REQUIRES TWO-THIRDS MAJORITY VOTE (§ 2)
S.B. 97
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SENATE BILL NO. 97–SENATOR SEEVERS GANSERT
PREFILED FEBRUARY 2, 2023
____________
Referred to Committee on Commerce and Labor
SUMMARY—Enacts provisions governing the interstate practice of
physical therapy. (BDR 54-402)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Yes.
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to physical therapy; enacting and entering into the
Physical Therapy Licensure Compact; and providing
other matters properly relating thereto.
Legislative Counsel’s Digest:
The Physical Therapy Licensure Compact is an interstate compact that allows a 1
person who is licensed as a physical therapist or physical therapist assistant in a 2
state that is a member of the Compact to practice as a physical therapist or physical 3
therapist assistant in other states that are members of the Compact. In order to 4
practice as a physical therapist or physical therapist assistant under the Compact, 5
the Compact requires a physical therapist or physical therapist assistant to: (1) hold 6
a license in his or her home state; (2) have no encumbrances on his or her license; 7
(3) be eligible to practice under the Compact; (4) have had no adverse actions taken 8
against any license or authority to practice under the Compact within the previous 2 9
years; (5) notify the Physical Therapy Compact Commission that he or she is 10
seeking to practice under the Compact in another state; (6) pay any applicable fees; 11
(7) meet any requirements in the state in which he or she seeks to practice under the 12
Compact; and (8) report any adverse action taken against him or her within 30 days 13
after the date the adverse action is taken. The Compact authorizes a member state to 14
take adverse action against a physical therapist or physical therapist assistant 15
practicing in the member state under the Compact. The Compact requires member 16
states to create and establish a joint public agency called the Physical Therapy 17
Compact Commission. The Commission is required to: (1) establish bylaws; (2) 18
make rules that facilitate and coordinate implementation and administration of the 19
Compact; (3) hold meetings, which may be closed under certain conditions; (4) 20
develop, maintain and use a coordinated database and reporting system; and (5) 21
resolve disputes related to the Compact among states that are members of the 22
Compact. The Commission is additionally authorized to levy and collect an annual 23
assessment from each state that is a member of the Compact. Section 2 of this bill 24
enacts the Physical Therapy Licensure Compact, thereby joining Nevada as a 25
member state. 26
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Section 3 of this bill deems practicing as a physical therapist or physical 27
therapist assistant under the Compact to be equivalent to practicing under a license 28
issued by the Nevada Physical Therapy Board. Section 4 of this bill requires a 29
physical therapist practicing under the Compact to display proof that he or she is 30
authorized to practice under the Compact in the same manner as a licensed physical 31
therapist is required to display his or her license. Sections 5-12 of this bill replace 32
the term “registered physical therapist” with the term “licensed physical therapist” 33
to reflect current terminology used in existing law governing the practice of 34
physical therapy and this bill. 35
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 640 of NRS is hereby amended by adding 1
thereto the provisions set forth as sections 2 and 3 of this act. 2
Sec. 2. The Physical Therapy Licensure Compact, set forth 3
in this section, is hereby enacted into law and entered into with all 4
other jurisdictions legally joining the Compact, in substantially the 5
form set forth in this section: 6
7
PHYSICAL THERAPY LICENSURE COMPACT 8
9
ARTICLE 1. PURPOSE 10
11
The purpose of this Compact is to facilitate interstate practice 12
of physical therapy with the goal of improving public access to 13
physical therapy services. The practice of physical therapy occurs 14
in the state where the patient/client is located at the time of the 15
patient/client encounter. The Compact preserves the regulatory 16
authority of states to protect public health and safety through the 17
current system of state licensure. 18
This Compact is designed to achieve the following objectives: 19
1. Increase public access to physical therapy services by 20
providing for the mutual recognition of other member state 21
licenses; 22
2. Enhance the states’ ability to protect the public’s health 23
and safety; 24
3. Encourage the cooperation of member states in regulating 25
multistate physical therapy practice; 26
4. Support spouses of relocating military members; 27
5. Enhance the exchange of licensure, investigative and 28
disciplinary information between member states; and 29
6. Allow a remote state to hold a provider of services with a 30
compact privilege in that state accountable to that state’s practice 31
standards. 32
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ARTICLE 2. DEFINITIONS 1
2
As used in this Compact, and except as otherwise provided, the 3
following definitions shall apply: 4
1. “Active Duty Military” means full-time duty status in the 5
active uniformed service of the United States, including, without 6
limitation, members of the National Guard and Reserve on active 7
duty orders pursuant to 10 U.S.C. Section 1209 and 1211. 8
2. “Adverse Action” means disciplinary action taken by a 9
physical therapy licensing board based upon misconduct, 10
unacceptable performance or a combination of both. 11
3. “Alternative Program” means a nondisciplinary 12
monitoring or practice remediation process approved by a physical 13
therapy licensing board. This includes, but is not limited to, 14
substance abuse issues. 15
4. “Compact privilege” means the authorization granted by a 16
remote state to allow a licensee from another member state to 17
practice as a physical therapist or work as a physical therapist 18
assistant in the remote state under its laws and rules. The practice 19
of physical therapy occurs in the member state where the 20
patient/client is located at the time of the patient/client encounter. 21
5. “Continuing competence” means a requirement, as a 22
condition of license renewal, to provide evidence of participation 23
in, and/or completion of, educational and professional activities 24
relevant to practice or area of work. 25
6. “Data system” means a repository of information about 26
licensees, including examination, licensure, investigative, compact 27
privilege and adverse action. 28
7. “Encumbered license” means a license that a physical 29
therapy licensing board has limited in any way. 30
8. “Executive Board” means a group of directors elected or 31
appointed to act on behalf of, and within the powers granted to 32
them by, the Commission. 33
9. “Home state” means the member state that is the licensee’s 34
primary state of residence. 35
10. “Investigative information” means information, records 36
and documents received or generated by a physical therapy 37
licensing board pursuant to an investigation. 38
11. “Jurisprudence Requirement” means the assessment of 39
an individual’s knowledge of the laws and rules governing the 40
practice of physical therapy in a state. 41
12. “Licensee” means an individual who currently holds an 42
authorization from the state to practice as a physical therapist or 43
