Nevada Senate Bill SB189 Latest Draft

                            REQUIRES TWO-THIRDS MAJORITY VOTE   
  (§§ 7, 8, 10, 23)  
  	S.B. 189 
 
- 	*SB189* 
 
SENATE BILL NO. 189–SENATORS LANGE; CANNIZZARO,  
CRUZ-CRAWFORD, DALY, FLORES, NEAL, OHRENSCHALL, 
PAZINA, SCHEIBLE AND TAYLOR 
 
FEBRUARY 6, 2025 
____________ 
 
Referred to Committee on Commerce and Labor 
 
SUMMARY—Provides for the licensure and regulation of genetic 
counselors. (BDR 54-69) 
 
FISCAL NOTE: Effect on Local Government: Increases or Newly 
Provides for Term of Imprisonment in County or City 
Jail or Detention Facility. 
 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 genetic counseling; prescribing certain duties 
and authority of a genetic counselor; providing for the 
regulation of the practice of genetic counseling by  
the Board of Medical Examiners; prescribing the 
requirements for the issuance and renewal of a license as 
a genetic counselor; authorizing the Board to take certain 
actions to investigate and impose discipline against a 
genetic counselor; prohibiting the unlicensed practice of 
genetic counseling except in certain circumstances; 
establishing a privilege for certain confidential 
communications; providing penalties; and providing other 
matters properly relating thereto. 
Legislative Counsel’s Digest: 
 Existing law provides for the licensure and regulation of physicians, physician 1 
assistants, anesthesiologist assistants, perfusionists and practitioners of respiratory 2 
care by the Board of Medical Examiners. (Chapter 630 of NRS) This bill 3 
additionally provides for the licensure and regulation of genetic counselors by the 4 
Board. Sections 4 and 5 of this bill define the terms “genetic counseling” and 5 
“genetic counselor,” respectively, and section 14 of this bill establishes the 6 
applicability of those definitions. Section 40 of this bill makes it a felony for a 7 
person to practice genetic counseling or hold himself or herself out as a genetic 8 
counselor without a license. Section 7 of this bill prescribes the requirements to 9 
obtain such a license, including obtaining certain education, passing certain 10 
examinations and obtaining certification from the American Board of Genetic 11   
 	– 2 – 
 
 
- 	*SB189* 
Counseling. Section 8 of this bill authorizes the Board to issue a temporary license 12 
under which a person who has obtained the required education but has not yet 13 
passed the required examination or obtained the required certification may engage 14 
in the supervised practice of genetic counseling. Section 6 of this bill requires the 15 
Board to adopt certain other regulations regarding the licensure and practice of 16 
genetic counselors. Section 9 of this bill authorizes certain unlicensed persons to 17 
provide assistance or consulting services related to genetic counseling, and section 18 
16 of this bill exempts a genetic counselor of the Federal Government from 19 
licensure and regulation by the Board. Section 9 also authorizes a physician or a 20 
physician assistant to engage in genetic counseling as part of his or her practice 21 
without obtaining a license as a genetic counselor. Section 10 of this bill prescribes 22 
the date on which a license as a genetic counselor expires and the requirements to 23 
renew such a license. Section 23 of this bill prescribes the maximum fees that the 24 
Board may charge for the issuance or renewal of a license or a temporary license as 25 
a genetic counselor. Section 11 of this bill prescribes the procedure for the 26 
voluntary surrender of such a license.  27 
 Section 12 of this bill prescribes the grounds for disciplinary action against a 28 
genetic counselor. Sections 24, 25 and 27 of this bill apply to genetic counselors 29 
the existing process for the filing of a complaint with the Board concerning a 30 
licensee or notifying the Board of certain actions taken against a licensee. Sections 31 
26, 28-33, 36 and 38 of this bill apply to genetic counselors: (1) existing 32 
procedures for the investigation of complaints and the imposition of disciplinary 33 
action against licensees; and (2) certain other existing procedures to address 34 
incompetence or misconduct by a licensee. Section 34 of this bill applies to genetic 35 
counselors the existing procedure to remove limitations that the Board has placed 36 
on a license or to restore a revoked license. Sections 36, 37, 39 and 40 of this bill 37 
authorize or require the Board to take certain actions against a person who is 38 
practicing genetic counseling or holding himself or herself out as a genetic 39 
counselor without a license. 40 
 Sections 13, 15 and 19-21 of this bill make various conforming changes so that 41 
genetic counselors are treated similarly to other providers of health care licensed by 42 
the Board for certain purposes related to licensure and regulation. Section 17 of this 43 
bill deems any act that constitutes the practice of genetic counseling to occur where 44 
the patient is located at the time the act is performed. Section 18 of this bill 45 
authorizes the Board to select genetic counselors to serve as advisory members of 46 
the Board. Sections 22 and 35 of this bill subject genetic counselors to certain 47 
provisions required by federal law for the enforcement of child support obligations. 48 
(42 U.S.C. § 666) 49 
 Existing law defines the term “provider of health care” to mean a person who 50 
practices any of certain professions related to the provision of health care. (NRS 51 
629.031) Existing law imposes certain requirements upon providers of health care, 52 
including requirements for billing, standards for advertisements and criminal 53 
penalties for acquiring certain debts. (NRS 629.071, 629.076, 629.078) Section 1 of 54 
this bill includes genetic counselors in the definition of “provider of health care,” 55 
thereby subjecting genetic counselors to those same requirements. Section 42 of 56 
this bill requires a genetic counselor to report misconduct by a person licensed or 57 
certified by the State Board of Nursing to the Executive Director of that Board. 58 
 Existing law establishes a privilege for confidential communications between a 59 
patient and a physician, dentist or chiropractor or person participating in the 60 
diagnosis or treatment of the patient under the direction of such a provider. (NRS 61 
49.215-49.245) Section 48 of this bill extends that same privilege to apply to 62 
confidential communications between a patient and a genetic counselor or a person 63 
under the direction of a genetic counselor. 64 
 Existing law provides that: (1) assault is generally a misdemeanor, with certain 65 
exceptions; and (2) assault upon a provider of health care is a gross misdemeanor or 66   
 	– 3 – 
 
 
- 	*SB189* 
felony, depending on the circumstances. (NRS 200.471) Section 51 of this bill 67 
includes a genetic counselor within the definition of “provider of health care” for 68 
that purpose, thereby making assault upon a genetic counselor a gross misdemeanor 69 
or felony, depending on the circumstances. Section 52 of this bill requires a genetic 70 
counselor to report the abuse, neglect, exploitation, isolation or abandonment of an 71 
older person or vulnerable person or the abuse or neglect of a child in the same 72 
manner as other providers of health care. A genetic counselor would also be 73 
required to report the abuse, neglect or commercial sexual exploitation of a child. 74 
(NRS 432B.220, 432C.110) Sections 41, 43 and 44 of this bill provide that a 75 
genetic counselor acting within his or her scope of practice is not violating 76 
provisions governing certain other providers of health care. Sections 2, 45-47, 49, 77 
50 and 53-59 of this bill make revisions to treat genetic counselors in the same 78 
manner as other similar providers of health care in other certain respects. 79 
 
 
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN 
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: 
 
 Section 1.  NRS 629.031 is hereby amended to read as follows: 1 
 629.031 Except as otherwise provided by a specific statute: 2 
 1.  “Provider of health care” means: 3 
 (a) A physician licensed pursuant to chapter 630, 630A or 633 4 
of NRS; 5 
 (b) A physician assistant; 6 
 (c) An anesthesiologist assistant; 7 
 (d) A genetic counselor; 8 
 (e) A dentist; 9 
 [(e)] (f) A dental therapist; 10 
 [(f)] (g) A dental hygienist; 11 
 [(g)] (h) A licensed nurse; 12 
 [(h)] (i) A person who holds a license as an attendant or who is 13 
certified as an emergency medical technician, advanced emergency 14 
medical technician or paramedic pursuant to chapter 450B of NRS 15 
or authorized to practice as an emergency medical technician, 16 
advanced emergency medical technician or paramedic in this State 17 
under the Recognition of Emergency Medical Services Personnel 18 
Licensure Interstate Compact ratified by NRS 450B.145; 19 
 [(i)] (j) A dispensing optician; 20 
 [(j)] (k) An optometrist; 21 
 [(k)] (l) A speech-language pathologist; 22 
 [(l)] (m) An audiologist; 23 
 [(m)] (n) A practitioner of respiratory care; 24 
 [(n)] (o) A licensed physical therapist; 25 
 [(o)] (p) An occupational therapist; 26 
 [(p)] (q) A podiatric physician; 27 
 [(q)] (r) A licensed psychologist; 28 
 [(r)] (s) A licensed marriage and family therapist; 29 
 [(s)] (t) A licensed clinical professional counselor; 30   
 	– 4 – 
 
 
- 	*SB189* 
 [(t)] (u) A music therapist; 1 
 [(u)] (v) A chiropractic physician; 2 
 [(v)] (w) An athletic trainer; 3 
 [(w)] (x) A perfusionist; 4 
 [(x)] (y) A doctor of Oriental medicine in any form; 5 
 [(y)] (z) A medical laboratory director or technician; 6 
 [(z)] (aa) A pharmacist; 7 
 [(aa)] (bb) A licensed dietitian; 8 
 [(bb)] (cc) An associate in social work, a social worker, a 9 
master social worker, an independent social worker or a clinical 10 
social worker licensed pursuant to chapter 641B of NRS; 11 
 [(cc)] (dd) An alcohol and drug counselor or a problem 12 
gambling counselor who is certified pursuant to chapter 641C of 13 
NRS; 14 
 [(dd)] (ee) An alcohol and drug counselor or a clinical alcohol 15 
and drug counselor who is licensed pursuant to chapter 641C of 16 
NRS; 17 
 [(ee)] (ff) A behavior analyst, assistant behavior analyst or 18 
registered behavior technician; 19 
 [(ff)] (gg) A naprapath; or 20 
 [(gg)] (hh) A medical facility as the employer of any person 21 
specified in this subsection. 22 
 2.  For the purposes of NRS 629.400 to 629.490, inclusive, the 23 
term includes a person who holds a current license or certificate to 24 
practice his or her respective discipline pursuant to the applicable 25 
provisions of law of another state or territory of the United States. 26 
 Sec. 2.  NRS 629.580 is hereby amended to read as follows: 27 
 629.580 1.  A person who provides wellness services in 28 
accordance with this section, but who is not licensed, certified or 29 
registered in this State as a provider of health care, is not in 30 
violation of any law based on the unlicensed practice of health care 31 
services or a health care profession unless the person: 32 
 (a) Performs surgery or any other procedure which punctures the 33 
skin of any person; 34 
 (b) Sets a fracture of any bone of any person; 35 
 (c) Prescribes or administers X-ray radiation to any person; 36 
 (d) Prescribes or administers a prescription drug or device or a 37 
controlled substance to any person; 38 
 (e) Recommends to a client that he or she discontinue or in any 39 
manner alter current medical treatment prescribed by a provider of 40 
health care licensed, certified or registered in this State; 41 
 (f) Makes a diagnosis of a medical disease of any person; 42 
 (g) Performs a manipulation or a chiropractic adjustment of the 43 
articulations of joints or the spine of any person; 44   
 	– 5 – 
 
 
- 	*SB189* 
 (h) Treats a person’s health condition in a manner that 1 
intentionally or recklessly causes that person recognizable and 2 
imminent risk of serious or permanent physical or mental harm;  3 
 (i) Holds out, states, indicates, advertises or implies to any 4 
person that he or she is a provider of health care; 5 
 (j) Engages in the practice of medicine or genetic counseling in 6 
violation of chapter 630 or 633 of NRS, the practice of homeopathic 7 
medicine in violation of chapter 630A of NRS, the practice of 8 
naprapathy in violation of chapter 634B of NRS or the practice of 9 
podiatry in violation of chapter 635 of NRS, unless otherwise 10 
expressly authorized by this section; 11 
 (k) Performs massage therapy as that term is defined in NRS 12 
640C.060, reflexology as that term is defined in NRS 640C.080 or 13 
structural integration as that term is defined in NRS 640C.085; 14 
 (l) Provides mental health services that are exclusive to the 15 
scope of practice of a psychiatrist licensed pursuant to chapter 630 16 
or 633 of NRS, or a psychologist licensed pursuant to chapter 641 of 17 
NRS; or 18 
 (m) Engages in the practice of applied behavior analysis in 19 
violation of chapter 641D of NRS. 20 
 2. Any person providing wellness services in this State who is 21 
not licensed, certified or registered in this State as a provider of 22 
health care and who is advertising or charging a fee for wellness 23 
services shall, before providing those services, disclose to each 24 
client in a plainly worded written statement: 25 
 (a) The person’s name, business address and telephone number; 26 
 (b) The fact that he or she is not licensed, certified or registered 27 
as a provider of health care in this State; 28 
 (c) The nature of the wellness services to be provided; 29 
 (d) The degrees, training, experience, credentials and other 30 
qualifications of the person regarding the wellness services to be 31 
provided; and 32 
 (e) A statement in substantially the following form: 33 
 34 
 It is recommended that before beginning any wellness 35 
plan, you notify your primary care physician or other licensed 36 
providers of health care of your intention to use wellness 37 
services, the nature of the wellness services to be provided 38 
and any wellness plan that may be utilized. It is also 39 
recommended that you ask your primary care physician or 40 
other licensed providers of health care about any potential 41 
drug interactions, side effects, risks or conflicts between any 42 
medications or treatments prescribed by your primary care 43 
physician or other licensed providers of health care and the 44 
wellness services you intend to receive. 45   
 	– 6 – 
 
 
- 	*SB189* 
 A person who provides wellness services shall obtain from each 1 
client a signed copy of the statement required by this subsection, 2 
provide the client with a copy of the signed statement at the time of 3 
service and retain a copy of the signed statement for a period of not 4 
less than 5 years.  5 
 3. A written copy of the statement required by subsection 2 6 
must be posted in a prominent place in the treatment location of the 7 
person providing wellness services in at least 12-point font. 8 
Reasonable accommodations must be made for clients who: 9 
 (a) Are unable to read; 10 
 (b) Are blind or visually impaired; 11 
 (c) Have communication impairments; or 12 
 (d) Do not read or speak English or any other language in which 13 
the statement is written. 14 
 4. Any advertisement for wellness services authorized pursuant 15 
to this section must disclose that the provider of those services is not 16 
licensed, certified or registered as a provider of health care in this 17 
State. 18 
 5.  A person who violates any provision of this section is guilty 19 
of a misdemeanor. Before a criminal proceeding is commenced 20 
against a person for a violation of a provision of this section, a 21 
notification, educational or mediative approach must be utilized by 22 
the regulatory body enforcing the provisions of this section to bring 23 
the person into compliance with such provisions. 24 
 6.  This section does not apply to or control: 25 
 (a) Any health care practice by a provider of health care 26 
pursuant to the professional practice laws of this State, or prevent 27 
such a health care practice from being performed. 28 
 (b) Any health care practice if the practice is exempt from the 29 
professional practice laws of this State, or prevent such a health care 30 
practice from being performed. 31 
 (c) A person who provides health care services if the person is 32 
exempt from the professional practice laws of this State, or prevent 33 
the person from performing such a health care service. 34 
 (d) A medical assistant, as that term is defined in NRS 630.0129 35 
and 633.075, an advanced practitioner of homeopathy, as that term 36 
is defined in NRS 630A.015, or a homeopathic assistant, as that 37 
term is defined in NRS 630A.035. 38 
 7.  As used in this section, “wellness services” means healing 39 
arts therapies and practices, and the provision of products, that are 40 
based on the following complementary health treatment approaches 41 
and which are not otherwise prohibited by subsection 1: 42 
 (a) Anthroposophy. 43 
 (b) Aromatherapy. 44 
 (c) Traditional cultural healing practices. 45   
 	– 7 – 
 
