REQUIRES TWO-THIRDS MAJORITY VOTE
(§§ 18, 20, 22, 50, 51 & NRS 453.221, 639.170)
S.B. 397
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SENATE BILL NO. 397–SENATOR OHRENSCHALL
MARCH 17, 2025
____________
Referred to Committee on Commerce and Labor
SUMMARY—Makes various changes relating to alternative
medicine. (BDR 54-117)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Yes.
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to alternative medicine; providing for the
licensure and regulation of naturopathic physicians and
naturopathic assistants by the Nevada Board of
Homeopathic and Naturopathic Medical Examiners;
authorizing homeopathic physicians to dispense,
administer and prescribe drugs in certain circumstances;
establishing additional grounds for disciplinary action
against persons licensed by the Board; revising other
provisions relating to the Board; providing penalties; and
providing other matters properly relating thereto.
Legislative Counsel’s Digest:
Existing law provides for the regulation and licensure of homeopathic 1
physicians by the Nevada Board of Homeopathic Medical Examiners. (Chapter 2
630A of NRS) The Board also certifies and regulates advanced practitioners of 3
homeopathy and homeopathic assistants. (NRS 630A.293-630A.299) This bill 4
generally provides for the regulation of naturopathic medicine and the licensure of 5
naturopathic physicians and the certification of naturopathic assistants by the 6
Board. Sections 33, 40 and 96 of this bill revise the name of the board to “Nevada 7
Board of Homeopathic and Naturopathic Medical Examiners” to reflect the new 8
authority and duties of the Board established by this bill. Sections 10 and 12 of this 9
bill define the terms “naturopathic assistant” and “naturopathic physician,” 10
respectively. Sections 11 and 16-18 of this bill: (1) define the practice of 11
naturopathic medicine; (2) set forth the scope of the practice of naturopathic 12
medicine; (3) provide the authorized methods of administration of natural 13
substances that may be administered by a naturopathic physician; (4) set forth the 14
requirements that a naturopathic physician must satisfy before administering 15
intravenous therapy in his or her practice; and (5) authorize a naturopathic 16
physician to dispense natural substances, drugs and devices, including certain 17
controlled substances. Sections 19-27 of this bill require the Board to: (1) license 18
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naturopathic physicians; (2) certify naturopathic physicians as specialists; (3) 19
certify naturopathic assistants; (4) certify naturopathic medical students who wish 20
to participate in a program of clinical training for naturopathic medicine; and (5) 21
certify graduates of an approved school of naturopathic medicine who wish to 22
participate in an internship, preceptorship or fellowship training program. Sections 23
19-27 also establish certain requirements that an applicant for a license or 24
certificate must satisfy before the Board may issue the applicant such a license or 25
certificate. Section 28 of this bill requires naturopathic physicians to comply with 26
certain legal requirements governing the registration of births and deaths. Section 27
31 of this bill requires a naturopathic physician to take certain actions which are 28
also required of similar providers under existing law to assist a patient with an 29
opioid use disorder in accessing medication-assisted treatment. (NRS 630.3737, 30
632.2383, 633.6947, 641.2293, 641A.299, 641B.360, 641C.620) Section 50 of this 31
bill establishes certain procedures and requirements for renewing a license or 32
certificate, which are consistent with the procedures and requirements currently 33
applicable to practitioners of homeopathic medicine. Section 51 of this bill 34
establishes the fees for the issuance and renewal of a license or certificate issued 35
pursuant to sections 15 and 21-27. Sections 5-9, 13 and 14 of this bill define 36
certain other terms relating to the practice of naturopathic medicine and section 32 37
of this bill establishes the applicability of the definitions set forth in sections 5-14. 38
Sections 34, 36, 37 and 52-76 of this bill make the grounds and procedures that 39
are applicable to the investigation and discipline of homeopathic physicians, 40
advanced practitioners of homeopathy and homeopathic assistants, and the 41
unlicensed or uncertified practice of those professions, also applicable to 42
naturopathic physicians and naturopathic assistants and the unlicensed or 43
uncertified practice of those professions. Section 29 of this bill establishes 44
additional grounds for disciplinary action against all practitioners licensed by the 45
Board relating to medical records and reporting, and section 49 of this bill 46
authorizes the discipline of the holder of a limited license to practice homeopathic 47
medicine on those grounds. Section 75 prohibits misrepresenting that a school or 48
college of naturopathic medicine has been approved by the Board, and sections 43 49
and 76 of this bill prohibit the unlicensed practice of naturopathic medicine and 50
practice as a naturopathic assistant without the proper license or certificate. 51
Sections 38, 42, 44, 45, 47 and 48 of this bill make conforming changes to include 52
naturopathic physicians, naturopathic assistants and the practice of naturopathic 53
medicine within existing provisions currently applicable to homeopathic 54
physicians, advanced practitioners of homeopathy, homeopathic assistants and the 55
practice of homeopathic medicine, where appropriate. Section 39 of this bill 56
exempts certain persons from provisions governing homeopathic medicine and 57
naturopathic medicine. Section 46 of this bill limits to homeopathic physicians the 58
applicability of a provision relating to the examination of applicants for licensure as 59
a homeopathic physician. Section 40 expands the membership of the Board from 60
six members to eight members and section 41 of this bill requires that the 61
additional members added to the Board be naturopathic physicians who have 62
certain qualifications. 63
Existing law defines the term “physician” for the entirety of Nevada law, 64
except where specifically provided otherwise, to mean a person who engages in the 65
practice of medicine, including homeopathy. (NRS 0.040) Section 85 of this bill 66
includes within this definition a person who engages in the practice of naturopathic 67
medicine, thereby making certain provisions of existing law that are applicable to 68
all physicians also apply to naturopathic physicians, including provisions 69
concerning controlled substances and dangerous drugs. (Chapters 453 and 454 of 70
NRS) Sections 1 and 105-128 of this bill make revisions to treat naturopathic 71
physicians like other osteopathic and allopathic physicians for certain purposes 72
relating to provisions that require insurers to take, or refrain from taking, certain 73
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actions with respect to certain policies of health insurance and medical malpractice 74
insurance. 75
Sections 77, 78, 81, 83 and 84 of this bill clarify that provisions of law 76
governing certain other professions do not apply to naturopathic physicians. 77
Sections 2, 3, 79, 80, 82, 86-95 and 97-104 of this bill make revisions to treat 78
naturopathic physicians and naturopathic assistants, where applicable, in the same 79
manner as other similar providers of health care in other certain respects. 80
Existing law defines “homeopathic medicine” to include noninvasive 81
electrodiagnosis, cell therapy, neural therapy, herbal therapy, neuromuscular 82
integration, orthomolecular therapy and nutrition. (NRS 630A.040) Existing 83
regulations interpret “neural therapy” and “orthomolecular therapy” to include the 84
prescription and administration of pharmaceutical preparations. Existing 85
regulations interpret “pharmaceutical preparations” to include narcotic drugs and 86
opiates that are listed as schedule II controlled substances regulated by the State 87
Board of Pharmacy. (NAC 630A.014) Sections 30 and 35 of this bill affirmatively 88
authorize a homeopathic physician to dispense, administer and prescribe certain 89
drugs, including some controlled substances, in the course of providing neural 90
therapy or orthomolecular therapy, so long as the dosage and administration of the 91
drugs conform with the standards of practice for those therapies and the 92
homeopathic physician meets certain other qualifications. Section 30 also clarifies 93
the authority of a homeopathic physician to prescribe, dispense and administer 94
certain controlled substances and dangerous drugs in certain other contexts, so long 95
as the drug is: (1) in an amount suitable for a single use; and (2) only used for the 96
purpose of diluting the drug into a homeopathic preparation in accordance with the 97
standards prescribed in the Homeopathic Pharmacopoeia of the United States. 98
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 629.095 is hereby amended to read as follows: 1
629.095 1. Except as otherwise provided in subsection 2, the 2
Commissioner of Insurance shall develop, prescribe for use and 3
make available a single, standardized form for use by insurers, 4
carriers, societies, corporations, health maintenance organizations, 5
managed care organizations, hospitals, medical facilities and other 6
facilities that provide health care in obtaining any information 7
related to the credentials of a provider of health care. 8
2. The provisions of subsection 1 do not prohibit the 9
Commissioner of Insurance from developing, prescribing for use 10
and making available: 11
(a) Appropriate variations of the form described in that 12
subsection for use in different geographical regions of this State. 13
(b) Addenda or supplements to the form described in that 14
subsection to address, until such time as a new form may be 15
developed, prescribed for use and made available, any requirements 16
newly imposed by the Federal Government, the State or one of its 17
agencies, or a body that accredits hospitals, medical facilities or 18
health care plans. 19
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3. With respect to the form described in subsection 1, the 1
Commissioner of Insurance shall: 2
(a) Hold public hearings to seek input regarding the 3
development of the form; 4
(b) Develop the form in consideration of the input received 5
pursuant to paragraph (a); 6
(c) Ensure that the form is developed in such a manner as to 7
accommodate and reflect the different types of credentials 8
applicable to different classes of providers of health care; 9
(d) Ensure that the form is developed in such a manner as to 10
reflect standards of accreditation adopted by national organizations 11
which accredit hospitals, medical facilities and health care plans; 12
and 13
(e) Ensure that the form is developed to be used efficiently and 14
is developed to be neither unduly long nor unduly voluminous. 15
4. As used in this section: 16
(a) “Carrier” has the meaning ascribed to it in NRS 689C.025. 17
(b) “Corporation” means a corporation operating pursuant to the 18
provisions of chapter 695B of NRS. 19
(c) “Health maintenance organization” has the meaning ascribed 20
to it in NRS 695C.030. 21
(d) “Insurer” means: 22
(1) An insurer that issues policies of individual health 23
insurance in accordance with chapter 689A of NRS; and 24
(2) An insurer that issues policies of group health insurance 25
in accordance with chapter 689B of NRS. 26
(e) “Managed care organization” has the meaning ascribed to it 27
in NRS 695G.050. 28
(f) “Provider of health care” means a provider of health care 29
who is licensed pursuant to chapter 630, 631, 632 or 633 of NRS [.] 30
or a naturopathic physician or naturopathic assistant licensed or 31
certified pursuant to chapter 630A of NRS. 32
(g) “Society” has the meaning ascribed to it in NRS 695A.044. 33
Sec. 2. NRS 629.580 is hereby amended to read as follows: 34
629.580 1. A person who provides wellness services in 35
accordance with this section, but who is not licensed, certified or 36
registered in this State as a provider of health care, is not in 37
violation of any law based on the unlicensed practice of health care 38
services or a health care profession unless the person: 39
(a) Performs surgery or any other procedure which punctures the 40
skin of any person; 41
(b) Sets a fracture of any bone of any person; 42
(c) Prescribes or administers X-ray radiation to any person; 43
(d) Prescribes or administers a prescription drug or device or a 44
controlled substance to any person; 45
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(e) Recommends to a client that he or she discontinue or in any 1
manner alter current medical treatment prescribed by a provider of 2
health care licensed, certified or registered in this State; 3
(f) Makes a diagnosis of a medical disease of any person; 4
(g) Performs a manipulation or a chiropractic adjustment of the 5
articulations of joints or the spine of any person; 6
(h) Treats a person’s health condition in a manner that 7
intentionally or recklessly causes that person recognizable and 8