to work as a physical therapist assistant. 44
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13. “Member state” means a state that has enacted the 1
Compact. 2
14. “Party state” means any member state in which a licensee 3
holds a current license or compact privilege or is applying for a 4
license or compact privilege. 5
15. “Physical therapist” means an individual who is licensed 6
by a state to practice physical therapy. 7
16. “Physical therapist assistant” means an individual who is 8
licensed/certified by a state and who assists the physical therapist 9
in selected components of physical therapy. 10
17. “Physical therapy,” “physical therapy practice” and “the 11
practice of physical therapy” mean the care and services provided 12
by or under the direction and supervision of a licensed physical 13
therapist. 14
18. “Physical Therapy Compact Commission” or 15
“Commission” means the national administrative body whose 16
membership consists of all states that have enacted the Compact. 17
19. “Physical therapy licensing board” or “licensing board” 18
means the agency of a state that is responsible for the licensing 19
and regulation of physical therapists and physical therapist 20
assistants. 21
20. “Remote State” means a member state, other than the 22
home state, where a licensee is exercising or seeking to exercise 23
the compact privilege. 24
21. “Rule” means a regulation, principle or directive 25
promulgated by the Commission that has the force of law. 26
22. “State” means any state, commonwealth, district or 27
territory of the United States of America that regulates the practice 28
of physical therapy. 29
30
ARTICLE 3. STATE PARTICIPATION IN THE COMPACT 31
32
A. To participate in the Compact, a state must: 33
1. Participate fully in the Commission’s data system, 34
including using the Commission’s unique identifier as defined in 35
rules; 36
2. Have a mechanism in place for receiving and investigating 37
complaints about licensees; 38
3. Notify the Commission, in compliance with the terms of the 39
Compact and rules, of any adverse action or the availability of 40
investigative information regarding a licensee; 41
4. Fully implement a criminal background check 42
requirement, within a time frame established by rule, by receiving 43
the results of the Federal Bureau of Investigation record search 44
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on criminal background checks and use the results in making 1
licensure decisions in accordance with Article 3B; 2
5. Comply with the rules of the Commission; 3
6. Utilize a recognized national examination as a requirement 4
for licensure pursuant to the rules of the Commission; and 5
7. Have continuing competence requirements as a condition 6
for license renewal. 7
B. Upon adoption of this Compact, the member state shall 8
have the authority to obtain biometric-based information from 9
each physical therapy licensure applicant and submit this 10
information to the Federal Bureau of Investigation for a criminal 11
background check in accordance with 28 U.S.C. § 534 and 34 12
U.S.C. § 40316. 13
C. A member state shall grant the compact privilege to a 14
licensee holding a valid unencumbered license in another member 15
state in accordance with the terms of the Compact and rules. 16
D. Member states may charge a fee for granting a compact 17
privilege. 18
19
ARTICLE 4. COMPACT PRIVILEGE 20
21
A. To exercise the compact privilege under the terms and 22
provisions of the Compact, the licensee shall: 23
1. Hold a license in the home state; 24
2. Have no encumbrance on any state license; 25
3. Be eligible for a compact privilege in any member state in 26
accordance with Article 4D, G and H; 27
4. Have not had any adverse action against any license or 28
compact privilege within the previous 2 years; 29
5. Notify the Commission that the licensee is seeking the 30
compact privilege within a remote state(s); 31
6. Pay any applicable fees, including any state fee, for the 32
compact privilege; 33
7. Meet any jurisprudence requirements established by the 34
remote state(s) in which the licensee is seeking a compact 35
privilege; and 36
8. Report to the Commission adverse action taken by any 37
nonmember state within 30 days from the date the adverse action 38
is taken. 39
B. The compact privilege is valid until the expiration date of 40
the home license. The licensee must comply with the requirements 41
of Article 4A to maintain the compact privilege in the remote state. 42
C. A licensee providing physical therapy in a remote state 43
under the compact privilege shall function within the laws and 44
regulations of the remote state. 45
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D. A licensee providing physical therapy in a remote state is 1
subject to that state’s regulatory authority. A remote state may, in 2
accordance with due process and that state’s laws, remove a 3
licensee’s compact privilege in the remote state for a specific 4
period of time, impose fines and/or take any other necessary 5
actions to protect the health and safety of its citizens. The licensee 6
is not eligible for a compact privilege in any state until the specific 7
time for removal has passed and all fines are paid. 8
E. If a home state license is encumbered, the licensee shall 9
lose the compact privilege in any remote state until the following 10
occur: 11
1. The home state license is no longer encumbered; and 12
2. Two years have elapsed from the date of the adverse 13
action. 14
F. Once an encumbered license in the home state is restored 15
to good standing, the licensee must meet the requirements of 16
Article 4A to obtain a compact privilege in any remote state. 17
G. If a licensee’s compact privilege in any remote state is 18
removed, the individual shall lose the compact privilege in any 19
remote state until the following occur: 20
1. The specific period of time for which the compact privilege 21
was removed has ended; 22
2. All fines have been paid; and 23
3. Two years have elapsed from the date of the adverse 24
action. 25
H. Once the requirements of Article 4G have been met, the 26
licensee must meet the requirements in Article 4A to obtain a 27
compact privilege in a remote state. 28
29
ARTICLE 5. ACTIVE DUTY MILITARY 30
PERSONNEL OR THEIR SPOUSES 31
32
A licensee who is active duty military or is the spouse of an 33
individual who is active duty military may designate one of the 34
following as the home state: 35
A. Home of record; 36
B. Permanent Change of Station (PCS); or 37
C. State of current residence if it is different from the PCS 38
state or home of record. 39
40
ARTICLE 6. ADVERSE ACTIONS 41
42
A. A home state shall have exclusive power to impose adverse 43
action against a license issued by the home state. 44
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B. A home state may take adverse action based on the 1
investigative information of a remote state, so long as the home 2
state follows its own procedures for imposing adverse action. 3
C. Nothing in this Compact shall override a member state’s 4
decision that participation in an alternative program may be used 5
in lieu of adverse action and that such participation shall remain 6
nonpublic if required by the member state’s laws. Member states 7
must require licensees who enter any alternative programs in lieu 8
of discipline to agree not to practice in any other member state 9
during the term of the alternative program without prior 10
authorization from such other member state. 11
D. Any member state may investigate actual or alleged 12
