Nevada 2023 Regular Session

Nevada Senate Bill SB336 Compare Versions

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1	1
2	2
3	3	- 82nd Session (2023)
4	4	Senate Bill No. 336–Senators Ohrenschall and Stone
5	5
6	6	CHAPTER..........
7	7
8	8	AN ACT relating to health care; exempting certain conduct of
9	9	certain practitioners of healing arts practicing within their
10	10	authorized scope of authority from provisions governing
11	11	certain practitioners of other healing arts; enacting provisions
12	12	governing the certification and regulation of certified
13	13	registered nurse anesthetists; authorizing a certified registered
14	14	nurse anesthetist to order, prescribe, possess and administer
15	15	controlled substances, poisons, dangerous drugs and devices
16	16	under certain circumstances; and providing other matters
17	17	properly relating thereto.
18	18	Legislative Counsel’s Digest:
19	19	Existing law authorizes a physician, physician assistant, dentist, advanced
20	20	practice registered nurse, podiatric physician or optometrist to prescribe and
21	21	dispense controlled substances and dangerous drugs under certain circumstances.
22	22	(NRS 453.226, 454.215, 639.235) Existing law provides that provisions of existing
23	23	law governing the practice of physicians, physician assistants, perfusionists and
24	24	practitioners of respiratory care do not apply to any person permitted to practice
25	25	any other healing art under title 54 of NRS who does so within the scope of that
26	26	authority. (NRS 630.047) Sections 1, 2.2 and 3-5 of this bill provide similar
27	27	exemptions from provisions governing dentists, nurses, osteopathic physicians and
28	28	physician assistants, podiatrists and optometrists for practitioners of healing arts
29	29	who are acting within the scope of their authority. Section 6 of this bill provides
30	30	that the provisions of sections 1, 2.2 and 3-5 apply to any conduct by a practitioner
31	31	of a healing art before, on or after the effective date of this bill which has not been
32	32	the subject of a final order from the Board of Dental Examiners of Nevada, the
33	33	State Board of Nursing, the State Board of Osteopathic Medicine, the State Board
34	34	of Podiatry or the Nevada State Board of Optometry. Section 6 also requires those
35	35	boards to terminate any investigation or disciplinary proceedings for conduct that is
36	36	outside the scope of those boards.
37	37	Existing law: (1) provides for the certification of certified registered nurse
38	38	anesthetists by the State Board of Nursing; and (2) authorizes a certified registered
39	39	nurse anesthetist to administer anesthetic agents to a person under the care of a
40	40	licensed physician, dentist or podiatric physician. (NRS 632.014) Section 2.4 of
41	41	this bill requires the State Board of Nursing to issue a certificate of registration to
42	42	practice as a certified registered nurse anesthetist to a registered nurse who meets
43	43	the requirements prescribed by existing law for such certification and any
44	44	additional requirements prescribed by the Board. Section 2.4 also requires the
45	45	Board to adopt regulations governing certified registered nurse anesthetists.
46	46	Existing law authorizes a registered nurse to possess and administer controlled
47	47	substances and dangerous drugs under certain circumstances. (NRS 453.375,
48	48	454.213) Sections 2.6, 5.1, 5.5 and 5.9 of this bill additionally authorize a certified
49	49	registered nurse anesthetist working under the supervision of a physician licensed
50	50	to practice medicine or osteopathic medicine in this State to order, prescribe,
51	51	possess and administer controlled substances, poisons, dangerous drugs and devices
52	52	to treat a person under the care of a licensed physician in a critical access hospital
53	53	before, during and after surgery or childbirth. Sections 5.2-5.4 and 5.6-5.85 of this
54	54	bill make additional changes necessary to authorize a certified registered nurse
55	55	– 2 –
56	56
57	57
58	58	- 82nd Session (2023)
59	59	anesthetist to order, prescribe, possess and administer controlled substances,
60	60	poisons, dangerous drugs and devices in such circumstances. A certified registered
61	61	nurse anesthetist who unlawfully possesses, prescribes or administers a controlled
62	62	substance, dangerous drug or poison would be subject to discipline and criminal
63	63	and civil penalties to the same extent as other practitioners who unlawfully possess,
64	64	prescribe or administer such drugs. (NRS 453.236, 453.305, 453.326, 453.3363,
65	65	453.553, 454.170, 454.356)
66	66	Section 2.8 of this bill makes a conforming change to remove a provision now
67	67	duplicated in section 2.4.
