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.

 

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.

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

1-7  person who is:

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

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

2-3  2.  Enrolled in a program of training for pharmaceutical

2-4  technicians that is approved by the Board.

2-5  Sec. 3.5. 1.  A wholesaler may sell a prescription drug only

2-6  to:

2-7  (a) A pharmacy or practitioner; or

2-8  (b) Another wholesaler if:

2-9       (1) The wholesaler who purchases the drug is licensed by

2-10  the Board; and

2-11          (2) The sale is a bona fide transaction.

2-12      2.  A wholesaler may purchase a prescription drug only from:

2-13      (a) A manufacturer; or

2-14      (b) Another wholesaler if:

2-15          (1) The wholesaler who sells the drug is licensed by the

2-16  Board; and

2-17          (2) The sale is a bona fide transaction.

2-18      3.  The Board shall not limit the quantity of prescription drugs

2-19  a wholesaler may purchase, sell, distribute or otherwise provide to

2-20  another wholesaler, distributor or manufacturer.

2-21      4.  For the purposes of this section:

2-22      (a) A purchase shall be deemed a bona fide transaction if:

2-23          (1) The wholesaler purchased the drug:

2-24             (I) Directly from the manufacturer of the drug; or

2-25             (II) With a reasonable belief that the drug was

2-26  originally purchased directly from the manufacturer of the drug;

2-27          (2) The circumstances of the purchase reasonably indicate

2-28  that the drug was not purchased from a source prohibited by law;

2-29          (3) Unless the drug is purchased by the wholesaler from the

2-30  manufacturer, before the wholesaler sells the drug to another

2-31  wholesaler, the wholesaler who sells the drug conducts a

2-32  reasonable visual examination of the drug to ensure that the drug

2-33  is not:

2-34             (I) Counterfeit;

2-35             (II) Deemed to be adulterated or misbranded in

2-36  accordance with the provisions of chapter 585 of NRS;

2-37             (III) Mislabeled;

2-38             (IV) Damaged or compromised by improper handling,

2-39  storage or temperature control;

2-40             (V) From a foreign or unlawful source; or

2-41             (VI) Manufactured, packaged, labeled or shipped in

2-42  violation of any state or federal law relating to prescription drugs;

2-43          (4) The drug is shipped directly from the wholesaler who

2-44  sells the drug to the wholesaler who purchases the drug; and

3-1       (5) The documents of the shipping company concerning the

3-2  shipping of the drug are attached to the invoice for the drug and

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

3-4  (b) A sale shall be deemed a bona fide transaction if there is a

3-5  reasonable assurance by the wholesaler that purchases the drug

3-6  that the wholesaler will sell the drug directly and only to a

3-7  pharmacy or practitioner.

3-8  (c) The purchase or sale of a prescription drug includes,

3-9  without limitation, the distribution, transfer, trading, bartering or

3-10  any other provision of a prescription drug to another person by a

3-11  wholesaler. A transfer of a prescription drug from a wholesale

3-12  facility of a wholesaler to another wholesale facility of the

3-13  wholesaler shall not be deemed a purchase or sale of a

3-14  prescription drug pursuant to this section if the wholesaler is a

3-15  corporation whose securities are publicly traded and regulated by

3-16  the Securities Exchange Act of 1934.

3-17      Sec. 4.  NRS 639.001 is hereby amended to read as follows:

3-18      639.001  As used in this chapter, unless the context otherwise

3-19  requires, the words and terms defined in NRS 639.0015 to 639.016,

3-20  inclusive, and sections 2 and 3 of this act have the meanings

3-21  ascribed to them in those sections.

3-22      Sec. 5.  NRS 639.0124 is hereby amended to read as follows:

3-23      639.0124  “Practice of pharmacy” includes, but is not limited

3-24  to, the:

3-25      1.  Performance or supervision of activities associated with

3-26  manufacturing, compounding, labeling, dispensing and distributing

3-27  of a drug[.] , including the receipt, handling and storage of

3-28  prescriptions and other confidential information relating to

3-29  patients.

3-30      2.  Interpretation and evaluation of prescriptions or orders for

3-31  medicine.

3-32      3.  Participation in drug evaluation and drug research.