violations of the statutes and rules authorizing the practice of 13
physical therapy in any other member state in which a physical 14
therapist or physical therapist assistant holds a license or compact 15
privilege. 16
E. A remote state shall have the authority to: 17
1. Take adverse actions as set forth in Article 4D against a 18
licensee’s compact privilege in the state; 19
2. Issue subpoenas for both hearings and investigations that 20
require the attendance and testimony of witnesses and the 21
production of evidence. Subpoenas issued by a physical therapy 22
licensing board in a party state for the attendance and testimony 23
of witnesses and/or the production of evidence from another party 24
state shall be enforced in the latter state by any court of competent 25
jurisdiction, according to the practice and procedure of that court 26
applicable to subpoenas issued in proceedings pending before it. 27
The issuing authority shall pay any witness fees, travel expenses, 28
mileage and other fees required by the service statutes of the state 29
where the witnesses and/or evidence are located; and 30
3. If otherwise permitted by state law, recover from the 31
licensee the costs of investigations and disposition of cases 32
resulting from any adverse action taken against that licensee. 33
F. Joint Investigations 34
1. In addition to the authority granted to a member state by 35
its respective physical therapy practice act or other applicable state 36
law, a member state may participate with other member states in 37
joint investigations of licensees. 38
2. Member states shall share any investigative, litigation or 39
compliance materials in furtherance of any joint or individual 40
investigation initiated under the Compact. 41
42
ARTICLE 7. ESTABLISHMENT OF THE PHYSICAL 43
THERAPY COMPACT COMMISSION 44
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A. The Compact member states hereby create and establish a 1
joint public agency known as the Physical Therapy Compact 2
Commission: 3
1. The Commission is an instrumentality of the Compact 4
states. 5
2. Venue is proper and judicial proceedings by or against the 6
Commission shall be brought solely and exclusively in a court of 7
competent jurisdiction where the principal office of the 8
Commission is located. The Commission may waive venue and 9
jurisdictional defenses to the extent it adopts or consents to 10
participate in alternative dispute resolution proceedings. 11
3. Nothing in this Compact shall be construed to be a waiver 12
of sovereign immunity. 13
B. Membership, Voting and Meetings 14
1. Each member state shall have and be limited to one 15
delegate selected by that member state’s licensing board. 16
2. The delegate shall be a current member of the licensing 17
board, who is a physical therapist, physical therapist assistant, 18
public member or the board administrator. 19
3. Any delegate may be removed or suspended from office as 20
provided by the law of the state from which the delegate is 21
appointed. 22
4. The member state board shall fill any vacancy occurring in 23
the Commission. 24
5. Each delegate shall be entitled to one vote with regard to 25
the promulgation of rules and creation of bylaws and shall 26
otherwise have an opportunity to participate in the business and 27
affairs of the Commission. 28
6. A delegate shall vote in person or by such other means as 29
provided in the bylaws. The bylaws may provide for delegates’ 30
participation in meetings by telephone or other means of 31
communication. 32
7. The Commission shall meet at least once during each 33
calendar year. Additional meetings shall be held as set forth in the 34
bylaws. 35
C. The Commission shall have the following powers and 36
duties: 37
1. Establish the fiscal year of the Commission; 38
2. Establish bylaws; 39
3. Maintain its financial records in accordance with the 40
bylaws; 41
4. Meet and take such actions as are consistent with the 42
provisions of this Compact and the bylaws; 43
5. Promulgate uniform rules to facilitate and coordinate 44
implementation and administration of this Compact. The rules 45
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shall have the force and effect of law and shall be binding in all 1
member states; 2
6. Bring and prosecute legal proceedings or actions in the 3
name of the Commission, provided that the standing of any state 4
physical therapy licensing board to sue or be sued under 5
applicable law shall not be affected; 6
7. Purchase and maintain insurance and bonds; 7
8. Borrow, accept or contract for services of personnel, 8
including, but not limited to, employees of a member state; 9
9. Hire employees, elect or appoint officers, fix compensation, 10
define duties, grant such individuals appropriate authority to carry 11
out the purposes of the Compact and to establish the 12
Commission’s personnel policies and programs relating to 13
conflicts of interest, qualifications of personnel and other related 14
personnel matters; 15
10. Accept any and all appropriate donations and grants of 16
money, equipment, supplies, materials and services, and to receive, 17
utilize and dispose of the same; provided that at all times the 18
Commission shall avoid any appearance of impropriety and/or 19
conflict of interest; 20
11. Lease, purchase, accept appropriate gifts or donations of, 21
or otherwise to own, hold, improve or use, any property, real, 22
personal or mixed; provided that at all times the Commission shall 23
avoid any appearance of impropriety; 24
12. Sell, convey, mortgage, pledge, lease, exchange, abandon 25
or otherwise dispose of any property real, personal or mixed; 26
13. Establish a budget and make expenditures; 27
14. Borrow money; 28
15. Appoint committees, including standing committees 29
composed of members, state regulators, state legislators or their 30
representatives, and consumer representatives and such other 31
interested persons as may be designated in this Compact and the 32
bylaws; 33
16. Provide and receive information from, and cooperate 34
with, law enforcement agencies; 35
17. Establish and elect an Executive Board; and 36
18. Perform such other functions as may be necessary or 37
appropriate to achieve the purposes of this Compact consistent 38
with the state regulation of physical therapy licensure and 39
practice. 40
D. The Executive Board 41
The Executive Board shall have the power to act on behalf of 42
the Commission according to the terms of this Compact: 43
1. The Executive Board shall be composed of nine members: 44
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a. Seven voting members who are elected by the 1
Commission from the current membership of the Commission; 2
b. One ex officio, nonvoting member from the recognized 3
national physical therapy professional association; and 4
c. One ex officio, nonvoting member from the recognized 5
membership organization of the physical therapy licensing boards. 6
2. The ex officio members will be selected by their respective 7
organizations. 8
3. The Commission may remove any member of the Executive 9
Board as provided in bylaws. 10
4. The Executive Board shall meet at least annually. 11
5. The Executive Board shall have the following duties and 12
responsibilities: 13
a. Recommend to the entire Commission changes to the 14
rules or bylaws, changes to this Compact legislation, fees paid by 15
Compact member states such as annual dues, and any 16
Commission Compact fee charged to licensees for the compact 17
privilege; 18
b. Ensure Compact administration services are 19
appropriately provided, contractual or otherwise; 20