imminent risk of serious or permanent physical or mental harm; 9
(i) Holds out, states, indicates, advertises or implies to any 10
person that he or she is a provider of health care; 11
(j) Engages in the practice of medicine in violation of chapter 12
630 or 633 of NRS, the practice of homeopathic medicine or 13
naturopathic medicine in violation of chapter 630A of NRS, the 14
practice of naprapathy in violation of chapter 634B of NRS or the 15
practice of podiatry in violation of chapter 635 of NRS, unless 16
otherwise expressly authorized by this section; 17
(k) Performs massage therapy as that term is defined in NRS 18
640C.060, reflexology as that term is defined in NRS 640C.080 or 19
structural integration as that term is defined in NRS 640C.085; 20
(l) Provides mental health services that are exclusive to the 21
scope of practice of a psychiatrist licensed pursuant to chapter 630 22
or 633 of NRS, or a psychologist licensed pursuant to chapter 641 of 23
NRS; or 24
(m) Engages in the practice of applied behavior analysis in 25
violation of chapter 641D of NRS. 26
2. Any person providing wellness services in this State who is 27
not licensed, certified or registered in this State as a provider of 28
health care and who is advertising or charging a fee for wellness 29
services shall, before providing those services, disclose to each 30
client in a plainly worded written statement: 31
(a) The person’s name, business address and telephone number; 32
(b) The fact that he or she is not licensed, certified or registered 33
as a provider of health care in this State; 34
(c) The nature of the wellness services to be provided; 35
(d) The degrees, training, experience, credentials and other 36
qualifications of the person regarding the wellness services to be 37
provided; and 38
(e) A statement in substantially the following form: 39
40
It is recommended that before beginning any wellness 41
plan, you notify your primary care physician or other licensed 42
providers of health care of your intention to use wellness 43
services, the nature of the wellness services to be provided 44
and any wellness plan that may be utilized. It is also 45
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recommended that you ask your primary care physician or 1
other licensed providers of health care about any potential 2
drug interactions, side effects, risks or conflicts between any 3
medications or treatments prescribed by your primary care 4
physician or other licensed providers of health care and the 5
wellness services you intend to receive. 6
7
A person who provides wellness services shall obtain from each 8
client a signed copy of the statement required by this subsection, 9
provide the client with a copy of the signed statement at the time of 10
service and retain a copy of the signed statement for a period of not 11
less than 5 years. 12
3. A written copy of the statement required by subsection 2 13
must be posted in a prominent place in the treatment location of the 14
person providing wellness services in at least 12-point font. 15
Reasonable accommodations must be made for clients who: 16
(a) Are unable to read; 17
(b) Are blind or visually impaired; 18
(c) Have communication impairments; or 19
(d) Do not read or speak English or any other language in which 20
the statement is written. 21
4. Any advertisement for wellness services authorized pursuant 22
to this section must disclose that the provider of those services is not 23
licensed, certified or registered as a provider of health care in this 24
State. 25
5. A person who violates any provision of this section is guilty 26
of a misdemeanor. Before a criminal proceeding is commenced 27
against a person for a violation of a provision of this section, a 28
notification, educational or mediative approach must be utilized by 29
the regulatory body enforcing the provisions of this section to bring 30
the person into compliance with such provisions. 31
6. This section does not apply to or control: 32
(a) Any health care practice by a provider of health care 33
pursuant to the professional practice laws of this State, or prevent 34
such a health care practice from being performed. 35
(b) Any health care practice if the practice is exempt from the 36
professional practice laws of this State, or prevent such a health care 37
practice from being performed. 38
(c) A person who provides health care services if the person is 39
exempt from the professional practice laws of this State, or prevent 40
the person from performing such a health care service. 41
(d) A medical assistant, as that term is defined in NRS 630.0129 42
and 633.075, an advanced practitioner of homeopathy, as that term 43
is defined in NRS 630A.015, [or] a homeopathic assistant, as that 44
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term is defined in NRS 630A.035 [.] or a naturopathic assistant, as 1
that term is defined in section 10 of this act. 2
7. As used in this section, “wellness services” means healing 3
arts therapies and practices, and the provision of products, that are 4
based on the following complementary health treatment approaches 5
and which are not otherwise prohibited by subsection 1: 6
(a) Anthroposophy. 7
(b) Aromatherapy. 8
(c) Traditional cultural healing practices. 9
(d) Detoxification practices and therapies. 10
(e) Energetic healing. 11
(f) Folk practices. 12
(g) Gerson therapy and colostrum therapy. 13
(h) Healing practices using food, dietary supplements, nutrients 14
and the physical forces of heat, cold, water and light. 15
(i) Herbology and herbalism. 16
(j) Reiki. 17
(k) Mind-body healing practices. 18
(l) Nondiagnostic iridology. 19
(m) Noninvasive instrumentalities. 20
(n) Holistic kinesiology. 21
Sec. 3. NRS 629.600 is hereby amended to read as follows: 22
629.600 1. A psychotherapist shall not provide any 23
conversion therapy to a person who is under 18 years of age 24
regardless of the willingness of the person or his or her parent or 25
legal guardian to authorize such therapy. 26
2. Any violation of subsection 1 is a ground for disciplinary 27
action by a state board that licenses a psychotherapist as defined in 28
subsection 3. 29
3. As used in this section: 30
(a) “Conversion therapy” means any practice or treatment that 31
seeks to change the sexual orientation or gender identity of a person, 32
including, without limitation, a practice or treatment that seeks to 33
change behaviors or gender expressions or to eliminate or reduce 34
sexual or romantic attractions or feelings toward persons of the 35
same gender. The term does not include counseling that: 36
(1) Provides assistance to a person undergoing gender 37
transition; or 38
(2) Provides acceptance, support and understanding of a 39
person or facilitates a person’s ability to cope, social support and 40
identity exploration and development, including, without limitation, 41
an intervention to prevent or address unlawful conduct or unsafe 42
sexual practices that is neutral as to the sexual-orientation of the 43
person receiving the intervention and does not seek to change the 44
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sexual orientation or gender identity of the person receiving the 1
intervention. 2
(b) “Psychotherapist” means: 3
(1) A psychiatrist licensed to practice medicine in this State 4
pursuant to chapter 630 of NRS; 5
(2) A homeopathic physician, naturopathic physician, 6
advanced practitioner of homeopathy , [or] homeopathic assistant or 7
naturopathic assistant licensed or certified pursuant to chapter 8
630A of NRS; 9
(3) A psychiatrist licensed to practice medicine in this State 10
pursuant to chapter 633 of NRS; 11
(4) A psychologist licensed to practice in this State pursuant 12
to chapter 641 of NRS; 13
(5) A social worker licensed in this State as an independent 14
social worker or a clinical social worker pursuant to chapter 641B of 15
NRS; 16
(6) A registered nurse holding a master’s degree in the field 17
of psychiatric nursing and licensed to practice professional nursing 18
in this State pursuant to chapter 632 of NRS; 19
(7) A marriage and family therapist or clinical professional 20
counselor licensed in this State pursuant to chapter 641A of NRS; or 21
(8) A person who provides counseling services as part of his 22
or her training for any of the professions listed in subparagraphs (1) 23
to (7), inclusive. 24
Sec. 4. Chapter 630A of NRS is hereby amended by adding 25
thereto the provisions set forth as sections 5 to 31, inclusive, of this 26
act. 27
Sec. 5. “Approved school of naturopathic medicine” means a 28
school or college: 29
1. Determined by the Board to have an educational program 30
that meets the standards prescribed by the Council on 31
Naturopathic Medical Education, or its successor agency; and 32
2. That offers a course of study that: 33
(a) Upon successful completion, results in the awarding of the 34
degree of doctor of naturopathic medicine; and 35
(b) Is accredited or a candidate for accreditation by an 36
accrediting agency recognized by: 37
(1) The United States Secretary of Education as a 38
specialized accrediting agency for schools of naturopathic 39
medicine or its successor agency; or 40
(2) The Council for Higher Education Accreditation or its 41
successor agency. 42
Sec. 6. “Dangerous drug” has the meaning ascribed to it in 43
NRS 454.201. 44
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Sec. 7. “Drug” has the meaning ascribed to it in 1
NRS 453.081. 2
Sec. 8. “Healing art” means any system, treatment, 3
diagnosis, prescription or practice for the ascertainment, cure, 4
relief, palliation, adjustment or correction of any human disease, 5
ailment, deformity, injury, or unhealthy or abnormal physical or 6
mental condition for the practice of which long periods of 7
specialized education and training and a degree of specialized 8
knowledge of an intellectual as well as physical nature are 9
required. 10
Sec. 9. “Natural substance” means a homeopathic, 11
botanical, nutritional or other supplement that: 12
1. Does not require a prescription pursuant to federal law 13
before it is prescribed, dispensed or otherwise furnished to a 14
patient; and 15
2. Is prescribed by a naturopathic physician to enhance 16
health, prevent disease or treat a medical condition diagnosed by 17
the naturopathic physician. 18
Sec. 10. “Naturopathic assistant” means a person who: 19
1. Satisfies the educational requirements prescribed by the 20
Board; 21
2. Is qualified to perform naturopathic medical services 22
under the supervision of a naturopathic physician; and 23
3. Has been issued a certificate as a naturopathic assistant by 24
the Board. 25
Sec. 11. “Naturopathic medicine” means: 26
1. A system of medicine employing accepted procedures for 27
diagnosis and treatment of human disorders, including the 28
prescribing and administering of drugs and using diet and 29
nutrition, including vitamins, fresh or dried herbs, minerals, 30
enzymes and tissue concentrates and manual manipulation, 31
including the physical, chemical and other properties of heat, 32
light, water and electricity. 33
2. To perform any of the acts described in subsection 1 by 34
using equipment that transfers information concerning the 35
medical condition of the patient electronically, telephonically or by 36
fiber optics, including, without limitation, through telehealth, as 37
defined in NRS 629.515 from within or outside this State or the 38
United States. 39
Sec. 12. “Naturopathic physician” means a person who: 40
1. Is a graduate of an approved school of naturopathic 41
medicine; and 42
2. Has been issued a license to practice naturopathic 43
medicine from the Board. 44
Sec. 13. “Prescription drug” means: 45
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1. A controlled substance or dangerous drug that may be 1
dispensed to an ultimate user only pursuant to a lawful 2
prescription; and 3
2. Any other substance or drug substituted for such a 4
controlled substance or dangerous drug. 5
Sec. 14. “Specialist” means a naturopathic physician who 6
has successfully completed approved postdoctoral training, who is 7
certified by a specialty board of examiners recognized by the 8
Board and who is certified by the Board to practice a specialty 9
pursuant to section 27 of this act. 10
Sec. 15. 1. Every person desiring to practice naturopathic 11
medicine as a naturopathic physician must, before beginning to 12
practice, procure from the Board a license authorizing such 13
practice. 14
2. Except as otherwise provided in NRS 630A.225, a license 15
may be issued to any person who: 16
(a) Is of good moral character; 17
(b) Is a graduate of an approved school of naturopathic 18
medicine located in the United States or Canada; 19
(c) Has satisfactorily completed an internship, preceptorship 20
or fellowship training program in naturopathic medicine approved 21
by the Board; 22
(d) Has passed all examinations required by the Board or this 23
chapter; and 24
(e) Meets any additional requirements established by the 25
Board, including, without limitation, requirements established by 26
regulations adopted by the Board. 27
Sec. 16. 1. A naturopathic physician may: 28
(a) Order and perform physical and laboratory examinations 29