3-33      4.  Advising of the therapeutic value, reaction, drug interaction,

3-34  hazard and use of a drug.

3-35      5.  Selection of the source, storage and distribution of a drug.

3-36      6.  Maintenance of proper documentation of the source, storage

3-37  and distribution of a drug.

3-38      7.  Interpretation of clinical data contained in a person’s record

3-39  of medication.

3-40      8.  Development of written guidelines and protocols in

3-41  collaboration with a practitioner which are intended for a patient in a

3-42  licensed medical facility and authorize the implementation,

3-43  monitoring and modification of drug therapy. The written

3-44  guidelines and protocols may authorize a pharmacist to order and

3-45  use the findings of laboratory tests and examinations.

4-1  9.  Implementation and modification of drug therapy in

4-2  accordance with the authorization of the prescribing practitioner for

4-3  a patient in a pharmacy in which drugs, controlled substances,

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

4-5  The term does not include the changing of a prescription by a

4-6  pharmacist or practitioner without the consent of the prescribing

4-7  practitioner, except as otherwise provided in NRS 639.2583.

4-8  Sec. 6.  NRS 639.015 is hereby amended to read as follows:

4-9  639.015  “Registered pharmacist” means:

4-10      1.  A person registered in this state as such on July 1, 1947;

4-11      2.  A person registered in this state as such in compliance with

4-12  the provisions of paragraph (c) of section 3 of chapter 195, Statutes

4-13  of Nevada 1951; or

4-14      3.  A person who has complied with the provisions of NRS

4-15  639.120 [and 639.133] and whose name has been entered in the

4-16  registry of pharmacists of this state by the Executive Secretary of

4-17  the Board and to whom a valid certificate as a registered pharmacist

4-18  or valid renewal thereof has been issued by the Board.

4-19      Sec. 7.  NRS 639.0152 is hereby amended to read as follows:

4-20      639.0152  “Supportive personnel” means [persons who perform

4-21  technical services in a pharmacy that do not require the judgment of

4-22  a pharmacist but which are related to the preparation and

4-23  distribution of drugs under the direct supervision of the pharmacist

4-24  who is responsible for all of the work performed in the pharmacy.]

4-25  any person, other than a pharmacist, intern pharmacist,

4-26  pharmaceutical technician or pharmaceutical technician in

4-27  training, who is employed by a pharmacy and has access to the

4-28  secured premises of the pharmacy.

4-29      Sec. 8.  NRS 639.040 is hereby amended to read as follows:

4-30      639.040  1.  The Board shall elect a President and a Treasurer

4-31  from among its members.

4-32      2.  The Board shall employ [a] an Executive Secretary, who

4-33  must not be a member of the Board. The Executive Secretary shall

4-34  keep a complete record of all proceedings of the Board and of all

4-35  certificates issued, and shall perform such other duties as the Board

4-36  may require, for which services he is entitled to receive a salary to

4-37  be determined by the Board.

4-38      Sec. 9.  NRS 639.070 is hereby amended to read as follows:

4-39      639.070  1.  The Board may:

4-40      (a) Adopt such regulations, not inconsistent with the laws of this

4-41  state, as are necessary for the protection of the public, appertaining

4-42  to the practice of pharmacy and the lawful performance of its duties.

4-43      (b) Adopt regulations requiring that prices charged by retail

4-44  pharmacies for drugs and medicines which are obtained by

5-1  prescription be posted in the pharmacies and be given on the

5-2  telephone to persons requesting such information.

5-3  (c) Adopt regulations, not inconsistent with the laws of this

5-4  state, authorizing the Executive Secretary of the Board to issue

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

5-6  chapters 453 and 454 of NRS.

5-7  (d) Adopt regulations governing the dispensing of poisons,

5-8  drugs, chemicals and medicines.

5-9  (e) Regulate the practice of pharmacy.

5-10      (f) Regulate the sale and dispensing of poisons, drugs, chemicals

5-11  and medicines.

5-12      (g) Regulate the means of recordkeeping and storage, handling,

5-13  sanitation and security of drugs, poisons, medicines, chemicals and

5-14  devices, including, but not limited to, requirements relating to:

5-15          (1) Pharmacies, institutional pharmacies and pharmacies in

5-16  correctional institutions;

5-17          (2) Drugs stored in hospitals; and

5-18          (3) Drugs stored for the purpose of wholesale distribution.