c. Prepare and recommend the budget; 21
d. Maintain financial records on behalf of the Commission; 22
e. Monitor Compact compliance of member states and 23
provide compliance reports to the Commission; 24
f. Establish additional committees as necessary; and 25
g. Other duties as provided in rules or bylaws. 26
E. Meetings of the Commission 27
1. All meetings shall be open to the public, and public notice 28
of meetings shall be given in the same manner as required under 29
the rulemaking provisions in Article 9. 30
2. The Commission or the Executive Board or other 31
committees of the Commission may convene in a closed, nonpublic 32
meeting if the Commission or Executive Board or other 33
committees of the Commission must discuss: 34
a. Noncompliance of a member state with its obligations 35
under the Compact; 36
b. The employment, compensation, discipline or other 37
matters, practices or procedures related to specific employees or 38
other matters related to the Commission’s internal personnel 39
practices and procedures; 40
c. Current, threatened or reasonably anticipated litigation; 41
d. Negotiation of contracts for the purchase, lease or sale of 42
goods, services or real estate; 43
e. Accusing any person of a crime or formally censuring 44
any person; 45
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f. Disclosure of trade secrets or commercial or financial 1
information that is privileged or confidential; 2
g. Disclosure of information of a personal nature where 3
disclosure would constitute a clearly unwarranted invasion of 4
personal privacy; 5
h. Disclosure of investigative records compiled for law 6
enforcement purposes; 7
i. Disclosure of information related to any investigative 8
reports prepared by or on behalf of or for use of the Commission 9
or other committee charged with responsibility of investigation or 10
determination of compliance issues pursuant to the Compact; or 11
j. Matters specifically exempted from disclosure by federal 12
or member state statute. 13
3. If a meeting, or portion of a meeting, is closed pursuant to 14
this provision, the Commission’s legal counsel or designee shall 15
certify that the meeting may be closed and shall reference each 16
relevant exempting provision. 17
4. The Commission shall keep minutes that fully and clearly 18
describe all matters discussed in a meeting and shall provide a full 19
and accurate summary of actions taken, and the reasons 20
therefore, including a description of the views expressed. All 21
documents considered in connection with an action shall be 22
identified in such minutes. All minutes and documents of a closed 23
meeting shall remain under seal, subject to release by a majority 24
vote of the Commission or order of a court of competent 25
jurisdiction. 26
F. Financing of the Commission 27
1. The Commission shall pay, or provide for the payment of, 28
the reasonable expenses of its establishment, organization and 29
ongoing activities. 30
2. The Commission may accept any and all appropriate 31
revenue sources, donations and grants of money, equipment, 32
supplies, materials and services. 33
3. The Commission may levy on and collect an annual 34
assessment from each member state or impose fees on other 35
parties to cover the cost of the operations and activities of the 36
Commission and its staff, which must be in a total amount 37
sufficient to cover its annual budget as approved each year for 38
which revenue is not provided by other sources. The aggregate 39
annual assessment amount shall be allocated based upon a 40
formula to be determined by the Commission, which shall 41
promulgate a rule binding upon all member states. 42
4. The Commission shall not incur obligations of any kind 43
prior to securing the funds adequate to meet the same; nor shall 44
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the Commission pledge the credit of any of the member states, 1
except by and with the authority of the member state. 2
5. The Commission shall keep accurate accounts of all 3
receipts and disbursements. The receipts and disbursements of the 4
Commission shall be subject to the audit and accounting 5
procedures established under its bylaws. However, all receipts and 6
disbursements of funds handled by the Commission shall be 7
audited yearly by a certified or licensed public accountant, and the 8
report of the audit shall be included in and become part of the 9
annual report of the Commission. 10
G. Qualified Immunity, Defense and Indemnification 11
1. The members, officers, executive director, employees and 12
representatives of the Commission shall be immune from suit and 13
liability, either personally or in their official capacity, for any 14
claim for damage to or loss of property or personal injury or other 15
civil liability caused by or arising out of any actual or alleged act, 16
error or omission that occurred, or that the person against whom 17
the claim is made had a reasonable basis for believing occurred 18
within the scope of Commission employment, duties or 19
responsibilities; provided that nothing in this paragraph shall be 20
construed to protect any such person from suit and/or liability for 21
any damage, loss, injury or liability caused by the intentional or 22
willful or wanton misconduct of that person. 23
2. The Commission shall defend any member, officer, 24
executive director, employee or representative of the Commission 25
in any civil action seeking to impose liability arising out of any 26
actual or alleged act, error or omission that occurred within the 27
scope of Commission employment, duties or responsibilities, or 28
that the person against whom the claim is made had a reasonable 29
basis for believing occurred within the scope of Commission 30
employment, duties or responsibilities; provided that nothing 31
herein shall be construed to prohibit that person from retaining 32
his or her own counsel; and provided further, that the actual or 33
alleged act, error or omission did not result from that person’s 34
intentional or willful or wanton misconduct. 35
3. The Commission shall indemnify and hold harmless any 36
member, officer, executive director, employee or representative of 37
the Commission for the amount of any settlement or judgment 38
obtained against that person arising out of any actual or alleged 39
act, error or omission that occurred within the scope of 40
Commission employment, duties or responsibilities, or that such 41
person had a reasonable basis for believing occurred within the 42
scope of Commission employment, duties or responsibilities, 43
provided that the actual or alleged act, error or omission did not 44
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result from the intentional or willful or wanton misconduct of that 1
person. 2
4. Nothing in this Compact provides immunity from civil or 3
criminal liability for any act, error or omission from negligent 4
conduct or intentional misconduct by any physical therapist or 5
physical therapist assistant. 6
7
ARTICLE 8. DATA SYSTEM 8
9
A. The Commission shall provide for the development, 10
maintenance and utilization of a coordinated database and 11
reporting system containing licensure, adverse action and 12
investigative information on all licensed individuals in member 13
states. 14
B. Notwithstanding any other provision of state law to the 15
contrary, a member state shall submit a uniform data set to the 16
data system on all individuals to whom this Compact is applicable 17
as required by the rules of the Commission, including: 18
