Senate Bill No. 425–Committee on Commerce and Labor
(On Behalf of the Board of Pharmacy)
March 24, 2003
____________
Referred to Committee on Commerce and Labor
SUMMARY—Makes various changes relating to pharmacy. (BDR 54‑530)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: No.
~
EXPLANATION
– Matter in bolded italics is new; matter
between brackets [omitted material] is material to be omitted.
Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).
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 inclusive, of
1-3 this act.
1-4 Sec. 2. “Pharmaceutical technician” means a person who
1-5 performs technical services in a pharmacy under the direct
1-6 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 or the board or other relevant authority of another
2-13 state; and
2-14 (2) The sale is a bona fide transaction.
2-15 2. A wholesaler may purchase a prescription drug only from:
2-16 (a) A manufacturer; or
2-17 (b) Another wholesaler if:
2-18 (1) The wholesaler who sells the drug is licensed by the
2-19 Board; and
2-20 (2) The sale is a bona fide transaction.
2-21 3. The Board shall not limit the quantity of prescription drugs
2-22 a wholesaler may purchase, sell, distribute or otherwise provide to
2-23 another wholesaler, distributor or manufacturer.
2-24 4. For the purposes of this section:
2-25 (a) A purchase shall be deemed a bona fide transaction if:
2-26 (1) The wholesaler purchased the drug:
2-27 (I) Directly from the manufacturer of the drug; or
2-28 (II) With a reasonable belief that the drug was
2-29 originally purchased directly from the manufacturer of the drug;
2-30 (2) The circumstances of the purchase reasonably indicate
2-31 that the drug was not purchased from a source prohibited by law;
2-32 (3) Unless the drug is purchased by the wholesaler from the
2-33 manufacturer, before the wholesaler sells the drug to another
2-34 wholesaler, the wholesaler who sells the drug conducts a
2-35 reasonable visual examination of the drug to ensure that the drug
2-36 is not:
2-37 (I) Counterfeit;
2-38 (II) Deemed to be adulterated or misbranded in
2-39 accordance with the provisions of chapter 585 of NRS;
2-40 (III) Mislabeled;
2-41 (IV) Damaged or compromised by improper handling,
2-42 storage or temperature control;
2-43 (V) From a foreign or unlawful source; or
2-44 (VI) Manufactured, packaged, labeled or shipped in
2-45 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. (Deleted by amendment.)
4-22 Sec. 8. NRS 639.040 is hereby amended to read as follows:
4-23 639.040 1. The Board shall elect a President and a Treasurer
4-24 from among its members.
4-25 2. The Board shall employ [a] an Executive Secretary, who
4-26 must not be a member of the Board. The Executive Secretary shall
4-27 keep a complete record of all proceedings of the Board and of all
4-28 certificates issued, and shall perform such other duties as the Board
4-29 may require, for which services he is entitled to receive a salary to
4-30 be determined by the Board.
4-31 Sec. 9. NRS 639.070 is hereby amended to read as follows:
4-32 639.070 1. The Board may:
4-33 (a) Adopt such regulations, not inconsistent with the laws of this
4-34 state, as are necessary for the protection of the public, appertaining
4-35 to the practice of pharmacy and the lawful performance of its duties.
4-36 (b) Adopt regulations requiring that prices charged by retail
4-37 pharmacies for drugs and medicines which are obtained by
4-38 prescription be posted in the pharmacies and be given on the
4-39 telephone to persons requesting such information.
4-40 (c) Adopt regulations, not inconsistent with the laws of this
4-41 state, authorizing the Executive Secretary of the Board to issue
4-42 certificates, licenses and permits required by this chapter and
4-43 chapters 453 and 454 of NRS.
4-44 (d) Adopt regulations governing the dispensing of poisons,
4-45 drugs, chemicals and medicines.
5-1 (e) Regulate the practice of pharmacy.
5-2 (f) Regulate the sale and dispensing of poisons, drugs, chemicals
5-3 and medicines.
5-4 (g) Regulate the means of recordkeeping and storage, handling,
5-5 sanitation and security of drugs, poisons, medicines, chemicals and
5-6 devices, including, but not limited to, requirements relating to:
5-7 (1) Pharmacies, institutional pharmacies and pharmacies in
5-8 correctional institutions;
5-9 (2) Drugs stored in hospitals; and
5-10 (3) Drugs stored for the purpose of wholesale distribution.
5-11 (h) Examine and register, upon application, pharmacists and
5-12 other persons who dispense or distribute medications whom it
5-13 deems qualified.
5-14 (i) Charge and collect necessary and reasonable fees for its
5-15 services, other than those specifically set forth in this chapter.
5-16 (j) Maintain offices in as many localities in the State as it finds
5-17 necessary to carry out the provisions of this chapter.
5-18 (k) Employ an attorney, inspectors, investigators and other
5-19 professional consultants and clerical personnel necessary to the
5-20 discharge of its duties.
5-21 (l) Enforce the provisions of NRS 453.011 to 453.552, inclusive,
5-22 and enforce the provisions of this chapter and chapter 454 of NRS.
5-23 (m) Adopt regulations concerning the information required to be
5-24 submitted in connection with an application for any license,
5-25 certificate or permit required by this chapter or chapter 453 or 454
5-26 of NRS.
5-27 (n) Adopt regulations concerning the education, experience and
5-28 background of a person who is employed by the holder of a license
5-29 or permit issued pursuant to this chapter and who has access to
5-30 drugs and devices.
5-31 (o) Adopt regulations concerning the use of computerized
5-32 mechanical equipment for the filling of prescriptions.
5-33 (p) Participate in and expend money for programs that enhance
5-34 the practice of pharmacy.
5-35 2. This section does not authorize the Board to prohibit open-
5-36 market competition in the advertising and sale of prescription drugs
5-37 and pharmaceutical services.
5-38 Sec. 10. NRS 639.081 is hereby amended to read as follows:
5-39 639.081 1. Except as otherwise provided in subsection 3, all
5-40 money coming into the possession of the Board must be kept or
5-41 deposited by the Executive Secretary of the Board in banks, credit
5-42 unions or savings and loan associations in the State of Nevada, or
5-43 invested in United States treasury bills or notes, to be expended for
5-44 payment of compensation and expenses of members of the Board
6-1 and for other necessary or proper purposes in the administration of
6-2 this chapter.
6-3 2. The Board may delegate to a hearing officer or panel its
6-4 authority to take any disciplinary action pursuant to this chapter,
6-5 impose and collect fines therefor and deposit the money therefrom
6-6 in banks, credit unions or savings and loan associations in this state.
6-7 3. If a hearing officer or panel is not authorized to take
6-8 disciplinary action pursuant to subsection 2 and the Board deposits
6-9 the money collected from the imposition of fines with the State
6-10 Treasurer for credit to the State General Fund, it may present a
6-11 claim to the State Board of Examiners for recommendation to the
6-12 Interim Finance Committee if money is needed to pay attorney’s
6-13 fees or the costs of an investigation, or both.
6-14 Sec. 11. NRS 639.120 is hereby amended to read as follows:
6-15 639.120 1. An applicant to become a registered pharmacist in
6-16 this state must:
6-17 (a) Be of good moral character.
6-18 (b) Be a graduate of a college of pharmacy or department of
6-19 pharmacy of a university accredited by the American Council on
6-20 Pharmaceutical Education or Canadian Council for Accreditation
6-21 of Pharmacy Programs and approved by the Board or a graduate of
6-22 a foreign school who has passed an examination for foreign
6-23 graduates approved by the Board to demonstrate that his education
6-24 is equivalent.
6-25 (c) Pass an examination approved and given by the Board with a
6-26 grade of at least 75 on the examination as a whole and a grade of at
6-27 least 75 on the examination on law. An applicant for registration by
6-28 reciprocity must pass the examination on law with at least a grade
6-29 of 75.
6-30 (d) Complete not less than 1,500 hours of practical
6-31 pharmaceutical experience as an intern pharmacist under the direct
6-32 and immediate supervision of a registered pharmacist.
6-33 2. The practical pharmaceutical experience required pursuant
6-34 to paragraph (d) of subsection 1 must relate primarily to the selling
6-35 of drugs, poisons and devices, the compounding and dispensing of
6-36 prescriptions, preparing prescriptions , and keeping records and
6-37 preparing reports required by state and federal statutes.
6-38 3. The Board may accept evidence of compliance with the
6-39 requirements set forth in paragraph (d) of subsection 1 from boards
6-40 of pharmacy of other states in which the experience requirement is
6-41 equivalent to the requirements in this state.
