Nevada 2025 Regular Session

Nevada Assembly Bill AB170 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	REQUIRES TWO-THIRDS MAJORITY VOTE
2	2	(§§ 9, 21, 26 & NRS 453.221, 453.226, 639.170)
3	3	A.B. 170
4	4
5	5	- AB170
6	6
7	7	ASSEMBLY BILL NO. 170–ASSEMBLYMEMBER NADEEM
8	8
9	9	PREFILED JANUARY 31, 2025
10	10	____________
11	11
12	12	Referred to Committee on Commerce and Labor
13	13
14	14	SUMMARY—Providing for the licensure of associate physicians
15	15	and associate osteopathic physicians. (BDR 54-840)
16	16
17	17	FISCAL NOTE: Effect on Local Government: No.
18	18	Effect on the State: Yes.
19	19
20	20	~
21	21
22	22	EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
23	23
24	24
25	25	AN ACT relating to health care; providing for the licensure of
26	26	associate physicians and associate osteopathic physicians;
27	27	prescribing the conditions under which an associate
28	28	physician or associate osteopathic physician is authorized
29	29	to practice medicine or osteopathic medicine; authorizing
30	30	an associate physician or associate osteopathic physician
31	31	to register to possess, administer, prescribe or dispense
32	32	controlled substances; and providing other matters
33	33	properly relating thereto.
34	34	Legislative Counsel’s Digest:
35	35	Existing law provides for the licensing of physicians and physician assistants 1
36	36	by the Board of Medical Examiners and for the licensing of osteopathic physicians 2
37	37	and physician assistants by the State Board of Osteopathic Medicine. (NRS 3
38	38	630.160-630.1607, 630.258-630.2665, 630.271-630.2755, 633.305-633.420, 4
39	39	633.432-633.4336) Sections 2-9 and 14-21 of this bill create limited licenses that 5
40	40	authorize certain medical school graduates to engage in the supervised practice of 6
41	41	medicine as an associate physician or associate osteopathic physician. Sections 2 7
42	42	and 14 authorize the Board of Medical Examiners and State Board of Osteopathic 8
43	43	Medicine, respectively, to issue a limited license as an associate physician or 9
44	44	associate osteopathic physician to an applicant who: (1) has graduated from certain 10
45	45	medical schools; (2) has completed at least 1 year of postgraduate medical 11
46	46	education as a resident or intern as a part of certain programs; and (3) possesses 12
47	47	certain other qualifications. Sections 3 and 15 limit an associate physician or 13
48	48	associate osteopathic physician to practicing medicine under the supervision and 14
49	49	control of a supervising physician or supervising osteopathic physician. Sections 5 15
50	50	and 17 prescribe the required qualifications of a supervising physician or 16
51	51	supervising osteopathic physician. Sections 3 and 15 require an associate physician 17
52	52	or associate osteopathic physician to enter into a collaborative practice agreement 18
53	53	with his or her supervising physician or supervising osteopathic physician. 19
54	54	– 2 –
55	55
56	56
57	57	- AB170
58	58	Sections 6 and 18 prescribe the provisions that are required to be included in the 20
59	59	collaborative practice agreement. 21
60	60	Sections 3 and 15 require a supervising physician or supervising osteopathic 22
61	61	physician to be on the same premises and available to assist an associate physician 23
62	62	or associate osteopathic physician for the first 30 days of supervision. Sections 3 24
63	63	and 15 require a supervising physician or supervising osteopathic physician, or 25
64	64	designee thereof, to be on the same premises and available to assist at all times an 26
65	65	associate physician or associate osteopathic physician, as applicable, who is 27
66	66	practicing in a county whose population is less than 100,000 (currently all counties 28
67	67	other than Clark and Washoe Counties). Sections 3 and 15 also require the 29
68	68	employer of an associate physician or associate osteopathic physician to credential 30
69	69	and bill for services rendered by an associate physician or associate osteopathic 31
70	70	physician in the same manner as a physician assistant. Sections 4 and 16 require a 32
71	71	supervising physician and associate physician or supervising osteopathic physician 33
72	72	and associate osteopathic physician to take certain measures to notify the public of 34
73	73	their respective statuses and their relationship. Sections 5 and 17: (1) provide that a 35
74	74	supervising physician or supervising osteopathic physician is responsible for the 36
75	75	practice of medicine or osteopathic medicine by the associate physician or associate 37
76	76	osteopathic physician, as applicable, that he or she is supervising; and (2) require a 38
77	77	supervising physician or supervising osteopathic physician to maintain insurance 39
78	78	that covers malpractice by an associate physician or associate osteopathic 40
79	79	physician, as applicable. Sections 5 and 17 prohibit a supervising physician or 41
80	80	supervising osteopathic physician from entering into a collaborative practice 42
81	81	agreement with more than three associate physicians or associate osteopathic 43
82	82	physicians, as applicable. Sections 5 and 17 additionally prohibit the Board of 44
83	83	Medical Examiners and the State Board of Osteopathic Medicine, respectively, 45
84	84	from disciplining a supervising physician or supervising osteopathic physician for 46
85	85	legal activity of an associate physician or associate osteopathic physician that is 47
86	86	within the scope of the relevant collaborative practice agreement. 48
87	87	Sections 7 and 19 authorize an associate physician or associate osteopathic 49
88	88	physician, respectively, to prescribe or dispense certain controlled substances and 50
89	89	establish the conditions under which an associate physician or associate osteopathic 51
90	90	physician may prescribe or dispense such controlled substances. Existing law: (1) 52
91	91	authorizes the State Board of Pharmacy to issue a registration certificate to 53
92	92	authorize a physician assistant to possess, administer, prescribe or dispense 54
93	93	controlled substances, poisons, dangerous drugs or devices in or out of the presence 55
94	94	of his or her supervising physician; and (2) requires the Board to adopt regulations 56
95	95	governing the storage, security, recordkeeping and transportation of controlled 57
96	96	substances, poisons, dangerous drugs or devices by a physician assistant. (NRS 58
97	97	639.1373) Section 26 of this bill authorizes the State Board of Pharmacy to 59
98	98	additionally issue such a registration certificate to associate physicians and 60
99	99	associate osteopathic physicians and to regulate associate physicians and associate 61
100	100	osteopathic physicians who hold such a certificate in the same manner as physician 62
101	101	assistants. 63
102	102	Sections 8 and 20 provide for the expiration and renewal of the limited licenses 64
103	103	issued to associate physicians and associate osteopathic physicians, respectively. 65
104	104	Sections 11 and 25 of this bill require a physician or osteopathic physician to 66
105	105	biennially submit to the Board of Medical Examiners or the State Board of 67
106	106	Osteopathic Medicine, as applicable, a list of the names of each associate physician 68
107	107	or associate osteopathic physician who is supervised by the physician or 69
108	108	osteopathic physician. Sections 9 and 21 of this bill require those Boards to adopt 70
109	109	regulations to implement sections 2-9 and 19-21. 71
110	110	Sections 10, 22 and 27 of this bill make conforming changes to clarify the 72
111	111	meaning of the terms “supervising physician,” “associate physician,” “supervising 73
112	112	osteopathic physician” and “associate osteopathic physician.” Sections 11 and 23 74
113	113	– 3 –
114	114
115	115
116	116	- AB170
117	117	of this bill make conforming changes to clarify that an applicant for a license as an 75
118	118	associate physician or an associate osteopathic physician does not hold the same 76
119	119	qualifications for licensure as an applicant for a standard license as a physician or 77
120	120	an osteopathic physician. Section 24 of this bill makes a conforming change to 78
121	121	clarify the applicability of a provision relating to the supervising osteopathic 79
122	122	physician of a physician assistant. 80
123	123
124	124
125	125	THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
126	126	SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
127	127
128	128	Section 1. Chapter 630 of NRS is hereby amended by adding 1
129	129	thereto the provisions set forth as sections 2 to 9, inclusive, of this 2
130	130	act. 3
131	131	Sec. 2. Except as otherwise provided in NRS 630.161, the 4