 
- 	*SB189* 
 (d) Detoxification practices and therapies. 1 
 (e) Energetic healing. 2 
 (f) Folk practices. 3 
 (g) Gerson therapy and colostrum therapy. 4 
 (h) Healing practices using food, dietary supplements, nutrients 5 
and the physical forces of heat, cold, water and light. 6 
 (i) Herbology and herbalism. 7 
 (j) Reiki. 8 
 (k) Mind-body healing practices. 9 
 (l) Nondiagnostic iridology. 10 
 (m) Noninvasive instrumentalities. 11 
 (n) Holistic kinesiology. 12 
 Sec. 3.  Chapter 630 of NRS is hereby amended by adding 13 
thereto the provisions set forth as sections 4 to 12, inclusive, of this 14 
act. 15 
 Sec. 4.  1. “Genetic counseling” means: 16 
 (a) Obtaining and evaluating the medical histories of patients 17 
and their families to determine the risk of medical or genetic 18 
conditions in the patient, his or her children and other family 19 
members; 20 
 (b) Discussing the features, natural history and means of 21 
diagnosing medical or genetic conditions, genetic and 22 
environmental factors that affect such conditions and ways to 23 
manage the risk related to such conditions; 24 
 (c) Identifying, ordering and coordinating genetic laboratory 25 
tests as appropriate to assess the genetics of a patient; 26 
 (d) Integrating the results of genetic laboratory tests and other 27 
diagnostic studies with the medical histories of patients and their 28 
families to assess and communicate the existence and severity of 29 
risk factors for medical or genetic conditions; 30 
 (e) Explaining the clinical implications and results of a genetic 31 
laboratory test; 32 
 (f) Evaluating the responses of a patient or the family of a 33 
patient to learning of a genetic or medical condition or the risk of 34 
such a condition occurring or recurring and providing patient-35 
centered counseling and anticipatory guidance; 36 
 (g) Identifying and utilizing resources in the community that 37 
provide medical, educational, financial and psychosocial support 38 
and advocacy for persons who have or are at risk of having 39 
medical or genetic conditions; and 40 
 (h) Providing written documentation of medical and genetic 41 
information, and counseling relating to such information, for 42 
patients, families of patients and providers of health care. 43 
 2. The term does not include diagnosis or treatment. 44   
 	– 8 – 
 
 
- 	*SB189* 
 Sec. 5.  “Genetic counselor” means a person who is licensed 1 
to engage in the practice of genetic counseling by the Board. 2 
 Sec. 6.  The Board shall adopt regulations regarding the 3 
licensure and practice of genetic counselors, including, without 4 
limitation, regulations: 5 
 1. Adopting by reference the Code of Ethics published by the 6 
National Society of Genetic Counselors, or its successor 7 
organization, as a code of ethics governing the professional 8 
conduct of genetic counselors; 9 
 2.  Defining “temporary basis” for the purposes of subsection 10 
3 of section 9 of this act; and 11 
 3. Establishing the requirements for the renewal of a license, 12 
in addition to those set forth in section 10 of this act. 13 
 Sec. 7.  To be eligible for licensing by the Board as a genetic 14 
counselor, an applicant must: 15 
 1. Be a natural person of good moral character; 16 
 2. Submit a completed application as required by the Board 17 
by the date established by the Board; 18 
 3. Submit the fee prescribed by the Board pursuant to  19 
NRS 630.268; 20 
 4. Have received a master’s degree or higher in genetic 21 
counseling from a program in genetic counseling that is: 22 
 (a) Accredited by the Accreditation Council for Genetic 23 
Counseling, or its successor organization; or 24 
 (b) Located in a foreign country and has educational 25 
standards that are at least as stringent as those established by the 26 
Accreditation Council for Genetic Counseling, or its successor 27 
organization, as determined by the Board; 28 
 5. Pass the examination administered by the American Board 29 
of Genetic Counseling, or its successor organization, or the 30 
examination in clinical genetics and genomics administered by the 31 
American Board of Medical Genetics and Genomics, or its 32 
successor organization; and 33 
 6. Hold a valid certification issued by the American Board of 34 
Genetic Counseling, or its successor organization. 35 
 Sec. 8.  1. The Board may issue a temporary license to 36 
practice as a genetic counselor to a person who: 37 
 (a) Has satisfied all requirements for licensure except the 38 
requirements of subsections 5 and 6 of section 7 of this act; and 39 
 (b) Submits the fee prescribed by the Board pursuant to  40 
NRS 630.268. 41 
 2. Except as otherwise provided in subsections 3 and 4, a 42 
temporary license to practice as a genetic counselor issued 43 
pursuant to this section expires on the earlier of: 44   
 	– 9 – 
 
 
- 	*SB189* 
 (a) The issuance to the temporarily licensed genetic counselor 1 
of a license as a genetic counselor pursuant to section 7 of this 2 
act; 3 
 (b) If the temporarily licensed genetic counselor passes an 4 
examination described in subsection 5 of section 7 of this act, 30 5 
days after the results of the examination are issued by the 6 
administering organization; or 7 
 (c) One year after the date on which the temporarily licensed 8 
genetic counselor temporary license is issued pursuant to this 9 
section. 10 
 3. The Board may renew a temporary license issued pursuant 11 
to this section once for good cause, as determined by the Board, if 12 
the temporarily licensed genetic counselor: 13 
 (a) Maintains active status as a candidate with the American 14 
Board of Genetic Counseling, or its successor organization; and 15 
 (b) Submits the fee prescribed by the Board pursuant to  16 
NRS 630.268. 17 
 4. If the Board renews a temporary license pursuant to 18 
subsection 3, the Board shall prescribe the length of time for 19 
which the temporary license remains valid. 20 
 5. A temporarily licensed genetic counselor may practice 21 
genetic counseling only under the supervision of a genetic 22 
counselor or a physician. The supervisor shall assess the work of 23 
the temporarily licensed genetic counselor, but is not required to 24 
be present while the temporarily licensed genetic counselor is 25 
practicing genetic counseling. 26 
 6. Before commencing a supervisory relationship pursuant to 27 
subsection 5 and annually thereafter for the duration of the 28 
supervisory relationship, a supervisor and a temporarily licensed 29 
genetic counselor must enter into a contract that prescribes the 30 
responsibilities of the supervisor and the temporarily licensed 31 
genetic counselor. 32 
 7. The Board may adopt regulations establishing additional 33 
requirements for the supervision of a temporarily licensed genetic 34 
counselor pursuant to subsection 5. 35 
 Sec. 9.  1. A student who is enrolled in a program in genetic 36 
counseling described in subsection 4 of section 7 of this act and 37 
who does not hold a license to practice genetic counseling may 38 
assist a genetic counselor in the practice of genetic counseling if 39 
such assistance is within the scope of the education and training 40 
of the student. 41 
 2. Any other person who is not licensed to practice genetic 42 
counseling may assist a genetic counselor in the practice of 43 
genetic counseling under the direct supervision of a genetic 44   
 	– 10 – 
 
 
- 	*SB189* 
counselor who is on the same premises where the assistance is 1 
being provided. 2 
 3. A person who is not licensed to practice genetic counseling 3 
in this State, the District of Columbia or any state or territory of 4 
the United States but holds a valid certification issued by the 5 
American Board of Genetic Counseling, or its successor 6 
organization, may provide consulting services related to genetic 7 
counseling in this State on a temporary basis if he or she receives 8 
authorization from the Board. 9 
 4. A physician or physician assistant who engages in genetic 10 
counseling as part of his or her practice of medicine or practice as 11 
a physician assistant, as applicable, is not required to obtain a 12 
license as a genetic counselor. 13 
 Sec. 10.  1. Each license issued pursuant to section 7 of this 14 
act expires on June 30 or, if June 30 is a Saturday, Sunday or 15 
legal holiday, on the next business day after June 30, of every odd-16 
numbered year and may be renewed if, before the license expires, 17 
the holder of the license submits to the Board: 18 
 (a) A completed application for renewal on a form prescribed 19 
by the Board; 20 
 (b) Proof that the applicant has successfully completed at least 21 
30 hours of continuing education approved by the National 22 
Society of Genetic Counselors, or its successor organization, since 23 
the license was issued or most recently renewed, as applicable; 24 
 (c) Proof that the applicant holds a valid certification issued by 25 
the American Board of Genetic Counseling, or its successor 26 
organization; 27 
 (d) Proof that the applicant has satisfied any other 28 
requirements prescribed by the regulations adopted by the Board 29 
pursuant to section 6 of this act; and 30 
 (e) The applicable fee for renewal of the license prescribed by 31 
the Board pursuant to NRS 630.268. 32 
 2. The Board shall send a notice of renewal to each licensee 33 
not later than 60 days before his or her license expires. The notice 34 
must include the amount of the fee for renewal of the license. 35 
 Sec. 11.  1. If a genetic counselor desires to surrender his or 36 
her license, the genetic counselor shall submit to the Board a 37 
sworn written statement of surrender of the license and the actual 38 
license issued to him or her. The Board may accept or reject the 39 
surrender of the license and may negotiate stipulations for 40 
accepting the surrender of the license.  41 
 2. If the Board accepts the surrender of a license pursuant to 42 
subsection 1, the Board may restore the license at a later date 43 
under such conditions as the Board deems appropriate. 44   
 	– 11 – 
 
 
- 	*SB189* 
 Sec. 12.  1. The following acts constitute grounds for 1 
initiating disciplinary action against a genetic counselor or 2 
denying licensure as a genetic counselor: 3 
 (a) Obtaining, maintaining or renewing or attempting to 4 
obtain, maintain or renew a license to practice genetic counseling 5 
by bribery, fraud or misrepresentation or by any false, misleading, 6 
inaccurate or incomplete statement. 7 
 (b) Disobeying any order of the Board or an investigative 8 
committee of the Board. 9 
 (c) Conviction of: 10 
  (1) A crime relating to the practice of genetic counseling; 11 
  (2) A violation of any of the provisions of NRS 616D.200, 12 
616D.220, 616D.240 or 616D.300 to 616D.440, inclusive; or 13 
  (3) Any offense involving moral turpitude. 14 
 (d) Being adjudicated incompetent or incapacitated. 15 
 (e) Advertising the practice of genetic counseling in a false, 16 
deceptive or misleading manner. 17 
 (f) Advertising, practicing or attempting to practice genetic 18 
counseling under a name other than one’s own. 19 
 (g) Practicing or assisting in the practice of genetic counseling 20 
while under the influence of alcohol, any controlled substance or 21 
any other substance which impairs the mental capacity of the 22 
genetic counselor. 23 
 (h) Violating the Code of Ethics adopted by reference pursuant 24 
to section 6 of this act. 25 
 (i) Lack of ability to safely and skillfully practice genetic 26 
counseling due to a lack of knowledge or training or the inability 27 
to apply professional principles and skills. 28 
 (j) Violating or attempting to violate, or assisting or abetting 29 
the violation of, or conspiring to violate any provision of this 30 
chapter or the regulations adopted pursuant thereto. 31 
 (k) Encouraging a patient who is an expectant parent to obtain 32 
an abortion. 33 
 (l) Any disciplinary action, including, without limitation, the 34 
revocation, suspension, modification or limitation of a license to 35 
practice genetic counseling, taken by another state, the Federal 36 
Government, a foreign country or any other jurisdiction or the 37 
surrender of the license or discontinuing the practice of genetic 38 
counseling while under investigation by any licensing authority, a 39 
medical facility, a branch of the Armed Forces of the United 40 
States, an insurance company, an agency of the Federal 41 
Government or an employer. 42 
 (m) Failure to be found competent to practice genetic 43 
counseling as a result of an examination to determine competency 44 
pursuant to NRS 630.318. 45   
 	– 12 – 
 
 
- 	*SB189* 
 (n) Performing or supervising the performance of a pelvic 1 
examination in violation of NRS 629.085. 2 
 (o) Operation of a medical facility at any time during which: 3 
  (1) The license of the facility is suspended or revoked; or 4 
  (2) An act or omission occurs which results in the 5 
suspension or revocation of the license pursuant to NRS 449.160. 6 
 This paragraph applies to an owner or other principal 7 
responsible for the operation of the facility. 8 
 (p) Any other grounds specified by regulation of the Board. 9 
 2.  A genetic counselor shall notify the Board not later than 10 
48 hours after the certification of the genetic counselor by the 11 
American Board of Genetic Counseling, or its successor 12 
organization, lapses or is revoked. Upon receipt of such 13 
notification, the Board shall immediately revoke the license of the 14 
genetic counselor. 15 
 Sec. 13.  NRS 630.003 is hereby amended to read as follows: 16 
 630.003 1.  The Legislature finds and declares that: 17 
 (a) It is among the responsibilities of State Government to 18 
ensure, as far as possible, that only competent persons practice 19 
medicine, genetic counseling, perfusion and respiratory care within 20 
this State; 21 
 (b) For the protection and benefit of the public, the Legislature 22 
delegates to the Board of Medical Examiners the power and duty to 23 
determine the initial and continuing competence of physicians, 24 
genetic counselors, perfusionists, physician assistants, 25 
anesthesiologist assistants and practitioners of respiratory care who 26 
are subject to the provisions of this chapter; 27 
 (c) The Board must exercise its regulatory power to ensure that 28 
the interests of the medical profession do not outweigh the interests 29 
of the public; 30 
 (d) The Board must ensure that unfit physicians, genetic 31 
counselors, perfusionists, physician assistants, anesthesiologist 32 
assistants and practitioners of respiratory care are removed from [the 33 
medical profession] those professions so that they will not cause 34 
harm to the public; and 35 
 (e) The Board must encourage and allow for public input into its 36 
regulatory activities to further improve the quality of medical 37 
practice within this State. 38 
 2.  The powers conferred upon the Board by this chapter must 39 
be liberally construed to carry out these purposes for the protection 40 
and benefit of the public. 41 
 Sec. 14.  NRS 630.005 is hereby amended to read as follows: 42 
 630.005 As used in this chapter, unless the context otherwise 43 
requires, the words and terms defined in NRS 630.007 to 630.026, 44   
 	– 13 – 
 