6-42 Sec. 12. NRS 639.127 is hereby amended to read as follows:
6-43 639.127 1. An applicant for registration as a pharmacist in
6-44 this state must submit an application to the Executive Secretary of
6-45 the Board on a form furnished by the Board and must pay the fee
7-1 fixed by the Board. The fee must be paid at the time the application
7-2 is submitted and is compensation to the Board for the investigation
7-3 and the examination of the applicant. Under no circumstances may
7-4 the fee be refunded.
7-5 2. Proof of the qualifications of any applicant must be made to
7-6 the satisfaction of the Board and must be substantiated by affidavits,
7-7 records or such other evidence as the Board may require.
7-8 3. An application is only valid for 1 year after the date it is
7-9 received by the Board unless the Board extends its period of
7-10 validity.
7-11 4. A certificate of registration as a pharmacist must be issued to
7-12 each person who the Board determines is qualified pursuant to the
7-13 provisions of NRS 639.120[, 639.133] and 639.134. The certificate
7-14 entitles the person to whom it is issued to practice pharmacy in this
7-15 state.
7-16 Sec. 13. NRS 639.128 is hereby amended to read as follows:
7-17 639.128 The application of a natural person who applies for the
7-18 issuance of a certificate of registration as a pharmacist, [an]
7-19 intern pharmacist [or supportive personnel] , pharmaceutical
7-20 technician or pharmaceutical technician in training or a license
7-21 issued pursuant to NRS 639.233 must include the social security
7-22 number of the applicant.
7-23 Sec. 14. NRS 639.129 is hereby amended to read as follows:
7-24 639.129 1. A natural person who applies for the issuance or
7-25 renewal of a certificate of registration as a pharmacist, [an]
7-26 intern pharmacist [or supportive personnel] , pharmaceutical
7-27 technician or pharmaceutical technician in training or a license
7-28 issued pursuant to NRS 639.233 shall submit to the Board the
7-29 statement prescribed by the Welfare Division of the Department of
7-30 Human Resources pursuant to NRS 425.520. The statement must be
7-31 completed and signed by the applicant.
7-32 2. The Board shall include the statement required pursuant to
7-33 subsection 1 in:
7-34 (a) The application or any other forms that must be submitted
7-35 for the issuance or renewal of the certificate or license; or
7-36 (b) A separate form prescribed by the Board.
7-37 3. A certificate of registration as a pharmacist, [an]
7-38 intern pharmacist [or supportive personnel] , pharmaceutical
7-39 technician or pharmaceutical technician in training or a license
7-40 issued issued pursuant to NRS 639.233 may not be issued or
7-41 renewed by the Board if the applicant is a natural person who:
7-42 (a) Fails to submit the statement required pursuant to
7-43 subsection 1; or
7-44 (b) Indicates on the statement submitted pursuant to subsection
7-45 1 that he is subject to a court order for the support of a child and is
8-1 not in compliance with the order or a plan approved by the district
8-2 attorney or other public agency enforcing the order for the
8-3 repayment of the amount owed pursuant to the order.
8-4 4. If an applicant indicates on the statement submitted pursuant
8-5 to subsection 1 that he is subject to a court order for the support of a
8-6 child and is not in compliance with the order or a plan approved by
8-7 the district attorney or other public agency enforcing the order for
8-8 the repayment of the amount owed pursuant to the order, the Board
8-9 shall advise the applicant to contact the district attorney or other
8-10 public agency enforcing the order to determine the actions that the
8-11 applicant may take to satisfy the arrearage.
8-12 Sec. 15. NRS 639.137 is hereby amended to read as follows:
8-13 639.137 1. Any person who is not a registered pharmacist,
8-14 but who is employed in this state for the purpose of fulfilling the
8-15 requirements of paragraph (d) of subsection 1 of NRS 639.120 to
8-16 become eligible for registration as a pharmacist, shall register with
8-17 the Board as an intern pharmacist. An applicant, to be eligible for
8-18 registration as an intern pharmacist, must be enrolled in a college of
8-19 pharmacy or a department of pharmacy of a university approved by
8-20 the Board or be a graduate of a foreign school and pass an
8-21 examination for foreign graduates approved by the Board. The
8-22 application must be made on a form furnished by the Board.
8-23 2. The Executive Secretary of the Board, upon approval of the
8-24 application, shall issue a certificate of registration authorizing
8-25 the applicant to undergo practical pharmaceutical training under the
8-26 direct and immediate supervision of a registered pharmacist. The
8-27 period of validity of the certificate of registration, including any
8-28 renewal, must not exceed 4 years after the date of issue. The
8-29 certificate of registration authorizes the holder, if acting under the
8-30 direct and immediate supervision of a registered pharmacist, to
8-31 perform:
8-32 (a) The duties of a registered pharmacist as authorized by
8-33 regulation of the Board; and
8-34 (b) Other activities as authorized by regulation of the Board.
8-35 3. The certificate of registration must be posted as required by
8-36 NRS 639.150.
8-37 4. Any certificate of registration issued pursuant to the
8-38 provisions of this section may be suspended, terminated or revoked
8-39 by the Board for:
8-40 (a) Any reason set forth in this chapter as grounds for the
8-41 suspension or revocation of any certificate, license or permit; or
8-42 (b) The failure of the registered pharmacist whose name appears
8-43 on the certificate of registration to provide adequate training and
8-44 supervision for the intern pharmacist in compliance with regulations
8-45 adopted by the Board.
9-1 Sec. 16. NRS 639.1371 is hereby amended to read as follows:
9-2 639.1371 1. The ratio of [supportive personnel]
9-3 pharmaceutical technicians to pharmacists must not allow more
9-4 than one [supportive personnel] pharmaceutical technician to each
9-5 pharmacist unless the Board by regulation expands the ratio.
9-6 2. The Board shall adopt regulations concerning[supportive
9-7 personnel,] pharmaceutical technicians, including requirements
9-8 for:
9-9 (a) The qualifications, registration and supervision of
9-10 [supportive personnel;] pharmaceutical technicians, and
9-11 (b) [Services] The services which may be performed by
9-12 [supportive personnel,] pharmaceutical technicians,
9-13 to ensure the protection and safety of the public in the provision of
9-14 pharmaceutical care.
9-15 3. The regulations adopted by the Board pursuant to this
9-16 section which prescribe:
9-17 (a) The qualifications for [supportive personnel]
9-18 pharmaceutical technicians must include:
9-19 (1) [At least 1 year of education at a postsecondary school
9-20 which is directly related to the duties performed by supportive
9-21 personnel;
9-22 (2)] The successful completion of a program for [supportive
9-23 personnel] pharmaceutical technicians which is approved by the
9-24 Board;
9-25 [(3)] (2) The completion of at least 1,500 hours of experience
9-26 in carrying out the duties of [supportive personnel; or
9-27 (4)] a pharmaceutical technician; or
9-28 (3) Any other experience or education deemed equivalent by
9-29 the Board.
9-30 (b) An expanded ratio of [supportive personnel] pharmaceutical
9-31 technicians to pharmacists must [not allow more than two
9-32 supportive personnel for each pharmacist in] be appropriate and
9-33 necessary for a particular category of pharmacy at any time.
9-34 (c) The services which may be performed by [supportive
9-35 personnel] pharmaceutical technicians must include, without
9-36 limitation, the:
9-37 (1) Removal of drugs from stock;
9-38 (2) Counting, pouring or mixing of drugs;
9-39 (3) Placing of drugs in containers;
9-40 (4) Affixing of labels to containers; and
9-41 (5) Packaging and repackaging of drugs.
9-42 4. For the purposes of this chapter, and chapters 453 and 454 of
9-43 NRS, [supportive personnel] pharmaceutical technicians may
9-44 perform acts required to be performed by pharmacists , but only to
9-45 the extent provided in regulations.
10-1 Sec. 17. NRS 639.138 is hereby amended to read as follows:
10-2 639.138 If the Board, after an investigation, denies any
10-3 application for a certificate, license or permit, the Executive
10-4 Secretary of the Board shall notify the applicant, within 10 days
10-5 after the denial is approved by the Board and entered in the official
10-6 minutes, by registered or certified mail, of the denial of the
10-7 application and the reasons therefor. The notice must inform the
10-8 applicant of his right to petition the Board for reconsideration and
10-9 his right to submit evidence to controvert the alleged violations on
10-10 which the denial was based.
10-11 Sec. 18. NRS 639.139 is hereby amended to read as follows:
10-12 639.139 1. At any time within 30 days after receipt of the
10-13 notice of denial of his application, an applicant may petition the
10-14 Board for reconsideration of the application. The petition must set
10-15 forth a denial, in whole or in part, of the violations alleged and a
10-16 statement that the applicant is prepared to submit evidence in
10-17 support of his denial of the allegations.
10-18 2. Within 30 days after the petition is received by the Board,
10-19 the Executive Secretary of the Board shall notify the petitioner, by
10-20 registered or certified mail, of the Board’s decision [either] to grant
10-21 or deny the petition for reconsideration. If the petition is granted, the
10-22 notice [shall] must include the time and place set for reconsideration
10-23 of the application by the Board.