68	68
69	69	EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
70	70
71	71
72	72	THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
73	73	SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
74	74
75	75	Section 1. NRS 631.115 is hereby amended to read as follows:
76	76	631.115 1. Except as otherwise provided in subsection 2 of
77	77	NRS 631.317, this chapter does not apply to:
78	78	[1.] (a) A legally qualified physician or surgeon unless he or
79	79	she practices dentistry as a specialty.
80	80	[2.] (b) A dentist, dental hygienist or dental therapist of the
81	81	United States Army, Navy, Air Force, Public Health Service, Coast
82	82	Guard or Department of Veterans Affairs in the discharge of his or
83	83	her official duties, including, without limitation, providing medical
84	84	care in a hospital in accordance with an agreement entered into
85	85	pursuant to NRS 449.2455.
86	86	(c) Any person permitted to practice any other healing art
87	87	under this title who does so within the scope of that authority.
88	88	2. As used in this section, “healing art” has the meaning
89	89	ascribed to it in NRS 630.0122.
90	90	Sec. 2. Chapter 632 of NRS is hereby amended by adding
91	91	thereto the provisions set forth as section 2.2, 2.4 and 2.6 of this act.
92	92	Sec. 2.2. 1. Except as otherwise provided in NRS 632.472,
93	93	this chapter does not apply to any person permitted to practice any
94	94	other healing art under this title who does so within the scope of
95	95	that authority.
96	96	2. As used in this section, “healing art” has the meaning
97	97	ascribed to it in NRS 630.0122.
98	98	Sec. 2.4. 1. The Board shall issue a certificate of
99	99	registration to practice as a certified registered nurse anesthetist to
100	100	an applicant who:
101	101	(a) Has successfully completed a nationally accredited
102	102	program in the science of anesthesia; and
103	103	(b) Meets any additional requirements prescribed by the Board
104	104	pursuant to subsection 2.
105	105	– 3 –
106	106
107	107
108	108	- 82nd Session (2023)
109	109	2. The Board shall adopt regulations to carry out the
110	110	provisions of this section and section 2.6 of this act, including,
111	111	without limitation, regulations:
112	112	(a) Specifying any additional training, education and
113	113	experience necessary for certification as a certified registered
114	114	nurse anesthetist;
115	115	(b) Delineating the authorized scope of practice of a certified
116	116	registered nurse anesthetist; and
117	117	(c) Establishing the procedure to apply for certification as a
118	118	certified registered nurse anesthetist.
119	119	Sec. 2.6. 1. A certified registered nurse anesthetist may:
120	120	(a) Under the supervision of a physician licensed pursuant to
121	121	chapter 630 or 633 of NRS, order, prescribe, possess and
122	122	administer controlled substances, poisons, dangerous drugs and
123	123	devices to treat a patient under the care of a licensed physician in
124	124	a critical access hospital in preparation for surgery or childbirth,
125	125	during surgery or childbirth and while a patient recovers from
126	126	surgery or childbirth.
127	127	(b) Possess and administer controlled substances, poisons,
128	128	dangerous drugs and devices in other circumstances under which
129	129	a registered nurse is authorized to possess and administer
130	130	controlled substances, poisons, dangerous drugs and devices.
131	131	2. A certified registered nurse anesthetist shall not order or
132	132	prescribe a controlled substance, poison, dangerous drug or device
133	133	except as authorized by paragraph (a) of subsection 1.
134	134	3. As used in this section, “critical access hospital” means a
135	135	hospital which has been certified as a critical access hospital by
136	136	the Secretary of Health and Human Services pursuant to 42
137	137	U.S.C. 1395i-4(e).
138	138	Sec. 2.8. NRS 632.014 is hereby amended to read as follows:
139	139	632.014 “Certified registered nurse anesthetist” means a
140	140	registered nurse who [:
141	141	1. Has completed a nationally accredited program in the
142	142	science of anesthesia; and
143	143	2. Is] is certified by the Board pursuant to section 2.4 of this
144	144	act to administer anesthetic agents to a person under the care of a
145	145	licensed physician, a licensed dentist or a licensed podiatric
146	146	physician.