132	132	Board may issue a limited license for a person to practice 5
133	133	medicine as an associate physician if the applicant: 6
134	134	1. Has received the degree of doctor of medicine from a 7
135	135	medical school in the United States or Canada: 8
136	136	(a) Approved by the Liaison Committee on Medical Education 9
137	137	of the American Medical Association and Association of American 10
138	138	Medical Colleges; or 11
139	139	(b) Which provides a course of professional instruction 12
140	140	equivalent to that provided in medical schools in the United States 13
141	141	approved by the Liaison Committee on Medical Education; 14
142	142	2. Has passed the Step 1 Exam and Step 2 CK Exam of the 15
143	143	United States Medical Licensing Examination or an examination 16
144	144	deemed equivalent by the Board; 17
145	145	3. Has not completed a residency in a program described in 18
146	146	sub-subparagraph (I) of subparagraph (1) of paragraph (c) of 19
147	147	subsection 2 of NRS 630.160; 20
148	148	4. Has completed at least his or her first year of postgraduate 21
149	149	medical education as a resident or intern as part of a program 22
150	150	that: 23
151	151	(a) Has been approved by the Accreditation Council for 24
152	152	Graduate Medical Education; 25
153	153	(b) Conforms to the minimum standards for intern training 26
154	154	established by the American Osteopathic Association; or 27
155	155	(c) Is approved by the Board in accordance with the 28
156	156	regulations adopted pursuant to section 9 of this act; and 29
157	157	5. Has basic fluency in the English language. 30
158	158	Sec. 3. 1. An associate physician shall only practice 31
159	159	medicine under the supervision and control of a physician: 32
160	160	(a) Who meets the requirements of section 5 of this act; and 33
161	161	– 4 –
162	162
163	163
164	164	- AB170
165	165	(b) With whom the associate physician has entered into a 1
166	166	collaborative practice agreement that meets the requirements of 2
167	167	section 6 of this act. 3
168	168	2. An associate physician shall not practice medicine in a 4
169	169	manner that exceeds the skill, training and competence of the 5
170	170	associate physician or his or her supervising physician. 6
171	171	3. For the first 30 days during which an associate physician 7
172	172	practices medicine under the supervision of a new supervising 8
173	173	physician, the supervising physician must be physically present on 9
174	174	the same premises and available to assist the associate physician. 10
175	175	4. An associate physician shall not practice medicine in a 11
176	176	county whose population is less than 100,000 unless the 12
177	177	supervising physician or another physician designated by the 13
178	178	supervising physician is physically present on the same premises 14
179	179	and is available to assist the associate physician. 15
180	180	5. An associate physician working in a rural health clinic, as 16
181	181	defined in 42 U.S.C. § 1395x(aa)(2), shall be considered to be a 17
182	182	physician assistant for the purposes of the regulations of the 18
183	183	Centers for Medicare and Medicaid Services of the United States 19
184	184	Department of Health and Human Services. Such an associate 20
185	185	physician and his or her supervising physician are not required to 21
186	186	comply with the requirements of any regulations adopted pursuant 22
187	187	to section 9 of this act governing the supervision of an associate 23
188	188	physician that are more stringent than the requirements of federal 24
189	189	law and regulations. 25
190	190	6. A person or entity that employs an associate physician 26
191	191	shall credential the associate physician and bill for services 27
192	192	rendered by the associate physician in the same manner as the 28
193	193	person or entity credentials and bills for the services of a physician 29
194	194	assistant. 30
195	195	Sec. 4. 1. The supervising physician of an associate 31
196	196	physician shall prominently display a disclosure at every office 32
197	197	where the associate physician practices medicine explaining to 33
198	198	patients that the patient may be seen by an associate physician and 34
199	199	the patient may instead request to be seen by the supervising 35
200	200	physician. 36
201	201	2. An associate physician shall clearly identify himself or 37
202	202	herself as an associate physician, including, without limitation, by 38
203	203	wearing an identification badge that clearly identifies the person 39
204	204	as an associate physician. An associate physician may identify 40
205	205	himself or herself as a doctor. 41
206	206	3. While acting as the supervising physician of an associate 42
207	207	physician, a physician shall wear an identification badge that 43
208	208	clearly identifies the person as a supervising physician of an 44
209	209	associate physician. 45
210	210	– 5 –
211	211
212	212
213	213	- AB170
214	214	Sec. 5. 1. A physician shall not serve as the supervising 1
215	215	physician of an associate physician pursuant to subsection 1 of 2
216	216	section 3 of this act or the designee of a supervising physician 3
217	217	pursuant to subsection 4 of section 3 of this act unless the 4
218	218	physician: 5
219	219	(a) Holds an active unrestricted license to practice medicine in 6
220	220	this State; and 7
221	221	(b) Practices in the same specialty area as the associate 8
222	222	physician or a substantially similar specialty area as the associate 9
223	223	physician. 10
224	224	2. The supervising physician of an associate physician: 11
225	225	(a) Is responsible for any act that constitutes the practice of 12
226	226	medicine by the associate physician; 13
227	227	(b) Must have insurance that includes coverage for any claim 14
228	228	of malpractice against the associate physician; and 15
229	229	(c) May not enter into a collaborative practice agreement with 16
230	230	more than three associate physicians. 17
231	231	3. The Board may not deny, revoke or suspend the license of 18
232	232	or take any other disciplinary action against the supervising 19
233	233	physician of an associate physician for any act performed by the 20
234	234	associate physician that: 21
235	235	(a) Is performed in accordance with the collaborative practice 22
236	236	agreement entered into pursuant to section 3 of this act; and 23
237	237	(b) Does not violate applicable federal, state or local laws or 24
238	238	the regulations of the Board. 25
239	239	Sec. 6. 1. A collaborative practice agreement entered into 26
240	240	pursuant to section 3 of this act must be in writing and must 27
241	241	include, without limitation: 28
242	242	(a) The names, home and business addresses and telephone 29
243	243	numbers of the supervising physician and associate physician; 30
244	244	(b) A list of each location where the associate physician may 31
245	245	practice medicine, including, without limitation, the prescribing 32
246	246	and dispensing of controlled substances; 33
247	247	(c) Any specialty or board certification held by the supervising 34
248	248	physician; 35
249	249	(d) Any certification held by the associate physician; 36
250	250	(e) Requirements governing collaboration between the 37
251	251	supervising physician and the associate physician, including, 38
252	252	without limitation: 39
253	253	(1) The geographic proximity which must exist between the 40
254	254	supervising physician and the associate physician while the 41
255	255	associate physician is practicing medicine; and 42
256	256	(2) A plan for alternative supervision if the supervising 43
257	257	physician is absent, incapacitated or otherwise unavailable; 44
258	258	– 6 –
259	259
260	260
261	261	- AB170
262	262	(f) Any controlled substance the supervising physician 1
263	263	authorizes the associate physician to prescribe or dispense in 2
264	264	accordance with section 7 of this act; 3
265	265	(g) The procedure by which the supervising physician will 4
266	266	review the standard of care the associate physician is providing to 5
267	267	patients, which must comply with the regulations adopted 6
268	268	pursuant to section 9 of this act; 7
269	269	(h) The duration of the collaborative practice agreement; and 8
270	270	(i) A statement of any other collaborative practice agreements 9
271	271	into which: 10
272	272	(1) The supervising physician has entered with another 11
273	273	associate physician; and 12
274	274	(2) The associate physician has entered with another 13
275	275	supervising physician. 14
276	276	2. Upon entering into a new collaborative practice agreement 15
277	277	with an associate physician, a supervising physician shall file with 16
278	278	the Board: 17