 
- 	*SB189* 
inclusive, and sections 4 and 5 of this act have the meanings 1 
ascribed to them in those sections. 2 
 Sec. 15.  NRS 630.045 is hereby amended to read as follows: 3 
 630.045 1.  The purpose of licensing physicians, genetic 4 
counselors, perfusionists, physician assistants, anesthesiologist 5 
assistants and practitioners of respiratory care is to protect the public 6 
health and safety and the general welfare of the people of this State. 7 
 2.  Any license issued pursuant to this chapter is a revocable 8 
privilege. 9 
 Sec. 16.  NRS 630.047 is hereby amended to read as follows: 10 
 630.047 1.  This chapter does not apply to: 11 
 (a) A medical officer [or] , genetic counselor, perfusionist or 12 
practitioner of respiratory care of the Armed Forces or a medical 13 
officer [or] , genetic counselor, perfusionist or practitioner of 14 
respiratory care of any division or department of the United States in 15 
the discharge of his or her official duties, including, without 16 
limitation, providing medical care in a hospital in accordance with 17 
an agreement entered into pursuant to NRS 449.2455; 18 
 (b) Physicians who are called into this State, other than on a 19 
regular basis, for consultation with or assistance to a physician 20 
licensed in this State, and who are legally qualified to practice in the 21 
state where they reside; 22 
 (c) Physicians who are legally qualified to practice in the state 23 
where they reside and come into this State on an irregular basis to: 24 
  (1) Obtain medical training approved by the Board from a 25 
physician who is licensed in this State; or 26 
  (2) Provide medical instruction or training approved by the 27 
Board to physicians licensed in this State; 28 
 (d) Physicians who are temporarily exempt from licensure 29 
pursuant to NRS 630.2665 and are practicing medicine within the 30 
scope of the exemption; 31 
 (e) Any person permitted to practice any other healing art under 32 
this title who does so within the scope of that authority, or healing 33 
by faith or Christian Science; 34 
 (f) The practice of respiratory care by a student as part of a 35 
program of study in respiratory care that is approved by the Board, 36 
or is recognized by a national organization which is approved by the 37 
Board to review such programs, if the student is enrolled in the 38 
program and provides respiratory care only under the supervision of 39 
a practitioner of respiratory care; 40 
 (g) The practice of respiratory care by a student who: 41 
  (1) Is enrolled in a clinical program of study in respiratory 42 
care which has been approved by the Board; 43 
  (2) Is employed by a medical facility, as defined in NRS 44 
449.0151; and 45   
 	– 14 – 
 
 
- 	*SB189* 
  (3) Provides respiratory care to patients who are not in a 1 
critical medical condition or, in an emergency, to patients who are in 2 
a critical medical condition and a practitioner of respiratory care is 3 
not immediately available to provide that care and the student is 4 
directed by a physician to provide respiratory care under the 5 
supervision of the physician until a practitioner of respiratory care is 6 
available; 7 
 (h) The practice of respiratory care by a person on himself or 8 
herself or gratuitous respiratory care provided to a friend or a 9 
member of a person’s family if the provider of the care does not 10 
represent himself or herself as a practitioner of respiratory care; 11 
 (i) A person who is employed by a physician and provides 12 
respiratory care or services as a perfusionist under the supervision of 13 
that physician; 14 
 (j) The maintenance of medical equipment for perfusion or 15 
respiratory care that is not attached to a patient; 16 
 (k) A person who installs medical equipment for respiratory care 17 
that is used in the home and gives instructions regarding the use of 18 
that equipment if the person is trained to provide such services and 19 
is supervised by a provider of health care who is acting within the 20 
authorized scope of his or her practice; 21 
 (l) The performance of medical services by a student enrolled in 22 
an educational program for a physician assistant which is accredited 23 
by the Accreditation Review Commission on Education for the 24 
Physician Assistant, Inc., or its successor organization, as part of 25 
such a program; and 26 
 (m) A physician assistant of any division or department of the 27 
United States in the discharge of his or her official duties unless 28 
licensure by a state is required by the division or department of the 29 
United States. 30 
 2.  This chapter does not repeal or affect any statute of Nevada 31 
regulating or affecting any other healing art. 32 
 3.  This chapter does not prohibit: 33 
 (a) Gratuitous services outside of a medical school or medical 34 
facility by a person who is not a physician, genetic counselor, 35 
perfusionist, physician assistant, anesthesiologist assistant or 36 
practitioner of respiratory care in cases of emergency. 37 
 (b) The domestic administration of family remedies. 38 
 Sec. 17.  NRS 630.049 is hereby amended to read as follows: 39 
 630.049 For the purposes of this chapter, any act that 40 
constitutes the practice of medicine or genetic counseling shall be 41 
deemed to occur at the place where the patient is located at the time 42 
the act is performed. 43   
 	– 15 – 
 
 
- 	*SB189* 
 Sec. 18.  NRS 630.075 is hereby amended to read as follows: 1 
 630.075 1. The Board may, by majority vote, select 2 
physicians [, anesthesiologist assistants] and members of the public, 3 
who must meet the same qualifications as required for members of 4 
the Board, to serve as advisory members of the Board.  5 
 2. The Board may, by majority vote, select genetic counselors 6 
and anesthesiologist assistants, who must be licensed to practice in 7 
this State, be actively engaged in practice in this State and have 8 
resided and practiced in this State for at least 5 years immediately 9 
preceding the selection, to serve as advisory members of the 10 
Board. 11 
 3. One or more advisory members may be designated by the 12 
Board to assist a committee of its members in an investigation as 13 
provided in NRS 630.311 but may not vote on any matter before the 14 
committee. Advisory members may also serve as members of the 15 
panel selected to hear charges as provided in NRS 630.339 and may 16 
vote on any recommendation made by the panel to the Board. 17 
 Sec. 19.  NRS 630.120 is hereby amended to read as follows: 18 
 630.120 1.  The Board shall procure a seal. 19 
 2.  All licenses issued to physicians, genetic counselors, 20 
perfusionists, physician assistants, anesthesiologist assistants and 21 
practitioners of respiratory care must bear the seal of the Board and 22 
the signatures of its President and Secretary-Treasurer. 23 
 Sec. 20.  NRS 630.137 is hereby amended to read as follows: 24 
 630.137 1.  Notwithstanding any other provision of law and 25 
except as otherwise provided in this section, the Board shall not 26 
adopt any regulations that prohibit or have the effect of prohibiting a 27 
physician, genetic counselor, perfusionist, physician assistant, 28 
anesthesiologist assistant or practitioner of respiratory care from 29 
collaborating or consulting with another provider of health care. 30 
 2.  The provisions of this section do not prevent the Board from 31 
adopting regulations that prohibit a physician, genetic counselor, 32 
perfusionist, physician assistant, anesthesiologist assistant or 33 
practitioner of respiratory care from aiding or abetting another 34 
person in the unlicensed practice of medicine or the unlicensed 35 
practice of genetic counseling, perfusion or respiratory care. 36 
 3.  As used in this section, “provider of health care” has the 37 
meaning ascribed to it in NRS 629.031. 38 
 Sec. 21.  NRS 630.167 is hereby amended to read as follows: 39 
 630.167 1. In addition to any other requirements set forth in 40 
this chapter, each applicant for a license to practice medicine, 41 
including, without limitation, an expedited license pursuant to NRS 42 
630.1606 or 630.1607 or chapter 629A of NRS, and each applicant 43 
for a license to practice as a genetic counselor, to practice as a 44 
perfusionist, to practice as a physician assistant, to practice as an 45   
 	– 16 – 
 
 
- 	*SB189* 
anesthesiologist assistant or to practice respiratory care shall submit 1 
to the Board a complete set of fingerprints and written permission 2 
authorizing the Board to forward the fingerprints to the Central 3 
Repository for Nevada Records of Criminal History for submission 4 
to the Federal Bureau of Investigation for its report. Any fees or 5 
costs charged by the Board for this service pursuant to NRS 630.268 6 
are not refundable. 7 
 2. Any communication between the Board and the Interstate 8 
Medical Licensure Compact Commission created by NRS 629A.100 9 
relating to verification of a physician’s eligibility for expedited 10 
licensure pursuant to that section must not include any information 11 
received in a report from the Federal Bureau of Investigation 12 
relating to a state and federal criminal records check performed for 13 
the purposes of an application for an expedited license issued 14 
pursuant to NRS 629A.100. 15 
 Sec. 22.  NRS 630.197 is hereby amended to read as follows: 16 
 630.197 1.  In addition to any other requirements set forth in 17 
this chapter: 18 
 (a) An applicant for the issuance of a license to practice 19 
medicine, to practice as a genetic counselor, to practice as a 20 
perfusionist, to practice as a physician assistant, to practice as an 21 
anesthesiologist assistant or to practice as a practitioner of 22 
respiratory care shall include the social security number of the 23 
applicant in the application submitted to the Board. 24 
 (b) An applicant for the issuance or renewal of a license to 25 
practice medicine, to practice as a genetic counselor, to practice as 26 
a perfusionist, to practice as a physician assistant, to practice as an 27 
anesthesiologist assistant or to practice as a practitioner of 28 
respiratory care shall submit to the Board the statement prescribed 29 
by the Division of Welfare and Supportive Services of the 30 
Department of Health and Human Services pursuant to NRS 31 
425.520. The statement must be completed and signed by the 32 
applicant. 33 
 2.  The Board shall include the statement required pursuant to 34 
subsection 1 in: 35 
 (a) The application or any other forms that must be submitted 36 
for the issuance or renewal of the license; or 37 
 (b) A separate form prescribed by the Board. 38 
 3.  A license to practice medicine, to practice as a genetic 39 
counselor, to practice as a perfusionist, to practice as a physician 40 
assistant, to practice as an anesthesiologist assistant or to practice as 41 
a practitioner of respiratory care may not be issued or renewed by 42 
the Board if the applicant: 43 
 (a) Fails to submit the statement required pursuant to subsection 44 
1; or 45   
 	– 17 – 
 
 
- 	*SB189* 
 (b) Indicates on the statement submitted pursuant to subsection 1 
1 that the applicant is subject to a court order for the support of a 2 
child and is not in compliance with the order or a plan approved by 3 
the district attorney or other public agency enforcing the order for 4 
the repayment of the amount owed pursuant to the order. 5 
 4.  If an applicant indicates on the statement submitted pursuant 6 
to subsection 1 that the applicant is subject to a court order for the 7 
support of a child and is not in compliance with the order or a plan 8 
approved by the district attorney or other public agency enforcing 9 
the order for the repayment of the amount owed pursuant to the 10 
order, the Board shall advise the applicant to contact the district 11 
attorney or other public agency enforcing the order to determine the 12 
actions that the applicant may take to satisfy the arrearage. 13 
 Sec. 23.  NRS 630.268 is hereby amended to read as follows: 14 
 630.268 1.  The Board shall charge and collect not more than 15 
the following fees: 16 
 17 
For application for and issuance of a license to 18 
practice as a physician, including a license by 19 
endorsement ................................................................ $600 20 
For application for and issuance of a temporary, 21 
locum tenens, limited, restricted, authorized 22 
facility, special, special purpose or special 23 
event license .................................................................. 400 24 
For renewal of a limited, restricted, authorized 25 
facility or special license ............................................... 400 26 
For application for and issuance of a license as a 27 
physician assistant, including a license by 28 
endorsement .................................................................. 400 29 
For application for and issuance of a 30 
simultaneous license as a physician assistant ................ 200 31 
For biennial registration of a physician assistant................ 800 32 
For biennial simultaneous registration of a 33 
physician assistant ......................................................... 400 34 
For biennial registration of a physician .............................. 800 35 
For application for and issuance of a license as a 36 
perfusionist or practitioner of respiratory care .............. 400 37 
For biennial renewal of a license as a 38 
perfusionist .................................................................... 600 39 
For application for and issuance of a license or 40 
temporary license to practice as an 41 
anesthesiologist assistant ............................................... 400 42 
For application for and initial issuance of a 43 
simultaneous license as an anesthesiologist 44 
assistant ......................................................................... 200 45   
 	– 18 – 
 
 
- 	*SB189* 
For biennial registration of an anesthesiologist 1 
assistant ....................................................................... $800 2 
For biennial simultaneous registration of an 3 
anesthesiologist assistant ............................................... 400 4 
For biennial registration of a practitioner of 5 
respiratory care .............................................................. 600 6 
For biennial registration for a physician who is 7 
on inactive status ................................................................ 400 8 
For application for and issuance of a license or 9 
temporary license to practice as a genetic 10 
counselor....................................................................... 400 11 
For biennial renewal of a license to practice as 12 
a genetic counselor or renewal of a 13 
temporary license to practice as a genetic 14 
counselor....................................................................... 600 15 
For written verification of licensure ..................................... 50 16 
For a duplicate identification card ........................................ 25 17 
For a duplicate license .......................................................... 50 18 
For computer printouts or labels ......................................... 500 19 
For verification of a listing of physicians, per 20 
hour ................................................................................. 20 21 
For furnishing a list of new physicians ............................... 100 22 
 23 
 2.  Except as otherwise provided in subsections 4 and 5, in 24 
addition to the fees prescribed in subsection 1, the Board shall 25 
charge and collect necessary and reasonable fees for the expedited 26 
processing of a request or for any other incidental service the Board 27 
provides. 28 
 3.  The cost of any special meeting called at the request of a 29 
licensee, an institution, an organization, a state agency or an 30 
applicant for licensure must be paid for by the person or entity 31 
requesting the special meeting. Such a special meeting must not be 32 
called until the person or entity requesting it has paid a cash deposit 33 
with the Board sufficient to defray all expenses of the meeting. 34 
 4. If an applicant submits an application for a license by 35 
endorsement pursuant to: 36 
 (a) NRS 630.1607, and the applicant is an active member of, or 37 
the spouse of an active member of, the Armed Forces of the United 38 
States, a veteran or the surviving spouse of a veteran, the Board 39 
shall collect not more than one-half of the fee set forth in subsection 40 
1 for the initial issuance of the license. As used in this paragraph, 41 
“veteran” has the meaning ascribed to it in NRS 417.005.  42 
 (b) NRS 630.2752, the Board shall collect not more than one-43 
half of the fee set forth in subsection 1 for the initial issuance of the 44 
license. 45   
 	– 19 – 
 
 
- 	*SB189* 
 5.  If an applicant submits an application for a license by 1 
endorsement pursuant to NRS 630.1606 or 630.2751, as applicable, 2 
the Board shall charge and collect not more than the fee specified in 3 
subsection 1 for the application for and initial issuance of a license. 4 
 Sec. 24.  NRS 630.3067 is hereby amended to read as follows: 5 
 630.3067 1.  The insurer of a physician, physician assistant, 6 
genetic counselor, practitioner of respiratory care or perfusionist 7 
licensed under this chapter shall report to the Board: 8 
 (a) Any action for malpractice against the physician, physician 9 
assistant, genetic counselor, practitioner of respiratory care or 10 
perfusionist not later than 45 days after the physician, physician 11 
assistant, genetic counselor, practitioner of respiratory care or 12 
perfusionist receives service of a summons and complaint for the 13 
action; 14 
 (b) Any claim for malpractice against the physician, physician 15 
assistant, genetic counselor, practitioner of respiratory care or 16 
perfusionist that is submitted to arbitration or mediation not later 17 
than 45 days after the claim is submitted to arbitration or mediation; 18 
and 19 
 (c) Any settlement, award, judgment or other disposition of any 20 
action or claim described in paragraph (a) or (b) not later than 45 21 
days after the settlement, award, judgment or other disposition. 22 
 2.  The Board shall report any failure to comply with subsection 23 
1 by an insurer licensed in this State to the Division of Insurance of 24 
the Department of Business and Industry. If, after a hearing, the 25 
Division of Insurance determines that any such insurer failed to 26 
comply with the requirements of subsection 1, the Division may 27 
impose an administrative fine of not more than $10,000 against the 28 
insurer for each such failure to report. If the administrative fine is 29 
not paid when due, the fine must be recovered in a civil action 30 
brought by the Attorney General on behalf of the Division. 31 
 Sec. 25.  NRS 630.3068 is hereby amended to read as follows: 32 
 630.3068 1.  A physician, physician assistant, genetic 33 
counselor, practitioner of respiratory care or perfusionist shall 34 
report to the Board: 35 
 (a) Any action for malpractice against the physician, physician 36 
assistant, genetic counselor, practitioner of respiratory care or 37 
perfusionist not later than 45 days after the physician, physician 38 
assistant, genetic counselor, practitioner of respiratory care or 39 
perfusionist receives service of a summons and complaint for the 40 
action; 41 
 (b) Any claim for malpractice against the physician, physician 42 
assistant, genetic counselor, practitioner of respiratory care or 43 
perfusionist that is submitted to arbitration or mediation not later 44 
than 45 days after the claim is submitted to arbitration or mediation; 45   
 	– 20 – 
 