5-19      (h) Examine and register, upon application, pharmacists and

5-20  other persons who dispense or distribute medications whom it

5-21  deems qualified.

5-22      (i) Charge and collect necessary and reasonable fees for its

5-23  services, other than those specifically set forth in this chapter.

5-24      (j) Maintain offices in as many localities in the State as it finds

5-25  necessary to carry out the provisions of this chapter.

5-26      (k) Employ an attorney, inspectors, investigators and other

5-27  professional consultants and clerical personnel necessary to the

5-28  discharge of its duties.

5-29      (l) Enforce the provisions of NRS 453.011 to 453.552, inclusive,

5-30  and enforce the provisions of this chapter and chapter 454 of NRS.

5-31      (m) Adopt regulations concerning the information required to be

5-32  submitted in connection with an application for any license,

5-33  certificate or permit required by this chapter or chapter 453 or 454

5-34  of NRS.

5-35      (n) Adopt regulations concerning the education, experience and

5-36  background of a person who is employed by the holder of a license

5-37  or permit issued pursuant to this chapter and who has access to

5-38  drugs and devices.

5-39      (o) Adopt regulations concerning the use of computerized

5-40  mechanical equipment for the filling of prescriptions.

5-41      (p) Participate in and expend money for programs that enhance

5-42  the practice of pharmacy.

5-43      2.  This section does not authorize the Board to prohibit open-

5-44  market competition in the advertising and sale of prescription drugs

5-45  and pharmaceutical services.

6-1  Sec. 10.  NRS 639.081 is hereby amended to read as follows:

6-2  639.081  1.  Except as otherwise provided in subsection 3, all

6-3  money coming into the possession of the Board must be kept or

6-4  deposited by the Executive Secretary of the Board in banks, credit

6-5  unions or savings and loan associations in the State of Nevada, or

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

6-7  payment of compensation and expenses of members of the Board

6-8  and for other necessary or proper purposes in the administration of

6-9  this chapter.

6-10      2.  The Board may delegate to a hearing officer or panel its

6-11  authority to take any disciplinary action pursuant to this chapter,

6-12  impose and collect fines therefor and deposit the money therefrom

6-13  in banks, credit unions or savings and loan associations in this state.

6-14      3.  If a hearing officer or panel is not authorized to take

6-15  disciplinary action pursuant to subsection 2 and the Board deposits

6-16  the money collected from the imposition of fines with the State

6-17  Treasurer for credit to the State General Fund, it may present a

6-18  claim to the State Board of Examiners for recommendation to the

6-19  Interim Finance Committee if money is needed to pay attorney’s

6-20  fees or the costs of an investigation, or both.

6-21      Sec. 11.  NRS 639.120 is hereby amended to read as follows:

6-22      639.120  1.  An applicant to become a registered pharmacist in

6-23  this state must:

6-24      (a) Be of good moral character.

6-25      (b) Be a graduate of a college of pharmacy or department of

6-26  pharmacy of a university accredited by the American Council on

6-27  Pharmaceutical Education or Canadian Council for Accreditation

6-28  of Pharmacy Programs and approved by the Board or a graduate of

6-29  a foreign school who has passed an examination for foreign

6-30  graduates approved by the Board to demonstrate that his education

6-31  is equivalent.

6-32      (c) Pass an examination approved and given by the Board with a

6-33  grade of at least 75 on the examination as a whole and a grade of at

6-34  least 75 on the examination on law. An applicant for registration by

6-35  reciprocity must pass the examination on law with at least a grade

6-36  of 75.

6-37      (d) Complete not less than 1,500 hours of practical

6-38  pharmaceutical experience as an intern pharmacist under the direct

6-39  and immediate supervision of a registered pharmacist.

6-40      2.  The practical pharmaceutical experience required pursuant

6-41  to paragraph (d) of subsection 1 must relate primarily to the selling

6-42  of drugs, poisons and devices, the compounding and dispensing of

6-43  prescriptions, preparing prescriptions , and keeping records and

6-44  preparing reports required by state and federal statutes.