279	279	(a) A copy of the agreement; and 18
280	280	(b) Proof that any controlled substance included in the 19
281	281	agreement pursuant to paragraph (f) of subsection 1 is within the 20
282	282	skill, training and competence of the associate physician and his 21
283	283	or her supervising physician to prescribe and dispense. 22
284	284	3. A supervising physician or associate physician may 23
285	285	terminate a collaborative practice agreement or a relationship with 24
286	286	a supervising physician or an associate physician, as applicable, at 25
287	287	any time. Any provision of a collaborative practice agreement or 26
288	288	any other agreement that limits the authority of a supervising 27
289	289	physician or an associate physician to terminate a collaborative 28
290	290	practice agreement or such a relationship is void. 29
291	291	Sec. 7. 1. An associate physician may prescribe or dispense 30
292	292	the controlled substances listed in subsection 2 under the 31
293	293	conditions prescribed by this section if the associate physician: 32
294	294	(a) Is registered with the State Board of Pharmacy pursuant to 33
295	295	NRS 639.1373; 34
296	296	(b) Has entered into a collaborative practice agreement 35
297	297	pursuant to section 3 of this act authorizing the associate 36
298	298	physician to prescribe the controlled substance; and 37
299	299	(c) Meets all other requirements prescribed by federal and 38
300	300	state law to prescribe controlled substances. 39
301	301	2. Subject to the limitations prescribed in NRS 639.1373, an 40
302	302	associate physician who meets the requirements of subsection 1 41
303	303	may prescribe or dispense: 42
304	304	(a) Any controlled substance listed in schedule III, IV or V; 43
305	305	and 44
306	306	– 7 –
307	307
308	308
309	309	- AB170
310	310	(b) Any controlled substance listed in schedule II that contains 1
311	311	hydrocodone. 2
312	312	3. Except as otherwise provided in this subsection, an 3
313	313	associate physician shall not prescribe or dispense more than a 5-4
314	314	day supply of a controlled substance listed in schedule II or III. 5
315	315	An associate physician may prescribe or dispense a 30-day supply 6
316	316	of buprenorphine for the treatment of a substance use disorder 7
317	317	under the direction of his or her supervising physician. 8
318	318	4. An associate physician shall not prescribe or dispense 9
319	319	controlled substances unless: 10
320	320	(a) The supervising physician of the associate physician is 11
321	321	physically present on the same premises; or 12
322	322	(b) The associate physician has, at any time, completed 120 13
323	323	hours practicing medicine over a period of not more than 4 14
324	324	months with his or her supervising physician physically present on 15
325	325	the same premises. 16
326	326	Sec. 8. 1. A limited license to practice medicine as an 17
327	327	associate physician issued pursuant to section 2 of this act expires 18
328	328	2 years after it is issued. 19
329	329	2. The Board may renew a limited license to practice 20
330	330	medicine as an associate physician upon application by the 21
331	331	associate physician. An application for renewal must include, 22
332	332	without limitation, proof that the associate physician has actually 23
333	333	engaged in the practice of medicine under a collaborative practice 24
334	334	agreement entered into pursuant to section 3 of this act during the 25
335	335	immediately preceding 2 years. 26
336	336	Sec. 9. 1. The Board shall adopt regulations necessary: 27
337	337	(a) To carry out the provisions of sections 2 to 9, inclusive, of 28
338	338	this act, including, without limitation: 29
339	339	(1) Any additional requirements for the issuance or 30
340	340	renewal of a limited license to practice medicine as an associate 31
341	341	physician. 32
342	342	(2) The standards for the approval of programs of 33
343	343	postgraduate medical education pursuant to paragraph (c) of 34
344	344	subsection 4 of section 2 of this act. 35
345	345	(3) The required fees for the issuance and renewal of such 36
346	346	a license. 37
347	347	(4) Standards of practice for associate physicians, 38
348	348	including, without limitation, limitations on the practice of 39
349	349	medicine by an associate physician in addition to those prescribed 40
350	350	by sections 2 to 9, inclusive, of this act. 41
351	351	(5) Any additional requirements governing collaborative 42
352	352	practice agreements entered into pursuant to section 3 of this act. 43
353	353	(6) Requirements concerning the supervision of an 44
354	354	associate physician by a supervising physician, including, without 45
355	355	– 8 –
356	356
357	357
358	358	- AB170
359	359	limitation, requirements governing the review by the supervising 1
360	360	physician of the standard of care the associate physician is 2
361	361	providing to patients. Such regulations must not be more stringent 3
362	362	than any similar requirements that apply to physician assistants. 4
363	363	(b) For an associate physician to be eligible to work in a clinic 5
364	364	that receives federal funding. 6
365	365	2. The regulations adopted pursuant to this section and NRS 7
366	366	630.253 must not require an associate physician to complete a 8
367	367	greater amount of continuing education than a physician licensed 9
368	368	pursuant to NRS 630.160. 10
369	369	3. The Board shall publish on the Internet website 11
370	370	maintained pursuant to NRS 630.144 the name of each associate 12
371	371	physician and the physician or physicians supervising the 13
372	372	associate physician. 14
373	373	Sec. 10. NRS 630.025 is hereby amended to read as follows: 15
374	374	630.025 “Supervising physician” means an active physician 16
375	375	licensed and in good standing in the State of Nevada who supervises 17
376	376	a physician assistant [.] or an associate physician. 18
377	377	Sec. 11. NRS 630.160 is hereby amended to read as follows: 19
378	378	630.160 1. Every person desiring to practice medicine must, 20
379	379	before beginning to practice, procure from the Board a license 21
380	380	authorizing the person to practice. 22
381	381	2. Except as otherwise provided in NRS 630.1605 to 630.161, 23
382	382	inclusive, and 630.258 to 630.2665, inclusive, and sections 2 to 9, 24
383	383	inclusive, of this act, a license may be issued to any person who: 25
384	384	(a) Has received the degree of doctor of medicine from a 26
385	385	medical school: 27
386	386	(1) Approved by the Liaison Committee on Medical 28
387	387	Education of the American Medical Association and Association of 29
388	388	American Medical Colleges; or 30
389	389	(2) Which provides a course of professional instruction 31
390	390	equivalent to that provided in medical schools in the United States 32
391	391	approved by the Liaison Committee on Medical Education; 33
392	392	(b) Is currently certified by a specialty board of the American 34
393	393	Board of Medical Specialties and who agrees to maintain the 35
394	394	certification for the duration of the licensure, or has passed: 36
395	395	(1) All parts of the examination given by the National Board 37
396	396	of Medical Examiners; 38
397	397	(2) All parts of the Federation Licensing Examination; 39
398	398	(3) All parts of the United States Medical Licensing 40
399	399	Examination; 41
400	400	(4) All parts of a licensing examination given by any state or 42
401	401	territory of the United States, if the applicant is certified by a 43
402	402	specialty board of the American Board of Medical Specialties; 44
403	403	– 9 –
404	404
405	405
406	406	- AB170
407	407	(5) All parts of the examination to become a licentiate of the 1
408	408	Medical Council of Canada; or 2
409	409	(6) Any combination of the examinations specified in 3
410	410	subparagraphs (1), (2) and (3) that the Board determines to be 4
411	411	sufficient; 5
412	412	(c) Is currently certified by a specialty board of the American 6
413	413	Board of Medical Specialties in the specialty of emergency 7
414	414	medicine, preventive medicine or family medicine and who agrees 8
415	415	to maintain certification in at least one of these specialties for the 9
416	416	duration of the licensure, or: 10
417	417	(1) Has completed 36 months of progressive postgraduate: 11
418	418	(I) Education as a resident in the United States or Canada 12
419	419	in a program approved by the Board, the Accreditation Council for 13
420	420	Graduate Medical Education, the Royal College of Physicians and 14
421	421	Surgeons of Canada, the Collège des médecins du Québec or the 15
422	422	College of Family Physicians of Canada, or, as applicable, their 16
423	423	successor organizations; or 17
424	424	(II) Fellowship training in the United States or Canada 18