 
- 	*SB189* 
 (c) Any settlement, award, judgment or other disposition of any 1 
action or claim described in paragraph (a) or (b) not later than 45 2 
days after the settlement, award, judgment or other disposition, 3 
including, without limitation, any amount paid to resolve the claim; 4 
and 5 
 (d) Any sanctions imposed against the physician, physician 6 
assistant, genetic counselor, practitioner of respiratory care or 7 
perfusionist that are reportable to the National Practitioner Data 8 
Bank not later than 45 days after the sanctions are imposed. 9 
 2.  If the Board finds that a physician, physician assistant, 10 
genetic counselor, practitioner of respiratory care or perfusionist 11 
has violated any provision of this section, the Board may impose a 12 
fine of not more than $5,000 against the physician, physician 13 
assistant, genetic counselor, practitioner of respiratory care or 14 
perfusionist for each violation, in addition to any other fines or 15 
penalties permitted by law. 16 
 3.  All reports made by a physician, physician assistant, genetic 17 
counselor, practitioner of respiratory care or perfusionist pursuant to 18 
this section are public records. 19 
 Sec. 26.  NRS 630.3069 is hereby amended to read as follows: 20 
 630.3069 If the Board receives a report pursuant to the 21 
provisions of NRS 630.3067, 630.3068 or 690B.250 indicating that 22 
a judgment has been rendered or an award has been made against a 23 
physician, physician assistant, genetic counselor, practitioner of 24 
respiratory care or perfusionist regarding an action or claim for 25 
malpractice or that such an action or claim against the physician, 26 
physician assistant, genetic counselor, practitioner of respiratory 27 
care or perfusionist has been resolved by settlement, the Board shall 28 
conduct an investigation to determine whether to impose 29 
disciplinary action against the physician, physician assistant, genetic 30 
counselor, practitioner of respiratory care or perfusionist regarding 31 
the action or claim, unless the Board has already commenced or 32 
completed such an investigation regarding the action or claim before 33 
it receives the report. 34 
 Sec. 27.  NRS 630.307 is hereby amended to read as follows: 35 
 630.307 1.  Except as otherwise provided in subsection 2, any 36 
person may file with the Board a complaint against a physician, 37 
genetic counselor, perfusionist, physician assistant, anesthesiologist 38 
assistant or practitioner of respiratory care on a form provided by 39 
the Board. The form may be submitted in writing or electronically. 40 
If a complaint is submitted anonymously, the Board may accept the 41 
complaint but may refuse to consider the complaint if the lack of the 42 
identity of the complainant makes processing the complaint 43 
impossible or unfair to the person who is the subject of the 44 
complaint. 45   
 	– 21 – 
 
 
- 	*SB189* 
 2.  Any licensee, medical school or medical facility that 1 
becomes aware that a person practicing medicine, genetic 2 
counseling, perfusion or respiratory care in this State has, is or is 3 
about to become engaged in conduct which constitutes grounds for 4 
initiating disciplinary action shall file a written complaint with the 5 
Board within 30 days after becoming aware of the conduct. 6 
 3.  Except as otherwise provided in subsection 4, any hospital, 7 
clinic or other medical facility licensed in this State, or medical 8 
society, shall report to the Board any change in the privileges of a 9 
physician, genetic counselor, perfusionist, physician assistant, 10 
anesthesiologist assistant or practitioner of respiratory care to 11 
practice while the physician, genetic counselor, perfusionist, 12 
physician assistant, anesthesiologist assistant or practitioner of 13 
respiratory care is under investigation and the outcome of any 14 
disciplinary action taken by that facility or society against the 15 
physician, genetic counselor, perfusionist, physician assistant, 16 
anesthesiologist assistant or practitioner of respiratory care 17 
concerning the care of a patient or the competency of the physician, 18 
genetic counselor, perfusionist, physician assistant, anesthesiologist 19 
assistant or practitioner of respiratory care within 30 days after the 20 
change in privileges is made or disciplinary action is taken. 21 
 4. A hospital, clinic or other medical facility licensed in this 22 
State, or medical society, shall report to the Board within 5 days 23 
after a change in the privileges of a physician, genetic counselor, 24 
perfusionist, physician assistant, anesthesiologist assistant or 25 
practitioner of respiratory care to practice that is based on: 26 
 (a) An investigation of the mental, medical or psychological 27 
competency of the physician, genetic counselor, perfusionist, 28 
physician assistant, anesthesiologist assistant or practitioner of 29 
respiratory care; or  30 
 (b) Suspected or alleged substance abuse in any form by the 31 
physician, genetic counselor, perfusionist, physician assistant, 32 
anesthesiologist assistant or practitioner of respiratory care. 33 
 5. The Board shall report any failure to comply with subsection 34 
3 or 4 by a hospital, clinic or other medical facility licensed in this 35 
State to the Division of Public and Behavioral Health of the 36 
Department of Health and Human Services. If, after a hearing, the 37 
Division of Public and Behavioral Health determines that any such 38 
facility or society failed to comply with the requirements of 39 
subsection 3 or 4, the Division may impose an administrative fine of 40 
not more than $10,000 against the facility or society for each such 41 
failure to report. If the administrative fine is not paid when due, the 42 
fine must be recovered in a civil action brought by the Attorney 43 
General on behalf of the Division. 44   
 	– 22 – 
 
 
- 	*SB189* 
 6.  The clerk of every court shall report to the Board any 1 
finding, judgment or other determination of the court that a 2 
physician, genetic counselor, perfusionist, physician assistant, 3 
anesthesiologist assistant or practitioner of respiratory care: 4 
 (a) Is mentally ill; 5 
 (b) Is mentally incompetent; 6 
 (c) Has been convicted of a felony or any law governing 7 
controlled substances or dangerous drugs; 8 
 (d) Is guilty of abuse or fraud under any state or federal program 9 
providing medical assistance; or 10 
 (e) Is liable for damages for malpractice or negligence, 11 
 within 45 days after such a finding, judgment or determination is 12 
made. 13 
 7.  The Board shall retain all complaints filed with the Board 14 
pursuant to this section for at least 10 years, including, without 15 
limitation, any complaints not acted upon. 16 
 Sec. 28.  NRS 630.309 is hereby amended to read as follows: 17 
 630.309 To institute a disciplinary action against a genetic 18 
counselor, perfusionist, physician assistant, anesthesiologist 19 
assistant or practitioner of respiratory care, a written complaint, 20 
specifying the charges, must be filed with the Board by: 21 
 1.  The Board or a committee designated by the Board to 22 
investigate a complaint; 23 
 2.  Any member of the Board; or 24 
 3.  Any other person who is aware of any act or circumstance 25 
constituting a ground for disciplinary action set forth in the 26 
regulations adopted by the Board. 27 
 Sec. 29.  NRS 630.318 is hereby amended to read as follows: 28 
 630.318 1.  If the Board or any investigative committee of the 29 
Board has reason to believe that the conduct of any physician, 30 
physician assistant, genetic counselor, practitioner of respiratory 31 
care or perfusionist has raised a reasonable question as to his or her 32 
competence to practice medicine, genetic counseling, respiratory 33 
care or perfusion or practice as a physician assistant, as applicable, 34 
with reasonable skill and safety to patients, or if the Board has 35 
received a report pursuant to the provisions of NRS 630.3067, 36 
630.3068 or 690B.250 indicating that a judgment has been rendered 37 
or an award has been made against a physician, physician assistant, 38 
genetic counselor, practitioner of respiratory care or perfusionist 39 
regarding an action or claim for malpractice or that such an action or 40 
claim against the physician, physician assistant, genetic counselor, 41 
practitioner of respiratory care or perfusionist has been resolved by 42 
settlement, the Board or committee may order that the physician, 43 
physician assistant, genetic counselor, practitioner of respiratory 44 
care or perfusionist undergo a mental or physical examination, an 45   
 	– 23 – 
 
 
- 	*SB189* 
examination testing his or her competence to practice medicine, 1 
genetic counseling, respiratory care or perfusion or practice as a 2 
physician assistant, as applicable, or any other examination 3 
designated by the Board to assist the Board or committee in 4 
determining the fitness of the physician, physician assistant, genetic 5 
counselor, practitioner of respiratory care or perfusionist to practice 6 
medicine, genetic counseling, respiratory care or perfusion or 7 
practice as a physician assistant, as applicable. 8 
 2.  For the purposes of this section: 9 
 (a) Every physician, physician assistant, genetic counselor, 10 
practitioner of respiratory care or perfusionist who applies for a 11 
license or who is licensed under this chapter shall be deemed to 12 
have given consent to submit to a mental or physical examination or 13 
an examination testing his or her competence to practice medicine, 14 
genetic counseling, respiratory care or perfusion or practice as a 15 
physician assistant, as applicable, when ordered to do so in writing 16 
by the Board or an investigative committee of the Board. 17 
 (b) The testimony or reports of a person who conducts an 18 
examination of a physician, physician assistant, genetic counselor, 19 
practitioner of respiratory care or perfusionist on behalf of the Board 20 
or an investigative committee of the Board pursuant to this section 21 
are not privileged communications. 22 
 3.  Except in extraordinary circumstances, as determined by the 23 
Board, the failure of a physician, physician assistant, genetic 24 
counselor, practitioner of respiratory care or perfusionist licensed 25 
under this chapter to submit to an examination when directed as 26 
provided in this section constitutes an admission of the charges 27 
against the physician, physician assistant, genetic counselor, 28 
practitioner of respiratory care or perfusionist. 29 
 Sec. 30.  NRS 630.326 is hereby amended to read as follows: 30 
 630.326 1.  If an investigation by the Board regarding a 31 
physician, genetic counselor, perfusionist, physician assistant, 32 
anesthesiologist assistant or practitioner of respiratory care 33 
reasonably determines that the health, safety or welfare of the public 34 
or any patient served by the licensee is at risk of imminent or 35 
continued harm, the Board may summarily suspend the license of 36 
the licensee pending the conclusion of a hearing to consider a formal 37 
complaint against the licensee. The order of summary suspension 38 
may be issued only by the Board or an investigative committee of 39 
the Board.  40 
 2.  If the Board or an investigative committee of the Board 41 
issues an order summarily suspending the license of a physician, 42 
genetic counselor, perfusionist, physician assistant, anesthesiologist 43 
assistant or practitioner of respiratory care pursuant to subsection 1, 44 
the Board shall hold a hearing not later than 60 days after the date 45   
 	– 24 – 
 
 
- 	*SB189* 
on which the order is issued, unless the Board and the licensee 1 
mutually agree to a longer period, to determine whether a reasonable 2 
basis exists to continue the suspension of the license pending the 3 
conclusion of a hearing to consider a formal complaint against the 4 
licensee. If no formal complaint against the licensee is pending 5 
before the Board on the date on which a hearing is held pursuant to 6 
this section, the Board shall reinstate the license of the licensee. 7 
 3.  If the Board or an investigative committee of the Board 8 
issues an order summarily suspending the license of a licensee 9 
pursuant to subsection 1 and the Board requires the licensee to 10 
submit to a mental or physical examination or an examination 11 
testing his or her competence to practice, the examination must be 12 
conducted and the results obtained not later than 30 days after the 13 
order is issued. 14 
 Sec. 31.  NRS 630.329 is hereby amended to read as follows: 15 
 630.329 If the Board issues an order suspending the license of 16 
a physician, genetic counselor, perfusionist, physician assistant, 17 
anesthesiologist assistant or practitioner of respiratory care pending 18 
proceedings for disciplinary action, including, without limitation, a 19 
summary suspension pursuant to NRS 233B.127, the court shall not 20 
stay that order. 21 
 Sec. 32.  NRS 630.336 is hereby amended to read as follows: 22 
 630.336 1.  Any deliberations conducted or vote taken by the 23 
Board or any investigative committee of the Board regarding its 24 
ordering of a physician, genetic counselor, perfusionist, physician 25 
assistant, anesthesiologist assistant or practitioner of respiratory care 26 
to undergo a physical or mental examination or any other 27 
examination designated to assist the Board or committee in 28 
determining the fitness of a physician, genetic counselor, 29 
perfusionist, physician assistant, anesthesiologist assistant or 30 
practitioner of respiratory care are not subject to the requirements of 31 
NRS 241.020. 32 
 2.  Except as otherwise provided in subsection 3 or 4, all 33 
applications for a license to practice medicine, genetic counseling, 34 
perfusion or respiratory care, any charges filed by the Board, 35 
financial records of the Board, formal hearings on any charges heard 36 
by the Board or a panel selected by the Board, records of such 37 
hearings and any order or decision of the Board or panel must be 38 
open to the public. 39 
 3.  Except as otherwise provided in NRS 239.0115, the 40 
following may be kept confidential: 41 
 (a) Any statement, evidence, credential or other proof submitted 42 
in support of or to verify the contents of an application; 43   
 	– 25 – 
 
 
- 	*SB189* 
 (b) Any report concerning the fitness of any person to receive or 1 
hold a license to practice medicine, genetic counseling, perfusion or 2 
respiratory care; and 3 
 (c) Any communication between: 4 
  (1) The Board and any of its committees or panels; and 5 
  (2) The Board or its staff, investigators, experts, committees, 6 
panels, hearing officers, advisory members or consultants and 7 
counsel for the Board. 8 
 4.  Except as otherwise provided in subsection 5 and NRS 9 
239.0115, a complaint filed with the Board pursuant to NRS 10 
630.307, all documents and other information filed with the 11 
complaint and all documents and other information compiled as a 12 
result of an investigation conducted to determine whether to initiate 13 
disciplinary action are confidential. 14 
 5.  The formal complaint or other document filed by the Board 15 
to initiate disciplinary action and all documents and information 16 
considered by the Board when determining whether to impose 17 
discipline are public records. 18 
 6.  The Board shall, to the extent feasible, communicate or 19 
cooperate with or provide any documents or other information to 20 
any other licensing board or agency or any agency which is 21 
investigating a person, including a law enforcement agency. Such 22 
cooperation may include, without limitation, providing the board or 23 
agency with minutes of a closed meeting, transcripts of oral 24 
examinations and the results of oral examinations. 25 
 Sec. 33.  NRS 630.346 is hereby amended to read as follows: 26 
 630.346 In any disciplinary hearing: 27 
 1.  The Board, a panel of the members of the Board and a 28 
hearing officer are not bound by formal rules of evidence, except 29 
that evidence must be taken and considered in the hearing pursuant 30 
to NRS 233B.123, and a witness must not be barred from testifying 31 
solely because the witness was or is incompetent. 32 
 2.  A finding of the Board must be supported by a 33 
preponderance of the evidence. 34 
 3.  Proof of actual injury need not be established. 35 
 4.  A certified copy of the record of a court or a licensing 36 
agency showing a conviction or plea of nolo contendere or the 37 
suspension, revocation, limitation, modification, denial or surrender 38 
of a license to practice medicine, genetic counseling, perfusion or 39 
respiratory care is conclusive evidence of its occurrence. 40 
 Sec. 34.  NRS 630.358 is hereby amended to read as follows: 41 
 630.358 1.  Any person: 42 
 (a) Whose practice of medicine, genetic counseling, perfusion 43 
or respiratory care has been limited; or 44   
 	– 26 – 
 