for diagnostic purposes, including, without limitation, phlebotomy, 30
clinical laboratory tests, orifical examinations and physiological 31
function tests; 32
(b) Order diagnostic imaging studies, consistent with 33
naturopathic training as determined by the Board; 34
(c) Subject to the provisions of section 18 of this act, where 35
applicable, dispense, administer, order, prescribe and furnish or 36
perform the following: 37
(1) Food, extracts of food, nutraceuticals, vitamins, amino 38
acids, minerals, enzymes, botanicals and their extracts, botanical 39
medicines, homeopathic medicines, hormones, drugs and all 40
dietary supplements, consistent with the routes of administration 41
set forth in paragraph (d); 42
(2) Hot or cold hydrotherapy, naturopathic physical 43
medicine, electromagnetic energy, colon hydrotherapy and 44
therapeutic exercise; 45
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(3) Devices, including, without limitation, therapeutic 1
devices, barrier contraception and durable medical equipment; 2
(4) Immunizations; 3
(5) Health education and health counseling; 4
(6) Repair and care for incidental and superficial 5
lacerations and abrasions; 6
(7) Removal of foreign bodies located in the superficial 7
tissues; and 8
(8) Musculoskeletal manipulation consistent with the 9
education and training of a naturopathic physician as determined 10
by the Board; and 11
(d) Use routes of administration that include, without 12
limitation, oral, nasal, auricular, ocular, rectal, vaginal, 13
transdermal, intradermal, subcutaneous, intravenous and 14
intramuscular. 15
2. The Board shall adopt regulations relating to intravenous 16
routes of administration. The regulations must identify and 17
exclude nutrients that are not suitable for intravenous 18
administration. 19
3. As used in this section: 20
(a) “Dietary supplement” has the meaning ascribed to it in 21 21
U.S.C. § 321. 22
(b) “Nutrient” means a substance that provides nourishment 23
for growth or metabolism and that: 24
(1) Is manufactured and supplied for intravenous use by a 25
manufacturer registered with the United States Food and Drug 26
Administration; or 27
(2) Compounded by a pharmacy licensed pursuant to 28
chapter 639 of NRS. 29
Sec. 17. 1. A naturopathic physician may administer a 30
natural substance through the means of intramuscular, 31
intravenous, subcutaneous and intradermal injections. 32
2. To qualify to administer intravenous therapy in his or her 33
practice pursuant to this section and section 16 of this act, a 34
naturopathic physician must submit to the Board an attestation 35
that he or she has completed training in intravenous therapy 36
approved by the Board. At a minimum, the training must consist 37
of 16 hours, at least 8 of which must be at a graduate level from a 38
school approved by the Board, and must include all of the 39
following topics relating to intravenous therapy: 40
(a) Indications; 41
(b) Contraindications; 42
(c) Formularies; 43
(d) Emergency protocols; 44
(e) Osmolarity calculation; 45
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(f) Aseptic techniques; and 1
(g) Proper documentation. 2
3. The naturopathic physician shall retain documentation of 3
his or her training for at least 3 years after the date of the 4
attestation described in subsection 2. 5
4. A naturopathic physician who uses injection or 6
intravenous therapy must have a plan to manage adverse events, 7
including, without limitation, sensitivity, allergy, overdose or other 8
unintended reactions. 9
Sec. 18. 1. Subject to the provisions of subsection 2, where 10
applicable, a naturopathic physician may dispense a natural 11
substance, drug or device to a patient for a condition being 12
diagnosed or treated by the naturopathic physician if: 13
(a) The naturopathic physician is certified to dispense by the 14
Board. 15
(b) The natural substance, drug or device is dispensed and, if 16
required by federal law, properly labeled with the following 17
information: 18
(1) The name, address and telephone number of the 19
dispensing naturopathic physician and a prescription number or 20
other method of identifying the prescription; 21
(2) The date on which the natural substance, drug or device 22
is dispensed; 23
(3) The patient’s name; and 24
(4) The name and strength of the natural substance, drug 25
or device, directions for proper and appropriate use and any 26
cautionary statements for the natural substance, drug or device. If 27
a generic drug is dispensed, the manufacturer’s name must be 28
included. 29
(c) The dispensing naturopathic physician enters into the 30
patient’s medical record the name and strength of the natural 31
substance, drug or device dispensed, the date on which the natural 32
substance, drug or device is dispensed and the therapeutic reason. 33
(d) The dispensing naturopathic physician keeps all 34
prescription drugs and devices in a secured cabinet or room, 35
controls access to the cabinet or room by a written procedure and 36
maintains an ongoing inventory of its contents. 37
2. A naturopathic physician: 38
(a) May dispense morphine, any controlled substance listed in 39
schedule II, III, IV or V which is also a homeopathic preparation, 40
controlled substances listed in schedule III, IV or V which are not 41
narcotics and any controlled substance which is newly classified 42
as schedule II after January 1, 2026, if the naturopathic physician 43
has registered with the State Board of Pharmacy pursuant to NRS 44
453.226; and 45
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(b) Shall not dispense controlled substances except as 1
authorized by paragraph (a). 2
3. Except in an emergency, a naturopathic physician who 3
dispenses a natural substance, drug or device without being 4
certified to dispense by the Board is subject to the imposition of a 5
civil penalty by the Board of not less than $100 and not more than 6
$500 for each transaction and may be prohibited from further 7
dispensing for a period determined by the Board. 8
4. Before delivering a natural substance, drug or device to a 9
patient pursuant to this section, the treating naturopathic 10
physician shall give the patient or the patient’s legal guardian a 11
written prescription and must inform the patient or the patient’s 12
legal guardian that the prescription may be filled by the 13
prescribing physician or the pharmacy of the patient’s choice. If 14
the patient chooses to have the medication delivered by the 15
naturopathic physician, the naturopathic physician must retrieve 16
the written prescription and place it in a prescription file kept by 17
the naturopathic physician. 18
5. A naturopathic physician shall provide supervision to a 19
registered nurse, licensed practical nurse or attendant involved in 20
the dispensing process. For the purposes of this subsection, 21
“supervision” means that the naturopathic physician is available 22
in person or by telephone. 23
6. This section does not prohibit a registered nurse or 24
licensed practical nurse employed by a naturopathic physician 25
from assisting in the delivery of natural substances, drugs and 26
devices in accordance with this chapter. 27
7. The Board shall adopt regulations regarding the 28
dispensing of a natural substance, drug or device, including 29
regulations prescribing: 30
(a) The procedure to become certified by the Board to engage 31
in such dispensing; and 32
(b) Requirements governing the labeling, recordkeeping, 33
storage and packaging of natural substances, drugs and devices 34
that are consistent with the requirements of chapters 453 and 454 35
of NRS. 36
8. As used in this section, “dispense” means to deliver a 37
natural substance, drug or device to an ultimate user, patient or 38
subject of research by or pursuant to the lawful order of a 39
naturopathic physician, including the prescribing by a 40
naturopathic physician, administering, packaging, labeling or 41
compounding necessary to prepare the natural substance, drug or 42
device for that delivery. 43
Sec. 19. 1. An applicant for a license to practice 44
naturopathic medicine must pass: 45
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(a) The Naturopathic Physicians Licensing Examination or its 1
successor administered by the North American Board of 2
Naturopathic Examiners; and 3
(b) A practical examination approved by the Board with a 4
grade of at least 75 percent, unless a higher standard is required 5
for passing the examination, that tests the applicant’s knowledge 6
and understanding of: 7
(1) The laws and regulations of this State relating to the 8
health and safety of the public in the practice of naturopathic 9
medicine; and 10
(2) Additional subject areas which are not covered by the 11
examination described in paragraph (a). 12
2. The Board may establish by regulation: 13
(a) The additional subject areas to be included in the practical 14
examination; and 15
(b) Specific methods for the administration of the practical 16
examination. 17
3. Except as otherwise provided in subsection 4, the Board 18
shall offer the practical examination at least twice each year at the 19
time and place established by the Board. 20
4. The Board may cancel a scheduled practical examination 21
if, within 60 days before the examination, the Board has not 22
received a request to take the examination. 23
5. A person who fails the practical examination described in 24
paragraph (b) of subsection 1 may retake the examination as 25
provided in section 20 of this act. 26
6. The Board may employ other professional consultants or 27
examining services in conducting an examination pursuant to this 28
section. 29
7. Each member of the Board who is not licensed in any state 30
to practice any healing art may not participate in preparing, 31
conducting or grading any examination required by the Board. 32
Sec. 20. 1. If an applicant for a license to practice 33
naturopathic medicine fails in a first examination administered by 34
the Board pursuant to paragraph (b) of subsection 1 of section 19 35
of this act, the applicant may be reexamined after not less than 6 36
months. 37
2. If an applicant fails in a second examination, he or she 38
may not be reexamined within less than 1 year after the date of the 39
second examination, and before such reexamination he or she 40
must furnish to the Board proof of further postgraduate study in 41
naturopathic medicine that: 42
(a) Was completed after the second examination; and 43
(b) Is satisfactory to the Board. 44
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3. Each applicant who fails an examination and whom the 1
Board authorizes to be reexamined shall pay for each 2
reexamination the reexamination fee prescribed by the Board. 3
Sec. 21. 1. Except as otherwise provided in NRS 630A.225, 4
the Board may issue to an applicant who is a graduate of a 5
naturopathic medical school from an institution outside of the 6
United States or Canada a license to practice naturopathic 7
medicine if the applicant submits to the Board proof that the 8
applicant: 9
(a) Is of good moral character; 10
(b) Is a graduate of an approved school of naturopathic 11
medicine; 12
(c) Has completed a program of clinical training; 13
(d) Has completed a 2-year internship training program or 14
postgraduate training satisfactory to the Board; 15
(e) Has passed all examinations required by the Board or this 16
chapter; and 17
(f) Meets any additional requirements established by the 18
Board, including, without limitation, requirements established by 19
regulations adopted by the Board. 20
2. In addition to the proofs required by subsection 1, the 21
Board may take such further evidence and require such further 22
proof of the professional and moral qualifications of the applicant 23
as in its discretion may be deemed proper. 24
3. If the applicant is a diplomate of an approved specialty 25
board recognized by this Board, the Board may waive the 26
requirements of paragraph (e) of subsection 1. 27
Sec. 22. 1. Except as otherwise provided in NRS 630A.225, 28
the Board may issue a license to practice naturopathic medicine by 29
endorsement to a person who meets the requirements set forth in 30
this section, including, without limitation, that the person has been 31
issued a license to practice naturopathic medicine by: 32
(a) The District of Columbia or any state or territory of the 33
United States; or 34
(b) Another country if that country requires a written 35
examination that is substantially equivalent to the written 36
examination required pursuant to paragraph (a) of subsection 1 of 37
section 19 of this act. 38
2. To qualify for a license pursuant to this section, at the time 39
the person files an application with the Board: 40
(a) The license of the applicant to practice naturopathic 41
medicine in a jurisdiction described in paragraph (a) or (b) of 42
subsection 1 must be in effect and unrestricted; and 43
(b) The applicant must: 44
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(1) If the applicant was issued a license described in 1
paragraph (a) of subsection 1 before January 1, 2015, provide 2
proof: 3
(I) Of completion of a course of at least 60 hours in 4
pharmacotherapeutics; and 5
(II) That the applicant passed an examination at the 6