1. Identifying information; 19
2. Licensure data; 20
3. Adverse actions against a license or compact privilege; 21
4. Nonconfidential information related to alternative 22
program participation; 23
5. Any denial of application for licensure and the reason(s) 24
for such denial; and 25
6. Other information that may facilitate the administration of 26
this Compact, as determined by the rules of the Commission. 27
C. Investigative information pertaining to a licensee in any 28
member state will only be available to other party states. 29
D. The Commission shall promptly notify all member states 30
of any adverse action taken against a licensee or an individual 31
applying for a license. Adverse action information pertaining to a 32
licensee in any member state will be available to any other 33
member state. 34
E. Member states contributing information to the data system 35
may designate information that may not be shared with the public 36
without the express permission of the contributing state. 37
F. Any information submitted to the data system that is 38
subsequently required to be expunged by the laws of the member 39
state contributing the information shall be removed from the data 40
system. 41
42
ARTICLE 9. RULEMAKING 43
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A. The Commission shall exercise its rulemaking powers 1
pursuant to the criteria set forth in this article and the rules 2
adopted thereunder. Rules and amendments shall become binding 3
as of the date specified in each rule or amendment. 4
B. If a majority of the legislatures of the member states 5
rejects a rule by enactment of a statute or resolution in the same 6
manner used to adopt the Compact within 4 years of the date of 7
adoption of the rule, then such rule shall have no further force 8
and effect in any member state. 9
C. Rules or amendments to the rules shall be adopted at a 10
regular or special meeting of the Commission. 11
D. Prior to promulgation and adoption of a final rule or rules 12
by the Commission, and at least 30 days in advance of the meeting 13
at which the rule will be considered and voted upon, the 14
Commission shall file a Notice of Proposed Rulemaking: 15
1. On the website of the Commission or other publicly 16
accessible platform; and 17
2. On the website of each member state physical therapy 18
licensing board or other publicly accessible platform or the 19
publication in which each state would otherwise publish proposed 20
rules. 21
E. The Notice of Proposed Rulemaking shall include: 22
1. The proposed time, date and location of the meeting in 23
which the rule will be considered and voted upon; 24
2. The text of the proposed rule or amendment and the reason 25
for the proposed rule; 26
3. A request for comments on the proposed rule from any 27
interested person; and 28
4. The manner in which interested persons may submit notice 29
to the Commission of their intention to attend the public hearing 30
and any written comments. 31
F. Prior to adoption of a proposed rule, the Commission shall 32
allow persons to submit written data, facts, opinions and 33
arguments, which shall be made available to the public. 34
G. The Commission shall grant an opportunity for a public 35
hearing before it adopts a rule or amendment if a hearing is 36
requested by: 37
1. At least 25 persons; 38
2. A state or federal governmental subdivision or agency; or 39
3. An association having at least 25 members. 40
H. If a hearing is held on the proposed rule or amendment, 41
the Commission shall publish the place, time and date of the 42
scheduled public hearing. If the hearing is held via electronic 43
means, the Commission shall publish the mechanism for access to 44
the electronic hearing. 45
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1. All persons wishing to be heard at the hearing shall notify 1
the executive director of the Commission or other designated 2
member in writing of their desire to appear and testify at the 3
hearing not less than 5 business days before the scheduled date of 4
the hearing. 5
2. Hearings shall be conducted in a manner providing each 6
person who wishes to comment a fair and reasonable opportunity 7
to comment orally or in writing. 8
3. All hearings will be recorded. A copy of the recording will 9
be made available on request. 10
4. Nothing in this article shall be construed as requiring a 11
separate hearing on each rule. Rules may be grouped for the 12
convenience of the Commission at hearings required by this 13
article. 14
I. Following the scheduled hearing date, or by the close of 15
business on the scheduled hearing date if the hearing was not 16
held, the Commission shall consider all written and oral comments 17
received. 18
J. If no written notice of intent to attend the public hearing 19
by interested parties is received, the Commission may proceed with 20
promulgation of the proposed rule without a public hearing. 21
K. The Commission shall, by majority vote of all members, 22
take final action on the proposed rule and shall determine the 23
effective date of the rule, if any, based on the rulemaking record 24
and the full text of the rule. 25
L. Upon determination that an emergency exists, the 26
Commission may consider and adopt an emergency rule without 27
prior notice, opportunity for comment or hearing, provided that 28
the usual rulemaking procedures provided in the Compact and in 29
this article shall be retroactively applied to the rule as soon as 30
reasonably possible, in no event later than 90 days after the 31
effective date of the rule. For the purposes of this provision, an 32
emergency rule is one that must be adopted immediately in order 33
to: 34
1. Meet an imminent threat to public health, safety or 35
welfare; 36
2. Prevent a loss of Commission or member state funds; 37
3. Meet a deadline for the promulgation of an administrative 38
rule that is established by federal law or rule; or 39
4. Protect public health and safety. 40
M. The Commission or an authorized committee of the 41
Commission may direct revisions to a previously adopted rule or 42
amendment for purposes of correcting typographical errors, errors 43
in format, errors in consistency or grammatical errors. Public 44
notice of any revisions shall be posted on the website of the 45
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Commission. The revision shall be subject to challenge by any 1
person for a period of 30 days after posting. The revision may be 2
challenged only on grounds that the revision results in a material 3
change to a rule. A challenge shall be made in writing and 4
delivered to the chair of the Commission prior to the end of the 5
notice period. If no challenge is made, the revision will take effect 6
without further action. If the revision is challenged, the revision 7
may not take effect without the approval of the Commission. 8
9
ARTICLE 10. OVERSIGHT, DISPUTE 10
RESOLUTION AND ENFORCEMENT 11
12
A. Oversight 13
1. The executive, legislative and judicial branches of state 14
government in each member state shall enforce this Compact and 15
take all actions necessary and appropriate to effectuate the 16
Compact’s purposes and intent. The provisions of this Compact 17
and the rules promulgated hereunder shall have standing as 18
statutory law. 19
2. All courts shall take judicial notice of the Compact and the 20
rules in any judicial or administrative proceeding in a member 21
state pertaining to the subject matter of this Compact which may 22
affect the powers, responsibilities or actions of the Commission. 23