 
- 	*SB189* 
 (b) Whose license to practice medicine, genetic counseling, 1 
perfusion or respiratory care has been: 2 
  (1) Suspended until further order; or 3 
  (2) Revoked, 4 
 by an order of the Board, may apply to the Board for removal of 5 
the limitation or restoration of the license. 6 
 2.  In hearing the application, the Board: 7 
 (a) May require the person to submit to a mental or physical 8 
examination or an examination testing his or her competence to 9 
practice medicine, genetic counseling, perfusion or respiratory care 10 
by physicians, genetic counselors, perfusionists or practitioners of 11 
respiratory care, as appropriate, or other examinations it designates 12 
and submit such other evidence of changed conditions and of fitness 13 
as it deems proper; 14 
 (b) Shall determine whether under all the circumstances the time 15 
of the application is reasonable; and 16 
 (c) May deny the application or modify or rescind its order as it 17 
deems the evidence and the public safety warrants. 18 
 3.  The licensee has the burden of proving by clear and 19 
convincing evidence that the requirements for restoration of the 20 
license or removal of the limitation have been met. 21 
 4.  The Board shall not restore a license unless it is satisfied that 22 
the person has complied with all of the terms and conditions set 23 
forth in the final order of the Board and that the person is capable of 24 
practicing medicine, genetic counseling, perfusion or respiratory 25 
care in a safe manner. 26 
 5.  To restore a license that has been revoked by the Board, the 27 
applicant must apply for a license and take an examination as 28 
though the applicant had never been licensed under this chapter. 29 
 Sec. 35.  NRS 630.366 is hereby amended to read as follows: 30 
 630.366 1.  If the Board receives a copy of a court order 31 
issued pursuant to NRS 425.540 that provides for the suspension of 32 
all professional, occupational and recreational licenses, certificates 33 
and permits issued to a person who is the holder of a license to 34 
practice medicine, to practice as a genetic counselor, to practice as 35 
a perfusionist, to practice as a physician assistant, to practice as an 36 
anesthesiologist assistant or to practice as a practitioner of 37 
respiratory care, the Board shall deem the license issued to that 38 
person to be suspended at the end of the 30th day after the date on 39 
which the court order was issued unless the Board receives a letter 40 
issued to the holder of the license by the district attorney or other 41 
public agency pursuant to NRS 425.550 stating that the holder of the 42 
license has complied with the subpoena or warrant or has satisfied 43 
the arrearage pursuant to NRS 425.560. 44   
 	– 27 – 
 
 
- 	*SB189* 
 2.  The Board shall reinstate a license to practice medicine, to 1 
practice as a genetic counselor, to practice as a perfusionist, to 2 
practice as a physician assistant, to practice as an anesthesiologist 3 
assistant or to practice as a practitioner of respiratory care that has 4 
been suspended by a district court pursuant to NRS 425.540 if the 5 
Board receives a letter issued by the district attorney or other public 6 
agency pursuant to NRS 425.550 to the person whose license was 7 
suspended stating that the person whose license was suspended has 8 
complied with the subpoena or warrant or has satisfied the arrearage 9 
pursuant to NRS 425.560. 10 
 Sec. 36.  NRS 630.388 is hereby amended to read as follows: 11 
 630.388 1.  In addition to any other remedy provided by law, 12 
the Board, through its President or Secretary-Treasurer or the 13 
Attorney General, may apply to any court of competent jurisdiction: 14 
 (a) To enjoin any prohibited act or other conduct of a licensee 15 
which is harmful to the public; 16 
 (b) To enjoin any person who is not licensed under this chapter 17 
from practicing medicine, genetic counseling, perfusion or 18 
respiratory care; 19 
 (c) To limit the practice of a physician, genetic counselor, 20 
perfusionist, physician assistant, anesthesiologist assistant or 21 
practitioner of respiratory care, or suspend his or her license to 22 
practice; 23 
 (d) To enjoin the use of the title “P.A.,” “P.A.-C,” “C.A.A.,” 24 
“R.C.P.” or any other word, combination of letters or other 25 
designation intended to imply or designate a person as a physician 26 
assistant, anesthesiologist assistant or practitioner of respiratory 27 
care, when not licensed by the Board pursuant to this chapter, unless 28 
the use is otherwise authorized by a specific statute; [or] 29 
 (e) To enjoin the use of the title “L.P.,” “T.L.P.,” “licensed 30 
perfusionist,” “temporarily licensed perfusionist” or any other word, 31 
combination of letters or other designation intended to imply or 32 
designate a person as a perfusionist, when not licensed by the Board 33 
pursuant to this chapter, unless the use is otherwise authorized by a 34 
specific statute [.] ; or 35 
 (f) To enjoin the use of the title “G.A.,” “G.C.,” “L.G.C.,” 36 
“R.G.C.,” “genetic associate,” “genetic counselor,” “licensed 37 
genetic counselor,” “registered genetic counselor” or any other 38 
word, combination of letters or other designation intended to imply 39 
or designate a person as a genetic counselor, when not licensed by 40 
the Board pursuant to this chapter, unless the use is otherwise 41 
authorized by a specific statute. 42 
 2.  The court in a proper case may issue a temporary restraining 43 
order or a preliminary injunction for the purposes set forth in 44 
subsection 1: 45   
 	– 28 – 
 
 
- 	*SB189* 
 (a) Without proof of actual damage sustained by any person; 1 
 (b) Without relieving any person from criminal prosecution for 2 
engaging in the practice of medicine, genetic counseling, perfusion 3 
or respiratory care without a license; and 4 
 (c) Pending proceedings for disciplinary action by the Board. 5 
 Sec. 37.  NRS 630.390 is hereby amended to read as follows: 6 
 630.390 In seeking injunctive relief against any person for an 7 
alleged violation of this chapter by practicing medicine, genetic 8 
counseling, perfusion or respiratory care without a license, it is 9 
sufficient to allege that the person did, upon a certain day, and in a 10 
certain county of this State, engage in the practice of medicine, 11 
genetic counseling, perfusion or respiratory care without having a 12 
license to do so, without alleging any further or more particular facts 13 
concerning the same. 14 
 Sec. 38.  NRS 630.395 is hereby amended to read as follows: 15 
 630.395 Any member or agent of the Board may enter any 16 
premises in this State where a person who holds a license issued 17 
pursuant to the provisions of this chapter practices medicine, genetic 18 
counseling, perfusion or respiratory care and inspect it to determine 19 
whether a violation of any provision of this chapter has occurred, 20 
including, without limitation: 21 
 1.  An inspection to determine whether any person at the 22 
premises is practicing medicine, genetic counseling, perfusion or 23 
respiratory care without the appropriate license issued pursuant to 24 
the provisions of this chapter; or 25 
 2.  An inspection to determine whether any physician is 26 
allowing a person to perform or participate in any activity under the 27 
supervision of the physician for the purpose of receiving credit 28 
toward a degree of doctor of medicine, osteopathy or osteopathic 29 
medicine in violation of the provisions of NRS 630.3745. 30 
 Sec. 39.  NRS 630.397 is hereby amended to read as follows: 31 
 630.397 Unless the Board determines that extenuating 32 
circumstances exist, the Board shall forward to the appropriate law 33 
enforcement agency any substantiated information submitted to the 34 
Board concerning a person who practices or offers to practice 35 
medicine, genetic counseling, perfusion or respiratory care without 36 
the appropriate license issued pursuant to the provisions of this 37 
chapter. 38 
 Sec. 40.  NRS 630.400 is hereby amended to read as follows: 39 
 630.400 1.  It is unlawful for any person to: 40 
 (a) Present to the Board as his or her own the diploma, license or 41 
credentials of another; 42 
 (b) Give either false or forged evidence of any kind to the 43 
Board; 44   
 	– 29 – 
 
 
- 	*SB189* 
 (c) Practice medicine, genetic counseling, perfusion or 1 
respiratory care under a false or assumed name or falsely personate 2 
another licensee; 3 
 (d) Except as otherwise provided by a specific statute, practice 4 
medicine, genetic counseling, perfusion or respiratory care without 5 
being licensed under this chapter; 6 
 (e) Hold himself or herself out as a perfusionist or use any other 7 
term indicating or implying that he or she is a perfusionist without 8 
being licensed by the Board; 9 
 (f) Hold himself or herself out as a physician assistant or use any 10 
other term indicating or implying that he or she is a physician 11 
assistant without being licensed by the Board; 12 
 (g) Hold himself or herself out as an anesthesiologist assistant or 13 
use any other term indicating or implying that he or she is an 14 
anesthesiologist assistant without being licensed by the Board; [or] 15 
 (h) Hold himself or herself out as a practitioner of respiratory 16 
care or use any other term indicating or implying that he or she is a 17 
practitioner of respiratory care without being licensed by the Board 18 
[.] ; or 19 
 (i) Hold himself or herself out as a genetic counselor or use 20 
any other term indicating or implying that he or she is a genetic 21 
counselor without being licensed by the Board. 22 
 2.  Unless a greater penalty is provided pursuant to NRS 23 
200.830 or 200.840, a person who violates any provision of 24 
subsection 1: 25 
 (a) If no substantial bodily harm results, is guilty of a category 26 
D felony; or 27 
 (b) If substantial bodily harm results, is guilty of a category C 28 
felony, 29 
 and shall be punished as provided in NRS 193.130. 30 
 3.  In addition to any other penalty prescribed by law, if the 31 
Board determines that a person has committed any act described in 32 
subsection 1, the Board may: 33 
 (a) Issue and serve on the person an order to cease and desist 34 
until the person obtains from the Board the proper license or 35 
otherwise demonstrates that he or she is no longer in violation of 36 
subsection 1. An order to cease and desist must include a telephone 37 
number with which the person may contact the Board. 38 
 (b) Issue a citation to the person. A citation issued pursuant to 39 
this paragraph must be in writing, describe with particularity the 40 
nature of the violation and inform the person of the provisions of 41 
this paragraph. Each activity in which the person is engaged 42 
constitutes a separate offense for which a separate citation may be 43 
issued. To appeal a citation, the person must submit a written 44   
 	– 30 – 
 
 
- 	*SB189* 
request for a hearing to the Board not later than 30 days after the 1 
date of issuance of the citation. 2 
 (c) Assess against the person an administrative fine of not more 3 
than $5,000. 4 
 (d) Impose any combination of the penalties set forth in 5 
paragraphs (a), (b) and (c). 6 
 Sec. 41.  NRS 630A.090 is hereby amended to read as follows: 7 
 630A.090 1.  This chapter does not apply to: 8 
 (a) The practice of genetic counseling, dentistry, chiropractic, 9 
naprapathy, Oriental medicine, podiatry, optometry, perfusion, 10 
respiratory care, faith or Christian Science healing, nursing, 11 
veterinary medicine or fitting hearing aids. 12 
 (b) A medical officer of the Armed Forces or a medical officer 13 
of any division or department of the United States in the discharge 14 
of his or her official duties, including, without limitation, providing 15 
medical care in a hospital in accordance with an agreement entered 16 
into pursuant to NRS 449.2455. 17 
 (c) Licensed or certified nurses in the discharge of their duties as 18 
nurses. 19 
 (d) Homeopathic physicians who are called into this State, other 20 
than on a regular basis, for consultation or assistance to any 21 
physician licensed in this State, and who are legally qualified to 22 
practice in the state or country where they reside. 23 
 2.  This chapter does not repeal or affect any statute of Nevada 24 
regulating or affecting any other healing art. 25 
 3.  This chapter does not prohibit: 26 
 (a) Gratuitous services of a person in case of emergency. 27 
 (b) The domestic administration of family remedies. 28 
 4.  This chapter does not authorize a homeopathic physician to 29 
practice medicine, including allopathic medicine, except as 30 
otherwise provided in NRS 630A.040. 31 
 Sec. 42.  NRS 632.472 is hereby amended to read as follows: 32 
 632.472 1.  The following persons shall report in writing to 33 
the Executive Director of the Board any conduct of a licensee or 34 
holder of a certificate which constitutes a violation of the provisions 35 
of this chapter: 36 
 (a) Any physician, dentist, dental hygienist, expanded function 37 
dental assistant, naprapath, chiropractic physician, optometrist, 38 
podiatric physician, medical examiner, resident, intern, professional 39 
or practical nurse, nursing assistant, medication aide - certified, 40 
genetic counselor, perfusionist, physician assistant licensed 41 
pursuant to chapter 630 or 633 of NRS, anesthesiologist assistant, 42 
psychiatrist, psychologist, marriage and family therapist, clinical 43 
professional counselor, alcohol or drug counselor, peer recovery 44 
support specialist, peer recovery support specialist supervisor, music 45   
 	– 31 – 
 
 
- 	*SB189* 
therapist, holder of a license or limited license issued pursuant to 1 
chapter 653 of NRS, driver of an ambulance, paramedic or other 2 
person providing medical services licensed or certified to practice in 3 
this State. 4 
 (b) Any personnel of a medical facility or facility for the 5 
dependent engaged in the admission, examination, care or treatment 6 
of persons or an administrator, manager or other person in charge of 7 
a medical facility or facility for the dependent upon notification by a 8 
member of the staff of the facility. 9 
 (c) A coroner. 10 
 (d) Any person who maintains or is employed by an agency to 11 
provide personal care services in the home. 12 
 (e) Any person who operates, who is employed by or who 13 
contracts to provide services for an intermediary service 14 
organization as defined in NRS 449.4304. 15 
 (f) Any person who maintains or is employed by an agency to 16 
provide nursing in the home. 17 
 (g) Any employee of the Department of Health and Human 18 
Services. 19 
 (h) Any employee of a law enforcement agency or a county’s 20 
office for protective services or an adult or juvenile probation 21 
officer. 22 
 (i) Any person who maintains or is employed by a facility or 23 
establishment that provides care for older persons. 24 
 (j) Any person who maintains, is employed by or serves as a 25 
volunteer for an agency or service which advises persons regarding 26 
the abuse, neglect or exploitation of an older person and refers them 27 
to persons and agencies where their requests and needs can be met. 28 
 (k) Any social worker. 29 
 (l) Any person who operates or is employed by a community 30 
health worker pool or with whom a community health worker pool 31 
contracts to provide the services of a community health worker, as 32 
defined in NRS 449.0027. 33 
 2.  Every physician who, as a member of the staff of a medical 34 
facility or facility for the dependent, has reason to believe that a 35 
nursing assistant or medication aide - certified has engaged in 36 
conduct which constitutes grounds for the denial, suspension or 37 
revocation of a certificate shall notify the superintendent, manager 38 
or other person in charge of the facility. The superintendent, 39 
manager or other person in charge shall make a report as required in 40 
subsection 1. 41 
 3.  A report may be filed by any other person. 42 
 4.  Any person who in good faith reports any violation of the 43 
provisions of this chapter to the Executive Director of the Board 44   
 	– 32 – 
 