completion of the course; 7
(2) Within the 3 years immediately preceding the 8
application, have been continuously and actively engaged in: 9
(I) The practice of naturopathic medicine as a 10
naturopathic physician; 11
(II) An internship, preceptorship or fellowship training 12
program in naturopathic medicine approved by the Board; 13
(III) Postgraduate training satisfactory to the Board; or 14
(IV) The study of naturopathic medicine as a resident at 15
an approved school of naturopathic medicine; 16
(3) Not be involved in or have pending any disciplinary 17
action concerning a license to practice naturopathic medicine in 18
the District of Columbia or any state or territory of the United 19
States; 20
(4) Provide information on all the medical malpractice 21
claims brought against him or her, without regard to when the 22
claims were filed or how the claims were resolved; 23
(5) Pass the practical examination required pursuant to 24
paragraph (b) of subsection 1 of section 19 of this act; and 25
(6) Meet all statutory requirements to obtain a license to 26
practice naturopathic medicine in this State except that the 27
applicant is not required to meet the requirements set forth in 28
section 15 or 19 of this act other than passing the practical 29
examination specified in paragraph (b) of subsection 1 of section 30
19 of this act. 31
3. Any person applying for a license by endorsement 32
pursuant to this section shall pay in advance to the Board the 33
application and initial license fee set forth in NRS 630A.330. 34
4. A license by endorsement may be issued at a meeting of the 35
Board or between its meetings by the President of the Board. Such 36
action shall be deemed to be an action of the Board. 37
Sec. 23. The Board shall not issue or renew a license to 38
practice naturopathic medicine unless the applicant for issuance 39
or renewal of the license attests to knowledge of and compliance 40
with the guidelines of the Centers for Disease Control and 41
Prevention concerning the prevention of transmission of 42
infectious agents through safe and appropriate injection practices. 43
Sec. 24. 1. The Board may issue a certificate as a 44
naturopathic assistant to an applicant who is qualified under the 45
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regulations of the Board and who has completed an educational 1
program designed to prepare the applicant to perform 2
naturopathic services under the supervision of a naturopathic 3
physician. 4
2. The Board may approve or deny an application for 5
certification as a naturopathic assistant and shall provide notice to 6
the applicant of its decision. 7
3. The Board may adopt regulations regarding the 8
certification of a naturopathic assistant pursuant to this section, 9
which may include, without limitation: 10
(a) The educational and other qualifications of applicants; and 11
(b) The naturopathic medical services that such a naturopathic 12
assistant is authorized to perform under the terms of the certificate 13
if the services are performed: 14
(1) Under the supervision and control of a naturopathic 15
physician; and 16
(2) Within the scope of the license of the supervising 17
naturopathic physician; 18
(c) The tasks that the naturopathic assistant may perform, 19
without supervision, provided that those tasks must not involve 20
diagnosing or treating the condition of a patient; 21
(d) The establishment of requirements for the continuing 22
education of naturopathic assistants; and 23
(e) The eligibility requirements for a naturopathic physician to 24
supervise a naturopathic assistant certified pursuant to this 25
section. 26
4. If the naturopathic physician who is supervising a 27
naturopathic assistant certified pursuant to this section withdraws 28
from supervision, the certificate of the naturopathic assistant is 29
automatically suspended. 30
5. A person shall not use the title “naturopathic assistant” or 31
a related title, abbreviation or other designation while engaged in 32
providing naturopathic medical services as a naturopathic 33
assistant in this State unless that person holds a certificate issued 34
by the Board pursuant to this section. 35
Sec. 25. 1. Except as otherwise provided in NRS 630A.225, 36
the Board may issue to a qualified applicant a certificate to 37
participate in a program of clinical training for naturopathic 38
medicine if the applicant: 39
(a) Is enrolled in an approved school of naturopathic 40
medicine; and 41
(b) Complies with any other requirements prescribed by the 42
Board. 43
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2. The Board may issue a certificate to participate in a 1
program of clinical training for not more than 1 year, but may 2
renew the certificate. 3
3. The Board may adopt regulations regarding the 4
certification of a student pursuant to this section, which may 5
include, without limitation: 6
(a) The naturopathic medical services that such a student is 7
authorized to perform under the terms of the certificate if the 8
services are performed: 9
(1) Under the supervision and control of a naturopathic 10
physician; and 11
(2) Within the scope of the license of the supervising 12
naturopathic physician; 13
(b) The tasks that the student may perform without 14
supervision, provided that those tasks must not involve diagnosing 15
or treating the condition of a patient; and 16
(c) The eligibility requirements for a naturopathic physician to 17
supervise a student certified pursuant to this section. 18
4. If the naturopathic physician who is supervising a student 19
pursuant to this section withdraws from supervision or if the 20
student ceases to be enrolled in an approved school of 21
naturopathic medicine, his or her certificate to participate in a 22
program of clinical training is automatically suspended. 23
5. A person shall not use the title “naturopathic medical 24
student” or a related title, abbreviation or other designation while 25
engaged in a program of clinical training in this State unless that 26
person holds a certificate issued by the Board pursuant to this 27
section. 28
6. The holder of a certificate issued by the Board pursuant to 29
this section is subject to the regulatory and disciplinary authority 30
of the Board to the same extent as a licensed naturopathic 31
physician, and is subject to discipline for the same grounds as a 32
licensed naturopathic physician. 33
Sec. 26. 1. Except as otherwise provided in NRS 630A.225, 34
the Board may issue to a qualified applicant a certificate to 35
participate in a naturopathic medicine internship, preceptorship or 36
fellowship training program if the applicant: 37
(a) Is a graduate of an approved school of naturopathic 38
medicine; and 39
(b) Complies with any other requirements prescribed by the 40
Board. 41
2. The Board may issue a certificate to participate in a 42
naturopathic medicine internship, preceptorship or fellowship 43
training program for not more than 1 year, but may renew the 44
certificate. 45
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3. The Board may adopt regulations regarding the 1
certification of a person pursuant to this section which may 2
include, without limitation: 3
(a) The naturopathic medical services that such a person is 4
authorized to perform under the terms of the certificate if the 5
services are performed: 6
(1) Under the supervision and control of a naturopathic 7
physician; and 8
(2) Within the scope of the license of the supervising 9
naturopathic physician; 10
(b) The tasks that the person may perform without supervision, 11
provided that those tasks must not involve diagnosing or treating 12
the condition of a patient; and 13
(c) The eligibility requirements for a naturopathic physician to 14
supervise a person certified pursuant to this section. 15
4. If the naturopathic physician who is supervising a person 16
certified pursuant to this section withdraws from supervision, the 17
certificate to participate in an internship, preceptorship or 18
fellowship training program is automatically suspended. 19
5. A person certified pursuant to this section must not: 20
(a) Employ the naturopathic physician who supervises the 21
person; or 22
(b) Have any financial interest in the business owned by the 23
naturopathic physician who supervises the person. 24
6. A person shall not use the title “naturopathic trainee,” 25
“naturopathic intern,” “naturopathic preceptee” or “naturopathic 26
fellow” or a related title, abbreviation or other designation while 27
engaged in an internship, preceptorship or fellowship training 28
program in this State unless that person holds a certificate issued 29
by the Board pursuant to this section. 30
7. The holder of a certificate issued by the Board pursuant to 31
this section is subject to the regulatory and disciplinary authority 32
of the Board to the same extent as a licensed naturopathic 33
physician, and is subject to discipline for the same grounds as a 34
licensed naturopathic physician. 35
Sec. 27. 1. The Board may grant a certificate as a specialist 36
practitioner of naturopathy to a person who: 37
(a) Holds a license to practice naturopathic medicine in this 38
State; 39
(b) Has successfully completed a postgraduate training 40
program, approved by the Board, in the specialty; and 41
(c) Is currently certified in the specialty by an approved 42
specialty board recognized by the Board. 43
2. A certificate issued to a naturopathic physician pursuant to 44
this section must be concurrently renewed, suspended or revoked 45
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with the naturopathic physician’s license to practice naturopathic 1
medicine. 2
3. The Board may adopt regulations relating to naturopathic 3
medical specialties, including, without limitation, regulations 4
establishing additional requirements for naturopathic physicians 5
who wish to be certified to practice a naturopathic medical 6
specialty. 7
Sec. 28. All state and local governmental regulations relative 8
to the reporting of births and deaths in any matter pertaining to 9
the public health apply to naturopathic physicians with the same 10
effect as to physicians of other schools of medicine. Such reports 11
by naturopathic physicians must be accepted by the officers of the 12
agency to which they are made. 13
Sec. 29. The following acts, among others, constitute 14
grounds for initiating disciplinary action or denying licensure: 15
1. Failure to maintain timely, legible, accurate and complete 16
medical records relating to the diagnosis, treatment and care of a 17
patient. 18
2. Altering the medical records of a patient. 19
3. Making or filing a report which the homeopathic 20
physician, naturopathic physician, advanced practitioner of 21
homeopathy, homeopathic assistant or naturopathic assistant 22
knows to be false, failing to file a record or report as required by 23
law or willfully obstructing or inducing another to obstruct such 24
filing. 25
4. Failure to make the medical records of a patient available 26
for inspection and copying as provided in NRS 629.061. 27
5. Failure to report any person the homeopathic physician, 28
naturopathic physician, advanced practitioner of homeopathy, 29
homeopathic assistant or naturopathic assistant knows, or has 30
reason to know, is in violation of the provisions of this chapter or 31
any regulation adopted pursuant thereto within 30 days after the 32
date on which the homeopathic physician, naturopathic physician, 33
advanced practitioner of homeopathy, homeopathic assistant or 34
naturopathic assistant knew or had reason to know of the 35
violation. 36
Sec. 30. 1. Except as otherwise provided by subsection 2, a 37
homeopathic physician may, during the provision of neural 38
therapy or orthomolecular therapy, dispense, administer and 39
prescribe any drug, including, without limitation, a controlled 40
substance or dangerous drug, if the administration and dosage of 41
the drug is medically appropriate and consistent with the current 42
standards of the practice of homeopathic medicine and any other 43
standard or regulation adopted by the Board applicable to neural 44
therapy or orthomolecular therapy, as applicable. 45
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2. A homeopathic physician may prescribe, dispense and 1
administer a controlled substance or dangerous drug for purposes 2
other than those described in subsection 1 only: 3
(a) If the controlled substance or dangerous drug is described 4
in the official Homeopathic Pharmacopoeia of the United States; 5
(b) In an amount suitable for a single use; and 6
(c) For the purpose of diluting the controlled substance or 7
dangerous drug into a homeopathic preparation at a dosage 8
prescribed in the Homeopathic Pharmacopoeia of the United 9
States. 10
3. In addition to satisfying the requirements of subsection 1 11
or 2, as applicable, a homeopathic physician who prescribes, 12
dispenses or administers a controlled substance must be registered 13
with the State Board of Pharmacy pursuant to NRS 453.226. 14
4. A homeopathic physician shall not dispense, administer or 15
prescribe a controlled substance that is a narcotic drug or opiate 16
which is listed in schedule II for control by the State Board of 17