425	425	approved by the Board or the Accreditation Council for Graduate 19
426	426	Medical Education; 20
427	427	(2) Has completed at least 36 months of postgraduate 21
428	428	education, not less than 24 months of which must have been 22
429	429	completed as a resident after receiving a medical degree from a 23
430	430	combined dental and medical degree program approved by the 24
431	431	Board; or 25
432	432	(3) Is a resident who is enrolled in a progressive postgraduate 26
433	433	training program in the United States or Canada approved by the 27
434	434	Board, the Accreditation Council for Graduate Medical Education, 28
435	435	the Royal College of Physicians and Surgeons of Canada, the 29
436	436	Collège des médecins du Québec or the College of Family 30
437	437	Physicians of Canada, or, as applicable, their successor 31
438	438	organizations, has completed at least 24 months of the program and 32
439	439	has committed, in writing, to the Board that he or she will complete 33
440	440	the program; and 34
441	441	(d) Passes a written or oral examination, or both, as to his or her 35
442	442	qualifications to practice medicine and provides the Board with a 36
443	443	description of the clinical program completed demonstrating that the 37
444	444	applicant’s clinical training met the requirements of paragraph (a). 38
445	445	3. The Board may issue a license to practice medicine after the 39
446	446	Board verifies, through any readily available source, that the 40
447	447	applicant has complied with the provisions of subsection 2. The 41
448	448	verification may include, but is not limited to, using the Federation 42
449	449	Credentials Verification Service. If any information is verified by a 43
450	450	source other than the primary source of the information, the Board 44
451	451	– 10 –
452	452
453	453
454	454	- AB170
455	455	may require subsequent verification of the information by the 1
456	456	primary source of the information. 2
457	457	4. Notwithstanding any provision of this chapter to the 3
458	458	contrary, if, after issuing a license to practice medicine, the Board 4
459	459	obtains information from a primary or other source of information 5
460	460	and that information differs from the information provided by the 6
461	461	applicant or otherwise received by the Board, the Board may: 7
462	462	(a) Temporarily suspend the license; 8
463	463	(b) Promptly review the differing information with the Board as 9
464	464	a whole or in a committee appointed by the Board; 10
465	465	(c) Declare the license void if the Board or a committee 11
466	466	appointed by the Board determines that the information submitted 12
467	467	by the applicant was false, fraudulent or intended to deceive the 13
468	468	Board; 14
469	469	(d) Refer the applicant to the Attorney General for possible 15
470	470	criminal prosecution pursuant to NRS 630.400; or 16
471	471	(e) If the Board temporarily suspends the license, allow the 17
472	472	license to return to active status subject to any terms and conditions 18
473	473	specified by the Board, including: 19
474	474	(1) Placing the licensee on probation for a specified period 20
475	475	with specified conditions; 21
476	476	(2) Administering a public reprimand; 22
477	477	(3) Limiting the practice of the licensee; 23
478	478	(4) Suspending the license for a specified period or until 24
479	479	further order of the Board; 25
480	480	(5) Requiring the licensee to participate in a program to 26
481	481	correct an alcohol or other substance use disorder; 27
482	482	(6) Requiring supervision of the practice of the licensee; 28
483	483	(7) Imposing an administrative fine not to exceed $5,000; 29
484	484	(8) Requiring the licensee to perform community service 30
485	485	without compensation; 31
486	486	(9) Requiring the licensee to take a physical or mental 32
487	487	examination or an examination testing his or her competence to 33
488	488	practice medicine; 34
489	489	(10) Requiring the licensee to complete any training or 35
490	490	educational requirements specified by the Board; and 36
491	491	(11) Requiring the licensee to submit a corrected application, 37
492	492	including the payment of all appropriate fees and costs incident to 38
493	493	submitting an application. 39
494	494	5. If the Board determines after reviewing the differing 40
495	495	information to allow the license to remain in active status, the action 41
496	496	of the Board is not a disciplinary action and must not be reported to 42
497	497	any national database. If the Board determines after reviewing the 43
498	498	differing information to declare the license void, its action shall be 44
499	499	– 11 –
500	500
501	501
502	502	- AB170
503	503	deemed a disciplinary action and shall be reportable to national 1
504	504	databases. 2
505	505	Sec. 12. NRS 630.267 is hereby amended to read as follows: 3
506	506	630.267 1. Each holder of a license to practice medicine for 4
507	507	which the procedure for renewal is not otherwise prescribed by 5
508	508	specific statute must, on or before June 30, or if June 30 is a 6
509	509	Saturday, Sunday or legal holiday, on the next business day after 7
510	510	June 30, of each odd-numbered year: 8
511	511	(a) Submit a list of all actions filed or claims submitted to 9
512	512	arbitration or mediation for malpractice or negligence against him or 10
513	513	her during the previous 2 years. 11
514	514	(b) Pay to the Secretary-Treasurer of the Board the applicable 12
515	515	fee for biennial registration. This fee must be collected for the 13
516	516	period for which a physician is licensed. 14
517	517	(c) Submit a list of the names of each associate physician 15
518	518	supervised by the holder of the license, if applicable. 16
519	519	(d) Submit all information required to complete the biennial 17
520	520	registration. 18
521	521	2. When a holder of a license fails to pay the fee for biennial 19
522	522	registration and submit all information required to complete the 20
523	523	biennial registration after they become due, his or her license to 21
524	524	practice medicine in this State expires. The holder may, within 2 22
525	525	years after the date the license expires, upon payment of twice the 23
526	526	amount of the current fee for biennial registration to the Secretary-24
527	527	Treasurer and submission of all information required to complete 25
528	528	the biennial registration and after he or she is found to be in good 26
529	529	standing and qualified under the provisions of this chapter, be 27
530	530	reinstated to practice. 28
531	531	3. Not later than 60 days before a license is scheduled to 29
532	532	expire, the Board shall make such reasonable attempts as are 30
533	533	practicable to notify the licensee: 31
534	534	(a) At least once that the fee for biennial registration and all 32
535	535	information required to complete the biennial registration are due; 33
536	536	and 34
537	537	(b) The date on which his or her license is scheduled to expire. 35
538	538	4. After a license expires, the Board shall make such 36
539	539	reasonable attempts as are practicable to notify the holder of the 37
540	540	license that his or her license has expired. 38
541	541	5. Not later than September 30 of each odd-numbered year, the 39
542	542	Board shall provide a list of licenses to practice medicine that have 40
543	543	expired during that year to the Drug Enforcement Administration of 41
544	544	the United States Department of Justice or its successor agency and 42
545	545	the State Board of Pharmacy. 43
546	546	– 12 –
547	547
548	548
549	549	- AB170
550	550	Sec. 13. Chapter 633 of NRS is hereby amended by adding 1
551	551	thereto the provisions set forth as sections 14 to 21, inclusive, of this 2
552	552	act. 3
553	553	Sec. 14. Except as otherwise provided in NRS 633.315, the 4
554	554	Board may issue a limited license for a person to practice 5
555	555	osteopathic medicine as an associate osteopathic physician if the 6
556	556	applicant: 7
557	557	1. Has received the degree of doctor of osteopathic medicine 8
558	558	from a medical school in the United States approved by the 9
559	559	Commission on Osteopathic College Accreditation of the 10
560	560	American Osteopathic Association; 11
561	561	2. Has passed the Level 1 Exam and Level 2 CE Exam of the 12
562	562	Comprehensive Osteopathic Medical Licensing Examination of 13
563	563	the United States of the National Board of Osteopathic Medical 14
564	564	Examiners, the Step 1 Exam and Step 2 CK Exam of the United 15
565	565	States Medical Licensing Examination or an examination deemed 16
566	566	equivalent by the Board; 17
567	567	3. Has not completed a residency in a program described in 18