147	147	Sec. 3. NRS 633.171 is hereby amended to read as follows:
148	148	633.171 1. This chapter does not apply to:
149	149	(a) The practice of medicine or perfusion pursuant to chapter
150	150	630 of NRS, dentistry, chiropractic, podiatry, optometry, respiratory
151	151	– 4 –
152	152
153	153
154	154	- 82nd Session (2023)
155	155	care, faith or Christian Science healing, nursing, veterinary medicine
156	156	or fitting hearing aids.
157	157	(b) A medical officer of the Armed Forces or a medical officer
158	158	of any division or department of the United States in the discharge
159	159	of his or her official duties, including, without limitation, providing
160	160	medical care in a hospital in accordance with an agreement entered
161	161	into pursuant to NRS 449.2455.
162	162	(c) Osteopathic physicians who are called into this State, other
163	163	than on a regular basis, for consultation or assistance to a physician
164	164	licensed in this State, and who are legally qualified to practice in the
165	165	state where they reside.
166	166	(d) Osteopathic physicians who are temporarily exempt from
167	167	licensure pursuant to NRS 633.420 and are practicing osteopathic
168	168	medicine within the scope of the exemption.
169	169	(e) The performance of medical services by a student enrolled in
170	170	an educational program for a physician assistant which is accredited
171	171	by the Accreditation Review Commission on Education for the
172	172	Physician Assistant, Inc., or its successor organization, as part of
173	173	such a program.
174	174	(f) A physician assistant of any division or department of the
175	175	United States in the discharge of his or her official duties unless
176	176	licensure by a state is required by the division or department of the
177	177	United States.
178	178	(g) Any person permitted to practice any other healing art
179	179	under this title who does so within the scope of that authority.
180	180	2. This chapter does not repeal or affect any law of this State
181	181	regulating or affecting any other healing art.
182	182	3. This chapter does not prohibit:
183	183	(a) Gratuitous services of a person in cases of emergency.
184	184	(b) The domestic administration of family remedies.
185	185	Sec. 4. NRS 635.015 is hereby amended to read as follows:
186	186	635.015 1. This chapter does not apply:
187	187	(a) To commissioned surgeons of the United States Army, Navy
188	188	or Marine Hospital Service in the actual performance of their
189	189	official duties, including, without limitation, providing medical care
190	190	in a hospital in accordance with an agreement entered into pursuant
191	191	to NRS 449.2455.
192	192	(b) To physicians licensed in the State of Nevada.
193	193	(c) To any person permitted to practice any other healing art
194	194	under this title who does so within the scope of that authority.
195	195	2. This chapter does not prohibit the manufacture,
196	196	recommendation, advertisement, demonstration or sale of arch-
197	197	support shoes, foot appliances or remedies by retail dealers.
198	198	– 5 –
199	199
200	200
201	201	- 82nd Session (2023)
202	202	3. As used in this section, “healing art” has the meaning
203	203	ascribed to it in NRS 630.0122.
204	204	Sec. 5. NRS 636.027 is hereby amended to read as follows:
205	205	636.027 This chapter:
206	206	1. Applies to any person who is licensed to practice optometry
207	207	pursuant to this chapter and any other person engaged in the practice
208	208	of optometry in this State.
209	209	2. Must not be construed to apply to [physicians] :
210	210	(a) Physicians and surgeons duly licensed to practice in this
211	211	State.
212	212	(b) Any person permitted to practice any other healing art
213	213	under this title who does so within the scope of that authority.
214	214	3. As used in this section, “healing art” has the meaning
215	215	ascribed to it in NRS 630.0122.
216	216	Sec. 5.1. NRS 639.0125 is hereby amended to read as follows:
217	217	639.0125 “Practitioner” means:
218	218	1. A physician, dentist, veterinarian or podiatric physician who
219	219	holds a license to practice his or her profession in this State;
220	220	2. A hospital, pharmacy or other institution licensed, registered
221	221	or otherwise permitted to distribute, dispense, conduct research with
222	222	respect to or administer drugs in the course of professional practice
223	223	or research in this State;
224	224	3. An advanced practice registered nurse who has been
225	225	authorized to prescribe controlled substances, poisons, dangerous
226	226	drugs and devices;
227	227	4. A physician assistant who:
228	228	(a) Holds a license issued by the Board of Medical Examiners;
229	229	and
230	230	(b) Is authorized by the Board to possess, administer, prescribe
231	231	or dispense controlled substances, poisons, dangerous drugs or
232	232	devices under the supervision of a physician as required by chapter
233	233	630 of NRS;
234	234	5. A physician assistant who:
235	235	(a) Holds a license issued by the State Board of Osteopathic
236	236	Medicine; and
237	237	(b) Is authorized by the Board to possess, administer, prescribe
238	238	or dispense controlled substances, poisons, dangerous drugs or
239	239	devices under the supervision of an osteopathic physician as
240	240	required by chapter 633 of NRS; or
241	241	6. An optometrist who is certified by the Nevada State Board
242	242	of Optometry to prescribe and administer pharmaceutical agents
243	243	pursuant to NRS 636.288, when the optometrist prescribes or
244	244	– 6 –
245	245
246	246
247	247	- 82nd Session (2023)
248	248	administers pharmaceutical agents within the scope of his or her
249	249	certification.