The Commission shall be entitled to receive service of process 24
in any such proceeding and shall have standing to intervene in 25
such a proceeding for all purposes. Failure to provide service of 26
process to the Commission shall render a judgment or order void 27
as to the Commission, this Compact or promulgated rules. 28
B. Default, Technical Assistance and Termination 29
1. If the Commission determines that a member state has 30
defaulted in the performance of its obligations or responsibilities 31
under this Compact or the promulgated rules, the Commission 32
shall: 33
a. Provide written notice to the defaulting state and other 34
member states of the nature of the default, the proposed means of 35
curing the default and/or any other action to be taken by the 36
Commission; and 37
b. Provide remedial training and specific technical 38
assistance regarding the default. 39
2. If a state in default fails to cure the default, the defaulting 40
state may be terminated from the Compact upon an affirmative 41
vote of a majority of the member states and all rights, privileges 42
and benefits conferred by this Compact may be terminated on the 43
effective date of termination. A cure of the default does not relieve 44
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the offending state of obligations or liabilities incurred during the 1
period of default. 2
3. Termination of membership in the Compact shall be 3
imposed only after all other means of securing compliance have 4
been exhausted. Notice of intent to suspend or terminate shall be 5
given by the Commission to the governor, the majority and 6
minority leaders of the defaulting state’s legislature and each of 7
the member states. 8
4. A state that has been terminated is responsible for all 9
assessments, obligations and liabilities incurred through the 10
effective date of termination, including obligations that extend 11
beyond the effective date of termination. 12
5. The Commission shall not bear any costs related to a state 13
that is found to be in default or that has been terminated from the 14
Compact, unless agreed upon in writing between the Commission 15
and the defaulting state. 16
6. The defaulting state may appeal the action of the 17
Commission by petitioning the United States District Court for the 18
District of Columbia or the federal district where the Commission 19
has its principal offices. The prevailing member shall be awarded 20
all costs of such litigation, including, without limitation, 21
reasonable attorney’s fees. 22
C. Dispute Resolution 23
1. Upon request by a member state, the Commission shall 24
attempt to resolve disputes related to the Compact that arise 25
among member states and between member and nonmember 26
states. 27
2. The Commission shall promulgate a rule providing for 28
both mediation and binding dispute resolution for disputes as 29
appropriate. 30
D. Enforcement 31
1. The Commission, in the reasonable exercise of its 32
discretion, shall enforce the provisions and rules of this Compact. 33
2. By majority vote, the Commission may initiate legal action 34
in the United States District Court for the District of Columbia or 35
the federal district where the Commission has its principal offices 36
against a member state in default to enforce compliance with the 37
provisions of the Compact and its promulgated rules and bylaws. 38
The relief sought may include both injunctive relief and damages. 39
In the event judicial enforcement is necessary, the prevailing 40
member shall be awarded all costs of such litigation, including 41
reasonable attorney’s fees. 42
3. The remedies herein shall not be the exclusive remedies of 43
the Commission. The Commission may pursue any other remedies 44
available under federal or state law. 45
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ARTICLE 11. DATE OF IMPLEMENTATION OF 1
THE INTERSTATE COMMISSION FOR PHYSICAL 2
THERAPY PRACTICE AND ASSOCIATED RULES, 3
WITHDRAWAL AND AMENDMENT 4
5
A. The Compact shall come into effect on the date on which 6
the Compact statute is enacted into law in the tenth member state. 7
The provisions, which become effective at that time, shall be 8
limited to the powers granted to the Commission relating to 9
assembly and the promulgation of rules. Thereafter, the 10
Commission shall meet and exercise rulemaking powers necessary 11
to the implementation and administration of the Compact. 12
B. Any state that joins the Compact subsequent to the 13
Commission’s initial adoption of the rules shall be subject to the 14
rules as they exist on the date on which the Compact becomes law 15
in that state. Any rule that has been previously adopted by the 16
Commission shall have the full force and effect of law on the day 17
the Compact becomes law in that state. 18
C. Any member state may withdraw from this Compact by 19
enacting a statute repealing the same. 20
1. A member state’s withdrawal shall not take effect until 6 21
months after enactment of the repealing statute. 22
2. Withdrawal shall not affect the continuing requirement of 23
the withdrawing state’s physical therapy licensing board to comply 24
with the investigative and adverse action reporting requirements of 25
this Compact prior to the effective date of withdrawal. 26
D. Nothing contained in this Compact shall be construed to 27
invalidate or prevent any physical therapy licensure agreement or 28
other cooperative arrangement between a member state and a 29
nonmember state that does not conflict with the provisions of this 30
Compact. 31
E. This Compact may be amended by the member states. No 32
amendment to this Compact shall become effective and binding 33
upon any member state until it is enacted into the laws of all 34
member states. 35
36
ARTICLE 12. CONSTRUCTION AND SEVERABILITY 37
38
This Compact shall be liberally construed so as to effectuate 39
the purposes thereof. The provisions of this Compact shall be 40
severable and if any phrase, clause, sentence or provision of this 41
Compact is declared to be contrary to the constitution of any party 42
state or of the United States or the applicability thereof to any 43
government, agency, person or circumstance is held invalid, the 44
validity of the remainder of this Compact and the applicability 45
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thereof to any government, agency, person or circumstance shall 1
not be affected thereby. If this Compact shall be held contrary to 2
the constitution of any party state, the Compact shall remain in 3
full force and effect as to the remaining party states and in full 4
force and effect as to the party state affected as to all severable 5
matters. 6
Sec. 3. Except as otherwise required by the Physical Therapy 7
Licensure Compact enacted by section 2 of this act, privilege to 8
practice as a physical therapist or physical therapist assistant in 9
this State under the Compact shall be deemed to be equivalent to 10
the corresponding license for all purposes. 11
Sec. 4. NRS 640.110 is hereby amended to read as follows: 12
640.110 1. The Board shall license as a physical therapist or 13
physical therapist assistant each applicant who proves to the 14
satisfaction of the Board his or her qualifications for licensure. 15
2. The Board shall issue to each applicant who proves to the 16
satisfaction of the Board his or her qualification for licensure: 17
(a) As a physical therapist, a license as a physical therapist. The 18
license authorizes the applicant to represent himself or herself as a 19
licensed physical therapist and to practice physical therapy in the 20