568	568	subparagraph (2) of paragraph (c) of subsection 1 of 19
569	569	NRS 633.311; 20
570	570	4. Has completed at least his or her first year of postgraduate 21
571	571	medical education as a resident or intern as part of a program 22
572	572	that: 23
573	573	(a) Conforms to the minimum standards for intern training 24
574	574	established by the American Osteopathic Association; 25
575	575	(b) Has been approved by the Accreditation Council for 26
576	576	Graduate Medical Education; or 27
577	577	(c) Is approved by the Board in accordance with the 28
578	578	regulations adopted pursuant to section 21 of this act; and 29
579	579	5. Has basic fluency in the English language. 30
580	580	Sec. 15. 1. An associate osteopathic physician shall only 31
581	581	practice osteopathic medicine under the supervision and control of 32
582	582	an osteopathic physician: 33
583	583	(a) Who meets the requirements of section 17 of this act; and 34
584	584	(b) With whom the associate osteopathic physician has entered 35
585	585	into a collaborative practice agreement that meets the 36
586	586	requirements of section 18 of this act. 37
587	587	2. An associate osteopathic physician shall not practice 38
588	588	osteopathic medicine in a manner that exceeds the skill, training 39
589	589	and competence of the associate osteopathic physician or his or 40
590	590	her supervising osteopathic physician. 41
591	591	3. For the first 30 days during which an associate osteopathic 42
592	592	physician practices osteopathic medicine under the supervision of 43
593	593	a new supervising osteopathic physician, the supervising 44
594	594	osteopathic physician must be physically present on the same 45
595	595	– 13 –
596	596
597	597
598	598	- AB170
599	599	premises and available to assist the associate osteopathic 1
600	600	physician. 2
601	601	4. An associate osteopathic physician shall not practice 3
602	602	osteopathic medicine in a county whose population is less than 4
603	603	100,000 unless the supervising osteopathic physician or another 5
604	604	osteopathic physician designated by the supervising osteopathic 6
605	605	physician is physically present on the same premises and available 7
606	606	to assist the associate osteopathic physician. 8
607	607	5. An associate osteopathic physician working in a rural 9
608	608	health clinic, as defined in 42 U.S.C. § 1395x(aa)(2), shall be 10
609	609	considered to be a physician assistant for the purposes of the 11
610	610	regulations of the Centers for Medicare and Medicaid Services of 12
611	611	the United States Department of Health and Human Services. 13
612	612	Such an associate osteopathic physician and his or her 14
613	613	supervising osteopathic physician are not required to comply with 15
614	614	the requirements of any regulations adopted pursuant to section 16
615	615	21 of this act governing the supervision of an associate osteopathic 17
616	616	physician that are more stringent than the requirements of federal 18
617	617	law and regulations. 19
618	618	6. A person or entity that employs an associate osteopathic 20
619	619	physician shall credential the associate osteopathic physician and 21
620	620	bill for services rendered by the associate osteopathic physician in 22
621	621	the same manner as the person or entity credentials and bills for 23
622	622	the services of a physician assistant. 24
623	623	Sec. 16. 1. The supervising osteopathic physician of an 25
624	624	associate osteopathic physician shall prominently display a 26
625	625	disclosure at every office where the associate osteopathic 27
626	626	physician practices osteopathic medicine explaining to patients 28
627	627	that the patient may be seen by an associate osteopathic physician 29
628	628	and the patient may instead request to be seen by the supervising 30
629	629	osteopathic physician. 31
630	630	2. An associate osteopathic physician shall clearly identify 32
631	631	himself or herself as an associate osteopathic physician, including, 33
632	632	without limitation, by wearing an identification badge that clearly 34
633	633	identifies the person as an associate osteopathic physician. An 35
634	634	associate osteopathic physician may identify himself or herself as 36
635	635	a doctor. 37
636	636	3. While acting as the supervising osteopathic physician of an 38
637	637	associate osteopathic physician, an osteopathic physician shall 39
638	638	wear an identification badge that clearly identifies the person as a 40
639	639	supervising osteopathic physician of an associate osteopathic 41
640	640	physician. 42
641	641	Sec. 17. 1. An osteopathic physician shall not serve as the 43
642	642	supervising osteopathic physician of an associate osteopathic 44
643	643	physician pursuant to subsection 1 of section 15 of this act or the 45
644	644	– 14 –
645	645
646	646
647	647	- AB170
648	648	designee of a supervising osteopathic physician pursuant to 1
649	649	subsection 4 of section 15 of this act unless the osteopathic 2
650	650	physician: 3
651	651	(a) Holds an active unrestricted license to practice osteopathic 4
652	652	medicine in this State; 5
653	653	(b) Practices in the same specialty area as the associate 6
654	654	osteopathic physician or a substantially similar specialty area as 7
655	655	the associate osteopathic physician; and 8
656	656	(c) Normally provides care to patients. 9
657	657	2. The supervising osteopathic physician of an associate 10
658	658	osteopathic physician: 11
659	659	(a) Is responsible for any act that constitutes the practice of 12
660	660	osteopathic medicine by the associate osteopathic physician; 13
661	661	(b) Must have insurance that includes coverage for any claim 14
662	662	of malpractice against the associate osteopathic physician; and 15
663	663	(c) May not enter into a collaborative practice agreement with 16
664	664	more than three associate osteopathic physicians. 17
665	665	3. The Board may not deny, revoke or suspend the license of 18
666	666	or take any other disciplinary action against the supervising 19
667	667	osteopathic physician of an associate osteopathic physician for 20
668	668	any act performed by the associate osteopathic physician that: 21
669	669	(a) Is performed in accordance with the collaborative practice 22
670	670	agreement entered into pursuant to section 15 of this act; and 23
671	671	(b) Does not violate applicable federal, state or local laws or 24
672	672	the regulations of the Board. 25
673	673	Sec. 18. 1. A collaborative practice agreement entered into 26
674	674	pursuant to section 15 of this act must be in writing and must 27
675	675	include, without limitation: 28
676	676	(a) The names, home and business addresses and telephone 29
677	677	numbers of the supervising osteopathic physician and associate 30
678	678	osteopathic physician; 31
679	679	(b) A list of each location where the associate osteopathic 32
680	680	physician may practice osteopathic medicine, including, without 33
681	681	limitation, the prescribing and dispensing of controlled 34
682	682	substances; 35
683	683	(c) Any specialty or board certification held by the supervising 36
684	684	osteopathic physician; 37
685	685	(d) Any certification held by the associate osteopathic 38
686	686	physician; 39
687	687	(e) Requirements governing collaboration between the 40
688	688	supervising osteopathic physician and the associate osteopathic 41
689	689	physician, including, without limitation: 42
690	690	(1) The geographic proximity which must exist between the 43
691	691	supervising osteopathic physician and the associate osteopathic 44
692	692	– 15 –
693	693
694	694
695	695	- AB170
696	696	physician while the associate osteopathic physician is practicing 1
697	697	osteopathic medicine; and 2
698	698	(2) A plan for alternative supervision if the supervising 3
699	699	osteopathic physician is absent, incapacitated or otherwise 4
700	700	unavailable; 5
701	701	(f) Any controlled substance the supervising osteopathic 6
702	702	physician authorizes the associate osteopathic physician to 7
703	703	prescribe or dispense in accordance with section 19 of this act; 8
704	704	(g) The procedure by which the supervising osteopathic 9
705	705	physician will review the standard of care the associate 10
706	706	osteopathic physician is providing to patients, which must comply 11
707	707	with the regulations adopted pursuant to section 21 of this act; 12
708	708	(h) The duration of the collaborative practice agreement; and 13
709	709	(i) A statement of any other collaborative practice agreements 14
710	710	into which: 15
711	711	(1) The supervising osteopathic physician has entered with 16
712	712	another associate osteopathic physician; and 17
713	713	(2) The associate osteopathic physician has entered with 18