250	250	7. A certified registered nurse anesthetist who orders,
251	251	prescribes, possesses or administers controlled substances,
252	252	poisons, dangerous drugs or devices in accordance with section
253	253	2.6 of this act.
254	254	Sec. 5.2. Chapter 453 of NRS is hereby amended by adding
255	255	thereto a new section to read as follows:
256	256	“Certified registered nurse anesthetist” has the meaning
257	257	ascribed to it in NRS 632.014.
258	258	Sec. 5.25. NRS 453.016 is hereby amended to read as follows:
259	259	453.016 As used in this chapter, the words and terms defined
260	260	in NRS 453.021 to 453.141, inclusive, and section 5.2 of this act
261	261	have the meanings ascribed to them in those sections except in
262	262	instances where the context clearly indicates a different meaning.
263	263	Sec. 5.3. NRS 453.038 is hereby amended to read as follows:
264	264	453.038 “Chart order” means an order entered on the chart of a
265	265	patient:
266	266	1. In a hospital, facility for intermediate care or facility for
267	267	skilled nursing which is licensed as such by the Division of Public
268	268	and Behavioral Health of the Department; or
269	269	2. Under emergency treatment in a hospital by a physician,
270	270	advanced practice registered nurse, certified registered nurse
271	271	anesthetist, dentist or podiatric physician, or on the written or oral
272	272	order of a physician, physician assistant licensed pursuant to chapter
273	273	630 or 633 of NRS, advanced practice registered nurse, certified
274	274	registered nurse anesthetist, dentist or podiatric physician
275	275	authorizing the administration of a drug to the patient.
276	276	Sec. 5.4. NRS 453.091 is hereby amended to read as follows:
277	277	453.091 1. “Manufacture” means the production, preparation,
278	278	propagation, compounding, conversion or processing of a substance,
279	279	either directly or indirectly by extraction from substances of natural
280	280	origin, or independently by means of chemical synthesis, or by a
281	281	combination of extraction and chemical synthesis, and includes any
282	282	packaging or repackaging of the substance or labeling or relabeling
283	283	of its container.
284	284	2. “Manufacture” does not include the preparation,
285	285	compounding, packaging or labeling of a substance by a pharmacist,
286	286	physician, physician assistant licensed pursuant to chapter 630 or
287	287	633 of NRS, dentist, podiatric physician, advanced practice
288	288	registered nurse , certified registered nurse anesthetist or
289	289	veterinarian:
290	290	– 7 –
291	291
292	292
293	293	- 82nd Session (2023)
294	294	(a) As an incident to the administering or dispensing of a
295	295	substance in the course of his or her professional practice; or
296	296	(b) By an authorized agent under his or her supervision, for the
297	297	purpose of, or as an incident to, research, teaching or chemical
298	298	analysis and not for sale.
299	299	Sec. 5.5. NRS 453.126 is hereby amended to read as follows:
300	300	453.126 “Practitioner” means:
301	301	1. A physician, dentist, veterinarian or podiatric physician who
302	302	holds a license to practice his or her profession in this State and is
303	303	registered pursuant to this chapter.
304	304	2. An advanced practice registered nurse who holds a
305	305	certificate from the State Board of Pharmacy authorizing him or her
306	306	to dispense or to prescribe and dispense controlled substances.
307	307	3. A scientific investigator or a pharmacy, hospital or other
308	308	institution licensed, registered or otherwise authorized in this State
309	309	to distribute, dispense, conduct research with respect to, to
310	310	administer, or use in teaching or chemical analysis, a controlled
311	311	substance in the course of professional practice or research.
312	312	4. A euthanasia technician who is licensed by the Nevada State
313	313	Board of Veterinary Medical Examiners and registered pursuant to
314	314	this chapter, while he or she possesses or administers sodium
315	315	pentobarbital pursuant to his or her license and registration.