State of Nevada subject to the conditions and limitations of this 21
chapter. 22
(b) As a physical therapist assistant, a license as a physical 23
therapist assistant. The license authorizes the applicant to represent 24
himself or herself as a licensed physical therapist assistant and to 25
practice as a licensed physical therapist assistant subject to the 26
conditions and limitations of this chapter. 27
3. Each physical therapist shall display his or her current 28
license or proof that he or she is authorized to practice in this 29
State under the Physical Therapy Licensure Compact enacted by 30
section 2 of this act, as applicable, in a location which is accessible 31
to the public. 32
4. The Board may charge a fee, not to exceed $25, to change a 33
name on a license. 34
5. A license as a physical therapist assistant remains valid 35
while a supervising physical therapist continues to supervise the 36
physical therapist assistant. 37
Sec. 5. NRS 7.095 is hereby amended to read as follows: 38
7.095 1. An attorney shall not contract for or collect a fee 39
contingent on the amount of recovery for representing a person 40
seeking damages in connection with an action for injury or death 41
against a provider of health care based upon professional negligence 42
in excess of: 43
(a) Forty percent of the first $50,000 recovered; 44
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(b) Thirty-three and one-third percent of the next $50,000 1
recovered; 2
(c) Twenty-five percent of the next $500,000 recovered; and 3
(d) Fifteen percent of the amount of recovery that exceeds 4
$600,000. 5
2. The limitations set forth in subsection 1 apply to all forms of 6
recovery, including, without limitation, settlement, arbitration and 7
judgment. 8
3. For the purposes of this section, “recovered” means the net 9
sum recovered by the plaintiff after deducting any disbursements or 10
costs incurred in connection with the prosecution or settlement of 11
the claim. Costs of medical care incurred by the plaintiff and general 12
and administrative expenses incurred by the office of the attorney 13
are not deductible disbursements or costs. 14
4. As used in this section: 15
(a) “Professional negligence” means a negligent act or omission 16
to act by a provider of health care in the rendering of professional 17
services, which act or omission is the proximate cause of a personal 18
injury or wrongful death. The term does not include services that are 19
outside the scope of services for which the provider of health care is 20
licensed or services for which any restriction has been imposed by 21
the applicable regulatory board or health care facility. 22
(b) “Provider of health care” means a physician licensed under 23
chapter 630 or 633 of NRS, dentist, registered nurse, dispensing 24
optician, optometrist, [registered] licensed physical therapist, 25
podiatric physician, licensed psychologist, chiropractic physician, 26
doctor of Oriental medicine, holder of a license or a limited license 27
issued under the provisions of chapter 653 of NRS, medical 28
laboratory director or technician, licensed dietitian or a licensed 29
hospital and its employees. 30
Sec. 6. NRS 41A.017 is hereby amended to read as follows: 31
41A.017 “Provider of health care” means a physician licensed 32
pursuant to chapter 630 or 633 of NRS, physician assistant, dentist, 33
licensed nurse, dispensing optician, optometrist, [registered] 34
licensed physical therapist, podiatric physician, licensed 35
psychologist, chiropractic physician, doctor of Oriental medicine, 36
holder of a license or a limited license issued under the provisions of 37
chapter 653 of NRS, medical laboratory director or technician, 38
licensed dietitian or a licensed hospital, clinic, surgery center, 39
physicians’ professional corporation or group practice that employs 40
any such person and its employees. 41
Sec. 7. NRS 42.021 is hereby amended to read as follows: 42
42.021 1. In an action for injury or death against a provider 43
of health care based upon professional negligence, if the defendant 44
so elects, the defendant may introduce evidence of any amount 45
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payable as a benefit to the plaintiff as a result of the injury or death 1
pursuant to the United States Social Security Act, any state or 2
federal income disability or worker’s compensation act, any health, 3
sickness or income-disability insurance, accident insurance that 4
provides health benefits or income-disability coverage, and any 5
contract or agreement of any group, organization, partnership or 6
corporation to provide, pay for or reimburse the cost of medical, 7
hospital, dental or other health care services. If the defendant elects 8
to introduce such evidence, the plaintiff may introduce evidence of 9
any amount that the plaintiff has paid or contributed to secure the 10
plaintiff’s right to any insurance benefits concerning which the 11
defendant has introduced evidence. 12
2. A source of collateral benefits introduced pursuant to 13
subsection 1 may not: 14
(a) Recover any amount against the plaintiff; or 15
(b) Be subrogated to the rights of the plaintiff against a 16
defendant. 17
3. In an action for injury or death against a provider of health 18
care based upon professional negligence, a district court shall, at the 19
request of either party, enter a judgment ordering that money 20
damages or its equivalent for future damages of the judgment 21
creditor be paid in whole or in part by periodic payments rather than 22
by a lump-sum payment if the award equals or exceeds $50,000 in 23
future damages. 24
4. In entering a judgment ordering the payment of future 25
damages by periodic payments pursuant to subsection 3, the court 26
shall make a specific finding as to the dollar amount of periodic 27
payments that will compensate the judgment creditor for such future 28
damages. As a condition to authorizing periodic payments of future 29
damages, the court shall require a judgment debtor who is not 30
adequately insured to post security adequate to assure full payment 31
of such damages awarded by the judgment. Upon termination of 32
periodic payments of future damages, the court shall order the return 33
of this security, or so much as remains, to the judgment debtor. 34
5. A judgment ordering the payment of future damages by 35
periodic payments entered pursuant to subsection 3 must specify the 36
recipient or recipients of the payments, the dollar amount of the 37
payments, the interval between payments, and the number of 38
payments or the period of time over which payments will be made. 39
Such payments must only be subject to modification in the event of 40
the death of the judgment creditor. Money damages awarded for loss 41
of future earnings must not be reduced or payments terminated by 42
reason of the death of the judgment creditor, but must be paid to 43
persons to whom the judgment creditor owed a duty of support, as 44
provided by law, immediately before the judgment creditor’s death. 45
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In such cases, the court that rendered the original judgment may, 1
upon petition of any party in interest, modify the judgment to award 2
and apportion the unpaid future damages in accordance with this 3
subsection. 4
6. If the court finds that the judgment debtor has exhibited a 5
continuing pattern of failing to make the periodic payments as 6
specified pursuant to subsection 5, the court shall find the judgment 7
