for

27-16  prescription drugs must not limit or exclude coverage for a drug if

27-17  the drug:

27-18     (a) Had previously been approved for coverage by the insurer

27-19  for a medical condition of an insured and the insured’s provider of

27-20  health care determines, after conducting a reasonable investigation,

27-21  that none of the drugs which are otherwise currently approved for

27-22  coverage are medically appropriate for the insured; and

27-23     (b) Is appropriately prescribed and considered safe and effective

27-24  for treating the medical condition of the insured.

27-25     2.  The provisions of subsection 1 do not:

27-26     (a) Apply to coverage for any drug that is prescribed for a use

27-27  that is different from the use for which that drug has been approved

27-28  for marketing by the Food and Drug Administration;

27-29     (b) Prohibit:

27-30         (1) The insurer from charging a deductible, copayment or

27-31  coinsurance for the provision of benefits for prescription drugs to

27-32  the insured or from establishing, by contract, limitations on the

27-33  maximum coverage for prescription drugs;

27-34         (2) A provider of health care from prescribing another drug

27-35  covered by the policy that is medically appropriate for the insured;

27-36  or

27-37         (3) The substitution of another drug pursuant to NRS

27-38  639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

27-39     (c) Require any coverage for a drug after the term of the policy.

27-40     3.  Any provision of a policy subject to the provisions of this

27-41  chapter that is delivered, issued for delivery or renewed on or after

27-42  October 1, 2001, which is in conflict with this section is void.

 

 

28-1      Sec. 43.  NRS 689B.0368 is hereby amended to read as

28-2  follows:

28-3      689B.0368  1.  Except as otherwise provided in this section, a

28-4  policy of group health insurance which provides coverage for

28-5  prescription drugs must not limit or exclude coverage for a drug if

28-6  the drug:

28-7      (a) Had previously been approved for coverage by the insurer

28-8  for a medical condition of an insured and the insured’s provider of

28-9  health care determines, after conducting a reasonable investigation,

28-10  that none of the drugs which are otherwise currently approved for

28-11  coverage are medically appropriate for the insured; and

28-12     (b) Is appropriately prescribed and considered safe and effective

28-13  for treating the medical condition of the insured.

28-14     2.  The provisions of subsection 1 do not:

28-15     (a) Apply to coverage for any drug that is prescribed for a use

28-16  that is different from the use for which that drug has been approved

28-17  for marketing by the Food and Drug Administration;

28-18     (b) Prohibit:

28-19         (1) The insurer from charging a deductible, copayment or

28-20  coinsurance for the provision of benefits for prescription drugs to

28-21  the insured or from establishing, by contract, limitations on the

28-22  maximum coverage for prescription drugs;

28-23         (2) A provider of health care from prescribing another drug

28-24  covered by the policy that is medically appropriate for the insured;

28-25  or

28-26         (3) The substitution of another drug pursuant to NRS

28-27  639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

28-28     (c) Require any coverage for a drug after the term of the policy.

28-29     3.  Any provision of a policy subject to the provisions of this

28-30  chapter that is delivered, issued for delivery or renewed on or after

28-31  October 1, 2001, which is in conflict with this section is void.

28-32     Sec. 44.  NRS 689C.168 is hereby amended to read as follows:

28-33     689C.168  1.  Except as otherwise provided in this section, a

28-34  health benefit plan which provides coverage for prescription drugs

28-35  must not limit or exclude coverage for a drug if the drug:

28-36     (a) Had previously been approved for coverage by the carrier for

28-37  a medical condition of an insured and the insured’s provider of

28-38  health care determines, after conducting a reasonable investigation,

28-39  that none of the drugs which are otherwise currently approved for

28-40  coverage are medically appropriate for the insured; and

28-41     (b) Is appropriately prescribed and considered safe and effective

28-42  for treating the medical condition of the insured.

28-43     2.  The provisions of subsection 1 do not:

29-1      (a) Apply to coverage for any drug that is prescribed for a use

29-2  that is different from the use for which that drug has been approved

29-3  for marketing by the Food and Drug Administration;

29-4      (b) Prohibit:

29-5          (1) The carrier from charging a deductible, copayment or

29-6  coinsurance for the provision of benefits for prescription drugs to

29-7  the insured or from establishing, by contract, limitations on the

29-8  maximum coverage for prescription drugs;

29-9          (2) A provider of health care from prescribing another drug

29-10  covered by the plan that is medically appropriate for the insured; or

29-11         (3) The substitution of another drug pursuant to NRS

29-12  639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

29-13     (c) Require any coverage for a drug after the term of the plan.