316	316	5. A physician assistant who:
317	317	(a) Holds a license from the Board of Medical Examiners; and
318	318	(b) Is authorized by the Board to possess, administer, prescribe
319	319	or dispense controlled substances under the supervision of a
320	320	physician as required by chapter 630 of NRS.
321	321	6. A physician assistant who:
322	322	(a) Holds a license from the State Board of Osteopathic
323	323	Medicine; and
324	324	(b) Is authorized by the Board to possess, administer, prescribe
325	325	or dispense controlled substances under the supervision of an
326	326	osteopathic physician as required by chapter 633 of NRS.
327	327	7. An optometrist who is certified by the Nevada State Board
328	328	of Optometry to prescribe and administer pharmaceutical agents
329	329	pursuant to NRS 636.288, when the optometrist prescribes or
330	330	administers pharmaceutical agents within the scope of his or her
331	331	certification.
332	332	8. A certified registered nurse anesthetist who orders,
333	333	prescribes, possesses or administers controlled substances in
334	334	accordance with section 2.6 of this act.
335	335	Sec. 5.6. NRS 453.128 is hereby amended to read as follows:
336	336	453.128 1. “Prescription” means:
337	337	– 8 –
338	338
339	339
340	340	- 82nd Session (2023)
341	341	(a) An order given individually for the person for whom
342	342	prescribed, directly from a physician, physician assistant licensed
343	343	pursuant to chapter 630 or 633 of NRS, dentist, podiatric physician,
344	344	optometrist, advanced practice registered nurse , certified registered
345	345	nurse anesthetist or veterinarian, or his or her agent, to a pharmacist
346	346	or indirectly by means of an order signed by the practitioner or an
347	347	electronic transmission from the practitioner to a pharmacist; or
348	348	(b) A chart order written for an inpatient specifying drugs which
349	349	he or she is to take home upon his or her discharge.
350	350	2. The term does not include a chart order written for an
351	351	inpatient for use while he or she is an inpatient.
352	352	Sec. 5.7. NRS 453.226 is hereby amended to read as follows:
353	353	453.226 1. Every practitioner or other person who dispenses
354	354	any controlled substance within this State or who proposes to
355	355	engage in the dispensing of any controlled substance within this
356	356	State shall obtain biennially a registration issued by the Board in
357	357	accordance with its regulations. A person must present proof that he
358	358	or she is authorized to access the database of the program
359	359	established pursuant to NRS 453.162 before the Board may issue or
360	360	renew a registration.
361	361	2. A person registered by the Board in accordance with the
362	362	provisions of NRS 453.011 to 453.552, inclusive, and section 5.2 of
363	363	this act to dispense or conduct research with controlled substances
364	364	may possess, dispense or conduct research with those substances to
365	365	the extent authorized by the registration and in conformity with the
366	366	other provisions of those sections.
367	367	3. The following persons are not required to register and may
368	368	lawfully possess and distribute controlled substances pursuant to the
369	369	provisions of NRS 453.011 to 453.552, inclusive [:] , and section
370	370	5.2 of this act:
371	371	(a) An agent or employee of a registered dispenser of a
372	372	controlled substance if he or she is acting in the usual course of his
373	373	or her business or employment;
374	374	(b) A common or contract carrier or warehouseman, or an
375	375	employee thereof, whose possession of any controlled substance is
376	376	in the usual course of business or employment;
377	377	(c) An ultimate user or a person in possession of any controlled
378	378	substance pursuant to a lawful order of a physician, physician
379	379	assistant licensed pursuant to chapter 630 or 633 of NRS, dentist,
380	380	advanced practice registered nurse, certified registered nurse
381	381	anesthetist, podiatric physician or veterinarian or in lawful
382	382	possession of a schedule V substance; or
383	383	(d) A physician who:
384	384	– 9 –
385	385
386	386
387	387	- 82nd Session (2023)
388	388	(1) Holds a locum tenens license issued by the Board of
389	389	Medical Examiners or a temporary license issued by the State Board
390	390	of Osteopathic Medicine; and
391	391	(2) Is registered with the Drug Enforcement Administration
392	392	at a location outside this State.
393	393	4. The Board may waive the requirement for registration of
394	394	certain dispensers if it finds it consistent with the public health and
395	395	safety.