 
- 	*SB189* 
pursuant to this section is immune from civil liability for reporting 1 
the violation. 2 
 5.  As used in this section: 3 
 (a) “Agency to provide personal care services in the home” has 4 
the meaning ascribed to it in NRS 449.0021. 5 
 (b) “Community health worker pool” has the meaning ascribed 6 
to it in NRS 449.0028. 7 
 (c) “Peer recovery support specialist” has the meaning ascribed 8 
to it in NRS 433.627. 9 
 (d) “Peer recovery support specialist supervisor” has the 10 
meaning ascribed to it in NRS 433.629. 11 
 Sec. 43.  NRS 633.171 is hereby amended to read as follows: 12 
 633.171 1.  This chapter does not apply to: 13 
 (a) The practice of medicine , genetic counseling or perfusion 14 
pursuant to chapter 630 of NRS, dentistry, chiropractic, naprapathy, 15 
podiatry, optometry, respiratory care, faith or Christian Science 16 
healing, nursing, veterinary medicine or fitting hearing aids. 17 
 (b) A medical officer of the Armed Forces or a medical officer 18 
of any division or department of the United States in the discharge 19 
of his or her official duties, including, without limitation, providing 20 
medical care in a hospital in accordance with an agreement entered 21 
into pursuant to NRS 449.2455. 22 
 (c) Osteopathic physicians who are called into this State, other 23 
than on a regular basis, for consultation or assistance to a physician 24 
licensed in this State, and who are legally qualified to practice in the 25 
state where they reside. 26 
 (d) Osteopathic physicians who are temporarily exempt from 27 
licensure pursuant to NRS 633.420 and are practicing osteopathic 28 
medicine within the scope of the exemption. 29 
 (e) The performance of medical services by a student enrolled in 30 
an educational program for a physician assistant which is accredited 31 
by the Accreditation Review Commission on Education for the 32 
Physician Assistant, Inc., or its successor organization, as part of 33 
such a program. 34 
 (f) A physician assistant of any division or department of the 35 
United States in the discharge of his or her official duties unless 36 
licensure by a state is required by the division or department of the 37 
United States. 38 
 (g) Any person permitted to practice any other healing art under 39 
this title who does so within the scope of that authority. 40 
 2.  This chapter does not repeal or affect any law of this State 41 
regulating or affecting any other healing art. 42 
 3.  This chapter does not prohibit: 43 
 (a) Gratuitous services of a person in cases of emergency. 44 
 (b) The domestic administration of family remedies. 45   
 	– 33 – 
 
 
- 	*SB189* 
 Sec. 44.  NRS 640E.090 is hereby amended to read as follows: 1 
 640E.090 1.  The provisions of this chapter do not apply to: 2 
 (a) Any person who is licensed or registered in this State as a 3 
physician pursuant to chapter 630, 630A or 633 of NRS, genetic 4 
counselor, dentist, nurse, dispensing optician, optometrist, 5 
occupational therapist, practitioner of respiratory care, physical 6 
therapist, podiatric physician, psychologist, marriage and  7 
family therapist, chiropractic physician, naprapath, athletic trainer, 8 
massage therapist, reflexologist, structural integration practitioner, 9 
perfusionist, doctor of Oriental medicine in any form, medical 10 
laboratory director or technician or pharmacist who: 11 
  (1) Practices within the scope of that license or registration; 12 
  (2) Does not represent that he or she is a licensed dietitian or 13 
registered dietitian; and 14 
  (3) Provides nutrition information incidental to the practice 15 
for which he or she is licensed or registered. 16 
 (b) A student enrolled in an educational program accredited by 17 
the Accreditation Council for Education in Nutrition and Dietetics, 18 
or its successor organization, if the student engages in the practice 19 
of dietetics under the supervision of a licensed dietitian or registered 20 
dietitian as part of that educational program. 21 
 (c) A registered dietitian employed by the Armed Forces of the 22 
United States, the United States Department of Veterans Affairs or 23 
any division or department of the Federal Government in the 24 
discharge of his or her official duties, including, without limitation, 25 
the practice of dietetics or providing nutrition services. 26 
 (d) A person who furnishes nutrition information, provides 27 
recommendations or advice concerning nutrition, or markets food, 28 
food materials or dietary supplements and provides nutrition 29 
information, recommendations or advice related to that marketing, if 30 
the person does not represent that he or she is a licensed dietitian or 31 
registered dietitian. While performing acts described in this 32 
paragraph, a person shall be deemed not to be engaged in the 33 
practice of dietetics or the providing of nutrition services. 34 
 (e) A person who provides services relating to weight loss or 35 
weight control through a program reviewed by and in consultation 36 
with a licensed dietitian or physician or a dietitian licensed or 37 
registered in another state which has equivalent licensure 38 
requirements as this State, as long as the person does not change the 39 
services or program without the approval of the person with whom 40 
he or she is consulting. 41 
 2.  As used in this section, “nutrition information” means 42 
information relating to the principles of nutrition and the effect of 43 
nutrition on the human body, including, without limitation: 44 
 (a) Food preparation; 45   
 	– 34 – 
 
 
- 	*SB189* 
 (b) Food included in a normal daily diet; 1 
 (c) Essential nutrients required by the human body and 2 
recommended amounts of essential nutrients, based on nationally 3 
established standards; 4 
 (d) The effect of nutrients on the human body and the effect of 5 
deficiencies in or excess amounts of nutrients in the human body; 6 
and 7 
 (e) Specific foods or supplements that are sources of essential 8 
nutrients. 9 
 Sec. 45.  NRS 7.095 is hereby amended to read as follows: 10 
 7.095 1.  An attorney shall not contract for or collect a fee 11 
contingent on the amount of recovery for representing a person 12 
seeking damages in connection with an action for injury or death 13 
against a provider of health care based upon professional negligence 14 
in excess of 35 percent of the amount recovered. 15 
 2.  The limitations set forth in subsection 1 apply to all forms of 16 
recovery, including, without limitation, settlement, arbitration and 17 
judgment. 18 
 3.  For the purposes of this section, “recovered” means the net 19 
sum recovered by the plaintiff after deducting any disbursements or 20 
costs incurred in connection with the prosecution or settlement of 21 
the claim. Costs of medical care incurred by the plaintiff and general 22 
and administrative expenses incurred by the office of the attorney 23 
are not deductible disbursements or costs. 24 
 4.  As used in this section: 25 
 (a) “Professional negligence” means a negligent act or omission 26 
to act by a provider of health care in the rendering of professional 27 
services, which act or omission is the proximate cause of a personal 28 
injury or wrongful death. The term does not include services that are 29 
outside the scope of services for which the provider of health care is 30 
licensed or services for which any restriction has been imposed by 31 
the applicable regulatory board or health care facility. 32 
 (b) “Provider of health care” means a physician licensed under 33 
chapter 630 or 633 of NRS, genetic counselor, dentist, registered 34 
nurse, dispensing optician, optometrist, registered physical therapist, 35 
podiatric physician, licensed psychologist, chiropractic physician, 36 
naprapath, doctor of Oriental medicine, holder of a license or a 37 
limited license issued under the provisions of chapter 653 of NRS, 38 
medical laboratory director or technician, licensed dietitian or a 39 
licensed hospital and its employees. 40 
 Sec. 46.  NRS 41A.017 is hereby amended to read as follows: 41 
 41A.017 “Provider of health care” means a physician licensed 42 
pursuant to chapter 630 or 633 of NRS, physician assistant, genetic 43 
counselor, anesthesiologist assistant, dentist, licensed nurse, 44 
dispensing optician, optometrist, registered physical therapist, 45   
 	– 35 – 
 
 
- 	*SB189* 
podiatric physician, licensed psychologist, chiropractic physician, 1 
naprapath, doctor of Oriental medicine, holder of a license or a 2 
limited license issued under the provisions of chapter 653 of NRS, 3 
medical laboratory director or technician, licensed dietitian or a 4 
licensed hospital, clinic, surgery center, physicians’ professional 5 
corporation or group practice that employs any such person and its 6 
employees. 7 
 Sec. 47.  NRS 42.021 is hereby amended to read as follows: 8 
 42.021 1.  In an action for injury or death against a provider 9 
of health care based upon professional negligence, if the defendant 10 
so elects, the defendant may introduce evidence of any amount 11 
payable as a benefit to the plaintiff as a result of the injury or death 12 
pursuant to the United States Social Security Act, any state or 13 
federal income disability or worker’s compensation act, any health, 14 
sickness or income-disability insurance, accident insurance that 15 
provides health benefits or income-disability coverage, and any 16 
contract or agreement of any group, organization, partnership or 17 
corporation to provide, pay for or reimburse the cost of medical, 18 
hospital, dental or other health care services. If the defendant elects 19 
to introduce such evidence, the plaintiff may introduce evidence of 20 
any amount that the plaintiff has paid or contributed to secure the 21 
plaintiff’s right to any insurance benefits concerning which the 22 
defendant has introduced evidence. 23 
 2.  A source of collateral benefits introduced pursuant to 24 
subsection 1 may not: 25 
 (a) Recover any amount against the plaintiff; or 26 
 (b) Be subrogated to the rights of the plaintiff against a 27 
defendant. 28 
 3.  In an action for injury or death against a provider of health 29 
care based upon professional negligence, a district court shall, at the 30 
request of either party, enter a judgment ordering that money 31 
damages or its equivalent for future damages of the judgment 32 
creditor be paid in whole or in part by periodic payments rather than 33 
by a lump-sum payment if the award equals or exceeds $50,000 in 34 
future damages. 35 
 4.  In entering a judgment ordering the payment of future 36 
damages by periodic payments pursuant to subsection 3, the court 37 
shall make a specific finding as to the dollar amount of periodic 38 
payments that will compensate the judgment creditor for such future 39 
damages. As a condition to authorizing periodic payments of future 40 
damages, the court shall require a judgment debtor who is not 41 
adequately insured to post security adequate to assure full payment 42 
of such damages awarded by the judgment. Upon termination of 43 
periodic payments of future damages, the court shall order the return 44 
of this security, or so much as remains, to the judgment debtor. 45   
 	– 36 – 
 
 
- 	*SB189* 
 5.  A judgment ordering the payment of future damages by 1 
periodic payments entered pursuant to subsection 3 must specify the 2 
recipient or recipients of the payments, the dollar amount of the 3 
payments, the interval between payments, and the number of 4 
payments or the period of time over which payments will be made. 5 
Such payments must only be subject to modification in the event of 6 
the death of the judgment creditor. Money damages awarded for loss 7 
of future earnings must not be reduced or payments terminated by 8 
reason of the death of the judgment creditor, but must be paid to 9 
persons to whom the judgment creditor owed a duty of support, as 10 
provided by law, immediately before the judgment creditor’s death. 11 
In such cases, the court that rendered the original judgment may, 12 
upon petition of any party in interest, modify the judgment to award 13 
and apportion the unpaid future damages in accordance with this 14 
subsection. 15 
 6.  If the court finds that the judgment debtor has exhibited a 16 
continuing pattern of failing to make the periodic payments as 17 
specified pursuant to subsection 5, the court shall find the judgment 18 
debtor in contempt of court and, in addition to the required periodic 19 
payments, shall order the judgment debtor to pay the judgment 20 
creditor all damages caused by the failure to make such periodic 21 
payments, including, but not limited to, court costs and attorney’s 22 
fees. 23 
 7.  Following the occurrence or expiration of all obligations 24 
specified in the periodic payment judgment, any obligation of the 25 
judgment debtor to make further payments ceases and any security 26 
given pursuant to subsection 4 reverts to the judgment debtor. 27 
 8.  As used in this section: 28 
 (a) “Future damages” includes damages for future medical 29 
treatment, care or custody, loss of future earnings, loss of bodily 30 
function, or future pain and suffering of the judgment creditor. 31 
 (b) “Periodic payments” means the payment of money or 32 
delivery of other property to the judgment creditor at regular 33 
intervals. 34 
 (c) “Professional negligence” means a negligent act or omission 35 
to act by a provider of health care in the rendering of professional 36 
services, which act or omission is the proximate cause of a personal 37 
injury or wrongful death. The term does not include services that are 38 
outside the scope of services for which the provider of health care is 39 
licensed or services for which any restriction has been imposed by 40 
the applicable regulatory board or health care facility. 41 
 (d) “Provider of health care” means a physician licensed under 42 
chapter 630 or 633 of NRS, genetic counselor, dentist, licensed 43 
nurse, dispensing optician, optometrist, registered physical therapist, 44 
podiatric physician, naprapath, licensed psychologist, chiropractic 45   
 	– 37 – 
 
 
- 	*SB189* 
physician, doctor of Oriental medicine, holder of a license or a 1 
limited license issued under the provisions of chapter 653 of NRS, 2 
medical laboratory director or technician, licensed dietitian or a 3 
licensed hospital and its employees. 4 
 Sec. 48.  NRS 49.215 is hereby amended to read as follows: 5 
 49.215 As used in NRS 49.215 to 49.245, inclusive: 6 
 1.  A communication is “confidential” if it is not intended to be 7 
disclosed to third persons other than: 8 
 (a) Those present to further the interest of the patient in the 9 
consultation, examination or interview; 10 
 (b) Persons reasonably necessary for the transmission of the 11 
communication; or 12 
 (c) Persons who are participating in the diagnosis and treatment 13 
under the direction of the doctor, including members of the patient’s 14 
family. 15 
 2.  “Doctor” means a person licensed to practice medicine, 16 
genetic counseling, dentistry or osteopathic medicine, chiropractic 17 
or naprapathy in any state or nation, or a person who is reasonably 18 
believed by the patient to be so licensed, and in addition includes a 19 
person employed by a public or private agency as a psychiatric 20 
social worker, or someone under his or her guidance, direction or 21 
control, while engaged in the examination, diagnosis or treatment of 22 
a patient for a mental condition. 23 
 3.  “Patient” means a person who consults or is examined or 24 
interviewed by a doctor for purposes of diagnosis or treatment. 25 
 Sec. 49.  NRS 52.320 is hereby amended to read as follows: 26 
 52.320 As used in NRS 52.320 to 52.375, inclusive, unless the 27 
context otherwise requires: 28 
 1.  “Custodian of medical records” means a chiropractic 29 
physician, naprapath, physician, genetic counselor, registered 30 
physical therapist or licensed nurse who prepares and maintains 31 
medical records, or any employee or agent of such a person or a 32 
facility for convalescent care, medical laboratory or hospital who 33 
has care, custody and control of medical records for such a person or 34 
institution. 35 
 2.  “Medical records” includes bills, ledgers, statements and 36 
other accounts which show the cost of medical services or care 37 
provided to a patient. 38 
 Sec. 50.  NRS 89.050 is hereby amended to read as follows: 39 
 89.050 1.  Except as otherwise provided in subsection 2, a 40 
professional entity may be organized only for the purpose of 41 
rendering one specific type of professional service and may not 42 
engage in any business other than rendering the professional service 43 
for which it was organized and services reasonably related thereto, 44 
except that a professional entity may own real and personal property 45   
 	– 38 – 
 