Pharmacy pursuant to NRS 453.146, unless the controlled 18
substance is described in the official Homeopathic Pharmacopoeia 19
of the United States and used in a manner and at a dosage 20
authorized by that publication. 21
5. The Board shall adopt regulations regarding the 22
dispensing, administration and prescribing of drugs pursuant to 23
this section that are consistent with the requirements of chapters 24
453 and 454 of NRS. 25
Sec. 31. 1. Upon diagnosing a patient as having an opioid 26
use disorder, a naturopathic physician shall counsel and provide 27
information to the patient concerning evidence-based treatment 28
for opioid use disorders, including, without limitation, medication-29
assisted treatment. 30
2. If the patient requests medication-assisted treatment, the 31
naturopathic physician shall refer the patient to a physician, 32
osteopathic physician, physician assistant licensed pursuant to 33
chapter 630 or 633 of NRS, advanced practice registered nurse or 34
pharmacist who is authorized to prescribe an appropriate 35
medication. 36
3. As used in this section, “medication-assisted treatment” 37
has the meaning ascribed to it in NRS 639.28079. 38
Sec. 32. NRS 630A.010 is hereby amended to read as follows: 39
630A.010 As used in this chapter, unless the context otherwise 40
requires, the words and terms defined in NRS 630A.015 to 41
630A.075, inclusive, and sections 5 to 14, inclusive, of this act 42
have the meanings ascribed to them in those sections. 43
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Sec. 33. NRS 630A.020 is hereby amended to read as follows: 1
630A.020 “Board” means the Nevada Board of Homeopathic 2
and Naturopathic Medical Examiners. 3
Sec. 34. NRS 630A.030 is hereby amended to read as follows: 4
630A.030 “Gross malpractice” means malpractice where the 5
failure to exercise the requisite degree of care, diligence or skill 6
consists of: 7
1. Ministering to a patient while the homeopathic physician, 8
naturopathic physician, advanced practitioner of homeopathy , [or] 9
homeopathic assistant or naturopathic assistant is under the 10
influence of alcohol or any controlled substance. 11
2. Gross negligence. 12
3. Willful disregard of homeopathic medical procedures [.] or 13
naturopathic procedures, as applicable. 14
4. Willful and consistent use of homeopathic medical 15
procedures, services or treatment or naturopathic procedures, 16
services or treatment considered by homeopathic physicians or 17
naturopathic physicians, as applicable, in the community to be 18
inappropriate or unnecessary in the cases where used. 19
Sec. 35. NRS 630A.040 is hereby amended to read as follows: 20
630A.040 “Homeopathic medicine” or “homeopathy” means a 21
system of medicine employing substances of animal, vegetable, 22
chemical or mineral origin, including: 23
1. Nosodes and sarcodes, which are: 24
(a) Given in micro-dosage, except that sarcodes may be given in 25
macro-dosage; 26
(b) Prepared according to homeopathic pharmacology by which 27
the formulation of homeopathic preparations is accomplished by the 28
methods of Hahnemannian dilution and succussion or magnetically 29
energized geometric patterns applicable in potencies above 30X, as 30
defined in the official Homeopathic Pharmacopoeia of the United 31
States; and 32
(c) Prescribed by homeopathic physicians or advanced 33
practitioners of homeopathy according to the medicines and dosages 34
in the Homeopathic Pharmacopoeia of the United States, 35
in accordance with the principle that a substance which produces 36
symptoms in a healthy person can eliminate those symptoms in an 37
ill person. 38
2. Noninvasive electrodiagnosis, cell therapy, neural therapy, 39
herbal therapy, neuromuscular integration, orthomolecular therapy 40
and nutrition. 41
3. The administration and prescribing of drugs in the course 42
of performing neural therapy and orthomolecular therapy, in 43
accordance with the requirements of section 30 of this act. 44
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Sec. 36. NRS 630A.060 is hereby amended to read as follows: 1
630A.060 “Malpractice” means failure on the part of a 2
homeopathic physician, naturopathic physician, advanced 3
practitioner of homeopathy , [or] homeopathic assistant or 4
naturopathic assistant to exercise the degree of care, diligence and 5
skill ordinarily exercised by homeopathic physicians, naturopathic 6
physicians, advanced practitioners of homeopathy , [or] 7
homeopathic assistants [,] or naturopathic assistants, respectively, 8
in good standing in the community in which he or she practices. As 9
used in this section, “community” embraces the entire area 10
customarily served by homeopathic physicians, naturopathic 11
physicians, advanced practitioners of homeopathy , [and] 12
homeopathic assistants and naturopathic assistants among whom a 13
patient may reasonably choose, not merely the particular area 14
inhabited by the patients of that individual homeopathic physician, 15
naturopathic physician, advanced practitioner of homeopathy , [or] 16
homeopathic assistant or naturopathic assistant or the particular 17
city or place where the homeopathic physician, naturopathic 18
physician, advanced practitioner of homeopathy , [or] homeopathic 19
assistant or naturopathic assistant has an office. 20
Sec. 37. NRS 630A.070 is hereby amended to read as follows: 21
630A.070 “Professional incompetence” means lack of ability 22
safely and skillfully to practice homeopathic medicine or 23
naturopathic medicine or one or more specified branches of 24
homeopathic medicine or naturopathic medicine as a homeopathic 25
physician [,] or naturopathic physician, as applicable, or to 26
practice as an advanced practitioner of homeopathy , [or as] a 27
homeopathic assistant [,] or as a naturopathic assistant, as 28
applicable, arising from: 29
1. Lack of knowledge or training. 30
2. Impaired physical or mental capability of the homeopathic 31
physician, naturopathic physician, advanced practitioner of 32
homeopathy , [or] homeopathic assistant [.] or naturopathic 33
assistant. 34
3. Indulgence in the use of alcohol or any controlled substance. 35
4. Any other sole or contributing cause. 36
Sec. 38. NRS 630A.080 is hereby amended to read as follows: 37
630A.080 The purpose of licensing homeopathic physicians 38
and naturopathic physicians and certifying advanced practitioners 39
of homeopathy , [and] homeopathic assistants and naturopathic 40
assistants is to protect the public health and safety and the general 41
welfare of the people of this State. Any license or certificate issued 42
pursuant to this chapter is a revocable privilege and no holder of 43
such a license or certificate acquires thereby any vested right. 44
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Sec. 39. NRS 630A.090 is hereby amended to read as follows: 1
630A.090 1. This chapter does not apply to: 2
(a) The practice of dentistry, chiropractic, naprapathy, Oriental 3
medicine, podiatry, optometry, perfusion, respiratory care, faith or 4
Christian Science healing, nursing, veterinary medicine or fitting 5
hearing aids. 6
(b) A medical officer of the Armed Forces or a medical officer 7
of any division or department of the United States in the discharge 8
of his or her official duties, including, without limitation, providing 9
medical care in a hospital in accordance with an agreement entered 10
into pursuant to NRS 449.2455. 11
(c) Licensed or certified nurses in the discharge of their duties as 12
nurses. 13
(d) Except as otherwise provided in section 25 of this act, the 14
practice of naturopathic medicine by a student who is enrolled in 15
an approved school of naturopathic medicine if the performance 16
of services is pursuant to a course of instruction and under the 17
supervision of a naturopathic physician. 18
(e) Homeopathic physicians or naturopathic physicians who 19
are called into this State, other than on a regular basis, for 20
consultation or assistance to any physician licensed in this State, and 21
who are legally qualified to practice in the state or country where 22
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
(c) A person who is engaged in the sale of vitamins or herbs 29
from providing information about those products. 30
(d) A person who is licensed, certified or otherwise authorized 31
pursuant to the laws of this State from performing services within 32
his or her authorized scope of practice, including, without 33
limitation, rendering advice concerning: 34
(1) Diet and nutrition; 35
(2) Nonprescription products; and 36
(3) Vitamins, minerals, herbs, natural food products and 37
their extracts and nutritional supplements. 38
4. This chapter does not authorize [a] : 39
(a) A homeopathic physician or naturopathic physician to 40
practice medicine, including allopathic medicine, except as 41
otherwise provided in NRS 630A.040 [.] or section 11 of this act. 42
(b) A homeopathic physician or naturopathic physician to 43
represent himself or herself as being licensed or certified by any 44
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other licensing board in this State unless the person holds a 1
license or certificate issued by that board. 2
Sec. 40. NRS 630A.100 is hereby amended to read as follows: 3
630A.100 The Nevada Board of Homeopathic and 4
Naturopathic Medical Examiners consists of [six] eight members 5
appointed by the Governor. After the initial terms, the term of office 6
of each member is 4 years. 7
Sec. 41. NRS 630A.110 is hereby amended to read as follows: 8
630A.110 1. Two members of the Board must be persons 9
who are licensed to practice allopathic or osteopathic medicine in 10
any state or country, the District of Columbia or a territory or 11
possession of the United States, have been engaged in the practice 12
of homeopathic medicine in this State for a period of more than 2 13
years preceding their respective appointments, are actually engaged 14
in the practice of homeopathic medicine in this State and are 15
residents of this State. 16
2. Two members of the Board must be persons who are 17
licensed to practice naturopathic medicine in this State, have been 18
engaged in the practice of naturopathic medicine in this State for 19
a period of more than 2 years preceding their respective 20
appointments, are actually engaged in the practice of naturopathic 21
medicine in this State and are residents of this State. 22
3. One member of the Board must be an advanced practitioner 23
of homeopathy who holds a valid certificate granted by the Board 24
pursuant to NRS 630A.293. 25
[3.] 4. One member of the Board must be a person who has 26
resided in this State for at least 3 years and who represents the 27
interests of persons or agencies that regularly provide health care to 28
patients who are indigent, uninsured or unable to afford health care. 29
This member may be licensed under the provisions of this chapter. 30
[4.] 5. The remaining two members of the Board must be 31
persons who: 32
(a) Are not licensed in any state to practice any healing art; 33
(b) Are not the spouse or the parent or child, by blood, marriage 34
or adoption, of a person licensed in any state to practice any healing 35
art; 36
(c) Are not actively engaged in the administration of any 37
medical facility or facility for the dependent as defined in chapter 38
449 of NRS; 39
(d) Do not have a pecuniary interest in any matter pertaining to 40
such a facility, except as a patient or potential patient; and 41
(e) Have resided in this State for at least 3 years. 42
[5.] 6. The members of the Board must be selected without 43
regard to their individual political beliefs. 44
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[6. As used in this section, “healing art” means any system, 1
treatment, operation, diagnosis, prescription or practice for the 2
ascertainment, cure, relief, palliation, adjustment or correction of 3
any human disease, ailment, deformity, injury, or unhealthy or 4
abnormal physical or mental condition for the practice of which 5
long periods of specialized education and training and a degree of 6
specialized knowledge of an intellectual as well as physical nature 7
are required.] 8
Sec. 42. NRS 630A.155 is hereby amended to read as follows: 9
630A.155 The Board shall: 10
1. Regulate the practice of homeopathic medicine and 11
naturopathic medicine in this State and any activities that are 12
within the scope of such practice, to protect the public health and 13
safety and the general welfare of the people of this State. 14
2. Determine the qualifications of, and examine, applicants for 15
licensure or certification pursuant to this chapter, and specify by 16
regulation the methods to be used to check the background of such 17
applicants. 18
3. License or certify those applicants it finds to be qualified. 19
4. Investigate and, if required, hear and decide in a manner 20
consistent with the provisions of chapter 622A of NRS all 21
complaints made against any homeopathic physician, naturopathic 22
physician, advanced practitioner of homeopathy, homeopathic 23
assistant , naturopathic assistant or any agent or employee of any 24
of them, or any facility where the primary practice is homeopathic 25
medicine [.] or naturopathic medicine. If a complaint concerns a 26