396	396	5. A separate registration is required at each principal place of
397	397	business or professional practice where the applicant dispenses
398	398	controlled substances.
399	399	6. The Board may inspect the establishment of a registrant or
400	400	applicant for registration in accordance with the Board’s regulations.
401	401	Sec. 5.75. NRS 453.336 is hereby amended to read as follows:
402	402	453.336 1. Except as otherwise provided in subsection 6, a
403	403	person shall not knowingly or intentionally possess a controlled
404	404	substance, unless the substance was obtained directly from, or
405	405	pursuant to, a prescription or order of a physician, physician
406	406	assistant licensed pursuant to chapter 630 or 633 of NRS, dentist,
407	407	podiatric physician, optometrist, advanced practice registered nurse ,
408	408	certified registered nurse anesthetist or veterinarian while acting in
409	409	the course of his or her professional practice, or except as otherwise
410	410	authorized by the provisions of NRS 453.005 to 453.552, inclusive
411	411	[.] , and section 5.2 of this act.
412	412	2. Except as otherwise provided in subsections 3, 4 and 5 and
413	413	in NRS 453.3363, and unless a greater penalty is provided in NRS
414	414	212.160, 453.3385 or 453.339, a person who violates this section:
415	415	(a) For a first or second offense, if the controlled substance is
416	416	listed in schedule I or II and the quantity possessed is less than 14
417	417	grams, or if the controlled substance is listed in schedule III, IV or V
418	418	and the quantity possessed is less than 28 grams, is guilty of
419	419	possession of a controlled substance and shall be punished for a
420	420	category E felony as provided in NRS 193.130. In accordance with
421	421	NRS 176.211, the court shall defer judgment upon the consent of the
422	422	person.
423	423	(b) For a third or subsequent offense, if the controlled substance
424	424	is listed in schedule I or II and the quantity possessed is less than 14
425	425	grams, or if the controlled substance is listed in schedule III, IV or V
426	426	and the quantity possessed is less than 28 grams, or if the offender
427	427	has previously been convicted two or more times in the aggregate of
428	428	any violation of the law of the United States or of any state, territory
429	429	or district relating to a controlled substance, is guilty of possession
430	430	of a controlled substance and shall be punished for a category D
431	431	– 10 –
432	432
433	433
434	434	- 82nd Session (2023)
435	435	felony as provided in NRS 193.130, and may be further punished by
436	436	a fine of not more than $20,000.
437	437	(c) If the controlled substance is listed in schedule I or II and the
438	438	quantity possessed is 14 grams or more, but less than 28 grams, or if
439	439	the controlled substance is listed in schedule III, IV or V and the
440	440	quantity possessed is 28 grams or more, but less than 200 grams, is
441	441	guilty of low-level possession of a controlled substance and shall be
442	442	punished for a category C felony as provided in NRS 193.130.
443	443	(d) If the controlled substance is listed in schedule I or II and the
444	444	quantity possessed is 28 grams or more, but less than 42 grams, or if
445	445	the controlled substance is listed in schedule III, IV or V and the
446	446	quantity possessed is 200 grams or more, is guilty of mid-level
447	447	possession of a controlled substance and shall be punished for a
448	448	category B felony by imprisonment in the state prison for a
449	449	minimum term of not less than 1 year and a maximum term of not
450	450	more than 10 years and by a fine of not more than $50,000.
451	451	(e) If the controlled substance is listed in schedule I or II and the
452	452	quantity possessed is 42 grams or more, but less than 100 grams, is
453	453	guilty of high-level possession of a controlled substance and shall be
454	454	punished for a category B felony by imprisonment in the state prison
455	455	for a minimum term of not less than 2 years and a maximum term of
456	456	not more than 15 years and by a fine of not more than $50,000.
457	457	3. Unless a greater penalty is provided in NRS 212.160,
458	458	453.337 or 453.3385, a person who is convicted of the possession of
459	459	flunitrazepam or gamma-hydroxybutyrate, or any substance for
460	460	which flunitrazepam or gamma-hydroxybutyrate is an immediate
461	461	precursor, is guilty of a category B felony and shall be punished by
462	462	imprisonment in the state prison for a minimum term of not less
463	463	than 1 year and a maximum term of not more than 6 years.