 
- 	*SB189* 
appropriate to its business and may invest its money in any form of 1 
real property, securities or any other type of investment. 2 
 2.  A professional entity may be organized to render a 3 
professional service relating to: 4 
 (a) Architecture, interior design, residential design, engineering 5 
and landscape architecture, or any combination thereof, and may be 6 
composed of persons: 7 
  (1) Engaged in the practice of architecture as provided in 8 
chapter 623 of NRS; 9 
  (2) Practicing as a registered interior designer as provided in 10 
chapter 623 of NRS; 11 
  (3) Engaged in the practice of residential design as provided 12 
in chapter 623 of NRS; 13 
  (4) Engaged in the practice of landscape architecture as 14 
provided in chapter 623A of NRS; and 15 
  (5) Engaged in the practice of professional engineering as 16 
provided in chapter 625 of NRS. 17 
 (b) Medicine, genetic counseling, homeopathy, osteopathy, 18 
naprapathy, chiropractic and psychology, or any combination 19 
thereof, and may be composed of persons engaged in the practice of: 20 
  (1) Medicine or genetic counseling as provided in chapter 21 
630 of NRS; 22 
  (2) Homeopathic medicine as provided in chapter 630A of 23 
NRS; 24 
  (3) Osteopathic medicine as provided in chapter 633 of NRS;  25 
  (4) Chiropractic as provided in chapter 634 of NRS; 26 
  (5) Naprapathy as provided in chapter 634B of NRS; and 27 
  (6) Psychology and licensed to provide services pursuant to 28 
chapter 641 of NRS. 29 
 Such a professional entity may market and manage additional 30 
professional entities which are organized to render a professional 31 
service relating to medicine, genetic counseling, homeopathy, 32 
osteopathy, naprapathy, chiropractic and psychology. 33 
 (c) Mental health services, and may be composed of the 34 
following persons, in any number and in any combination: 35 
  (1) Any psychologist who is licensed to practice in this State; 36 
  (2) Any social worker who holds a master’s degree in social 37 
work and who is licensed by this State as a clinical social worker; 38 
  (3) Any registered nurse who is licensed to practice 39 
professional nursing in this State and who holds a master’s degree in 40 
the field of psychiatric nursing; 41 
  (4) Any marriage and family therapist who is licensed by this 42 
State pursuant to chapter 641A of NRS; and 43 
  (5) Any clinical professional counselor who is licensed by 44 
this State pursuant to chapter 641A of NRS. 45   
 	– 39 – 
 
 
- 	*SB189* 
 Such a professional entity may market and manage additional 1 
professional entities which are organized to render a professional 2 
service relating to mental health services pursuant to this paragraph. 3 
 3.  A professional entity may render a professional service only 4 
through its officers, managers and employees who are licensed or 5 
otherwise authorized by law to render the professional service. 6 
 Sec. 51.  NRS 200.471 is hereby amended to read as follows: 7 
 200.471 1.  As used in this section: 8 
 (a) “Assault” means: 9 
  (1) Unlawfully attempting to use physical force against 10 
another person; or 11 
  (2) Intentionally placing another person in reasonable 12 
apprehension of immediate bodily harm. 13 
 (b) “Fire-fighting agency” has the meaning ascribed to it in  14 
NRS 239B.020. 15 
 (c) “Health care facility” means a facility licensed pursuant to 16 
chapter 449 of NRS, an office of a person listed in NRS 629.031, a 17 
clinic or any other location, other than a residence, where health 18 
care is provided.  19 
 (d) “Officer” means: 20 
  (1) A person who possesses some or all of the powers of a 21 
peace officer; 22 
  (2) A person employed in a full-time salaried occupation of 23 
fire fighting for the benefit or safety of the public; 24 
  (3) A member of a volunteer fire department; 25 
  (4) A jailer, guard or other correctional officer of a city or 26 
county jail; 27 
  (5) A prosecuting attorney of an agency or political 28 
subdivision of the United States or of this State; 29 
  (6) A justice of the Supreme Court, judge of the Court of 30 
Appeals, district judge, justice of the peace, municipal judge, 31 
magistrate, court commissioner, master or referee, including a 32 
person acting pro tempore in a capacity listed in this subparagraph; 33 
  (7) An employee of this State or a political subdivision of 34 
this State whose official duties require the employee to make home 35 
visits; 36 
  (8) A civilian employee or a volunteer of a law enforcement 37 
agency whose official duties require the employee or volunteer to: 38 
   (I) Interact with the public; 39 
   (II) Perform tasks related to law enforcement; and 40 
   (III) Wear identification, clothing or a uniform that 41 
identifies the employee or volunteer as working or volunteering for 42 
the law enforcement agency; 43 
  (9) A civilian employee or a volunteer of a fire-fighting 44 
agency whose official duties require the employee or volunteer to: 45   
 	– 40 – 
 
 
- 	*SB189* 
   (I) Interact with the public; 1 
   (II) Perform tasks related to fire fighting or fire 2 
prevention; and 3 
   (III) Wear identification, clothing or a uniform that 4 
identifies the employee or volunteer as working or volunteering for 5 
the fire-fighting agency; or 6 
  (10) A civilian employee or volunteer of this State or a 7 
political subdivision of this State whose official duties require the 8 
employee or volunteer to: 9 
   (I) Interact with the public; 10 
   (II) Perform tasks related to code enforcement; and 11 
   (III) Wear identification, clothing or a uniform that 12 
identifies the employee or volunteer as working or volunteering for 13 
this State or a political subdivision of this State. 14 
 (e) “Provider of health care” means: 15 
  (1) A physician, a medical student, a genetic counselor, a 16 
perfusionist, an anesthesiologist assistant or a physician assistant 17 
licensed pursuant to chapter 630 of NRS, a practitioner of 18 
respiratory care, a homeopathic physician, an advanced practitioner 19 
of homeopathy, a homeopathic assistant, an osteopathic physician, a 20 
physician assistant or anesthesiologist assistant licensed pursuant to 21 
chapter 633 of NRS, a podiatric physician, a podiatry hygienist, a 22 
physical therapist, a medical laboratory technician, an optometrist, a 23 
chiropractic physician, a chiropractic assistant, a naprapath, a doctor 24 
of Oriental medicine, a nurse, a student nurse, a certified nursing 25 
assistant, a nursing assistant trainee, a medication aide - certified, a 26 
person who provides health care services in the home for 27 
compensation, a dentist, a dental student, a dental hygienist, a dental 28 
hygienist student, an expanded function dental assistant, an 29 
expanded function dental assistant student, a pharmacist, a 30 
pharmacy student, an intern pharmacist, an attendant on an 31 
ambulance or air ambulance, a psychologist, a social worker, a 32 
marriage and family therapist, a marriage and family therapist 33 
intern, a clinical professional counselor, a clinical professional 34 
counselor intern, a behavior analyst, an assistant behavior analyst, a 35 
registered behavior technician, a mental health technician, a licensed 36 
dietitian, the holder of a license or a limited license issued under the 37 
provisions of chapter 653 of NRS, a public safety officer at a health 38 
care facility, an emergency medical technician, an advanced 39 
emergency medical technician, a paramedic or a participant in a 40 
program of training to provide emergency medical services; or  41 
  (2) An employee of or volunteer for a health care facility 42 
who: 43 
   (I) Interacts with the public; 44 
   (II) Performs tasks related to providing health care; and  45   
 	– 41 – 
 
 
- 	*SB189* 
   (III) Wears identification, clothing or a uniform that 1 
identifies the person as an employee or volunteer of the health care 2 
facility.  3 
 (f) “School employee” means a licensed or unlicensed person 4 
employed by a board of trustees of a school district pursuant to NRS 5 
391.100 or 391.281. 6 
 (g) “Sporting event” has the meaning ascribed to it in  7 
NRS 41.630. 8 
 (h) “Sports official” has the meaning ascribed to it in  9 
NRS 41.630. 10 
 (i) “Taxicab” has the meaning ascribed to it in NRS 706.8816. 11 
 (j) “Taxicab driver” means a person who operates a taxicab. 12 
 (k) “Transit operator” means a person who operates a bus or 13 
other vehicle as part of a public mass transportation system. 14 
 (l) “Utility worker” means an employee of a public utility as 15 
defined in NRS 704.020 whose official duties require the employee 16 
to: 17 
  (1) Interact with the public; 18 
  (2) Perform tasks related to the operation of the public 19 
utility; and 20 
  (3) Wear identification, clothing or a uniform that identifies 21 
the employee as working for the public utility. 22 
 2.  A person convicted of an assault shall be punished: 23 
 (a) If paragraph (c) or (d) does not apply to the circumstances of 24 
the crime and the assault is not made with the use of a deadly 25 
weapon or the present ability to use a deadly weapon, for a 26 
misdemeanor. 27 
 (b) If the assault is made with the use of a deadly weapon or the 28 
present ability to use a deadly weapon, for a category B felony by 29 
imprisonment in the state prison for a minimum term of not less 30 
than 1 year and a maximum term of not more than 6 years, or by a 31 
fine of not more than $5,000, or by both fine and imprisonment. 32 
 (c) If paragraph (d) does not apply to the circumstances of the 33 
crime and if the assault: 34 
  (1) Is committed upon: 35 
   (I) An officer, a school employee, a taxicab driver, a 36 
transit operator or a utility worker who is performing his or her 37 
duty; 38 
   (II) A provider of health care while the provider of health 39 
care is performing his or her duty or is on the premises where he or 40 
she performs that duty; or  41 
   (III) A sports official based on the performance of his or 42 
her duties at a sporting event; and  43 
  (2) The person charged knew or should have known that the 44 
victim was an officer, a provider of health care, a school employee, 45   
 	– 42 – 
 
 
- 	*SB189* 
a taxicab driver, a transit operator, a utility worker or a sports 1 
official,  2 
 for a gross misdemeanor, unless the assault is made with the use 3 
of a deadly weapon or the present ability to use a deadly weapon, 4 
then for a category B felony by imprisonment in the state prison for 5 
a minimum term of not less than 1 year and a maximum term of not 6 
more than 6 years, or by a fine of not more than $5,000, or by both 7 
fine and imprisonment. 8 
 (d) If the assault: 9 
  (1) Is committed by a probationer, a prisoner who is in 10 
lawful custody or confinement or a parolee upon: 11 
   (I) An officer, a school employee, a taxicab driver, a 12 
transit operator or a utility worker who is performing his or her 13 
duty; 14 
   (II) A provider of health care while the provider of health 15 
care is performing his or her duty or is on the premises where he or 16 
she performs that duty; or  17 
   (III) A sports official based on the performance of his or 18 
her duties at a sporting event; and 19 
  (2) The probationer, prisoner or parolee charged knew or 20 
should have known that the victim was an officer, a provider of 21 
health care, a school employee, a taxicab driver, a transit operator, a 22 
utility worker or a sports official,  23 
 for a category D felony as provided in NRS 193.130, unless the 24 
assault is made with the use of a deadly weapon or the present 25 
ability to use a deadly weapon, then for a category B felony by 26 
imprisonment in the state prison for a minimum term of not less 27 
than 1 year and a maximum term of not more than 6 years, or by a 28 
fine of not more than $5,000, or by both fine and imprisonment. 29 
 Sec. 52.  NRS 200.5093 is hereby amended to read as follows: 30 
 200.5093 1.  Any person who is described in subsection 4 and 31 
who, in a professional or occupational capacity, knows or has 32 
reasonable cause to believe that an older person or vulnerable 33 
person has been abused, neglected, exploited, isolated or abandoned 34 
shall: 35 
 (a) Except as otherwise provided in subsection 2, report the 36 
abuse, neglect, exploitation, isolation or abandonment of the older 37 
person or vulnerable person to: 38 
  (1) The local office of the Aging and Disability Services 39 
Division of the Department of Health and Human Services; 40 
  (2) A police department or sheriff’s office; or 41 
  (3) A toll-free telephone service designated by the Aging and 42 
Disability Services Division of the Department of Health and 43 
Human Services; and 44   
 	– 43 – 
 
 
- 	*SB189* 
 (b) Make such a report as soon as reasonably practicable but not 1 
later than 24 hours after the person knows or has reasonable cause to 2 
believe that the older person or vulnerable person has been abused, 3 
neglected, exploited, isolated or abandoned. 4 
 2.  If a person who is required to make a report pursuant to 5 
subsection 1 knows or has reasonable cause to believe that the 6 
abuse, neglect, exploitation, isolation or abandonment of the older 7 
person or vulnerable person involves an act or omission of the 8 
Aging and Disability Services Division, another division of the 9 
Department of Health and Human Services or a law enforcement 10 
agency, the person shall make the report to an agency other than the 11 
one alleged to have committed the act or omission. 12 
 3.  Each agency, after reducing a report to writing, shall forward 13 
a copy of the report to the Aging and Disability Services Division of 14 
the Department of Health and Human Services and the Unit for the 15 
Investigation and Prosecution of Crimes. 16 
 4.  A report must be made pursuant to subsection 1 by the 17 
following persons: 18 
 (a) Every physician, dentist, dental hygienist, expanded function 19 
dental assistant, chiropractic physician, naprapath, optometrist, 20 
podiatric physician, medical examiner, resident, intern, professional 21 
or practical nurse, physician assistant licensed pursuant to chapter 22 
630 or 633 of NRS, genetic counselor, anesthesiologist assistant, 23 
perfusionist, psychiatrist, psychologist, marriage and family 24 
therapist, clinical professional counselor, clinical alcohol and drug 25 
counselor, alcohol and drug counselor, music therapist, athletic 26 
trainer, driver of an ambulance, paramedic, licensed dietitian, holder 27 
of a license or a limited license issued under the provisions of 28 
chapter 653 of NRS, behavior analyst, assistant behavior analyst, 29 
registered behavior technician, peer recovery support specialist, as 30 
defined in NRS 433.627, peer recovery support specialist 31 
supervisor, as defined in NRS 433.629, or other person providing 32 
medical services licensed or certified to practice in this State, who 33 
examines, attends or treats an older person or vulnerable person who 34 
appears to have been abused, neglected, exploited, isolated or 35 
abandoned. 36 
 (b) Any personnel of a hospital or similar institution engaged in 37 
the admission, examination, care or treatment of persons or an 38 
administrator, manager or other person in charge of a hospital or 39 
similar institution upon notification of the suspected abuse, neglect, 40 
exploitation, isolation or abandonment of an older person or 41 
vulnerable person by a member of the staff of the hospital. 42 
 (c) A coroner. 43 
 (d) Every person who maintains or is employed by an agency to 44 
provide personal care services in the home. 45   
 	– 44 – 
 