714	714	another supervising osteopathic physician. 19
715	715	2. Upon entering into a new collaborative practice agreement 20
716	716	with an associate osteopathic physician, a supervising osteopathic 21
717	717	physician shall file with the Board: 22
718	718	(a) A copy of the agreement; and 23
719	719	(b) Proof that any controlled substance included in the 24
720	720	agreement pursuant to paragraph (f) of subsection 1 is within the 25
721	721	skill, training and competence of the associate osteopathic 26
722	722	physician and his or her supervising osteopathic physician to 27
723	723	prescribe and dispense. 28
724	724	3. A supervising osteopathic physician or associate 29
725	725	osteopathic physician may terminate a collaborative practice 30
726	726	agreement or a relationship with a supervising osteopathic 31
727	727	physician or an associate osteopathic physician, as applicable, at 32
728	728	any time. Any provision of a collaborative practice agreement or 33
729	729	any other agreement that limits the authority of a supervising 34
730	730	osteopathic physician or an associate osteopathic physician to 35
731	731	terminate a collaborative practice agreement or such a 36
732	732	relationship is void. 37
733	733	Sec. 19. 1. An associate osteopathic physician may 38
734	734	prescribe or dispense the controlled substances listed in subsection 39
735	735	2 under the conditions prescribed by this section if the associate 40
736	736	osteopathic physician: 41
737	737	(a) Is registered with the State Board of Pharmacy pursuant to 42
738	738	NRS 639.1373; 43
739	739	– 16 –
740	740
741	741
742	742	- AB170
743	743	(b) Has entered into a collaborative practice agreement 1
744	744	pursuant to section 15 of this act authorizing the associate 2
745	745	osteopathic physician to prescribe the controlled substance; and 3
746	746	(c) Meets all other requirements prescribed by federal and 4
747	747	state law to prescribe controlled substances. 5
748	748	2. Subject to the limitations prescribed in NRS 639.1373, an 6
749	749	associate osteopathic physician who meets the requirements of 7
750	750	subsection 1 may prescribe or dispense: 8
751	751	(a) Any controlled substance listed in schedule III, IV or V; 9
752	752	and 10
753	753	(b) Any controlled substance listed in schedule II that contains 11
754	754	hydrocodone. 12
755	755	3. Except as otherwise provided in this subsection, an 13
756	756	associate osteopathic physician shall not prescribe or dispense 14
757	757	more than a 5-day supply of a controlled substance listed in 15
758	758	schedule II or III. An associate osteopathic physician may 16
759	759	prescribe or dispense a 30-day supply of buprenorphine for the 17
760	760	treatment of a substance use disorder under the direction of his or 18
761	761	her supervising osteopathic physician. 19
762	762	4. An associate osteopathic physician shall not prescribe or 20
763	763	dispense controlled substances unless: 21
764	764	(a) The supervising osteopathic physician of the associate 22
765	765	osteopathic physician is physically present on the same premises; 23
766	766	or 24
767	767	(b) The associate osteopathic physician has, at any time, 25
768	768	completed 120 hours practicing osteopathic medicine over a period 26
769	769	of not more than 4 months with his or her supervising osteopathic 27
770	770	physician physically present on the same premises. 28
771	771	Sec. 20. 1. A limited license to practice osteopathic 29
772	772	medicine as an associate osteopathic physician issued pursuant to 30
773	773	section 14 of this act expires 2 years after it is issued. 31
774	774	2. The Board may renew a limited license to practice 32
775	775	osteopathic medicine as an associate osteopathic physician upon 33
776	776	application by the associate osteopathic physician. An application 34
777	777	for renewal must include, without limitation, proof that the 35
778	778	associate osteopathic physician has actually engaged in the 36
779	779	practice of osteopathic medicine under a collaborative practice 37
780	780	agreement entered into pursuant to section 15 of this act during 38
781	781	the immediately preceding 2 years. 39
782	782	Sec. 21. 1. The Board shall adopt regulations necessary: 40
783	783	(a) To carry out the provisions of sections 14 to 21, inclusive, 41
784	784	of this act, including, without limitation: 42
785	785	(1) Any additional requirements for the issuance or 43
786	786	renewal of a limited license to practice osteopathic medicine as an 44
787	787	associate osteopathic physician. 45
788	788	– 17 –
789	789
790	790
791	791	- AB170
792	792	(2) The standards for the approval of programs of 1
793	793	postgraduate medical education pursuant to paragraph (c) of 2
794	794	subsection 4 of section 14 of this act. 3
795	795	(3) The required fees for the issuance and renewal of such 4
796	796	a license. 5
797	797	(4) Standards of practice for associate osteopathic 6
798	798	physicians, including, without limitation, limitations on the 7
799	799	practice of osteopathic medicine by an associate osteopathic 8
800	800	physician in addition to those prescribed by sections 14 to 21, 9
801	801	inclusive, of this act. 10
802	802	(5) Any additional requirements governing collaborative 11
803	803	practice agreements entered into pursuant to section 15 of this act. 12
804	804	(6) Requirements concerning the supervision of an 13
805	805	associate osteopathic physician by a supervising osteopathic 14
806	806	physician, including, without limitation, requirements governing 15
807	807	the review by the supervising osteopathic physician of the standard 16
808	808	of care the associate osteopathic physician is providing to patients. 17
809	809	Such regulations must not be more stringent than any similar 18
810	810	requirements that apply to physician assistants. 19
811	811	(b) For an associate osteopathic physician to be eligible to 20
812	812	work in a clinic that receives federal funding. 21
813	813	2. The regulations adopted pursuant to this section and NRS 22
814	814	633.471 must not require an associate osteopathic physician to 23
815	815	complete a greater amount of continuing education than an 24
816	816	osteopathic physician licensed pursuant to NRS 633.311. 25
817	817	3. The Board shall publish on an Internet website maintained 26
818	818	by the Board the name of each associate osteopathic physician and 27
819	819	the osteopathic physician or osteopathic physicians supervising 28
820	820	the associate osteopathic physician. 29
821	821	Sec. 22. NRS 633.123 is hereby amended to read as follows: 30
822	822	633.123 “Supervising osteopathic physician” means an 31
823	823	osteopathic physician who is licensed in this State, is in good 32
824	824	standing with the Board and [supervises] : 33
825	825	1. Supervises a physician assistant with Board approval [.] ; or 34
826	826	2. Supervises an associate osteopathic physician. 35
827	827	Sec. 23. NRS 633.311 is hereby amended to read as follows: 36
828	828	633.311 1. Except as otherwise provided in NRS 633.315 37
829	829	and 633.381 to 633.419, inclusive, and sections 14 to 21, inclusive, 38
830	830	of this act, an applicant for a license to practice osteopathic 39
831	831	medicine may be issued a license by the Board if: 40
832	832	(a) The applicant is 21 years of age or older; 41
833	833	(b) The applicant is a graduate of a school of osteopathic 42
834	834	medicine; 43
835	835	(c) The applicant: 44
836	836	– 18 –
837	837
838	838
839	839	- AB170
840	840	(1) Has graduated from a school of osteopathic medicine 1
841	841	before 1995 and has completed: 2
842	842	(I) A hospital internship; or 3
843	843	(II) One year of postgraduate training that complies with 4
844	844	the standards of intern training established by the American 5
845	845	Osteopathic Association; 6
846	846	(2) Has completed 3 years, or such other length of time as 7
847	847	required by a specific program, of postgraduate medical education 8
848	848	as a resident in the United States or Canada in a program approved 9
849	849	by the Board, the Bureau of Professional Education of the American 10
850	850	Osteopathic Association or the Accreditation Council for Graduate 11
851	851	Medical Education; or 12
852	852	(3) Is a resident who is enrolled in a postgraduate training 13
853	853	program in this State, has completed 24 months of the program and 14
854	854	has committed, in writing, that he or she will complete the program; 15
855	855	(d) The applicant applies for the license as provided by law; 16
856	856	(e) The applicant passes: 17
857	857	(1) All parts of the licensing examination of the National 18
858	858	Board of Osteopathic Medical Examiners; 19
859	859	(2) All parts of the licensing examination of the Federation 20