29-14     3.  Any provision of a health benefit plan subject to the

29-15  provisions of this chapter that is delivered, issued for delivery or

29-16  renewed on or after October 1, 2001, which is in conflict with this

29-17  section is void.

29-18     Sec. 45.  NRS 695A.184 is hereby amended to read as follows:

29-19     695A.184  1.  Except as otherwise provided in this section, a

29-20  benefit contract which provides coverage for prescription drugs

29-21  must not limit or exclude coverage for a drug if the drug:

29-22     (a) Had previously been approved for coverage by the society

29-23  for a medical condition of an insured and the insured’s provider of

29-24  health care determines, after conducting a reasonable investigation,

29-25  that none of the drugs which are otherwise currently approved for

29-26  coverage are medically appropriate for the insured; and

29-27     (b) Is appropriately prescribed and considered safe and effective

29-28  for treating the medical condition of the insured.

29-29     2.  The provisions of subsection 1 do not:

29-30     (a) Apply to coverage for any drug that is prescribed for a use

29-31  that is different from the use for which that drug has been approved

29-32  for marketing by the Food and Drug Administration;

29-33     (b) Prohibit:

29-34         (1) The society from charging a deductible, copayment or

29-35  coinsurance for the provision of benefits for prescription drugs to

29-36  the insured or from establishing, by contract, limitations on the

29-37  maximum coverage for prescription drugs;

29-38         (2) A provider of health care from prescribing another drug

29-39  covered by the benefit contract that is medically appropriate for the

29-40  insured; or

29-41         (3) The substitution of another drug pursuant to NRS

29-42  639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

29-43     (c) Require any coverage for a drug after the term of the benefit

29-44  contract.

30-1      3.  Any provision of a benefit contract subject to the provisions

30-2  of this chapter that is delivered, issued for delivery or renewed on or

30-3  after October 1, 2001, which is in conflict with this section is void.

30-4      Sec. 46.  NRS 695B.1905 is hereby amended to read as

30-5  follows:

30-6      695B.1905  1.  Except as otherwise provided in this section, a

30-7  contract for hospital or medical services which provides coverage

30-8  for prescription drugs must not limit or exclude coverage for a drug

30-9  if the drug:

30-10     (a) Had previously been approved for coverage by the insurer

30-11  for a medical condition of an insured and the insured’s provider of

30-12  health care determines, after conducting a reasonable investigation,

30-13  that none of the drugs which are otherwise currently approved for

30-14  coverage are medically appropriate for the insured; and

30-15     (b) Is appropriately prescribed and considered safe and effective

30-16  for treating the medical condition of the insured.

30-17     2.  The provisions of subsection 1 do not:

30-18     (a) Apply to coverage for any drug that is prescribed for a use

30-19  that is different from the use for which that drug has been approved

30-20  for marketing by the Food and Drug Administration;

30-21     (b) Prohibit:

30-22         (1) The insurer from charging a deductible, copayment or

30-23  coinsurance for the provision of benefits for prescription drugs to

30-24  the insured or from establishing, by contract, limitations on the

30-25  maximum coverage for prescription drugs;

30-26         (2) A provider of health care from prescribing another drug

30-27  covered by the contract that is medically appropriate for the insured;

30-28  or

30-29         (3) The substitution of another drug pursuant to NRS

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

30-31     (c) Require any coverage for a drug after the term of the

30-32  contract.

30-33     3.  Any provision of a contract for hospital or medical services

30-34  subject to the provisions of this chapter that is delivered, issued for

30-35  delivery or renewed on or after October 1, 2001, which is in conflict

30-36  with this section is void.

30-37     Sec. 47.  NRS 695C.1734 is hereby amended to read as

30-38  follows:

30-39     695C.1734  1.  Except as otherwise provided in this section,

30-40  evidence of coverage which provides coverage for prescription

30-41  drugs must not limit or exclude coverage for a drug if the drug:

30-42     (a) Had previously been approved for coverage by the health

30-43  maintenance organization or insurer for a medical condition of an

30-44  enrollee and the enrollee’s provider of health care determines, after

30-45  conducting a reasonable investigation, that none of the drugs which

31-1  are otherwise currently approved for coverage are medically

31-2  appropriate for the enrollee; and

31-3      (b) Is appropriately prescribed and considered safe and effective

31-4  for treating the medical condition of the enrollee.