10-24 Sec. 19. NRS 639.160 is hereby amended to read as follows:
10-25 639.160 Every registered pharmacist shall, within 10 days after
10-26 changing his place of practice as designated on the books of the
10-27 Executive Secretary of the Board, notify the Executive Secretary [of
10-28 the Board of such] of the change and of his new place of practice.
10-29 Upon receipt of [such] the notification , the Executive Secretary
10-30 shall make the necessary change in his register.
10-31 Sec. 20. NRS 639.170 is hereby amended to read as follows:
10-32 639.170 1. The Board shall charge and collect not more than
10-33 the following fees for the following services:
10-34 Actual cost
10-35 For the examination of an applicant for registration of the
10-36 as a pharmacist........................ examination
10-37 For the investigation or registration of an
10-38 applicant as a registered pharmacist$200
10-39 For the investigation, examination or registration
10-40 of an applicant as a registered pharmacist by
10-41 reciprocity........................................... 300
10-42 For the investigation or issuance of an original
10-43 license to conduct a retail pharmacy. 600
11-1 For the biennial renewal of a license to conduct a
11-2 retail pharmacy.................................... 500
11-3 For the investigation or issuance of an original
11-4 license to conduct an institutional pharmacy 600
11-5 For the biennial renewal of a license to conduct an
11-6 institutional pharmacy........................ 500
11-7 For the issuance of an original or duplicate
11-8 certificate of registration as a registered
11-9 pharmacist............................................. 50
11-10 For the biennial renewal of registration as a
11-11 registered pharmacist......................... 200
11-12 For the reinstatement of a lapsed registration (in
11-13 addition to the fees for renewal for the period of
11-14 lapse)................................................... 100
11-15 [For the initial registration of supportive personnel........................... 50
11-16 For the biennial renewal of registration of
11-17 supportive personnel.......................... 50]
11-18 For the initial registration of a pharmaceutical
11-19 technician or pharmaceutical technician in
11-20 training.............................................. $50
11-21 For the biennial renewal of registration of a
11-22 pharmaceutical technician or pharmaceutical
11-23 technician in training....................... 50
11-24 For the investigation or registration of an intern
11-25 pharmacist............................................ 50
11-26 For the biennial renewal of registration as an
11-27 intern pharmacist................................. 40
11-28 For investigation or issuance of an original license
11-29 to a manufacturer or wholesaler........ 500
11-30 For the biennial renewal of a license for a
11-31 manufacturer or wholesaler.... [400] 500
11-32 For the reissuance of a license issued to a
11-33 pharmacy, when no change of ownership is
11-34 involved, but the license must be reissued because
11-35 of a change in the information required thereon100
11-36 [For the biennial renewal of registration issued to
11-37 a registered pharmacist placed on inactive status 100]
11-38 For authorization of a practitioner to dispense
11-39 controlled substances or dangerous drugs, or both300
11-40 For the biennial renewal of authorization of a
11-41 practitioner to dispense controlled substances or
11-42 dangerous drugs, or both................... 300
12-1 2. If a person requests a special service from the Board or
12-2 requests the Board to convene a special meeting, he must pay the
12-3 actual costs to the Board as a condition precedent to the rendition of
12-4 the special service or the convening of the special meeting.
12-5 3. All fees are payable in advance and are not refundable.
12-6 4. The Board may, by regulation, set the penalty for failure to
12-7 pay the fee for renewal for any license, permit, authorization or
12-8 certificate within the statutory period, at an amount not to exceed
12-9 100 percent of the fee for renewal for each year of delinquency in
12-10 addition to the fees for renewal for each year of delinquency.
12-11 Sec. 21. NRS 639.180 is hereby amended to read as follows:
12-12 639.180 1. Except as otherwise provided in this subsection, a
12-13 certificate, license or permit issued by the Board pursuant to this
12-14 chapter expires on October 31 of each even‑numbered year. A
12-15 certificate of registration as a pharmacist expires on October 31 of
12-16 each odd‑numbered year.
12-17 2. Except as otherwise provided by NRS 639.137, 639.230 and
12-18 639.2328, each person to whom a certificate, license or permit has
12-19 been issued may, if the certificate, license or permit has not been
12-20 revoked, renew the certificate, license or permit biennially by:
12-21 (a) Filing an application for renewal;
12-22 (b) Paying the fee for renewal;
12-23 (c) Complying with the requirement of continuing professional
12-24 education, if applicable; and
12-25 (d) If the applicant is a natural person who is applying for the
12-26 renewal of a certificate of registration as a pharmacist, [an]
12-27 intern pharmacist [or supportive personnel] , pharmaceutical
12-28 technician or pharmaceutical technician in training or a license
12-29 issued pursuant to NRS 639.233, submitting the statement required
12-30 pursuant to NRS 639.129.
12-31 3. The application for renewal, together with the fee for
12-32 renewal and, if applicable, the statement, must be delivered to the
12-33 Executive Secretary of the Board on or before the expiration date of
12-34 the certificate, license or permit, or the current renewal receipt
12-35 thereof.
12-36 4. If a certificate, license or permit is renewed, it must be
12-37 delivered to the applicant within a reasonable time after receipt of
12-38 the application for renewal and the fee for renewal.
12-39 5. The Board may refuse to renew a certificate, license or
12-40 permit if the applicant has committed any act proscribed by
12-41 NRS 639.210.
12-42 6. If the application for renewal and the fee for renewal and, if
12-43 applicable, the statement[,] are not postmarked on or before the
12-44 expiration date of the certificate, license or permit, or the current
12-45 renewal receipt thereof, the registration is automatically forfeited.
13-1 Sec. 22. NRS 639.2174 is hereby amended to read as follows:
13-2 639.2174 The Board shall not[:
13-3 1. Issue a certificate as a registered pharmacist to any person
13-4 pursuant to NRS 639.133; or
13-5 2. Renew] renew the certificate of any registered pharmacist[,]
13-6 until the applicant has submitted proof to the Board of the receipt of
13-7 the required number of continuing education units, obtained through
13-8 the satisfactory completion of an accredited program of continuing
13-9 professional education during the period for which the certificate
13-10 was issued.
13-11 Sec. 23. NRS 639.230 is hereby amended to read as follows:
13-12 639.230 1. A [pharmacy or a] person operating [as a
13-13 pharmacy] a business in this state shall not use the letters “Rx” or
13-14 “RX” or the word “drug” or “drugs,” “prescription” or “pharmacy,”
13-15 or similar words or words of similar import, without first having
13-16 secured a license from the Board.
13-17 2. Each license must be issued to a specific person and for a
13-18 specific location and is not transferable. The original license must be
13-19 displayed on the licensed premises as provided in NRS 639.150.
13-20 The original license and the fee required for reissuance of a license
13-21 must be submitted to the Board before the reissuance of the license.
13-22 3. If the owner of a pharmacy is a partnership or corporation,
13-23 any change of partners or corporate officers must be reported to the
13-24 Board at such a time as is required by a regulation of the Board.
13-25 4. In addition to the requirements for renewal set forth in NRS
13-26 639.180, every person holding a license to operate a pharmacy must
13-27 satisfy the Board that the pharmacy is conducted according to law.
13-28 5. Any violation of any of the provisions of this chapter by a
13-29 managing pharmacist or by personnel of the pharmacy under the
13-30 supervision of the managing pharmacist is cause for the suspension
13-31 or revocation of the license of the pharmacy by the Board.
13-32 Sec. 24. NRS 639.231 is hereby amended to read as follows:
13-33 639.231 1. An application to conduct a pharmacy must be
13-34 made on a form furnished by the Board and must state the name,
13-35 address, usual occupation and professional qualifications, if any, of
13-36 the applicant. If the applicant is other than a natural person, the
13-37 application must state such information as to each person
13-38 beneficially interested therein.
13-39 2. As used in subsection 1, and subject to the provisions of
13-40 subsection 3, the term “person beneficially interested” means:
13-41 (a) If the applicant is a partnership or other unincorporated
13-42 association, each partner or member.
13-43 (b) If the applicant is a corporation, each of its officers, directors
13-44 and stockholders, provided that no natural person shall be deemed to
13-45 be beneficially interested in a nonprofit corporation.
14-1 3. If the applicant is a partnership, unincorporated association
14-2 or corporation and the number of partners, members or stockholders,
14-3 as the case may be, exceeds four, the application must so state, and
14-4 must list each of the four partners, members or stockholders who
14-5 own the four largest interests in the applicant entity and state their
14-6 percentages of interest. Upon request of the Executive Secretary of
14-7 the Board, the applicant shall furnish the Board with information as
14-8 to partners, members or stockholders not named in the application or
14-9 shall refer the Board to an appropriate source of such information.