860	860	of State Medical Boards; 21
861	861	(3) All parts of the licensing examination of the Board, a 22
862	862	state, territory or possession of the United States, or the District of 23
863	863	Columbia, and is certified by a specialty board of the American 24
864	864	Osteopathic Association or by the American Board of Medical 25
865	865	Specialties; or 26
866	866	(4) A combination of the parts of the licensing examinations 27
867	867	specified in subparagraphs (1), (2) and (3) that is approved by the 28
868	868	Board; 29
869	869	(f) The applicant pays the fees provided for in this chapter; and 30
870	870	(g) The applicant submits all information required to complete 31
871	871	an application for a license. 32
872	872	2. An applicant for a license to practice osteopathic medicine 33
873	873	may satisfy the requirements for postgraduate education or training 34
874	874	prescribed by paragraph (c) of subsection 1: 35
875	875	(a) In one or more approved postgraduate programs, which may 36
876	876	be conducted at one or more facilities in this State or, except for a 37
877	877	resident who is enrolled in a postgraduate training program in this 38
878	878	State pursuant to subparagraph (3) of paragraph (c) of subsection 1, 39
879	879	in the District of Columbia or another state or territory of the United 40
880	880	States; 41
881	881	(b) In one or more approved specialties or disciplines; 42
882	882	(c) In nonconsecutive months; and 43
883	883	(d) At any time before receiving his or her license. 44
884	884	– 19 –
885	885
886	886
887	887	- AB170
888	888	Sec. 24. NRS 633.467 is hereby amended to read as follows: 1
889	889	633.467 An osteopathic physician who does not normally 2
890	890	provide care to patients may not be [a] the supervising osteopathic 3
891	891	physician [.] of a physician assistant. 4
892	892	Sec. 25. NRS 633.471 is hereby amended to read as follows: 5
893	893	633.471 1. Except as otherwise provided in subsection 15 , 6
894	894	[and] NRS 633.491 [,] and section 20 of this act, every holder of a 7
895	895	license, except a physician assistant or an anesthesiologist assistant, 8
896	896	issued under this chapter, except a temporary or a special license, 9
897	897	may renew the license on or before January 1 of each calendar year 10
898	898	after its issuance by: 11
899	899	(a) Applying for renewal on forms provided by the Board; 12
900	900	(b) Paying the annual license renewal fee specified in this 13
901	901	chapter; 14
902	902	(c) Submitting a list of all actions filed or claims submitted to 15
903	903	arbitration or mediation for malpractice or negligence against the 16
904	904	holder during the previous year; 17
905	905	(d) Subject to subsection 14, submitting evidence to the Board 18
906	906	that in the year preceding the application for renewal the holder has 19
907	907	attended courses or programs of continuing education approved by 20
908	908	the Board in accordance with regulations adopted by the Board 21
909	909	totaling a number of hours established by the Board which must not 22
910	910	be less than 35 hours nor more than that set in the requirements for 23
911	911	continuing medical education of the American Osteopathic 24
912	912	Association; [and] 25
913	913	(e) Submitting a list of the names of each associate osteopathic 26
914	914	physician supervised by the holder, if applicable; and 27
915	915	(f) Submitting all information required to complete the renewal. 28
916	916	2. The Secretary of the Board shall notify each licensee of the 29
917	917	requirements for renewal not less than 30 days before the date of 30
918	918	renewal. 31
919	919	3. The Board shall request submission of verified evidence of 32
920	920	completion of the required number of hours of continuing medical 33
921	921	education annually from a percentage of the applicants for renewal 34
922	922	of a license to practice osteopathic medicine or a license to practice 35
923	923	as a physician assistant or anesthesiologist assistant determined by 36
924	924	the Board. Subject to subsection 14, upon a request from the Board, 37
925	925	an applicant for renewal of a license to practice osteopathic 38
926	926	medicine or a license to practice as a physician assistant or 39
927	927	anesthesiologist assistant shall submit verified evidence satisfactory 40
928	928	to the Board that in the year preceding the application for renewal 41
929	929	the applicant attended courses or programs of continuing medical 42
930	930	education approved by the Board totaling the number of hours 43
931	931	established by the Board. 44
932	932	– 20 –
933	933
934	934
935	935	- AB170
936	936	4. The Board shall require each holder of a license to practice 1
937	937	osteopathic medicine to complete a course of instruction within 2 2
938	938	years after initial licensure that provides at least 2 hours of 3
939	939	instruction on evidence-based suicide prevention and awareness as 4
940	940	described in subsection 9. 5
941	941	5. The Board shall encourage each holder of a license to 6
942	942	practice osteopathic medicine to receive, as a portion of his or her 7
943	943	continuing education, training concerning methods for educating 8
944	944	patients about how to effectively manage medications, including, 9
945	945	without limitation, the ability of the patient to request to have the 10
946	946	symptom or purpose for which a drug is prescribed included on the 11
947	947	label attached to the container of the drug. 12
948	948	6. The Board shall encourage each holder of a license to 13
949	949	practice osteopathic medicine or as a physician assistant to receive, 14
950	950	as a portion of his or her continuing education, training and 15
951	951	education in the diagnosis of rare diseases, including, without 16
952	952	limitation: 17
953	953	(a) Recognizing the symptoms of pediatric cancer; and 18
954	954	(b) Interpreting family history to determine whether such 19
955	955	symptoms indicate a normal childhood illness or a condition that 20
956	956	requires additional examination. 21
957	957	7. The Board shall require, as part of the continuing education 22
958	958	requirements approved by the Board, the biennial completion by a 23
959	959	holder of a license to practice osteopathic medicine of at least 2 24
960	960	hours of continuing education credits in ethics, pain management, 25
961	961	care of persons with addictive disorders or the screening, brief 26
962	962	intervention and referral to treatment approach to substance use 27
963	963	disorder. 28
964	964	8. The continuing education requirements approved by the 29
965	965	Board must allow the holder of a license as an osteopathic 30
966	966	physician, physician assistant or anesthesiologist assistant to receive 31
967	967	credit toward the total amount of continuing education required by 32
968	968	the Board for the completion of a course of instruction relating to 33
969	969	genetic counseling and genetic testing. 34
970	970	9. The Board shall require each holder of a license to practice 35
971	971	osteopathic medicine to receive as a portion of his or her continuing 36
972	972	education at least 2 hours of instruction every 4 years on evidence-37
973	973	based suicide prevention and awareness which may include, without 38
974	974	limitation, instruction concerning: 39
975	975	(a) The skills and knowledge that the licensee needs to detect 40
976	976	behaviors that may lead to suicide, including, without limitation, 41
977	977	post-traumatic stress disorder; 42
978	978	(b) Approaches to engaging other professionals in suicide 43
979	979	intervention; and 44
980	980	– 21 –
981	981
982	982
983	983	- AB170
984	984	(c) The detection of suicidal thoughts and ideations and the 1
985	985	prevention of suicide. 2
986	986	10. A holder of a license to practice osteopathic medicine may 3
987	987	not substitute the continuing education credits relating to suicide 4
988	988	prevention and awareness required by this section for the purposes 5
989	989	of satisfying an equivalent requirement for continuing education in 6
990	990	ethics. 7
991	991	11. The Board shall require each holder of a license to practice 8
992	992	osteopathic medicine to complete at least 2 hours of training in the 9
993	993	screening, brief intervention and referral to treatment approach to 10
994	994	substance use disorder within 2 years after initial licensure. 11
995	995	12. The Board shall require each psychiatrist or a physician 12
996	996	assistant practicing under the supervision of a psychiatrist to 13
997	997	biennially complete one or more courses of instruction that provide 14
998	998	at least 2 hours of instruction relating to cultural competency and 15