 
- 	*SB189* 
 (e) Every person who maintains or is employed by an agency to 1 
provide nursing in the home. 2 
 (f) Every person who operates, who is employed by or who 3 
contracts to provide services for an intermediary service 4 
organization as defined in NRS 449.4304. 5 
 (g) Any employee of the Department of Health and Human 6 
Services, except the State Long-Term Care Ombudsman appointed 7 
pursuant to NRS 427A.125 and any of his or her advocates or 8 
volunteers where prohibited from making such a report pursuant to 9 
45 C.F.R. § 1321.11. 10 
 (h) Any employee of a law enforcement agency or a county’s 11 
office for protective services or an adult or juvenile probation 12 
officer. 13 
 (i) Any person who maintains or is employed by a facility or 14 
establishment that provides care for older persons or vulnerable 15 
persons. 16 
 (j) Any person who maintains, is employed by or serves as a 17 
volunteer for an agency or service which advises persons regarding 18 
the abuse, neglect, exploitation, isolation or abandonment of an 19 
older person or vulnerable person and refers them to persons and 20 
agencies where their requests and needs can be met. 21 
 (k) Every social worker. 22 
 (l) Any person who owns or is employed by a funeral home or 23 
mortuary. 24 
 (m) Every person who operates or is employed by a community 25 
health worker pool, as defined in NRS 449.0028, or with whom a 26 
community health worker pool contracts to provide the services of a 27 
community health worker, as defined in NRS 449.0027. 28 
 (n) Every person who is enrolled with the Division of Health 29 
Care Financing and Policy of the Department of Health and Human 30 
Services to provide doula services to recipients of Medicaid 31 
pursuant to NRS 422.27177. 32 
 5.  A report may be made by any other person. 33 
 6.  If a person who is required to make a report pursuant to 34 
subsection 1 knows or has reasonable cause to believe that an older 35 
person or vulnerable person has died as a result of abuse, neglect, 36 
isolation or abandonment, the person shall, as soon as reasonably 37 
practicable, report this belief to the appropriate medical examiner or 38 
coroner, who shall investigate the cause of death of the older person 39 
or vulnerable person and submit to the appropriate local law 40 
enforcement agencies, the appropriate prosecuting attorney, the 41 
Aging and Disability Services Division of the Department of Health 42 
and Human Services and the Unit for the Investigation and 43 
Prosecution of Crimes his or her written findings. The written 44   
 	– 45 – 
 
 
- 	*SB189* 
findings must include the information required pursuant to the 1 
provisions of NRS 200.5094, when possible. 2 
 7.  A division, office or department which receives a report 3 
pursuant to this section shall cause the investigation of the report to 4 
commence within 3 working days. A copy of the final report of the 5 
investigation conducted by a division, office or department, other 6 
than the Aging and Disability Services Division of the Department 7 
of Health and Human Services, must be forwarded within 30 days 8 
after the completion of the report to the: 9 
 (a) Aging and Disability Services Division; 10 
 (b) Repository for Information Concerning Crimes Against 11 
Older Persons or Vulnerable Persons created by NRS 179A.450; 12 
and 13 
 (c) Unit for the Investigation and Prosecution of Crimes. 14 
 8.  If the investigation of a report results in the belief that an 15 
older person or vulnerable person is abused, neglected, exploited, 16 
isolated or abandoned, the Aging and Disability Services Division 17 
of the Department of Health and Human Services or the county’s 18 
office for protective services may provide protective services to the 19 
older person or vulnerable person if the older person or vulnerable 20 
person is able and willing to accept them. 21 
 9.  A person who knowingly and willfully violates any of the 22 
provisions of this section is guilty of a misdemeanor. 23 
 10. As used in this section, “Unit for the Investigation and 24 
Prosecution of Crimes” means the Unit for the Investigation  25 
and Prosecution of Crimes Against Older Persons or Vulnerable 26 
Persons in the Office of the Attorney General created pursuant to 27 
NRS 228.265. 28 
 Sec. 53.  NRS 202.2491 is hereby amended to read as follows: 29 
 202.2491 1.  Except as otherwise provided in subsections 5 30 
and 6 and NRS 202.24915, the smoking of tobacco in any form is 31 
prohibited if done in any: 32 
 (a) Public elevator. 33 
 (b) Public building. 34 
 (c) Public waiting room, lobby or hallway of any: 35 
  (1) Medical facility or facility for the dependent as defined in 36 
chapter 449 of NRS; or 37 
  (2) Office of any chiropractic physician, naprapath, dentist, 38 
physical therapist, physician, genetic counselor, podiatric physician, 39 
psychologist, optician, optometrist or doctor of Oriental medicine. 40 
 (d) Hotel or motel when so designated by the operator thereof. 41 
 (e) Public area of a store principally devoted to the sale of food 42 
for human consumption off the premises. 43 
 (f) Child care facility. 44   
 	– 46 – 
 
 
- 	*SB189* 
 (g) Bus used by the general public, other than a chartered bus, or 1 
in any maintenance facility or office associated with a bus system 2 
operated by any regional transportation commission. 3 
 (h) School bus. 4 
 (i) Video arcade. 5 
 2.  The person in control of an area listed in paragraph (c), (d), 6 
(e) or (g) of subsection 1: 7 
 (a) Shall post in the area signs prohibiting smoking in any place 8 
not designated for that purpose as provided in paragraph (b). 9 
 (b) May designate separate rooms or portions of the area which 10 
may be used for smoking, except for a room or portion of the area of 11 
a store described in paragraph (e) of subsection 1 if the room or 12 
portion of the area: 13 
  (1) Is leased to or operated by a person licensed pursuant to 14 
NRS 463.160; and 15 
  (2) Does not otherwise qualify for an exemption set forth in 16 
NRS 202.24915. 17 
 3.  The person in control of a public building: 18 
 (a) Shall post in the area signs prohibiting smoking in any place 19 
not designated for that purpose as provided in paragraph (b). 20 
 (b) Shall, except as otherwise provided in this subsection, 21 
designate a separate area which may be used for smoking. 22 
 A school district which prohibits the use of tobacco by pupils 23 
need not designate an area which may be used by the pupils to 24 
smoke. 25 
 4.  The operator of a restaurant with a seating capacity of 50 or 26 
more shall maintain a flexible nonsmoking area within the restaurant 27 
and offer each patron the opportunity to be seated in a smoking or 28 
nonsmoking area. 29 
 5.  A business which derives more than 50 percent of its gross 30 
receipts from the sale of alcoholic beverages or 50 percent of its 31 
gross receipts from gaming operations may be designated as a 32 
smoking area in its entirety by the operator of the business. 33 
 6.  The smoking of tobacco is not prohibited in: 34 
 (a) Any room or area designated for smoking pursuant to 35 
paragraph (b) of subsection 2 or paragraph (b) of subsection 3. 36 
 (b) A licensed gaming establishment. A licensed gaming 37 
establishment may designate separate rooms or areas within the 38 
establishment which may or may not be used for smoking. 39 
 7.  As used in this section: 40 
 (a) “Child care facility” means an establishment operated and 41 
maintained to furnish care on a temporary or permanent basis, 42 
during the day or overnight, to five or more children under 18 years 43 
of age, if compensation is received for the care of any of those 44   
 	– 47 – 
 
 
- 	*SB189* 
children. The term does not include the home of a natural person 1 
who provides child care. 2 
 (b) “Licensed gaming establishment” has the meaning ascribed 3 
to it in NRS 463.0169. 4 
 (c) “Public building” means any building or office space owned 5 
or occupied by: 6 
  (1) Any component of the Nevada System of Higher 7 
Education and used for any purpose related to the System. 8 
  (2) The State of Nevada and used for any public purpose, 9 
other than that used by the Department of Corrections to house or 10 
provide other services to offenders. 11 
  (3) Any county, city, school district or other political 12 
subdivision of the State and used for any public purpose. 13 
 If only part of a building is owned or occupied by an entity 14 
described in this paragraph, the term means only that portion of the 15 
building which is so owned or occupied. 16 
 (d) “School bus” has the meaning ascribed to it in NRS 483.160. 17 
 (e) “Video arcade” means a facility legally accessible to persons 18 
under 18 years of age which is intended primarily for the use of 19 
pinball and video machines for amusement and which contains a 20 
minimum of 10 such machines. 21 
 Sec. 54.  NRS 226.454 is hereby amended to read as follows: 22 
 226.454 “Provider of health care” means: 23 
 1. A physician; 24 
 2. A physician assistant licensed pursuant to chapter 630 or 25 
633 of NRS; 26 
 3. A dentist; 27 
 4. A licensed nurse; 28 
 5. A person who holds a license as an attendant or is certified 29 
as an emergency medical technician, advanced emergency medical 30 
technician or paramedic pursuant to chapter 450B of NRS; 31 
 6. An optometrist; 32 
 7. An audiologist; 33 
 8. A practitioner of respiratory care; 34 
 9. A podiatric physician; 35 
 10. A psychologist; 36 
 11. A clinical professional counselor; 37 
 12. A genetic counselor; 38 
 13. A perfusionist; 39 
 [13.] 14.  A pharmacist or pharmacy technician; 40 
 [14.] 15.  An associate in social work, a social worker, a master 41 
social worker, an independent social worker or a clinical social 42 
worker licensed pursuant to chapter 641B of NRS; 43 
 [15.] 16.  A midwife; or 44   
 	– 48 – 
 
 
- 	*SB189* 
 [16.] 17.  A provider of doula services who is enrolled with the 1 
Division of Health Care Financing and Policy of the Department of 2 
Health and Human Services to receive reimbursement through 3 
Medicaid pursuant to NRS 422.27177. 4 
 Sec. 55.  NRS 288.140 is hereby amended to read as follows: 5 
 288.140 1.  It is the right of every local government 6 
employee, subject to the limitations provided in subsections 3, 4 and 7 
5, to join any employee organization of the employee’s choice or to 8 
refrain from joining any employee organization. A local government 9 
employer shall not discriminate in any way among its employees on 10 
account of membership or nonmembership in an employee 11 
organization. 12 
 2.  The recognition of an employee organization for negotiation, 13 
pursuant to this chapter, does not preclude any local government 14 
employee who is not a member of that employee organization from 15 
acting for himself or herself with respect to any condition of his or 16 
her employment, but any action taken on a request or in adjustment 17 
of a grievance shall be consistent with the terms of an applicable 18 
negotiated agreement, if any. 19 
 3.  A police officer, sheriff, deputy sheriff or other law 20 
enforcement officer may be a member of an employee organization 21 
only if such employee organization is composed exclusively of law 22 
enforcement officers. 23 
 4. A civilian employee of a metropolitan police department 24 
which is organized pursuant to chapter 280 of NRS may be a 25 
member of an employee organization only if such employee 26 
organization is composed exclusively of civilian employees of a 27 
metropolitan police department which is organized pursuant to 28 
chapter 280 of NRS. 29 
 5.  The following persons may not be a member of an employee 30 
organization: 31 
 (a) A supervisory employee described in paragraph (b) of 32 
subsection 1 of NRS 288.138, including but not limited to appointed 33 
officials and department heads who are primarily responsible for 34 
formulating and administering management, policy and programs. 35 
 (b) A doctor or physician who is employed by a local 36 
government employer. 37 
 (c) Except as otherwise provided in this paragraph, an attorney 38 
who is employed by a local government employer and who is 39 
assigned to a civil law division, department or agency. The 40 
provisions of this paragraph do not apply with respect to an attorney 41 
for the duration of a collective bargaining agreement to which the 42 
attorney is a party as of July 1, 2011. 43 
 6. As used in this section, “doctor or physician” means a 44 
doctor, physician, genetic counselor, homeopathic physician, 45   
 	– 49 – 
 
 
- 	*SB189* 
osteopathic physician, naprapath, chiropractic physician, 1 
practitioner of Oriental medicine, podiatric physician or practitioner 2 
of optometry, as those terms are defined or used, respectively, in 3 
NRS 630.014, 630A.050, 633.091, chapter 634 of NRS, chapter 4 
634A of NRS, NRS 634B.050, chapter 635 of NRS or chapter 636 5 
of NRS. 6 
 Sec. 56.  NRS 439A.0195 is hereby amended to read as 7 
follows: 8 
 439A.0195 “Practitioner” means a physician licensed under 9 
chapter 630, 630A or 633 of NRS, genetic counselor, dentist, 10 
licensed nurse, dispensing optician, optometrist, registered physical 11 
therapist, podiatric physician, licensed psychologist, chiropractic 12 
physician, naprapath, doctor of Oriental medicine in any form, 13 
medical laboratory director or technician, pharmacist or other person 14 
whose principal occupation is the provision of services for health. 15 
 Sec. 57.  NRS 598A.360 is hereby amended to read as follows: 16 
 598A.360 “Practitioner” means a physician licensed pursuant 17 
to chapter 630 or 633 of NRS, physician assistant, genetic 18 
counselor, licensed nurse, dispensing optician, optometrist, 19 
practitioner of respiratory care, registered physical therapist, 20 
occupational therapist, licensed psychologist or perfusionist. 21 
 Sec. 58.  NRS 685B.120 is hereby amended to read as follows: 22 
 685B.120 1.  Any person who provides coverage in this State 23 
for the cost of: 24 
 (a) Medical care; 25 
 (b) Surgery; 26 
 (c) Chiropractic; 27 
 (d) Physical therapy; 28 
 (e) Speech-language pathology; 29 
 (f) Audiology; 30 
 (g) Professional care of mental health; 31 
 (h) Dental care; 32 
 (i) Hospital care; 33 
 (j) Ophthalmic care; 34 
 (k) Naprapathy;  35 
 (l) Genetic counseling; or 36 
 [(l)] (m) Ambulance services, 37 
 whether the coverage provides for direct payment, reimbursement 38 
or any other method of payment, is subject to regulation by the 39 
Division and to the provisions of this Code unless the person shows 40 
that while providing such coverage the person is subject to 41 
regulation by the Federal Government. 42 
 2.  A nonprofit corporation that provides prepaid ambulance 43 
services is not subject to regulation by the Division or to the 44 
provisions of this Code if the corporation presents evidence 45   
 	– 50 – 
 
 
- 	*SB189* 
satisfactory to the Commissioner that the corporation is subject to 1 
regulation by a political subdivision of this State pursuant to an 2 
exclusive franchise which limits the number of times any such 3 
prepaid services may be used to a defined number that are medically 4 
necessary. 5 
 Sec. 59.  NRS 686A.2825 is hereby amended to read as 6 
follows: 7 
 686A.2825 “Practitioner” means: 8 
 1.  A physician, genetic counselor, dentist, nurse, dispensing 9 
optician, optometrist, physical therapist, podiatric physician, 10 
psychologist, chiropractic physician, naprapath, doctor of Oriental 11 
medicine in any form, director or technician of a medical laboratory, 12 
pharmacist, person who holds a license to engage in radiation 13 
therapy and radiologic imaging or a limited license to engage in 14 
radiologic imaging pursuant to chapter 653 of NRS or other 15 
provider of health services who is authorized to engage in his or her 16 
occupation by the laws of this state or another state; and 17 
 2.  An attorney admitted to practice law in this state or any 18 
other state. 19 
 Sec. 60.  1. Notwithstanding the amendatory provisions of 20 
this act, any person who is engaged in the practice of genetic 21 
counseling on or before January 1, 2026, may continue to engage in 22 
the practice of genetic counseling without obtaining a license 23 
pursuant to section 7 of this act until July 1, 2026. 24 
 2. As used in this section, “genetic counseling” has the 25 
meaning ascribed to it in section 4 of this act.  26 
 Sec. 61.  The provisions of subsection 1 of NRS 218D.380 do 27 
not apply to any provision of this act which adds or revises a 28 
requirement to submit a report to the Legislature. 29 
 Sec. 62.  This act becomes effective: 30 
 1. Upon passage and approval for the purpose of adopting any 31 
regulations and performing any other preparatory administrative 32 
tasks that are necessary to carry out the provisions of this act; and 33 
 2. On January 1, 2026, for all other purposes.  34 
 
H