14-10 4. The completed application form must be returned to the
14-11 Board with the fee prescribed by the Board, which may not be
14-12 refunded. Any application which is not complete as required by the
14-13 provisions of this section may not be presented to the Board for
14-14 consideration.
14-15 5. Upon compliance with all the provisions of this section and
14-16 upon approval of the application by the Board, the Executive
14-17 Secretary shall issue a license to the applicant to conduct a
14-18 pharmacy. Any other provision of law notwithstanding, such a
14-19 license authorizes the holder to conduct a pharmacy and to sell and
14-20 dispense drugs and poisons and devices and appliances that are
14-21 restricted by federal law to sale by or on the order of a physician.
14-22 Sec. 24.5. NRS 639.233 is hereby amended to read as follows:
14-23 639.233 1. Any person, including a wholesaler or
14-24 manufacturer, who engages in the business of wholesale distribution
14-25 or furnishing controlled substances, poisons, drugs, devices or
14-26 appliances that are restricted by federal law to sale by or on the
14-27 order of a physician to any person located within this state shall
14-28 obtain a license pursuant to the provisions of this chapter.
14-29 2. [The provisions of subsection 1 do not apply to a wholesaler
14-30 or manufacturer whose principal place of business is located in
14-31 another state and who ships controlled substances, drugs, poisons or
14-32 restricted devices or appliances to a wholesaler or manufacturer
14-33 located within this state and licensed by the Board.
14-34 3.] For the purpose of this section, a person is “engaged in the
14-35 business of furnishing” if he:
14-36 (a) Solicits or accepts orders for drugs or devices whose sale in
14-37 this state is restricted by this chapter or chapter 453 or 454 of NRS;
14-38 or
14-39 (b) Receives, stores or ships such drugs or devices.
14-40 Sec. 25. NRS 639.234 is hereby amended to read as follows:
14-41 639.234 1. The acceptance of a license issued pursuant to
14-42 NRS 639.233 constitutes a consent by the licensee to the inspection
14-43 , copying and removal for copying of his records maintained inside
14-44 and outside this state by any authorized representative of the Board.
15-1 2. If such a licensee is not a resident of this state and does not
15-2 maintain records within this state of his shipments of controlled
15-3 substances, poisons or drugs or devices or appliances that are
15-4 restricted by federal law to sale by or on the order of a physician to
15-5 persons in this state , he shall, on receipt of a written demand from
15-6 the Executive Secretary of the Board, furnish a true copy of the
15-7 records to the Board.
15-8 3. The Board may authorize as its representative any member
15-9 or representative of the Board of pharmacy or similar agency of the
15-10 state in which the records are located.
15-11 4. [Failure] The failure to furnish a true copy of the required
15-12 records or the refusal to permit their inspection is a ground for [the
15-13 revocation or] suspension of and disciplinary action relating to any
15-14 license issued pursuant to NRS 639.233.
15-15 Sec. 26. NRS 639.235 is hereby amended to read as follows:
15-16 639.235 1. No person other than a practitioner holding a
15-17 license to practice his profession in this state may prescribe or write
15-18 a prescription, except that a prescription written by a person who is
15-19 not licensed to practice in this state , but is authorized by the laws of
15-20 another state to prescribe , shall be deemed to be a legal prescription
15-21 unless the person prescribed or wrote the prescription in violation of
15-22 the provisions of NRS 453.3611 to 453.3648, inclusive.
15-23 2. If a prescription that is prescribed by a person who is not
15-24 licensed to practice in this state, but is authorized by the laws of
15-25 another state to prescribe, calls for a controlled substance listed in:
15-26 (a) Schedule II, the registered pharmacist who is to fill the
15-27 prescription shall establish and document that the prescription is
15-28 authentic and that a bona fide relationship between the patient and
15-29 the person prescribing the controlled substance did exist when the
15-30 prescription was written.
15-31 (b) Schedule III or IV, the registered pharmacist who is to fill
15-32 the prescription shall establish[, in his professional judgment,] that
15-33 the prescription is authentic and that a bona fide relationship
15-34 between the patient and the person prescribing the controlled
15-35 substance did exist when the prescription was written. This
15-36 paragraph does not require the registered pharmacist to inquire into
15-37 such a relationship upon the receipt of [each such prescription.] a
15-38 similar prescription subsequently issued for that patient.
15-39 3. A pharmacist who fills a prescription described in
15-40 subsection 2 shall record on the prescription or in the prescription
15-41 record in the pharmacy’s computer:
15-42 (a) The name of the person with whom he spoke concerning
15-43 the prescription;
15-44 (b) The date and time of the conversation; and
16-1 (c) The date and time the patient was physically examined by
16-2 the person prescribing the controlled substance for which the
16-3 prescription was issued.
16-4 4. For the purposes of subsection 2, a bona fide relationship
16-5 between the patient and the person prescribing the controlled
16-6 substance shall be deemed to exist if the patient was physically
16-7 examined by the person prescribing the controlled substances
16-8 within the 6 months immediately preceding the date the
16-9 prescription was issued.
16-10 Sec. 27. NRS 639.238 is hereby amended to read as follows:
16-11 639.238 1. Prescriptions filled and on file in a pharmacy are
16-12 not a public record. A pharmacist shall not divulge the contents of
16-13 any prescription or provide a copy of any prescription, except to:
16-14 (a) The patient for whom the original prescription was issued;
16-15 (b) The practitioner who originally issued the prescription;
16-16 (c) A practitioner who is then treating the patient;
16-17 (d) A member, inspector or investigator of the Board or an
16-18 inspector of the Food and Drug Administration or an agent of the
16-19 Investigation Division of the Department of Public Safety;
16-20 (e) An agency of State Government charged with the
16-21 responsibility of providing medical care for the patient;
16-22 (f) An insurance carrier, on receipt of written authorization
16-23 signed by the patient or his legal guardian, authorizing the release of
16-24 such information;
16-25 (g) Any person authorized by an order of a district court;
16-26 (h) Any member, inspector or investigator of a professional
16-27 licensing board which licenses a practitioner who orders
16-28 prescriptions filled at the pharmacy; [or]
16-29 (i) Other registered pharmacists for the limited purpose of and to
16-30 the extent necessary for the exchange of information relating to
16-31 persons who are suspected of:
16-32 (1) Misusing prescriptions to obtain excessive amounts of
16-33 drugs[.] ; or
16-34 (2) Failing to use a drug in conformity with the directions for
16-35 its use or taking a drug in combination with other drugs in a manner
16-36 that could result in injury to that person[.] ; or
16-37 (j) A peace officer employed by a local government for the
16-38 limited purpose of and to the extent necessary:
16-39 (1) For the investigation of an alleged crime reported by an
16-40 employee of the pharmacy where the crime was committed; or
16-41 (2) To carry out a search warrant or subpoena issued
16-42 pursuant to a court order.
16-43 2. Any copy of a prescription for a controlled substance or a
16-44 dangerous drug as defined in chapter 454 of NRS, issued to a person
16-45 authorized by this section to receive such a copy, must contain all of
17-1 the information appearing on the original prescription and be clearly
17-2 marked on its face[,] “Copy, Not Refillable—For Reference
17-3 Purposes Only.” The copy must bear the name or initials of the
17-4 registered pharmacist who prepared the copy.
17-5 3. If a copy of a prescription for any controlled substance or a
17-6 dangerous drug as defined in chapter 454 of NRS is furnished to the
17-7 customer, the original prescription must be voided and notations
17-8 made thereon showing the date and the name of the person to whom
17-9 the copy was furnished.
17-10 4. If, at the express request of a customer, a copy of a
17-11 prescription for any controlled substance or dangerous drug is
17-12 furnished to another pharmacist, the original prescription must be
17-13 voided and notations made thereon showing the date and the name
17-14 of the pharmacist to whom the copy was furnished. The pharmacist
17-15 receiving the copy shall call the prescribing practitioner for a new
17-16 prescription.
17-17 5. As used in this section, “peace officer” does not include:
17-18 (a) A member of the Police Department of the University and
17-19 Community College System of Nevada.
17-20 (b) A school police officer who is appointed or employed
17-21 pursuant to NRS 391.100.