999	999	diversity, equity and inclusion. Such instruction: 16
1000	1000	(a) May include the training provided pursuant to NRS 449.103, 17
1001	1001	where applicable. 18
1002	1002	(b) Must be based upon a range of research from diverse 19
1003	1003	sources. 20
1004	1004	(c) Must address persons of different cultural backgrounds, 21
1005	1005	including, without limitation: 22
1006	1006	(1) Persons from various gender, racial and ethnic 23
1007	1007	backgrounds; 24
1008	1008	(2) Persons from various religious backgrounds; 25
1009	1009	(3) Lesbian, gay, bisexual, transgender and questioning 26
1010	1010	persons; 27
1011	1011	(4) Children and senior citizens; 28
1012	1012	(5) Veterans; 29
1013	1013	(6) Persons with a mental illness; 30
1014	1014	(7) Persons with an intellectual disability, developmental 31
1015	1015	disability or physical disability; and 32
1016	1016	(8) Persons who are part of any other population that a 33
1017	1017	psychiatrist or physician assistant practicing under the supervision 34
1018	1018	of a psychiatrist may need to better understand, as determined by the 35
1019	1019	Board. 36
1020	1020	13. The Board shall require each holder of a license to practice 37
1021	1021	osteopathic medicine or as a physician assistant who provides or 38
1022	1022	supervises the provision of emergency medical services in a hospital 39
1023	1023	or primary care to complete at least 2 hours of training in the stigma, 40
1024	1024	discrimination and unrecognized bias toward persons who have 41
1025	1025	acquired or are at a high risk of acquiring human immunodeficiency 42
1026	1026	virus within 2 years after beginning to provide or supervise the 43
1027	1027	provision of such services or care. 44
1028	1028	– 22 –
1029	1029
1030	1030
1031	1031	- AB170
1032	1032	14. The Board shall not require a physician assistant to receive 1
1033	1033	or maintain certification by the National Commission on 2
1034	1034	Certification of Physician Assistants, or its successor organization, 3
1035	1035	or by any other nationally recognized organization for the 4
1036	1036	accreditation of physician assistants to satisfy any continuing 5
1037	1037	education requirement pursuant to paragraph (d) of subsection 1 and 6
1038	1038	subsection 3. 7
1039	1039	15. Members of the Armed Forces of the United States and the 8
1040	1040	United States Public Health Service are exempt from payment of the 9
1041	1041	annual license renewal fee during their active duty status. 10
1042	1042	16. As used in this section, “primary care” means the practice 11
1043	1043	of family medicine, pediatrics, internal medicine, obstetrics and 12
1044	1044	gynecology and midwifery. 13
1045	1045	Sec. 26. NRS 639.1373 is hereby amended to read as follows: 14
1046	1046	639.1373 1. A physician assistant or an associate physician 15
1047	1047	licensed pursuant to chapter 630 or 633 of NRS may, if authorized 16
1048	1048	by the Board, possess, administer, prescribe or dispense controlled 17
1049	1049	substances, or possess, administer, prescribe or dispense poisons, 18
1050	1050	dangerous drugs or devices in or out of the presence of his or her 19
1051	1051	supervising physician only to the extent and subject to the 20
1052	1052	limitations specified in the registration certificate issued to the 21
1053	1053	physician assistant or associate physician by the Board pursuant to 22
1054	1054	this section. 23
1055	1055	2. Each physician assistant and associate physician licensed 24
1056	1056	pursuant to chapter 630 or 633 of NRS who is authorized by his or 25
1057	1057	her physician assistant’s or associate physician’s license issued by 26
1058	1058	the Board of Medical Examiners or by the State Board of 27
1059	1059	Osteopathic Medicine, respectively, to possess, administer, 28
1060	1060	prescribe or dispense controlled substances, or to possess, 29
1061	1061	administer, prescribe or dispense poisons, dangerous drugs or 30
1062	1062	devices must apply for and obtain a registration certificate from the 31
1063	1063	Board, pay a fee to be set by regulations adopted by the Board and 32
1064	1064	pass an examination administered by the Board on the law relating 33
1065	1065	to pharmacy before the physician assistant or associate physician 34
1066	1066	can possess, administer, prescribe or dispense controlled substances, 35
1067	1067	or possess, administer, prescribe or dispense poisons, dangerous 36
1068	1068	drugs or devices. 37
1069	1069	3. The Board shall consider each application separately and 38
1070	1070	may, even though the physician assistant’s or associate physician’s 39
1071	1071	license issued by the Board of Medical Examiners or by the State 40
1072	1072	Board of Osteopathic Medicine authorizes the physician assistant or 41
1073	1073	associate physician to possess, administer, prescribe or dispense 42
1074	1074	controlled substances, or to possess, administer, prescribe or 43
1075	1075	dispense poisons, dangerous drugs and devices: 44
1076	1076	(a) Refuse to issue a registration certificate; 45
1077	1077	– 23 –
1078	1078
1079	1079
1080	1080	- AB170
1081	1081	(b) Issue a registration certificate limiting the authority of the 1
1082	1082	physician assistant or associate physician to possess, administer, 2
1083	1083	prescribe or dispense controlled substances, or to possess, 3
1084	1084	administer, prescribe or dispense poisons, dangerous drugs or 4
1085	1085	devices, the area in which the physician assistant or associate 5
1086	1086	physician may possess controlled substances, poisons, dangerous 6
1087	1087	drugs and devices, or the kind and amount of controlled substances, 7
1088	1088	poisons, dangerous drugs and devices; or 8
1089	1089	(c) Issue a registration certificate imposing other limitations or 9
1090	1090	restrictions which the Board feels are necessary and required to 10
1091	1091	protect the health, safety and welfare of the public. 11
1092	1092	4. If the registration of the physician assistant or associate 12
1093	1093	physician licensed pursuant to chapter 630 or 633 of NRS is 13
1094	1094	suspended or revoked, the physician’s controlled substance 14
1095	1095	registration may also be suspended or revoked. 15
1096	1096	5. The Board shall adopt regulations controlling the maximum 16
1097	1097	amount to be administered, possessed and dispensed, and the 17
1098	1098	storage, security, recordkeeping and transportation of controlled 18
1099	1099	substances and the maximum amount to be administered, possessed, 19
1100	1100	prescribed and dispensed and the storage, security, recordkeeping 20
1101	1101	and transportation of poisons, dangerous drugs and devices by 21
1102	1102	physician assistants and associate physicians licensed pursuant to 22
1103	1103	chapter 630 or 633 of NRS. In the adoption of those regulations, the 23
1104	1104	Board shall consider, but is not limited to, the following: 24
1105	1105	(a) The area in which the physician assistant or associate 25
1106	1106	physician is to operate; 26
1107	1107	(b) The population of that area; 27
1108	1108	(c) The experience and training of the physician assistant [;] or 28
1109	1109	associate physician; 29
1110	1110	(d) The distance to the nearest hospital and physician; and 30
1111	1111	(e) The effect on the health, safety and welfare of the public. 31
1112	1112	6. For the purposes of this section [, the] : 32
1113	1113	(a) The term “associate physician” includes an associate 33
1114	1114	osteopathic physician. 34
1115	1115	(b) The term “supervising physician” includes a supervising 35
1116	1116	osteopathic physician as defined in chapter 633 of NRS. 36
1117	1117	Sec. 27. NRS 0.040 is hereby amended to read as follows: 37
1118	1118	0.040 1. Except as otherwise provided in subsection 2, 38
1119	1119	“physician” means a person who engages in the practice of 39
1120	1120	medicine, including osteopathy and homeopathy. 40
1121	1121	2. The terms “physician,” “associate physician,” “osteopathic 41
1122	1122	physician,” “associate osteopathic physician,” “homeopathic 42
1123	1123	physician,” “chiropractic physician” and “podiatric physician” are 43
1124	1124	used in chapters 630, 630A, 633, 634 and 635 of NRS in the limited 44
1125	1125	senses prescribed by those chapters respectively. 45
1126	1126	– 24 –
1127	1127
1128	1128
1129	1129	- AB170
1130	1130	Sec. 28. 1. This section becomes effective upon passage and 1
1131	1131	approval. 2
1132	1132	2. Sections 1 to 27, inclusive, of this act become effective: 3
1133	1133	(a) Upon passage and approval for the purpose of adopting any 4
1134	1134	regulations and performing any other preparatory administrative 5
1135	1135	tasks that are necessary to carry out the provisions of this act; and 6
1136	1136	(b) On January 1, 2026, for all other purposes. 7
1137	1137
1138	1138	H