practice which is within the jurisdiction of another licensing board 27
or any other possible violation of state law, the Board shall refer the 28
complaint to the other licensing board. 29
5. Unless the Board determines that extenuating circumstances 30
exist, forward to the appropriate law enforcement agency any 31
substantiated information submitted to the Board concerning a 32
person who practices or offers to practice homeopathic medicine or 33
naturopathic medicine without the appropriate license or certificate 34
issued pursuant to the provisions of this chapter. 35
Sec. 43. NRS 630A.220 is hereby amended to read as follows: 36
630A.220 1. It is unlawful for any person: 37
(a) To practice homeopathic medicine [;] or naturopathic 38
medicine; 39
(b) To hold himself or herself out as qualified to practice 40
homeopathic medicine [;] or naturopathic medicine; or 41
(c) To use in connection with his or her name the words or 42
letters “H.M.D. [”] ,” “N.M.D.” or any other title, word, letter or 43
other designation intended to imply or designate the person as a 44
practitioner of homeopathic medicine [,] or naturopathic medicine, 45
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in this State without first obtaining a license so to do as provided 1
in this chapter. 2
2. A physician licensed pursuant to this chapter who holds a 3
degree such as doctor of medicine or doctor of osteopathy may 4
identify himself or herself by that degree or its appropriate 5
abbreviation, but unless the physician is also licensed pursuant to 6
chapter 630 or 633 of NRS must further identify himself or herself 7
by the words “practitioner of homeopathic medicine” or 8
“practitioner of naturopathic medicine,” as applicable, or their 9
equivalent. 10
Sec. 44. NRS 630A.225 is hereby amended to read as follows: 11
630A.225 1. The Board shall not issue a license to practice 12
homeopathic medicine or naturopathic medicine or a certificate to 13
practice as an advanced practitioner of homeopathy , [or as a] 14
homeopathic assistant or naturopathic assistant to an applicant who 15
has been licensed or certified to practice any type of medicine in 16
another jurisdiction and whose license or certificate was revoked for 17
gross medical negligence by that jurisdiction. 18
2. The Board may revoke the license or certificate of any 19
person who has been licensed or certified to practice any type of 20
medicine in another jurisdiction and whose license or certificate was 21
revoked for gross medical negligence by that jurisdiction. 22
3. The revocation of a license or certificate to practice any type 23
of medicine in another jurisdiction on grounds other than grounds 24
which would constitute gross medical negligence constitutes 25
grounds for initiating disciplinary action or denying the issuance of 26
a license or certificate. 27
4. If a license or certificate to practice any type of medicine 28
issued to an applicant in another jurisdiction has been revoked or 29
surrendered, the applicant must provide proof satisfactory to the 30
Board that the applicant is rehabilitated with respect to the conduct 31
that was the basis for the revocation or surrender of the license or 32
certificate when submitting an application for a license or certificate 33
to the Board. 34
5. The Board shall vacate an order to deny a license or 35
certificate if the denial is based on a conviction of: 36
(a) A felony for a violation or offense described in paragraph 37
(a), (b) or (d) of subsection 2 of NRS 630A.340; or 38
(b) An offense involving moral turpitude, 39
and the conviction is reversed on appeal. An applicant may 40
resubmit an application for a license or certificate after a court 41
enters an order reversing the conviction. 42
6. If the Board finds that an applicant has committed an act or 43
engaged in conduct that constitutes grounds for initiating 44
disciplinary action or denying the issuance of a license or certificate 45
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as set forth in NRS 630A.340 to 630A.380, inclusive, and section 1
29 of this act, the Board shall investigate whether the act or conduct 2
has been corrected or the matter has otherwise been resolved. If the 3
matter has not been resolved to the satisfaction of the Board, the 4
Board, before issuing a license or certificate, shall determine to its 5
satisfaction whether or not mitigating circumstances exist which 6
prevent the resolution of the matter. 7
7. For the purposes of this section, the Board shall adopt by 8
regulation a definition of gross medical negligence. 9
Sec. 45. NRS 630A.246 is hereby amended to read as follows: 10
630A.246 1. In addition to any other requirements set forth in 11
this chapter: 12
(a) An applicant for the issuance of a license [to practice 13
homeopathic medicine,] or a certificate [as an advanced practitioner 14
of homeopathy or a certificate as a homeopathic assistant] shall 15
include the social security number of the applicant in the application 16
submitted to the Board. 17
(b) An applicant for the issuance or renewal of a license [to 18
practice homeopathic medicine,] or a certificate [as an advanced 19
practitioner of homeopathy or a certificate as a homeopathic 20
assistant] shall submit to the Board the statement prescribed by the 21
Division of Welfare and Supportive Services of the Department of 22
Health and Human Services pursuant to NRS 425.520. The 23
statement must be completed and signed by the applicant. 24
2. The Board shall include the statement required pursuant to 25
subsection 1 in: 26
(a) The application or any other forms that must be submitted 27
for the issuance or renewal of the license or certificate; or 28
(b) A separate form prescribed by the Board. 29
3. A license [to practice homeopathic medicine,] or a 30
certificate [as an advanced practitioner of homeopathy or a 31
certificate as a homeopathic assistant] may not be issued or renewed 32
by the Board if the applicant: 33
(a) Fails to submit the statement required pursuant to subsection 34
1; or 35
(b) Indicates on the statement submitted pursuant to subsection 36
1 that the applicant is subject to a court order for the support of a 37
child and is not in compliance with the order or a plan approved by 38
the district attorney or other public agency enforcing the order for 39
the repayment of the amount owed pursuant to the order. 40
4. If an applicant indicates on the statement submitted pursuant 41
to subsection 1 that the applicant is subject to a court order for the 42
support of a child and is not in compliance with the order or a plan 43
approved by the district attorney or other public agency enforcing 44
the order for the repayment of the amount owed pursuant to the 45
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order, the Board shall advise the applicant to contact the district 1
attorney or other public agency enforcing the order to determine the 2
actions that the applicant may take to satisfy the arrearage. 3
Sec. 46. NRS 630A.260 is hereby amended to read as follows: 4
630A.260 1. If an applicant for a license to practice 5
homeopathic medicine fails in a first examination, the applicant 6
may be reexamined after not less than 6 months. 7
2. If the applicant fails in a second examination, he or she may 8
not be reexamined within less than 1 year after the date of the 9
second examination. Before taking a third examination, the 10
applicant shall furnish proof satisfactory to the Board of 1 year of 11
additional training in homeopathy after the second examination. 12
3. If an applicant fails three consecutive examinations, he or 13
she must show the Board by clear and convincing evidence that 14
extraordinary circumstances justify permitting the applicant to be 15
reexamined again. 16
Sec. 47. NRS 630A.290 is hereby amended to read as follows: 17
630A.290 1. The Board may deny an application for a license 18
[to practice homeopathic medicine] or a certificate [to practice as an 19
advanced practitioner of homeopathy or as a homeopathic assistant] 20
for any violation of the provisions of this chapter or the regulations 21
adopted by the Board. 22
2. The Board shall notify an applicant of any deficiency which 23
prevents any further action on the application or results in the denial 24
of the application. The applicant may respond in writing to the 25
Board concerning any deficiency and, if the applicant does so, the 26
Board shall respond in writing to the contentions of the applicant. 27
3. An unsuccessful applicant may appeal to the district court to 28
review the action of the Board within 30 days after the date of the 29
rejection of the application by the Board. Upon appeal the applicant 30
has the burden to show that the action of the Board is erroneous or 31
unlawful. 32
4. The Board shall maintain records pertaining to applicants to 33
whom licenses and certificates have been issued or denied. The 34
records must be open to the public and must contain: 35
(a) The name of each applicant. 36
(b) For an applicant for a license to practice homeopathic 37
medicine [,] or naturopathic medicine, the name of the school 38
granting the diploma and the date of the diploma. 39
(c) The date of issuance or denial of the license or certificate. 40
(d) The business address of the applicant. 41
Sec. 48. NRS 630A.310 is hereby amended to read as follows: 42
630A.310 1. Except as otherwise provided in NRS 43
630A.225, the Board may: 44
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(a) Issue a temporary license, to be effective not more than 6 1
months after issuance, to any homeopathic physician or 2
naturopathic physician who is eligible for a permanent license in 3
this State and who also is of good moral character and reputation. 4
The purpose of the temporary license is to enable an eligible 5
homeopathic physician or naturopathic physician to serve as a 6
substitute for some other homeopathic physician or naturopathic 7
physician who is licensed to practice homeopathic medicine or 8
naturopathic medicine in this State , as applicable, and who is 9
absent from his or her practice for reasons deemed sufficient by the 10
Board. A temporary license issued under the provisions of this 11
paragraph is not renewable. 12
(b) Issue a special license to a licensed homeopathic physician 13
or naturopathic physician of another state to come into Nevada to 14
care for or assist in the treatment of his or her own patients in 15
association with a physician licensed in this State. A special license 16
issued under the provisions of this paragraph is limited to the care of 17
a specific patient. 18
(c) Issue a restricted license for a specified period if the Board 19
determines the applicant needs supervision or restriction. 20
2. A person who is licensed pursuant to paragraph (a), (b) or 21
(c) of subsection 1 shall be deemed to have given consent to the 22
revocation of the license at any time by the Board for any of the 23
grounds provided in NRS 630A.225 or 630A.340 to 630A.380, 24
inclusive [.] , and section 29 of this act. 25
Sec. 49. NRS 630A.320 is hereby amended to read as follows: 26
630A.320 1. Except as otherwise provided in NRS 27
630A.225, the Board may issue to a qualified applicant a limited 28
license to practice homeopathic medicine as a resident homeopathic 29
physician in a postgraduate program of clinical training if: 30
(a) The applicant is a graduate of an accredited medical school 31
in the United States or Canada or is a graduate of a foreign medical 32
school recognized by the Educational Commission for Foreign 33
Medical Graduates and has completed 1 year of supervised clinical 34
training approved by the Board. 35
(b) The Board approves the program of clinical training, and the 36
medical school or other institution sponsoring the program provides 37
the Board with written confirmation that the applicant has been 38
appointed to a position in the program. 39
2. In addition to the requirements of subsection 1, an applicant 40
who is a graduate of a foreign medical school must have received 41
the standard certificate of the Educational Commission for Foreign 42
Medical Graduates. 43
3. The Board may issue this limited license for not more than 1 44
year, but may renew the license. 45
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4. The holder of this limited license may practice homeopathic 1
medicine only in connection with his or her duties as a resident 2
physician and shall not engage in the private practice of 3
homeopathic medicine. 4
5. A limited license granted under this section may be revoked 5
by the Board at any time for any of the grounds set forth in NRS 6
630A.225 or 630A.340 to 630A.380, inclusive [.] , and section 29 7
of this act. 8
Sec. 50. NRS 630A.325 is hereby amended to read as follows: 9
630A.325 1. To renew a license or certificate, other than a 10
temporary, special or limited license, issued pursuant to this chapter, 11
each person must, on or before January 1 of each year: 12
(a) Apply to the Board for renewal; 13
(b) Pay the annual fee for renewal set by the Board; 14
(c) Submit, if applicable, a list of all actions filed or claims 15
submitted to arbitration or mediation for malpractice or 16
negligence against the holder of the license or certificate during 17