17-22 Sec. 28. NRS 639.239 is hereby amended to read as follows:
17-23 639.239 Members, inspectors and investigators of the Board,
17-24 inspectors of the Food and Drug Administration , [and] agents of the
17-25 Investigation Division of the Department of Public Safety and peace
17-26 officers described in paragraph (j) of subsection 1 of NRS 639.238
17-27 may remove any record required to be retained by state or federal
17-28 law or regulation, including any prescription contained in the files of
17-29 a practitioner, if the record in question will be used as evidence in a
17-30 criminal action, civil action or an administrative proceeding, or
17-31 contemplated action or proceeding. The person who removes a
17-32 record pursuant to this section shall:
17-33 1. Affix the name and address of the practitioner to the back of
17-34 the record;
17-35 2. Affix his initials, cause an agent of the practitioner to affix
17-36 his initials and note the date of the removal of the record on the back
17-37 of the record;
17-38 3. Affix the name of the agency for which he is removing the
17-39 record to the back of the record;
17-40 4. Provide the practitioner with a receipt for the record; and
17-41 5. Return a photostatic copy of both sides of the record to the
17-42 practitioner within 15 working days after the record is removed.
17-43 Sec. 29. NRS 639.241 is hereby amended to read as follows:
17-44 639.241 1. A hearing to determine whether the rights and
17-45 privileges granted by any certificate, certification, license or permit
18-1 issued by the Board should be revoked, suspended, limited or
18-2 conditioned must be initiated by the filing of an accusation by the
18-3 Board. The action must be entitled: The Nevada State Board of
18-4 Pharmacy v. (insert the name of the party whose certificate, license
18-5 or permit is involved), who must be designated “Respondent.”
18-6 2. The accusation is a written statement of the charges alleged
18-7 and must set forth in ordinary and concise language the acts or
18-8 omissions with which the respondent is charged to the end that the
18-9 respondent will be able to prepare his defense. [It] The accusation
18-10 must specify the statutes and regulations which the respondent is
18-11 alleged to have violated, but must not consist merely of charges
18-12 phrased in language of the statute or regulation. The accusation must
18-13 be signed by the Executive Secretary of the Board acting in his
18-14 official capacity.
18-15 Sec. 30. NRS 639.242 is hereby amended to read as follows:
18-16 639.242 1. After filing the accusation, the Executive
18-17 Secretary of the Board shall cause a copy thereof, together with one
18-18 copy of the Statement to Respondent and three copies of the form of
18-19 the Notice of Defense, to be served on the respondent.
18-20 2. Service may be [either] by personal service or by first-class
18-21 registered or certified mail addressed to the respondent at his last
18-22 address of record, or by mail to his attorney of record. Proof of
18-23 service [shall] must be retained and made a part of the case record.
18-24 Sec. 31. NRS 639.244 is hereby amended to read as follows:
18-25 639.244 1. The form for the Notice of Defense [shall] must
18-26 be prepared and furnished by the Board and [shall] permit the
18-27 respondent, by completing and signing the notice , to:
18-28 (a) [Request a hearing;
18-29 (b)] Object to the accusation as being incomplete and failing to
18-30 set forth clearly the charges; and
18-31 [(c)] (b) Deny or admit, in part or in whole, the violations
18-32 alleged.
18-33 2. The Notice of Defense [shall] must be signed by the
18-34 respondent or [by] his attorney under penalty of perjury. Failure to
18-35 file a Notice of Defense [and request a hearing shall constitute]
18-36 constitutes a waiver of the respondent’s right to a hearing, but the
18-37 Board may[, in its discretion,] grant a hearing.
18-38 Sec. 32. NRS 639.245 is hereby amended to read as follows:
18-39 639.245 Whenever a hearing has been granted by the Board,
18-40 the Executive Secretary of the Board shall serve notice on the
18-41 respondent of the time and place set for the hearing on the
18-42 accusation. If the Board receives a report pursuant to subsection 5 of
18-43 NRS 228.420, a hearing must be held within 30 days after receiving
18-44 the report. Service may be effected in the same manner as provided
18-45 in NRS 639.242.
19-1 Sec. 33. NRS 639.246 is hereby amended to read as follows:
19-2 639.246 1. The Executive Secretary of the Board shall issue
19-3 subpoenas for the production of witnesses, documents or papers, in
19-4 accordance with statutory provisions, at the request of any party to a
19-5 hearing or for purposes of an investigation or other matter under
19-6 inquiry by the Board.
19-7 2. Witnesses appearing pursuant to a subpoena must receive
19-8 expenses and witness fees in the amounts and under the same
19-9 circumstances as prescribed by law for witnesses in civil actions.
19-10 The expenses and fees must be paid in full by the party at whose
19-11 request the witness is subpoenaed.
19-12 3. Subpoenas must be served in the same manner as prescribed
19-13 by law for the service of subpoenas in civil actions. If any person
19-14 fails to comply with a subpoena within 10 days after its issuance, the
19-15 President of the Board, or the Executive Secretary of the Board at
19-16 the direction of the President, may petition the district court for an
19-17 order of the court compelling compliance with the subpoena.
19-18 4. Upon such a petition, the court shall enter an order directing
19-19 the person subpoenaed to appear before the court at a time and place
19-20 to be fixed by the court in its order, the time to be not more than 10
19-21 days after the date of the order, and then and there to show cause
19-22 why he has not complied with the subpoena. A certified copy of the
19-23 order must be served upon the person.
19-24 5. If it appears to the court that the subpoena was regularly
19-25 issued by the Board, the court shall enter an order compelling
19-26 compliance with the subpoena. Failure to obey the order constitutes
19-27 contempt of court.
19-28 Sec. 34. NRS 639.247 is hereby amended to read as follows:
19-29 639.247 1. Any hearing held for the purpose of suspending or
19-30 revoking any certificate, certification, license or permit must be
19-31 conducted publicly by the Board. The hearing must be presided over
19-32 by a member of the Board or his designee and three members
19-33 constitute a quorum. Any decision by the Board requires the
19-34 concurrence of at least three members. The proceedings of the
19-35 hearing must be reported or recorded by an electronic recording
19-36 device, an official court reporter or another qualified person.
19-37 2. The member of the Board or his designee presiding at the
19-38 hearing or the Executive Secretary of the Board may administer
19-39 oaths or affirmations. Continuances and adjournments may be
19-40 ordered, or may be granted, by the member or his designee
19-41 presiding, for cause shown and by orally notifying those persons
19-42 present of the time and place at which the hearing will be continued.
19-43 Sec. 35. NRS 639.252 is hereby amended to read as follows:
19-44 639.252 1. If the respondent wishes to contest or appeal the
19-45 decision of the Board, the order or any part thereof, he may, [prior
20-1 to] not later than 10 days after the time the order becomes
20-2 effective, apply in writing to the Board for a rehearing. [Such
20-3 application shall] The application must set forth with particularity
20-4 the part or parts of the decision or order to which the respondent
20-5 objects and the basis of the objection.
20-6 2. The Executive Secretary of the Board shall, within 10 days
20-7 after receipt of a written application for rehearing, notify the
20-8 respondent and his attorney of record in writing, by registered or
20-9 certified mail, of [its] his action, either granting or denying [such]
20-10 the application. If the application is granted, the notice [shall] must
20-11 contain the date, time and place of the rehearing . [, which date shall
20-12 not be less than 30 days after the date of the notice.] The rehearing
20-13 must be held at the next regularly scheduled meeting of the Board.
20-14 Granting of the application by the [Board shall serve] Executive
20-15 Secretary does not serve as an automatic stay of execution of the
20-16 order pending conclusion of the rehearing.
20-17 Sec. 36. NRS 639.2555 is hereby amended to read as follows:
20-18 639.2555 1. If the Board receives a copy of a court order
20-19 issued pursuant to NRS 425.540 that provides for the suspension of
20-20 all professional, occupational and recreational licenses, certificates
20-21 and permits issued to a person who is the holder of a certificate of
20-22 registration as a pharmacist, [an] intern pharmacist [or supportive
20-23 personnel] , pharmaceutical technician or pharmaceutical
20-24 technician in training or a license issued pursuant to NRS 639.223,
20-25 the Board shall deem the certificate of registration or license issued
20-26 to that person to be suspended at the end of the 30th day after the
20-27 date on which the court order was issued unless the Board receives a
20-28 letter issued to the holder of the certificate of registration or license
20-29 by the district attorney or other public agency pursuant to NRS
20-30 425.550 stating that the holder of the certificate of registration or
20-31 license has complied with the subpoena or warrant or has satisfied
20-32 the arrearage pursuant to NRS 425.560.
20-33 2. The Board shall reinstate a certificate of registration as a
20-34 pharmacist, [an] intern pharmacist [or supportive personnel] ,
20-35 pharmaceutical technician or pharmaceutical technician in
20-36 training or a license issued pursuant to NRS 639.233 that has been
20-37 suspended by a district court pursuant to NRS 425.540 if the Board
20-38 receives a letter issued by the district attorney or other public agency
20-39 pursuant to NRS 425.550 to the person whose certificate of
20-40 registration or license was suspended stating that the person whose
20-41 certificate of registration or license was suspended has complied
20-42 with the subpoena or warrant or has satisfied the arrearage pursuant
20-43 to NRS 425.560.