7-1  3.  The Board may accept evidence of compliance with the

7-2  requirements set forth in paragraph (d) of subsection 1 from boards

7-3  of pharmacy of other states in which the experience requirement is

7-4  equivalent to the requirements in this state.

7-5  Sec. 12.  NRS 639.127 is hereby amended to read as follows:

7-6  639.127  1.  An applicant for registration as a pharmacist in

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

7-8  the Board on a form furnished by the Board and must pay the fee

7-9  fixed by the Board. The fee must be paid at the time the application

7-10  is submitted and is compensation to the Board for the investigation

7-11  and the examination of the applicant. Under no circumstances may

7-12  the fee be refunded.

7-13      2.  Proof of the qualifications of any applicant must be made to

7-14  the satisfaction of the Board and must be substantiated by affidavits,

7-15  records or such other evidence as the Board may require.

7-16      3.  An application is only valid for 1 year after the date it is

7-17  received by the Board unless the Board extends its period of

7-18  validity.

7-19      4.  A certificate of registration as a pharmacist must be issued to

7-20  each person who the Board determines is qualified pursuant to the

7-21  provisions of NRS 639.120[, 639.133] and 639.134. The certificate

7-22  entitles the person to whom it is issued to practice pharmacy in this

7-23  state.

7-24      Sec. 13.  NRS 639.128 is hereby amended to read as follows:

7-25      639.128  The application of a natural person who applies for the

7-26  issuance of a certificate of registration as a pharmacist, [an]

7-27  intern pharmacist , pharmaceutical technician, pharmaceutical

7-28  technician in training or supportive personnel or a license issued

7-29  pursuant to NRS 639.233 must include the social security number of

7-30  the applicant.

7-31      Sec. 14.  NRS 639.129 is hereby amended to read as follows:

7-32      639.129  1.  A natural person who applies for the issuance or

7-33  renewal of a certificate of registration as a pharmacist, [an]

7-34  intern pharmacist , pharmaceutical technician, pharmaceutical

7-35  technician in training or supportive personnel or a license issued

7-36  pursuant to NRS 639.233 shall submit to the Board the statement

7-37  prescribed by the Welfare Division of the Department of Human

7-38  Resources pursuant to NRS 425. 520. The statement must be

7-39  completed and signed by the applicant.

7-40      2.  The Board shall include the statement required pursuant to

7-41  subsection 1 in:

7-42      (a) The application or any other forms that must be submitted

7-43  for the issuance or renewal of the certificate or license; or

7-44      (b) A separate form prescribed by the Board.

8-1  3.  A certificate of registration as a pharmacist, [an]

8-2  intern pharmacist , pharmaceutical technician, pharmaceutical

8-3  technician in training or supportive personnel or a license issued

8-4  pursuant to NRS 639.233 may not be issued or renewed by the

8-5  Board if the applicant is a natural person who:

8-6  (a) Fails to submit the statement required pursuant to

8-7  subsection 1; or

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

8-9  1 that he is subject to a court order for the support of a child and is

8-10  not in compliance with the order or a plan approved by the district

8-11  attorney or other public agency enforcing the order for the

8-12  repayment of the amount owed pursuant to the order.

8-13      4.  If an applicant indicates on the statement submitted pursuant

8-14  to subsection 1 that he is subject to a court order for the support of a

8-15  child and is not in compliance with the order or a plan approved by

8-16  the district attorney or other public agency enforcing the order for

8-17  the repayment of the amount owed pursuant to the order, the Board

8-18  shall advise the applicant to contact the district attorney or other

8-19  public agency enforcing the order to determine the actions that the

8-20  applicant may take to satisfy the arrearage.

8-21      Sec. 15.  NRS 639.137 is hereby amended to read as follows:

8-22      639.137  1.  Any person who is not a registered pharmacist,

8-23  but who is employed in this state for the purpose of fulfilling the

8-24  requirements of paragraph (d) of subsection 1 of NRS 639.120 to

8-25  become eligible for registration as a pharmacist, shall register with

8-26  the Board as an intern pharmacist. An applicant, to be eligible for

8-27  registration as an intern pharmacist, must be enrolled in a college of

8-28  pharmacy or a department of pharmacy of a university approved by

8-29  the Board or be a graduate of a foreign school and pass an

8-30  examination for foreign graduates approved by the Board. The

8-31  application must be made on a form furnished by the Board.