31-5      2.  The provisions of subsection 1 do not:

31-6      (a) Apply to coverage for any drug that is prescribed for a use

31-7  that is different from the use for which that drug has been approved

31-8  for marketing by the Food and Drug Administration;

31-9      (b) Prohibit:

31-10         (1) The health maintenance organization or insurer from

31-11  charging a deductible, copayment or coinsurance for the provision

31-12  of benefits for prescription drugs to the enrollee or from

31-13  establishing, by contract, limitations on the maximum coverage for

31-14  prescription drugs;

31-15         (2) A provider of health care from prescribing another drug

31-16  covered by the evidence of coverage that is medically appropriate

31-17  for the enrollee; or

31-18         (3) The substitution of another drug pursuant to NRS

31-19  639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

31-20     (c) Require any coverage for a drug after the term of the

31-21  evidence of coverage.

31-22     3.  Any provision of an evidence of coverage subject to the

31-23  provisions of this chapter that is delivered, issued for delivery or

31-24  renewed on or after October 1, 2001, which is in conflict with this

31-25  section is void.

31-26     Sec. 48.  NRS 695F.156 is hereby amended to read as follows:

31-27     695F.156  1.  Except as otherwise provided in this section,

31-28  evidence of coverage which provides coverage for prescription

31-29  drugs must not limit or exclude coverage for a drug if the drug:

31-30     (a) Had previously been approved for coverage by the prepaid

31-31  limited health service organization for a medical condition of an

31-32  enrollee and the enrollee’s provider of health care determines, after

31-33  conducting a reasonable investigation, that none of the drugs which

31-34  are otherwise currently approved for coverage are medically

31-35  appropriate for the enrollee; and

31-36     (b) Is appropriately prescribed and considered safe and effective

31-37  for treating the medical condition of the enrollee.

31-38     2.  The provisions of subsection 1 do not:

31-39     (a) Apply to coverage for any drug that is prescribed for a use

31-40  that is different from the use for which that drug has been approved

31-41  for marketing by the Food and Drug Administration;

31-42     (b) Prohibit:

31-43         (1) The organization from charging a deductible, copayment

31-44  or coinsurance for the provision of benefits for prescription drugs to

32-1  the enrollee or from establishing, by contract, limitations on the

32-2  maximum coverage for prescription drugs;

32-3          (2) A provider of health care from prescribing another drug

32-4  covered by the evidence of coverage that is medically appropriate

32-5  for the enrollee; or

32-6          (3) The substitution of another drug pursuant to NRS

32-7  639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

32-8      (c) Require any coverage for a drug after the term of the

32-9  evidence of coverage.

32-10     3.  Any provision of an evidence of coverage subject to the

32-11  provisions of this chapter that is delivered, issued for delivery or

32-12  renewed on or after October 1, 2001, which is in conflict with this

32-13  section is void.

32-14     Sec. 49.  NRS 695G.166 is hereby amended to read as follows:

32-15     695G.166  1.  Except as otherwise provided in this section, a

32-16  health care plan which provides coverage for prescription drugs

32-17  must not limit or exclude coverage for a drug if the drug:

32-18     (a) Had previously been approved for coverage by the managed

32-19  care organization for a medical condition of an insured and the

32-20  insured’s provider of health care determines, after conducting a

32-21  reasonable investigation, that none of the drugs which are otherwise

32-22  currently approved for coverage are medically appropriate for the

32-23  insured; and

32-24     (b) Is appropriately prescribed and considered safe and effective

32-25  for treating the medical condition of the insured.

32-26     2.  The provisions of subsection 1 do not:

32-27     (a) Apply to coverage for any drug that is prescribed for a use

32-28  that is different from the use for which that drug has been approved

32-29  for marketing by the Food and Drug Administration;

32-30     (b) Prohibit:

32-31         (1) The organization from charging a deductible, copayment

32-32  or coinsurance for the provision of benefits for prescription drugs to

32-33  the insured or from establishing, by contract, limitations on the

32-34  maximum coverage for prescription drugs;

32-35         (2) A provider of health care from prescribing another drug

32-36  covered by the plan that is medically appropriate for the insured; or

32-37         (3) The substitution of another drug pursuant to NRS

32-38  639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or

32-39     (c) Require any coverage for a drug after the term of the plan.

32-40     3.  Any provision of a health care plan subject to the provisions

32-41  of this chapter that is delivered, issued for delivery or renewed on or

32-42  after October 1, 2001, which is in conflict with this section is void.

32-43     Sec. 50.  NRS 639.133, 639.205, 639.2323 and 639.2599 are

32-44  hereby repealed.

 

33-1  LEADLINES OF REPEALED SECTIONS

 

33-2      639.133  Registration of pharmacist not possessing formal

33-3   educational requirements.

33-4      639.205  Inactive status.

33-5      639.2323  Nuclear pharmacy: Publications required on

33-6   premises.

33-7      639.2599  Display of notice regarding substitution.

 

33-8  H