464	464	4. Unless a greater penalty is provided pursuant to NRS
465	465	212.160, a person who is convicted of the possession of 1 ounce or
466	466	less of marijuana is guilty of a misdemeanor and shall be punished
467	467	by:
468	468	(a) Performing not more than 24 hours of community service;
469	469	(b) Attending the live meeting described in paragraph (a) of
470	470	subsection 2 of NRS 484C.530 and complying with any other
471	471	requirements set forth in that section; or
472	472	(c) Being required to undergo an evaluation in accordance with
473	473	subsection 1 of NRS 484C.350,
474	474	 or any combination thereof.
475	475	5. Unless a greater penalty is provided pursuant to NRS
476	476	212.160, a person who is convicted of the possession of more than 1
477	477	ounce, but less than 50 pounds, of marijuana or more than
478	478	– 11 –
479	479
480	480
481	481	- 82nd Session (2023)
482	482	one-eighth of an ounce, but less than one pound, of concentrated
483	483	cannabis is guilty of a category E felony and shall be punished as
484	484	provided in NRS 193.130.
485	485	6. It is not a violation of this section if a person possesses a
486	486	trace amount of a controlled substance and that trace amount is in or
487	487	on a hypodermic device obtained from a sterile hypodermic device
488	488	program pursuant to NRS 439.985 to 439.994, inclusive.
489	489	7. The court may grant probation to or suspend the sentence of
490	490	a person convicted of violating this section.
491	491	8. If a person fulfills the terms and conditions imposed for a
492	492	violation of subsection 4, the court shall, without a hearing, order
493	493	sealed all documents, papers and exhibits in that person’s record,
494	494	minute book entries and entries on dockets, and other documents
495	495	relating to the case in the custody of such other agencies and
496	496	officers as are named in the court’s order. The court shall cause a
497	497	copy of the order to be sent to each agency or officer named in the
498	498	order. Each such agency or officer shall notify the court in writing
499	499	of its compliance with the order.
500	500	9. As used in this section:
501	501	(a) “Controlled substance” includes flunitrazepam, gamma-
502	502	hydroxybutyrate and each substance for which flunitrazepam or
503	503	gamma-hydroxybutyrate is an immediate precursor.
504	504	(b) “Marijuana” does not include concentrated cannabis.
505	505	(c) “Sterile hypodermic device program” has the meaning
506	506	ascribed to it in NRS 439.986.
507	507	Sec. 5.8. NRS 453.381 is hereby amended to read as follows:
508	508	453.381 1. In addition to the limitations imposed by NRS
509	509	453.256 and 453.3611 to 453.3648, inclusive, a physician, physician
510	510	assistant, dentist, advanced practice registered nurse , certified
511	511	registered nurse anesthetist or podiatric physician may prescribe or
512	512	administer controlled substances only for a legitimate medical
513	513	purpose and in the usual course of his or her professional practice,
514	514	and he or she shall not prescribe, administer or dispense a controlled
515	515	substance listed in schedule II for himself or herself, his or her
516	516	spouse or his or her children except in cases of emergency.
517	517	2. A veterinarian, in the course of his or her professional
518	518	practice only, and not for use by a human being, may prescribe,
519	519	possess and administer controlled substances, and the veterinarian
520	520	may cause them to be administered by a veterinary technician under
521	521	the direction and supervision of the veterinarian.
522	522	3. A euthanasia technician, within the scope of his or her
523	523	license, and not for use by a human being, may possess and
524	524	administer sodium pentobarbital.
525	525	– 12 –
526	526
527	527
528	528	- 82nd Session (2023)
529	529	4. A pharmacist shall not fill an order which purports to be a
530	530	prescription if the pharmacist has reason to believe that it was not
531	531	issued in the usual course of the professional practice of a physician,
532	532	physician assistant, dentist, advanced practice registered nurse,
533	533	certified registered nurse anesthetist, podiatric physician or
534	534	veterinarian.
535	535	5. Any person who has obtained from a physician, physician
536	536	assistant, dentist, advanced practice registered nurse, certified
537	537	registered nurse anesthetist, podiatric physician or veterinarian any
538	538	controlled substance for administration to a patient during the
539	539	absence of the physician, physician assistant, dentist, advanced
540	540	practice registered nurse, certified registered nurse anesthetist,
541	541	podiatric physician or veterinarian shall return to him or her any
542	542	unused portion of the substance when it is no longer required by the
543	543	patient.
544	544	6. A manufacturer, wholesale supplier or other person legally
545	545	able to furnish or sell any controlled substance listed in schedule II
546	546	shall not provide samples of such a controlled substance to
547	547	registrants.