8-32      2.  The Executive Secretary of the Board, upon approval of the

8-33  application, shall issue a certificate of registration authorizing

8-34  the applicant to undergo practical pharmaceutical training under the

8-35  direct and immediate supervision of a registered pharmacist. The

8-36  period of validity of the certificate of registration, including any

8-37  renewal, must not exceed 4 years after the date of issue. The

8-38  certificate of registration authorizes the holder, if acting under the

8-39  direct and immediate supervision of a registered pharmacist, to

8-40  perform:

8-41      (a) The duties of a registered pharmacist as authorized by

8-42  regulation of the Board; and

8-43      (b) Other activities as authorized by regulation of the Board.

8-44      3.  The certificate of registration must be posted as required by

8-45  NRS 639.150.

9-1  4.  Any certificate of registration issued pursuant to the

9-2  provisions of this section may be suspended, terminated or revoked

9-3  by the Board for:

9-4  (a) Any reason set forth in this chapter as grounds for the

9-5  suspension or revocation of any certificate, license or permit; or

9-6  (b) The failure of the registered pharmacist whose name appears

9-7  on the certificate of registration to provide adequate training and

9-8  supervision for the intern pharmacist in compliance with regulations

9-9  adopted by the Board.

9-10      Sec. 16.  NRS 639.1371 is hereby amended to read as follows:

9-11      639.1371  1.  The ratio of [supportive personnel]

9-12  pharmaceutical technicians to pharmacists must not allow more

9-13  than one [supportive personnel] pharmaceutical technician to each

9-14  pharmacist unless the Board by regulation expands the ratio.

9-15      2.  The Board shall adopt regulations concerning

9-16  pharmaceutical technicians and supportive personnel, including

9-17  requirements for:

9-18      (a) The qualifications, registration and supervision of

9-19  pharmaceutical technicians and supportive personnel; and

9-20      (b) [Services] The services which may be performed by

9-21  pharmaceutical technicians and supportive personnel,

9-22  to ensure the protection and safety of the public in the provision of

9-23  pharmaceutical care.

9-24      3.  The regulations adopted by the Board pursuant to this

9-25  section which prescribe:

9-26      (a) The qualifications for [supportive personnel]

9-27  pharmaceutical technicians must include:

9-28          (1) [At least 1 year of education at a postsecondary school

9-29  which is directly related to the duties performed by supportive

9-30  personnel;

9-31          (2)] The successful completion of a program for [supportive

9-32  personnel] pharmaceutical technicians which is approved by the

9-33  Board;

9-34          [(3)] (2) The completion of at least 1,500 hours of experience

9-35  in carrying out the duties of [supportive personnel; or

9-36          (4)] a pharmaceutical technician; or

9-37          (3) Any other experience or education deemed equivalent by

9-38  the Board.

9-39      (b) An expanded ratio of [supportive personnel] pharmaceutical

9-40  technicians to pharmacists must [not allow more than two

9-41  supportive personnel for each pharmacist in] be appropriate and

9-42  necessary for a particular category of pharmacy at any time.

9-43      (c) The services which may be performed by [supportive

9-44  personnel] pharmaceutical technicians must include, without

9-45  limitation, the:

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

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

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

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

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

10-6      4.  For the purposes of this chapter, and chapters 453 and 454 of

10-7  NRS, [supportive personnel] pharmaceutical technicians may

10-8  perform acts required to be performed by pharmacists , but only to

10-9  the extent provided in regulations.

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

10-11     639.138  If the Board, after an investigation, denies any

10-12  application for a certificate, license or permit, the Executive

10-13  Secretary of the Board shall notify the applicant, within 10 days

10-14  after the denial is approved by the Board and entered in the official

10-15  minutes, by registered or certified mail, of the denial of the

10-16  application and the reasons therefor. The notice must inform the

10-17  applicant of his right to petition the Board for reconsideration and

10-18  his right to submit evidence to controvert the alleged violations on

10-19  which the denial was based.