the immediately preceding year; 18
(d) Submit evidence to the Board of completion of the 19
requirements for continuing education; and 20
[(d)] (e) Submit all information required to complete the 21
renewal. 22
2. The Board shall, as a prerequisite for the renewal or 23
restoration of a license or certificate, other than a temporary, special 24
or limited license [,] or a certificate issued pursuant to section 25 25
or 26 of this act require each holder of a license or certificate to 26
comply with the requirements for continuing education adopted by 27
the Board. 28
3. Any holder who fails to pay the annual fee for renewal and 29
submit all information required to complete the renewal after they 30
become due must be given a period of 60 days in which to pay the 31
fee and submit all required information and, failing to do so, 32
automatically forfeits the right to practice homeopathic medicine or 33
naturopathic medicine or to practice as an advanced practitioner of 34
homeopathy or as a homeopathic assistant [,] or naturopathic 35
assistant, as applicable, and his or her license to practice 36
homeopathic medicine or naturopathic medicine or certificate to 37
practice as an advanced practitioner of homeopathy or as a 38
homeopathic assistant or naturopathic assistant in this State is 39
automatically suspended. The holder may, within 2 years after the 40
date his or her license or certificate is suspended, apply for the 41
restoration of the license or certificate. 42
4. The Board shall notify any holder whose license or 43
certificate is automatically suspended pursuant to subsection 3 and 44
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send a copy of the notice to the Drug Enforcement Administration 1
of the United States Department of Justice or its successor agency. 2
Sec. 51. NRS 630A.330 is hereby amended to read as follows: 3
630A.330 1. Except as otherwise provided in subsection [6,] 4
8, each applicant for a license to practice homeopathic medicine or 5
naturopathic medicine must: 6
(a) Pay a fee of $800; and 7
(b) Pay the cost of obtaining such further evidence and proof of 8
qualifications as the Board may require pursuant to subsection 2 of 9
NRS 630A.240 [.] or subsection 2 of section 21 of this act. 10
2. Each applicant for a certificate to dispense a natural 11
substance, drug or device as a naturopathic physician pursuant to 12
section 18 of this act must pay a fee of $100. 13
3. Each applicant for a certificate as a specialist practitioner 14
of naturopathy pursuant to section 27 of this act must pay a fee of 15
$100. 16
4. Each applicant for a certificate as an advanced practitioner 17
of homeopathy must: 18
(a) Pay a fee of $500; and 19
(b) Pay the cost of obtaining such further evidence and proof of 20
qualifications as the Board may require pursuant to NRS 630A.295. 21
[3.] 5. Each applicant for a certificate as a homeopathic 22
assistant or naturopathic assistant must pay a fee of $300. 23
[4.] 6. Each applicant for a license or certificate who fails an 24
examination and who is permitted to be reexamined must pay a fee 25
not to exceed $600 for each reexamination. 26
[5.] 7. If an applicant for a license or certificate does not appear 27
for examination, for any reason deemed sufficient by the Board, the 28
Board may, upon request, refund a portion of the application fee not 29
to exceed 50 percent of the fee. There must be no refund of the 30
application fee if an applicant appears for examination. 31
[6.] 8. Each applicant for a license or certificate issued under 32
the provisions of NRS 630A.310 or 630A.320 or section 25 or 26 of 33
this act must pay a fee not to exceed $400, as determined by the 34
Board, and must pay a fee of $250 for each renewal of the license [. 35
7.] or certificate. 36
9. The fee for the renewal of a license or certificate, as 37
determined by the Board, must be collected for the year in which a 38
homeopathic physician, naturopathic physician, advanced 39
practitioner of homeopathy , [or] homeopathic assistant or 40
naturopathic assistant is licensed or certified and must not exceed: 41
(a) For a homeopathic physician [,] or a naturopathic 42
physician, $2,000 per year. 43
(b) For an advanced practitioner of homeopathy, $1,500 per 44
year. 45
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(c) For a homeopathic assistant [,] or a naturopathic assistant, 1
$1,000 per year. 2
[8.] (d) For a certificate to dispense a natural substance, drug 3
or device as a naturopathic physician pursuant to section 18 of 4
this act, $150 per year. 5
(e) For a certificate as a specialist practitioner of naturopathy 6
issued pursuant to section 27 of this act, $150 per year. 7
10. The fee for the restoration of a suspended license or 8
certificate is twice the amount of the fee for the renewal of a license 9
or certificate at the time of the restoration of the license or 10
certificate. 11
Sec. 52. NRS 630A.340 is hereby amended to read as follows: 12
630A.340 The following acts, among others, constitute 13
grounds for initiating disciplinary action or denying the issuance of 14
a license or certificate: 15
1. Unprofessional conduct. 16
2. Conviction of: 17
(a) A violation of any federal or state law regulating the 18
possession, distribution or use of any controlled substance or any 19
dangerous drug as defined in chapter 454 of NRS; 20
(b) A violation of any of the provisions of NRS 616D.200, 21
616D.220, 616D.240, 616D.300, 616D.310, or 616D.350 to 22
616D.440, inclusive; 23
(c) Any offense involving moral turpitude; or 24
(d) Any offense relating to the practice of homeopathic medicine 25
or naturopathic medicine or the ability to practice homeopathic 26
medicine or naturopathic medicine or the practice, or the ability to 27
practice, as an advanced practitioner of homeopathy , [or as a] 28
homeopathic assistant [.] or naturopathic assistant. 29
A plea of nolo contendere to any offense listed in this subsection 30
shall be deemed a conviction. 31
3. The suspension, modification or limitation of a license or 32
certificate to practice any type of medicine or to perform any type of 33
medical services by any other jurisdiction. 34
4. The surrender of a license or certificate to practice any type 35
of medicine or to perform any type of medical services or the 36
discontinuance of the practice of medicine while under investigation 37
by any licensing or certifying authority, medical facility, facility for 38
the dependent, branch of the Armed Forces of the United States, 39
insurance company, agency of the Federal Government or employer. 40
5. Gross or repeated malpractice, which may be evidenced by 41
claims of malpractice settled against a homeopathic physician, 42
naturopathic physician, advanced practitioner of homeopathy , [or] 43
homeopathic assistant [.] or naturopathic assistant. 44
6. Professional incompetence. 45
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7. Failure of a homeopathic physician to adequately 1
supervise a homeopathic assistant pursuant to any regulations 2
adopted by the Board. 3
8. Failure of a naturopathic physician to adequately 4
supervise a naturopathic assistant or a participant in a program of 5
clinical training for naturopathic medicine or a participant in a 6
naturopathic internship, preceptorship or fellowship training 7
program pursuant to any regulations adopted by the Board. 8
Sec. 53. NRS 630A.350 is hereby amended to read as follows: 9
630A.350 The following acts, among others, constitute 10
grounds for initiating disciplinary action or denying the issuance of 11
a license or certificate: 12
1. Willfully making a false or fraudulent statement or 13
submitting a forged or false document in applying for a license to 14
practice homeopathic medicine or naturopathic medicine or a 15
certificate to practice as an advanced practitioner of homeopathy , 16
[or as a] homeopathic assistant [.] or naturopathic assistant. 17
2. Willfully representing with the purpose of obtaining 18
compensation or other advantages for himself or herself or for any 19
other person that a manifestly incurable disease or injury or other 20
manifestly incurable condition can be permanently cured. 21
3. Obtaining, maintaining or renewing, or attempting to obtain, 22
maintain or renew, a license to practice homeopathic medicine or 23
naturopathic medicine or a certificate to practice as an advanced 24
practitioner of homeopathy , [or as a] homeopathic assistant or 25
naturopathic assistant by bribery, fraud or misrepresentation or by 26
any false, misleading, inaccurate or incomplete statement. 27
4. Advertising the practice of homeopathic medicine or 28
naturopathic medicine or practice as an advanced practitioner of 29
homeopathy , [or as a] homeopathic assistant or naturopathic 30
assistant in a false, deceptive or misleading manner. 31
5. Practicing or attempting to practice homeopathic medicine 32
[,] or naturopathic medicine, or practicing or attempting to practice 33
as an advanced practitioner of homeopathy , [or as a] homeopathic 34
assistant [,] or naturopathic assistant under a name other than the 35
name under which the person practicing or attempting to practice is 36
licensed or certified. 37
6. Signing a blank prescription form. 38
7. Influencing a patient in order to engage in sexual activity 39
with the patient or another person. 40
8. Attempting directly or indirectly, by way of intimidation, 41
coercion or deception, to obtain or retain a patient or to discourage a 42
patient from obtaining a second opinion. 43
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9. Terminating the medical care of a patient without giving 1
adequate notice or making other arrangements for the continued care 2
of the patient. 3
Sec. 54. NRS 630A.360 is hereby amended to read as follows: 4
630A.360 The following acts, among others, constitute 5
grounds for initiating disciplinary action or denying the issuance of 6
a license: 7
1. Directly or indirectly receiving from any person any fee, 8
commission, rebate or other form of compensation which tends or is 9
intended to influence the homeopathic physician’s or naturopathic 10
physician’s objective evaluation or treatment of a patient. 11
2. Dividing a fee between homeopathic physicians [,] or 12
naturopathic physicians, as applicable, unless the patient is 13
informed of the division of fees and the division is made in 14
proportion to the services personally performed and the 15
responsibility assumed by each homeopathic physician [.] or 16
naturopathic physician, as applicable. 17
3. Charging for visits to the homeopathic physician’s or 18
naturopathic physician’s office which did not occur or for services 19
which were not rendered or documented in the records of the 20
patient. 21
4. Employing, directly or indirectly, any suspended or 22
unlicensed person in the practice of homeopathic medicine [,] or 23
naturopathic medicine, or the aiding, abetting or assisting of any 24
unlicensed person to practice homeopathic medicine or 25
naturopathic medicine contrary to the provisions of this chapter or 26
the regulations adopted by the Board. 27
5. Advertising the services of an unlicensed person in the 28
practice of homeopathic medicine [.] or naturopathic medicine. 29
6. Delegating responsibility for the care of a patient to a person 30
whom the homeopathic or naturopathic physician knows, or has 31
reason to know, is not qualified to undertake that responsibility. 32
7. Failing to disclose to a patient any financial or other conflict 33
of interest affecting the care of the patient. 34
Sec. 55. NRS 630A.370 is hereby amended to read as follows: 35
630A.370 The following acts, among others, constitute 36
grounds for initiating disciplinary action or denying the issuance of 37
a license or certificate: 38
1. Inability to practice homeopathic medicine or naturopathic 39
medicine or to practice as an advanced practitioner of homeopathy , 40
[or as a] homeopathic assistant [,] or naturopathic assistant, as 41
applicable, with reasonable skill and safety because of an illness, a 42
mental or physical condition or an alcohol or other substance use 43
disorder. 44
2. Engaging in any: 45
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(a) Professional conduct which is intended to deceive or which 1
the Board by regulation has determined is unethical. 2
(b) Medical practice harmful to the public or any conduct 3
detrimental to the public health, safety or morals which does not 4
constitute gross or repeated malpractice or professional 5
incompetence. 6
3. Administering, dispensing or prescribing any controlled 7
substance [,] or dangerous drug as defined in chapter 454 of NRS 8
except as authorized by law. 9
4. Performing, assisting or advising an unlawful abortion or in 10
the injection of any liquid substance into the human body to cause 11
an abortion. 12
5. Performing, assisting or advising in the injection of any 13
liquid silicone substance into the human body. 14
6. Practicing or offering to practice beyond the scope permitted 15
by law, or performing services which the homeopathic physician, 16
naturopathic physician, advanced practitioner of homeopathy , [or] 17
homeopathic assistant or naturopathic assistant knows or has 18