21-1 Sec. 37. NRS 639.256 is hereby amended to read as follows:
21-2 639.256 A certificate, license or permit which has been
21-3 suspended for a specified period of time [shall] must automatically
21-4 be restored to good standing on the first day following the period of
21-5 suspension. The Executive Secretary[,] of the Board, when
21-6 notifying the respondent of the penalty imposed by the Board, shall
21-7 inform the respondent of the date on which the certificate, license or
21-8 permit will be so restored.
21-9 Secs. 38 and 39. (Deleted by amendment.)
21-10 Sec. 40. NRS 453.1545 is hereby amended to read as follows:
21-11 453.1545 1. The Board and the Division shall cooperatively
21-12 develop a computerized program to track each prescription for a
21-13 controlled substance listed in schedule II, III or IV that is filled by a
21-14 pharmacy that is registered with the Board[.] or that is dispensed by
21-15 a practitioner who is registered with the Board. The program must:
21-16 (a) Be designed to provide information regarding:
21-17 (1) The inappropriate use by a patient of controlled
21-18 substances listed in schedules II, III and IV to pharmacies,
21-19 practitioners and appropriate state agencies to prevent the improper
21-20 or illegal use of those controlled substances; and
21-21 (2) Statistical data relating to the use of those controlled
21-22 substances that is not specific to a particular patient.
21-23 (b) Be administered by the Board, the Division, the Health
21-24 Division of the Department of Human Resources and various
21-25 practitioners, representatives of professional associations for
21-26 practitioners, representatives of occupational licensing boards and
21-27 prosecuting attorneys selected by the Board and the Division.
21-28 (c) Not infringe on the legal use of a controlled substance for the
21-29 management of severe or intractable pain.
21-30 2. The Board and the Division must have access to the program
21-31 established pursuant to subsection 1 to identify any suspected
21-32 fraudulent or illegal activity related to the dispensing of controlled
21-33 substances.
21-34 3. The Board or the Division shall report any activity it
21-35 reasonably suspects may be fraudulent or illegal to the appropriate
21-36 law enforcement agency or occupational licensing board and
21-37 provide the law enforcement agency or occupational licensing board
21-38 with the relevant information obtained from the program for further
21-39 investigation.
21-40 4. Information obtained from the program relating to a
21-41 practitioner or a patient is confidential and, except as otherwise
21-42 provided by this section, must not be disclosed to any person. That
21-43 information must be disclosed:
22-1 (a) Upon the request of a person about whom the information
22-2 requested concerns or upon the request on his behalf by his attorney;
22-3 or
22-4 (b) Upon the lawful order of a court of competent jurisdiction.
22-5 5. The Board and the Division may apply for any available
22-6 grants and accept any gifts, grants or donations to assist in
22-7 developing and maintaining the program required by this section.
22-8 Sec. 40.5. NRS 453.375 is hereby amended to read as follows:
22-9 453.375 A controlled substance may be possessed and
22-10 administered by the following persons:
22-11 1. A practitioner.
22-12 2. A registered nurse licensed to practice professional nursing
22-13 or licensed practical nurse, at the direction of a physician, physician
22-14 assistant, dentist, podiatric physician or advanced practitioner of
22-15 nursing, or pursuant to a chart order, for administration to a patient
22-16 at another location.
22-17 3. An advanced emergency medical technician:
22-18 (a) As authorized by regulation of:
22-19 (1) The State Board of Health in a county whose population
22-20 is less than 100,000; or
22-21 (2) A county or district board of health in a county whose
22-22 population is 100,000 or more; and
22-23 (b) In accordance with any applicable regulations of:
22-24 (1) The State Board of Health in a county whose population
22-25 is less than 100,000;
22-26 (2) A county board of health in a county whose population is
22-27 100,000 or more; or
22-28 (3) A district board of health created pursuant to NRS
22-29 439.370 in any county.
22-30 4. A respiratory therapist,at the direction of a physician or
22-31 physician assistant.
22-32 5. A medical student, student in training to become a physician
22-33 assistant or student nurse in the course of his studies at an approved
22-34 college of medicine or school of professional or practical nursing, at
22-35 the direction of a physician or physician assistant and:
22-36 (a) In the presence of a physician, physician assistant or a
22-37 registered nurse; or
22-38 (b) Under the supervision of a physician, physician assistant or a
22-39 registered nurse if the student is authorized by the college or school
22-40 to administer the substance outside the presence of a physician,
22-41 physician assistant or nurse.
22-42 A medical student or student nurse may administer a controlled
22-43 substance in the presence or under the supervision of a registered
22-44 nurse alone only if the circumstances are such that the registered
22-45 nurse would be authorized to administer it personally.
23-1 6. An ultimate user or any person whom the ultimate user
23-2 designates pursuant to a written agreement.
23-3 7. Any person designated by the head of a correctional
23-4 institution.
23-5 8. A veterinary technician at the direction of his supervising
23-6 veterinarian.
23-7 9. In accordance with applicable regulations of the State Board
23-8 of Health, an employee of a residential facility for groups, as
23-9 defined in NRS 449.017, pursuant to a written agreement entered
23-10 into by the ultimate user.
23-11 10. In accordance with applicable regulations of the State
23-12 Board of Pharmacy, an animal control officer, a wildlife biologist or
23-13 an employee designated by a federal, state or local governmental
23-14 agency whose duties include the control of domestic, wild and
23-15 predatory animals.
23-16 11. A person who is enrolled in a training program to become
23-17 an advanced emergency medical technician, respiratory therapist
23-18 or veterinary technician if the person possesses and administers
23-19 the controlled substance in the same manner and under the same
23-20 conditions that apply, respectively, to an advanced emergency
23-21 medical technician, respiratory therapist or veterinary technician
23-22 who may possess and administer the controlled substance, and
23-23 under the direct supervision of a person licensed or registered to
23-24 perform the respective medical art or a supervisor of such a
23-25 person.
23-26 Sec. 41. NRS 453.431 is hereby amended to read as follows:
23-27 453.431 1. A pharmacist shall not knowingly fill or refill any
23-28 prescription for a controlled substance for use by a person other than
23-29 the person for whom the prescription was originally issued.
23-30 2. A person shall not furnish a false name or address while
23-31 attempting to obtain a controlled substance or a prescription for a
23-32 controlled substance. A person prescribing, administering or
23-33 dispensing a controlled substance may request proper identification
23-34 from a person requesting controlled substances.
23-35 3. A pharmacist shall not fill a prescription for a controlled
23-36 substance if the prescription shows evidence of alteration, erasure or
23-37 addition, unless he obtains approval of the practitioner who issued
23-38 the prescription.
23-39 4. A pharmacist shall not fill a prescription for a controlled
23-40 substance classified in schedule II unless it is tendered on or before
23-41 the 14th day after the date of issue. This subsection does not
23-42 prohibit a practitioner from issuing a prescription on which he
23-43 indicates that the prescription may not be filled until the date
23-44 indicated on the prescription, which must not be later than 6
23-45 months after the date the prescription is issued.
24-1 5. A person who violates this section is guilty of a category C
24-2 felony and shall be punished as provided in NRS 193.130.
24-3 Sec. 41.5. NRS 454.213 is hereby amended to read as follows:
24-4 454.213 A drug or medicine referred to in NRS 454.181 to
24-5 454.371, inclusive, may be possessed and administered by:
24-6 1. A practitioner.
24-7 2. A physician assistant at the direction of his supervising
24-8 physician or a licensed dental hygienist acting in the office of and
24-9 under the supervision of a dentist.
24-10 3. Except as otherwise provided in subsection 4, a registered
24-11 nurse licensed to practice professional nursing or licensed practical
24-12 nurse, at the direction of a prescribing physician, physician assistant,
24-13 dentist, podiatric physician or advanced practitioner of nursing, or
24-14 pursuant to a chart order, for administration to a patient at another
24-15 location.
24-16 4. In accordance with applicable regulations of the Board, a
24-17 registered nurse licensed to practice professional nursing or licensed
24-18 practical nurse who is:
24-19 (a) Employed by a health care agency or health care facility that
24-20 is authorized to provide emergency care, or to respond to the
24-21 immediate needs of a patient, in the residence of the patient; and
24-22 (b) Acting under the direction of the medical director of that
24-23 agency or facility who works in this state.
24-24 5. An intermediate emergency medical technician or an
24-25 advanced emergency medical technician, as authorized by
24-26 regulation of the State Board of Pharmacy and in accordance with
24-27 any applicable regulations of:
24-28 (a) The State Board of Health in a county whose population is
24-29 less than 100,000;
24-30 (b) A county board of health in a county whose population is
24-31 100,000 or more; or
24-32 (c) A district board of health created pursuant to NRS 439.370
24-33 in any county.