10-20     Sec. 18.  NRS 639.139 is hereby amended to read as follows:

10-21     639.139  1.  At any time within 30 days after receipt of the

10-22  notice of denial of his application, an applicant may petition the

10-23  Board for reconsideration of the application. The petition must set

10-24  forth a denial, in whole or in part, of the violations alleged and a

10-25  statement that the applicant is prepared to submit evidence in

10-26  support of his denial of the allegations.

10-27     2.  Within 30 days after the petition is received by the Board,

10-28  the Executive Secretary of the Board shall notify the petitioner, by

10-29  registered or certified mail, of the Board’s decision [either] to grant

10-30  or deny the petition for reconsideration. If the petition is granted, the

10-31  notice [shall] must include the time and place set for reconsideration

10-32  of the application by the Board.

10-33     Sec. 19.  NRS 639.160 is hereby amended to read as follows:

10-34     639.160  Every registered pharmacist shall, within 10 days after

10-35  changing his place of practice as designated on the books of the

10-36  Executive Secretary of the Board, notify the Executive Secretary [of

10-37  the Board of such] of the change and of his new place of practice.

10-38  Upon receipt of [such] the notification , the Executive Secretary

10-39  shall make the necessary change in his register.

10-40     Sec. 20.  NRS 639.170 is hereby amended to read as follows:

10-41     639.170  1.  The Board shall charge and collect not more than

10-42  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 used for any prescription which is

21-36  issued 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” and a box near that statement for the purpose of indicating

21-39  that a substitution may not be made.] practitioner.

21-40     [2.  Substitutions may be made in filling prescriptions contained

21-41  in the orders of a physician, or of an advanced practitioner of

21-42  nursing who is a practitioner, in a facility for skilled nursing or

21-43  facility for intermediate care. Each page of the document which

21-44  contains the order must be printed with the words: “The biological

21-45  equivalent of drugs ordered may be dispensed unless initialed by the

22-1  prescriber here” and a box must be provided near that statement for

22-2  the purpose of indicating that a substitution may not be made.

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

22-4  on a patient’s chart in a hospital if the hospital’s medical staff has

22-5  approved a formulary for specific generic substitutions.]

22-6      Sec. 40.  NRS 453.1545 is hereby amended to read as follows:

22-7      453.1545  1.  The Board and the Division shall cooperatively

22-8  develop a computerized program to track each prescription for a

22-9  controlled substance listed in schedule II, III or IV that is filled by a

22-10  pharmacy that is registered with the Board[.] or that is dispensed by

22-11  a practitioner who is registered with the Board. The program must:

22-12     (a) Be designed to provide information regarding:

22-13         (1) The inappropriate use by a patient of controlled

22-14  substances listed in schedules II, III and IV to pharmacies,

22-15  practitioners and appropriate state agencies to prevent the improper

22-16  or illegal use of those controlled substances; and

22-17         (2) Statistical data relating to the use of those controlled

22-18  substances that is not specific to a particular patient.

22-19     (b) Be administered by the Board, the Division, the Health

22-20  Division of the Department of Human Resources and various

22-21  practitioners, representatives of professional associations for

22-22  practitioners, representatives of occupational licensing boards and

22-23  prosecuting attorneys selected by the Board and the Division.

22-24     (c) Not infringe on the legal use of a controlled substance for the

22-25  management of severe or intractable pain.

22-26     2.  The Board and the Division must have access to the program

22-27  established pursuant to subsection 1 to identify any suspected

22-28  fraudulent or illegal activity related to the dispensing of controlled

22-29  substances.

22-30     3.  The Board or the Division shall report any activity it

22-31  reasonably suspects may be fraudulent or illegal to the appropriate

22-32  law enforcement agency or occupational licensing board and

22-33  provide the law enforcement agency or occupational licensing board

22-34  with the relevant information obtained from the program for further

22-35  investigation.

22-36     4.  Information obtained from the program relating to a

22-37  practitioner or a patient is confidential and, except as otherwise

22-38  provided by this section, must not be disclosed to any person. That

22-39  information must be disclosed:

22-40     (a) Upon the request of a person about whom the information

22-41  requested concerns or upon the request on his behalf by his attorney;

22-42  or

22-43     (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