548	548	7. A salesperson of any manufacturer or wholesaler of
549	549	pharmaceuticals shall not possess, transport or furnish any
550	550	controlled substance listed in schedule II.
551	551	8. A person shall not dispense a controlled substance in
552	552	violation of a regulation adopted by the Board.
553	553	Sec. 5.85. NRS 453.391 is hereby amended to read as follows:
554	554	453.391 A person shall not:
555	555	1. Unlawfully take, obtain or attempt to take or obtain a
556	556	controlled substance or a prescription for a controlled substance
557	557	from a manufacturer, wholesaler, pharmacist, physician, physician
558	558	assistant, dentist, advanced practice registered nurse, certified
559	559	registered nurse anesthetist, veterinarian or any other person
560	560	authorized to administer, dispense or possess controlled substances.
561	561	2. While undergoing treatment and being supplied with any
562	562	controlled substance or a prescription for any controlled substance
563	563	from one practitioner, knowingly obtain any controlled substance or
564	564	a prescription for a controlled substance from another practitioner
565	565	without disclosing this fact to the second practitioner.
566	566	Sec. 5.9. NRS 454.00958 is hereby amended to read as
567	567	follows:
568	568	454.00958 “Practitioner” means:
569	569	1. A physician, dentist, veterinarian or podiatric physician who
570	570	holds a valid license to practice his or her profession in this State.
571	571	– 13 –
572	572
573	573
574	574	- 82nd Session (2023)
575	575	2. A pharmacy, hospital or other institution licensed or
576	576	registered to distribute, dispense, conduct research with respect to or
577	577	to administer a dangerous drug in the course of professional practice
578	578	in this State.
579	579	3. When relating to the prescription of poisons, dangerous
580	580	drugs and devices:
581	581	(a) An advanced practice registered nurse who holds a certificate
582	582	from the State Board of Pharmacy permitting him or her so to
583	583	prescribe; or
584	584	(b) A physician assistant who holds a license from the Board of
585	585	Medical Examiners and a certificate from the State Board of
586	586	Pharmacy permitting him or her so to prescribe.
587	587	4. An optometrist who is certified to prescribe and administer
588	588	pharmaceutical agents pursuant to NRS 636.288 when the
589	589	optometrist prescribes or administers dangerous drugs which are
590	590	within the scope of his or her certification.
591	591	5. A certified registered nurse anesthetist who orders,
592	592	prescribes, possesses or administers poisons, dangerous drugs or
593	593	devices in accordance with section 2.6 of this act.
594	594	Sec. 6. 1. The provisions of NRS 631.115, 633.171, 635.015
595	595	and 636.027, as amended by sections 1, 3, 4 and 5 of this act,
596	596	respectively, and section 2.2 of this act apply to any conduct that:
597	597	(a) Occurred before, on or after the effective date of this section;
598	598	and
599	599	(b) Has not been the subject of a final order of a regulatory
600	600	body.
601	601	2. A regulatory body shall terminate any investigation or
602	602	disciplinary proceedings:
603	603	(a) Against a person permitted to practice any healing art under
604	604	title 54 of NRS for conduct outside the scope of the regulatory body;
605	605	or
606	606	(b) Which are otherwise inconsistent with the amendatory
607	607	provisions of this act.
608	608	3. As used in this section:
609	609	(a) “Healing art” has the meaning ascribed to it in
610	610	NRS 630.0122.
611	611	(b) “Regulatory body” means the Board of Dental Examiners of
612	612	Nevada, the State Board of Nursing, the State Board of Osteopathic
613	613	Medicine, the State Board of Podiatry and the Nevada State Board
614	614	of Optometry.
615	615	Sec. 7. 1. This section and sections 1, 2, 2.2, 3, 4, 5 and 6 of
616	616	this act become effective upon passage and approval.
617	617	– 14 –
618	618
619	619
620	620	- 82nd Session (2023)
621	621	2. Sections 2.4, 2.6, 2.8 and 5.1 to 5.9, inclusive, of this act
622	622	become effective:
623	623	(a) Upon passage and approval for the purpose of adopting any
624	624	regulations and performing any other preparatory administrative
625	625	tasks that are necessary to carry out the provisions of this act; and
626	626	(b) On January 1, 2024, for all other purposes.
627	627
628	628	20 ~~~~~ 23
629	629
630	630
631	631
632	632
633	633