24-34 6. A respiratory therapist employed in a health care facility.
24-35 The therapist may possess and administer respiratory products only
24-36 at the direction of a physician.
24-37 7. A dialysis technician, under the direction or supervision of a
24-38 physician or registered nurse only if the drug or medicine is used for
24-39 the process of renal dialysis.
24-40 8. A medical student or student nurse in the course of his
24-41 studies at an approved college of medicine or school of professional
24-42 or practical nursing, at the direction of a physician and:
24-43 (a) In the presence of a physician or a registered nurse; or
24-44 (b) Under the supervision of a physician or a registered nurse if
24-45 the student is authorized by the college or school to administer the
25-1 drug or medicine outside the presence of a physician or
25-2 nurse.
25-3 A medical student or student nurse may administer a dangerous drug
25-4 in the presence or under the supervision of a registered nurse alone
25-5 only if the circumstances are such that the registered nurse would be
25-6 authorized to administer it personally.
25-7 9. Any person designated by the head of a correctional
25-8 institution.
25-9 10. An ultimate user or any person designated by the ultimate
25-10 user pursuant to a written agreement.
25-11 11. A nuclear medicine technologist, at the direction of a
25-12 physician and in accordance with any conditions established by
25-13 regulation of the Board.
25-14 12. A radiologic technologist, at the direction of a physician
25-15 and in accordance with any conditions established by regulation of
25-16 the Board.
25-17 13. A chiropractic physician, but only if the drug or medicine
25-18 is a topical drug used for cooling and stretching external tissue
25-19 during therapeutic treatments.
25-20 14. A physical therapist, but only if the drug or medicine is a
25-21 topical drug which is:
25-22 (a) Used for cooling and stretching external tissue during
25-23 therapeutic treatments; and
25-24 (b) Prescribed by a licensed physician for:
25-25 (1) Iontophoresis; or
25-26 (2) The transmission of drugs through the skin using
25-27 ultrasound.
25-28 15. In accordance with applicable regulations of the State
25-29 Board of Health, an employee of a residential facility for groups, as
25-30 defined in NRS 449.017, pursuant to a written agreement entered
25-31 into by the ultimate user.
25-32 16. A veterinary technician at the direction of his supervising
25-33 veterinarian.
25-34 17. In accordance with applicable regulations of the Board, a
25-35 registered pharmacist who:
25-36 (a) Is trained in and certified to carry out standards and practices
25-37 for immunization programs;
25-38 (b) Is authorized to administer immunizations pursuant to
25-39 written protocols from a physician; and
25-40 (c) Administers immunizations in compliance with the
25-41 “Standards of Immunization Practices” recommended and approved
25-42 by the United States Public Health Service Advisory Committee on
25-43 Immunization Practices.
25-44 18. A person who is enrolled in a training program to become
25-45 a physician assistant, dental hygienist, intermediate emergency
26-1 medical technician, advanced emergency medical technician,
26-2 respiratory therapist, dialysis technician, nuclear medicine
26-3 technologist, radiologic technologist, physical therapist or
26-4 veterinary technician if the person possesses and administers the
26-5 drug or medicine in the same manner and under the same
26-6 conditions that apply, respectively, to a physician assistant, dental
26-7 hygienist, intermediate emergency medical technician, advanced
26-8 emergency medical technician, respiratory therapist, dialysis
26-9 technician, nuclear medicine technologist, radiologic technologist,
26-10 physical therapist or veterinary technician who may possess and
26-11 administer the drug or medicine, and under the direct supervision
26-12 of a person licensed or registered to perform the respective
26-13 medical art or a supervisor of such a person.
26-14 Sec. 42. NRS 689A.04045 is hereby amended to read as
26-15 follows:
26-16 689A.04045 1. Except as otherwise provided in this section,
26-17 a policy of health insurance which provides coverage for
26-18 prescription drugs must not limit or exclude coverage for a drug if
26-19 the drug:
26-20 (a) Had previously been approved for coverage by the insurer
26-21 for a medical condition of an insured and the insured’s provider of
26-22 health care determines, after conducting a reasonable investigation,
26-23 that none of the drugs which are otherwise currently approved for
26-24 coverage are medically appropriate for the insured; and
26-25 (b) Is appropriately prescribed and considered safe and effective
26-26 for treating the medical condition of the insured.
26-27 2. The provisions of subsection 1 do not:
26-28 (a) Apply to coverage for any drug that is prescribed for a use
26-29 that is different from the use for which that drug has been approved
26-30 for marketing by the Food and Drug Administration;
26-31 (b) Prohibit:
26-32 (1) The insurer from charging a deductible, copayment or
26-33 coinsurance for the provision of benefits for prescription drugs to
26-34 the insured or from establishing, by contract, limitations on the
26-35 maximum coverage for prescription drugs;
26-36 (2) A provider of health care from prescribing another drug
26-37 covered by the policy that is medically appropriate for the insured;
26-38 or
26-39 (3) The substitution of another drug pursuant to NRS
26-40 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
26-41 (c) Require any coverage for a drug after the term of the policy.
26-42 3. Any provision of a policy subject to the provisions of this
26-43 chapter that is delivered, issued for delivery or renewed on or after
26-44 October 1, 2001, which is in conflict with this section is void.
27-1 Sec. 43. NRS 689B.0368 is hereby amended to read as
27-2 follows:
27-3 689B.0368 1. Except as otherwise provided in this section, a
27-4 policy of group health insurance which provides coverage for
27-5 prescription drugs must not limit or exclude coverage for a drug if
27-6 the drug:
27-7 (a) Had previously been approved for coverage by the insurer
27-8 for a medical condition of an insured and the insured’s provider of
27-9 health care determines, after conducting a reasonable investigation,
27-10 that none of the drugs which are otherwise currently approved for
27-11 coverage are medically appropriate for the insured; and
27-12 (b) Is appropriately prescribed and considered safe and effective
27-13 for treating the medical condition of the insured.
27-14 2. The provisions of subsection 1 do not:
27-15 (a) Apply to coverage for any drug that is prescribed for a use
27-16 that is different from the use for which that drug has been approved
27-17 for marketing by the Food and Drug Administration;
27-18 (b) Prohibit:
27-19 (1) The insurer from charging a deductible, copayment or
27-20 coinsurance for the provision of benefits for prescription drugs to
27-21 the insured or from establishing, by contract, limitations on the
27-22 maximum coverage for prescription drugs;
27-23 (2) A provider of health care from prescribing another drug
27-24 covered by the policy that is medically appropriate for the insured;
27-25 or
27-26 (3) The substitution of another drug pursuant to NRS
27-27 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
27-28 (c) Require any coverage for a drug after the term of the policy.
27-29 3. Any provision of a policy subject to the provisions of this
27-30 chapter that is delivered, issued for delivery or renewed on or after
27-31 October 1, 2001, which is in conflict with this section is void.
27-32 Sec. 44. NRS 689C.168 is hereby amended to read as follows:
27-33 689C.168 1. Except as otherwise provided in this section, a
27-34 health benefit plan which provides coverage for prescription drugs
27-35 must not limit or exclude coverage for a drug if the drug:
27-36 (a) Had previously been approved for coverage by the carrier for
27-37 a medical condition of an insured and the insured’s provider of
27-38 health care determines, after conducting a reasonable investigation,
27-39 that none of the drugs which are otherwise currently approved for
27-40 coverage are medically appropriate for the insured; and
27-41 (b) Is appropriately prescribed and considered safe and effective
27-42 for treating the medical condition of the insured.
27-43 2. The provisions of subsection 1 do not:
28-1 (a) Apply to coverage for any drug that is prescribed for a use
28-2 that is different from the use for which that drug has been approved
28-3 for marketing by the Food and Drug Administration;
28-4 (b) Prohibit:
28-5 (1) The carrier from charging a deductible, copayment or
28-6 coinsurance for the provision of benefits for prescription drugs to
28-7 the insured or from establishing, by contract, limitations on the
28-8 maximum coverage for prescription drugs;
28-9 (2) A provider of health care from prescribing another drug
28-10 covered by the plan that is medically appropriate for the insured; or
28-11 (3) The substitution of another drug pursuant to NRS
28-12 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
28-13 (c) Require any coverage for a drug after the term of the plan.
28-14 3. Any provision of a health benefit plan subject to the
28-15 provisions of this chapter that is delivered, issued for delivery or
28-16 renewed on or after October 1, 2001, which is in conflict with this
28-17 section is void.