debtor in contempt of court and, in addition to the required periodic 8
payments, shall order the judgment debtor to pay the judgment 9
creditor all damages caused by the failure to make such periodic 10
payments, including, but not limited to, court costs and attorney’s 11
fees. 12
7. Following the occurrence or expiration of all obligations 13
specified in the periodic payment judgment, any obligation of the 14
judgment debtor to make further payments ceases and any security 15
given pursuant to subsection 4 reverts to the judgment debtor. 16
8. As used in this section: 17
(a) “Future damages” includes damages for future medical 18
treatment, care or custody, loss of future earnings, loss of bodily 19
function, or future pain and suffering of the judgment creditor. 20
(b) “Periodic payments” means the payment of money or 21
delivery of other property to the judgment creditor at regular 22
intervals. 23
(c) “Professional negligence” means a negligent act or omission 24
to act by a provider of health care in the rendering of professional 25
services, which act or omission is the proximate cause of a personal 26
injury or wrongful death. The term does not include services that are 27
outside the scope of services for which the provider of health care is 28
licensed or services for which any restriction has been imposed by 29
the applicable regulatory board or health care facility. 30
(d) “Provider of health care” means a physician licensed under 31
chapter 630 or 633 of NRS, dentist, licensed nurse, dispensing 32
optician, optometrist, [registered] licensed physical therapist, 33
podiatric physician, licensed psychologist, chiropractic physician, 34
doctor of Oriental medicine, holder of a license or a limited license 35
issued under the provisions of chapter 653 of NRS, medical 36
laboratory director or technician, licensed dietitian or a licensed 37
hospital and its employees. 38
Sec. 8. NRS 52.320 is hereby amended to read as follows: 39
52.320 As used in NRS 52.320 to 52.375, inclusive, unless the 40
context otherwise requires: 41
1. “Custodian of medical records” means a chiropractic 42
physician, physician, [registered] licensed physical therapist or 43
licensed nurse who prepares and maintains medical records, or any 44
employee or agent of such a person or a facility for convalescent 45
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care, medical laboratory or hospital who has care, custody and 1
control of medical records for such a person or institution. 2
2. “Medical records” includes bills, ledgers, statements and 3
other accounts which show the cost of medical services or care 4
provided to a patient. 5
Sec. 9. NRS 372.7285 is hereby amended to read as follows: 6
372.7285 1. In administering the provisions of NRS 372.325, 7
the Department shall apply the exemption to the sale of a medical 8
device to a governmental entity that is exempt pursuant to that 9
section without regard to whether the person using the medical 10
device or the governmental entity that purchased the device is 11
deemed to be the holder of title to the device if: 12
(a) The medical device was ordered or prescribed by a provider 13
of health care, within his or her scope of practice, for use by the 14
person to whom it is provided; 15
(b) The medical device is covered by Medicaid or Medicare; and 16
(c) The purchase of the medical device is made pursuant to a 17
contract between the governmental entity that purchases the medical 18
device and the person who sells the medical device to the 19
governmental entity. 20
2. As used in this section: 21
(a) “Medicaid” means the program established pursuant to Title 22
XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., to 23
provide assistance for part or all of the cost of medical care rendered 24
on behalf of indigent persons. 25
(b) “Medicare” means the program of health insurance for aged 26
persons and persons with disabilities established pursuant to Title 27
XVIII of the Social Security Act, 42 U.S.C. §§ 1395 et seq. 28
(c) “Provider of health care” means a physician or physician 29
assistant licensed pursuant to chapter 630, 630A or 633 of NRS, 30
perfusionist, dentist, licensed nurse, dispensing optician, 31
optometrist, practitioner of respiratory care, [registered] licensed 32
physical therapist, podiatric physician, licensed psychologist, 33
licensed audiologist, licensed speech-language pathologist, licensed 34
hearing aid specialist, licensed marriage and family therapist, 35
licensed clinical professional counselor, chiropractic physician, 36
licensed dietitian or doctor of Oriental medicine in any form. 37
Sec. 10. NRS 374.731 is hereby amended to read as follows: 38
374.731 1. In administering the provisions of NRS 374.330, 39
the Department shall apply the exemption to the sale of a medical 40
device to a governmental entity that is exempt pursuant to that 41
section without regard to whether the person using the medical 42
device or the governmental entity that purchased the device is 43
deemed to be the holder of title to the device if: 44
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(a) The medical device was ordered or prescribed by a provider 1
of health care, within his or her scope of practice, for use by the 2
person to whom it is provided; 3
(b) The medical device is covered by Medicaid or Medicare; and 4
(c) The purchase of the medical device is made pursuant to a 5
contract between the governmental entity that purchases the medical 6
device and the person who sells the medical device to the 7
governmental entity. 8
2. As used in this section: 9
(a) “Medicaid” means the program established pursuant to Title 10
XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., to 11
provide assistance for part or all of the cost of medical care rendered 12
on behalf of indigent persons. 13
(b) “Medicare” means the program of health insurance for aged 14
persons and persons with disabilities established pursuant to Title 15
XVIII of the Social Security Act, 42 U.S.C. §§ 1395 et seq. 16
(c) “Provider of health care” means a physician or physician 17
assistant licensed pursuant to chapter 630, 630A or 633 of NRS, 18
perfusionist, dentist, licensed nurse, dispensing optician, 19
optometrist, practitioner of respiratory care, [registered] licensed 20
physical therapist, podiatric physician, licensed psychologist, 21
licensed audiologist, licensed speech-language pathologist, licensed 22
hearing aid specialist, licensed marriage and family therapist, 23
licensed clinical professional counselor, chiropractic physician, 24
licensed dietitian or doctor of Oriental medicine in any form. 25
Sec. 11. NRS 439A.0195 is hereby amended to read as 26
follows: 27
439A.0195 “Practitioner” means a physician licensed under 28
chapter 630, 630A or 633 of NRS, dentist, licensed nurse, 29
dispensing optician, optometrist, [registered] licensed physical 30
therapist, podiatric physician, licensed psychologist, chiropractic 31
physician, doctor of Oriental medicine in any form, medical 32
laboratory director or technician, pharmacist or other person whose 33
principal occupation is the provision of services for health. 34
Sec. 12. NRS 598A.360 is hereby amended to read as follows: 35
598A.360 “Practitioner” means a physician licensed pursuant 36
to chapter 630 or 633 of NRS, physician assistant, licensed nurse, 37
dispensing optician, optometrist, practitioner of respiratory care, 38
[registered] licensed physical therapist, occupational therapist, 39
licensed psychologist or perfusionist. 40
Sec. 13. This act becomes effective on July 1, 2023. 41
H