28-18 Sec. 45. NRS 695A.184 is hereby amended to read as follows:
28-19 695A.184 1. Except as otherwise provided in this section, a
28-20 benefit contract which provides coverage for prescription drugs
28-21 must not limit or exclude coverage for a drug if the drug:
28-22 (a) Had previously been approved for coverage by the society
28-23 for a medical condition of an insured and the insured’s provider of
28-24 health care determines, after conducting a reasonable investigation,
28-25 that none of the drugs which are otherwise currently approved for
28-26 coverage are medically appropriate for the insured; and
28-27 (b) Is appropriately prescribed and considered safe and effective
28-28 for treating the medical condition of the insured.
28-29 2. The provisions of subsection 1 do not:
28-30 (a) Apply to coverage for any drug that is prescribed for a use
28-31 that is different from the use for which that drug has been approved
28-32 for marketing by the Food and Drug Administration;
28-33 (b) Prohibit:
28-34 (1) The society from charging a deductible, copayment or
28-35 coinsurance for the provision of benefits for prescription drugs to
28-36 the insured or from establishing, by contract, limitations on the
28-37 maximum coverage for prescription drugs;
28-38 (2) A provider of health care from prescribing another drug
28-39 covered by the benefit contract that is medically appropriate for the
28-40 insured; or
28-41 (3) The substitution of another drug pursuant to NRS
28-42 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
28-43 (c) Require any coverage for a drug after the term of the benefit
28-44 contract.
29-1 3. Any provision of a benefit contract subject to the provisions
29-2 of this chapter that is delivered, issued for delivery or renewed on or
29-3 after October 1, 2001, which is in conflict with this section is void.
29-4 Sec. 46. NRS 695B.1905 is hereby amended to read as
29-5 follows:
29-6 695B.1905 1. Except as otherwise provided in this section, a
29-7 contract for hospital or medical services which provides coverage
29-8 for prescription drugs must not limit or exclude coverage for a drug
29-9 if the drug:
29-10 (a) Had previously been approved for coverage by the insurer
29-11 for a medical condition of an insured and the insured’s provider of
29-12 health care determines, after conducting a reasonable investigation,
29-13 that none of the drugs which are otherwise currently approved for
29-14 coverage are medically appropriate for the insured; and
29-15 (b) Is appropriately prescribed and considered safe and effective
29-16 for treating the medical condition of the insured.
29-17 2. The provisions of subsection 1 do not:
29-18 (a) Apply to coverage for any drug that is prescribed for a use
29-19 that is different from the use for which that drug has been approved
29-20 for marketing by the Food and Drug Administration;
29-21 (b) Prohibit:
29-22 (1) The insurer from charging a deductible, copayment or
29-23 coinsurance for the provision of benefits for prescription drugs to
29-24 the insured or from establishing, by contract, limitations on the
29-25 maximum coverage for prescription drugs;
29-26 (2) A provider of health care from prescribing another drug
29-27 covered by the contract that is medically appropriate for the insured;
29-28 or
29-29 (3) The substitution of another drug pursuant to NRS
29-30 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
29-31 (c) Require any coverage for a drug after the term of the
29-32 contract.
29-33 3. Any provision of a contract for hospital or medical services
29-34 subject to the provisions of this chapter that is delivered, issued for
29-35 delivery or renewed on or after October 1, 2001, which is in conflict
29-36 with this section is void.
29-37 Sec. 47. NRS 695C.1734 is hereby amended to read as
29-38 follows:
29-39 695C.1734 1. Except as otherwise provided in this section,
29-40 evidence of coverage which provides coverage for prescription
29-41 drugs must not limit or exclude coverage for a drug if the drug:
29-42 (a) Had previously been approved for coverage by the health
29-43 maintenance organization or insurer for a medical condition of an
29-44 enrollee and the enrollee’s provider of health care determines, after
29-45 conducting a reasonable investigation, that none of the drugs which
30-1 are otherwise currently approved for coverage are medically
30-2 appropriate for the enrollee; and
30-3 (b) Is appropriately prescribed and considered safe and effective
30-4 for treating the medical condition of the enrollee.
30-5 2. The provisions of subsection 1 do not:
30-6 (a) Apply to coverage for any drug that is prescribed for a use
30-7 that is different from the use for which that drug has been approved
30-8 for marketing by the Food and Drug Administration;
30-9 (b) Prohibit:
30-10 (1) The health maintenance organization or insurer from
30-11 charging a deductible, copayment or coinsurance for the provision
30-12 of benefits for prescription drugs to the enrollee or from
30-13 establishing, by contract, limitations on the maximum coverage for
30-14 prescription drugs;
30-15 (2) A provider of health care from prescribing another drug
30-16 covered by the evidence of coverage that is medically appropriate
30-17 for the enrollee; or
30-18 (3) The substitution of another drug pursuant to NRS
30-19 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
30-20 (c) Require any coverage for a drug after the term of the
30-21 evidence of coverage.
30-22 3. Any provision of an evidence of coverage subject to the
30-23 provisions of this chapter that is delivered, issued for delivery or
30-24 renewed on or after October 1, 2001, which is in conflict with this
30-25 section is void.
30-26 Sec. 48. NRS 695F.156 is hereby amended to read as follows:
30-27 695F.156 1. Except as otherwise provided in this section,
30-28 evidence of coverage which provides coverage for prescription
30-29 drugs must not limit or exclude coverage for a drug if the drug:
30-30 (a) Had previously been approved for coverage by the prepaid
30-31 limited health service organization for a medical condition of an
30-32 enrollee and the enrollee’s provider of health care determines, after
30-33 conducting a reasonable investigation, that none of the drugs which
30-34 are otherwise currently approved for coverage are medically
30-35 appropriate for the enrollee; and
30-36 (b) Is appropriately prescribed and considered safe and effective
30-37 for treating the medical condition of the enrollee.
30-38 2. The provisions of subsection 1 do not:
30-39 (a) Apply to coverage for any drug that is prescribed for a use
30-40 that is different from the use for which that drug has been approved
30-41 for marketing by the Food and Drug Administration;
30-42 (b) Prohibit:
30-43 (1) The organization from charging a deductible, copayment
30-44 or coinsurance for the provision of benefits for prescription drugs to
31-1 the enrollee or from establishing, by contract, limitations on the
31-2 maximum coverage for prescription drugs;
31-3 (2) A provider of health care from prescribing another drug
31-4 covered by the evidence of coverage that is medically appropriate
31-5 for the enrollee; or
31-6 (3) The substitution of another drug pursuant to NRS
31-7 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
31-8 (c) Require any coverage for a drug after the term of the
31-9 evidence of coverage.
31-10 3. Any provision of an evidence of coverage subject to the
31-11 provisions of this chapter that is delivered, issued for delivery or
31-12 renewed on or after October 1, 2001, which is in conflict with this
31-13 section is void.
31-14 Sec. 49. NRS 695G.166 is hereby amended to read as follows:
31-15 695G.166 1. Except as otherwise provided in this section, a
31-16 health care plan which provides coverage for prescription drugs
31-17 must not limit or exclude coverage for a drug if the drug:
31-18 (a) Had previously been approved for coverage by the managed
31-19 care organization for a medical condition of an insured and the
31-20 insured’s provider of health care determines, after conducting a
31-21 reasonable investigation, that none of the drugs which are otherwise
31-22 currently approved for coverage are medically appropriate for the
31-23 insured; and
31-24 (b) Is appropriately prescribed and considered safe and effective
31-25 for treating the medical condition of the insured.
31-26 2. The provisions of subsection 1 do not:
31-27 (a) Apply to coverage for any drug that is prescribed for a use
31-28 that is different from the use for which that drug has been approved
31-29 for marketing by the Food and Drug Administration;
31-30 (b) Prohibit:
31-31 (1) The organization from charging a deductible, copayment
31-32 or coinsurance for the provision of benefits for prescription drugs to
31-33 the insured or from establishing, by contract, limitations on the
31-34 maximum coverage for prescription drugs;
31-35 (2) A provider of health care from prescribing another drug
31-36 covered by the plan that is medically appropriate for the insured; or
31-37 (3) The substitution of another drug pursuant to NRS
31-38 639.23286 or 639.2583 to [639.2599,] 639.2597, inclusive; or
31-39 (c) Require any coverage for a drug after the term of the plan.
31-40 3. Any provision of a health care plan subject to the provisions
31-41 of this chapter that is delivered, issued for delivery or renewed on or
31-42 after October 1, 2001, which is in conflict with this section is void.
31-43 Sec. 50. NRS 639.0152, 639.133, 639.205, 639.2323 and
31-44 639.2599 are hereby repealed.
32-1 LEADLINES OF REPEALED SECTIONS
32-2 639.0152 “Supportive personnel” defined.
32-3 639.133 Registration of pharmacist not possessing formal
32-4 educational requirements.
32-5 639.205 Inactive status.
32-6 639.2323 Nuclear pharmacy: Publications required on
32-7 premises.
32-8 639.2599 Display of notice regarding substitution.
32-9 H