reason to know he or she is not competent to perform. 19
[6.] 7. Performing any procedure without first obtaining the 20
informed consent of the patient or the patient’s family or prescribing 21
any therapy which by the current standards of the practice of 22
homeopathic medicine or naturopathic medicine is experimental. 23
[7.] 8. Continued failure to exercise the skill or diligence or use 24
the methods ordinarily exercised under the same circumstances by 25
homeopathic physicians, naturopathic physicians, advanced 26
practitioners of homeopathy , [and] homeopathic assistants and 27
naturopathic assistants in good standing who practice homeopathy 28
and electrodiagnosis [,] or naturopathic medicine, as applicable. 29
[8.] 9. Operation of a medical facility, as defined in NRS 30
449.0151, at any time during which: 31
(a) The license of the facility is suspended or revoked; or 32
(b) An act or omission occurs which results in the suspension or 33
revocation of the license pursuant to NRS 449.160. 34
This subsection applies to an owner or other principal responsible 35
for the operation of the facility. 36
[9.] 10. Performing or supervising the performance of a pelvic 37
examination in violation of NRS 629.085. 38
Sec. 56. NRS 630A.380 is hereby amended to read as follows: 39
630A.380 The following acts, among others, constitute 40
grounds for initiating disciplinary action or denying the issuance of 41
a license or certificate: 42
1. Willful disclosure of a communication privileged under a 43
statute or court order. 44
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2. Willful failure to comply with any provision of this chapter, 1
regulation, subpoena or order of the Board or with any court order 2
relating to this chapter. 3
3. Willful failure to perform any statutory or other legal 4
obligation imposed upon a licensed homeopathic physician [,] or a 5
licensed naturopathic physician or a certified advanced practitioner 6
of homeopathy , [or] a certified homeopathic assistant [,] or a 7
certified naturopathic assistant, as applicable. 8
Sec. 57. NRS 630A.390 is hereby amended to read as follows: 9
630A.390 1. Any person who becomes aware that a person 10
practicing homeopathic medicine or naturopathic medicine or 11
practicing as an advanced practitioner of homeopathy , [or as a] 12
homeopathic assistant or naturopathic assistant in this State has, is 13
or is about to become engaged in conduct which constitutes grounds 14
for initiating disciplinary action may file a written complaint with 15
the Board. A complaint may be filed anonymously. If a complaint is 16
filed anonymously, the Board may accept the complaint but may 17
refuse to consider the complaint if anonymity of the complainant 18
makes processing the complaint impossible or unfair to the person 19
who is the subject of the complaint. 20
2. Any medical society or medical facility or facility for the 21
dependent licensed in this State shall report to the Board the 22
initiation and outcome of any disciplinary action against any 23
homeopathic physician, naturopathic physician, advanced 24
practitioner of homeopathy , [or] homeopathic assistant or 25
naturopathic assistant concerning the care of a patient or the 26
competency of the homeopathic physician, naturopathic physician, 27
advanced practitioner of homeopathy , [or] homeopathic assistant [.] 28
or naturopathic assistant. 29
3. The clerk of every court shall report to the Board any 30
finding, judgment or other determination of the court that a 31
homeopathic physician, naturopathic physician, advanced 32
practitioner of homeopathy , [or] homeopathic assistant [:] or 33
naturopathic assistant: 34
(a) Is mentally ill; 35
(b) Is mentally incompetent; 36
(c) Has been convicted of a felony or any law relating to 37
controlled substances or dangerous drugs; 38
(d) Is guilty of abuse or fraud under any state or federal program 39
providing medical assistance; or 40
(e) Is liable for damages for malpractice or negligence. 41
4. The Board shall retain all complaints filed with the Board 42
pursuant to this section for at least 10 years, including, without 43
limitation, any complaints not acted upon. 44
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Sec. 58. NRS 630A.400 is hereby amended to read as follows: 1
630A.400 1. The Board or a committee of its members 2
designated by the Board shall review every complaint filed with the 3
Board and conduct an investigation to determine whether there is a 4
reasonable basis for compelling a homeopathic physician or 5
naturopathic physician to take a mental or physical examination or 6
an examination of his or her competence to practice homeopathic 7
medicine [.] or naturopathic medicine. 8
2. If a committee is designated, it must be composed of at least 9
three members of the Board, at least one of whom is : 10
(a) If the complaint is filed against a homeopathic physician, a 11
licensed homeopathic physician. 12
(b) If the complaint is filed against a naturopathic physician, a 13
licensed naturopathic physician. 14
3. If, from the complaint or from other official records, it 15
appears that the complaint is not frivolous and the complaint 16
charges gross or repeated malpractice, the Board may: 17
(a) Retain the Attorney General to investigate the complaint; and 18
(b) If the Board retains the Attorney General, transmit the 19
original complaint, along with further facts or information derived 20
from its own review, to the Attorney General. 21
4. Following an investigation, the committee shall present its 22
evaluation and recommendations to the Board. The Board shall 23
review the committee’s findings to determine whether to take any 24
further action, but a member of the Board who participated in the 25
investigation may not participate in this review or in any subsequent 26
hearing or action taken by the Board. 27
Sec. 59. NRS 630A.420 is hereby amended to read as follows: 28
630A.420 1. If the Board or its investigative committee has 29
reason to believe that the conduct of any homeopathic physician or 30
naturopathic physician has raised a reasonable question as to his or 31
her competence to practice homeopathic medicine or naturopathic 32
medicine , as applicable, with reasonable skill and safety to patients, 33
it may order the homeopathic physician or naturopathic physician 34
to undergo: 35
(a) A mental or physical examination; or 36
(b) An examination of his or her competence to practice 37
homeopathic medicine [,] or naturopathic medicine, 38
by physicians or others designated by the Board to assist the 39
Board in determining the fitness of the homeopathic physician or 40
naturopathic physician to practice homeopathic medicine [.] or 41
naturopathic medicine, as applicable. 42
2. For the purposes of this section: 43
(a) Every homeopathic physician or naturopathic physician 44
who applies for a license or is licensed under this chapter shall be 45
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deemed to have given consent to submit to a mental or physical 1
examination or an examination of his or her competence to practice 2
homeopathic medicine or naturopathic medicine when directed to 3
do so in writing by the Board or an investigative committee of the 4
Board. 5
(b) The testimony or reports of the examining physicians are not 6
privileged communications. 7
3. Except in extraordinary circumstances, as determined by the 8
Board, the failure of a homeopathic physician or naturopathic 9
physician licensed under this chapter to submit to an examination 10
when directed as provided in this section constitutes an admission of 11
the charges against the homeopathic physician [.] or naturopathic 12
physician. 13
Sec. 60. NRS 630A.430 is hereby amended to read as follows: 14
630A.430 If the Board has reason to believe that the conduct of 15
any homeopathic physician or naturopathic physician has raised a 16
reasonable question as to his or her competence to practice 17
homeopathic medicine or naturopathic medicine with reasonable 18
skill and safety to patients, the Board may order an examination of 19
the homeopathic physician or naturopathic physician to determine 20
his or her fitness to practice homeopathic medicine [.] or 21
naturopathic medicine, as applicable. When such action is taken, 22
the reasons for the action must be documented and must be available 23
to the homeopathic physician or naturopathic physician being 24
examined. 25
Sec. 61. NRS 630A.440 is hereby amended to read as follows: 26
630A.440 Notwithstanding the provisions of chapter 622A of 27
NRS, if the Board issues an order summarily suspending the license 28
of a homeopathic physician or naturopathic physician pending 29
proceedings for disciplinary action and requires the homeopathic 30
physician or naturopathic physician to submit to a mental or 31
physical examination or an examination of his or her competence to 32
practice homeopathic medicine [,] or naturopathic medicine, as 33
applicable, the examination must be conducted and the results 34
obtained not later than 60 days after the Board issues its order. 35
Sec. 62. NRS 630A.450 is hereby amended to read as follows: 36
630A.450 Notwithstanding the provisions of chapter 622A of 37
NRS, if the Board issues an order summarily suspending the license 38
of a homeopathic physician or naturopathic physician pending 39
proceedings for disciplinary action, including, without limitation, a 40
summary suspension pursuant to NRS 233B.127, the court shall not 41
stay that order. 42
Sec. 63. NRS 630A.490 is hereby amended to read as follows: 43
630A.490 Except as otherwise provided in chapter 622A of 44
NRS: 45
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1. Service of process made under this chapter must be either 1
personal or by registered or certified mail with return receipt 2
requested, addressed to the homeopathic physician, naturopathic 3
physician, advanced practitioner of homeopathy , [or] homeopathic 4
assistant or naturopathic assistant at his or her last known address. 5
If personal service cannot be made and if notice by mail is returned 6
undelivered, the Secretary-Treasurer of the Board shall cause notice 7
to be published once a week for 4 consecutive weeks in a newspaper 8
published in the county of the last known address of the 9
homeopathic physician, naturopathic physician, advanced 10
practitioner of homeopathy , [or] homeopathic assistant or 11
naturopathic physician or, if no newspaper is published in that 12
county, then in a newspaper widely distributed in that county. 13
2. Proof of service of process or publication of notice made 14
under this chapter must be filed with the Board and recorded in the 15
minutes of the Board. 16
Sec. 64. NRS 630A.500 is hereby amended to read as follows: 17
630A.500 Notwithstanding the provisions of chapter 622A of 18
NRS, in any disciplinary hearing: 19
1. Proof of actual injury need not be established. 20
2. A certified copy of the record of a court or a licensing or 21
certifying agency showing a conviction or plea of nolo contendere 22
or the suspension, revocation, limitation, modification, denial or 23
surrender of a license to practice homeopathic medicine or 24
naturopathic medicine or a certificate to practice as an advanced 25
practitioner of homeopathy , [or as a] homeopathic assistant or 26
naturopathic assistant is conclusive evidence of its occurrence. 27
Sec. 65. NRS 630A.510 is hereby amended to read as follows: 28
630A.510 1. Except as otherwise provided in NRS 29
630A.150, any member of the Board who was not a member of the 30
investigative committee, if one was appointed, may participate in 31
the final order of the Board. If the Board, after notice and a hearing 32
as required by law, determines that a violation of the provisions of 33
this chapter or the regulations adopted by the Board has occurred, it 34
shall issue and serve on the person charged an order, in writing, 35
containing its findings and any sanctions imposed by the Board. If 36
the Board determines that no violation has occurred, it shall dismiss 37
the charges, in writing, and notify the person that the charges have 38
been dismissed. 39
2. If the Board finds that a violation has occurred, it may by 40
order: 41
(a) Place the person on probation for a specified period on any 42
of the conditions specified in the order. 43
(b) Administer to the person a public reprimand. 44
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(c) Limit the practice of the person or exclude a method of 1
treatment from the scope of his or her practice. 2
(d) Suspend the license or certificate of the person for a 3
specified period or until further order of the Board. 4
(e) Revoke the person’s license to practice homeopathic 5
medicine or naturopathic medicine or certificate to practice as an 6
advanced practitioner of homeopathy , [or as a] homeopathic 7
assistant [.] or naturopathic assistant. 8
(f) Require the person to participate in a program to correct an 9
alcohol or other substance use disorder or any other impairment. 10
(g) Require supervision of the person’s practice. 11
(h) Impose an administrative fine not to exceed $10,000. 12
(i) Require the person to perform community service without 13
compensation. 14
(j) Require the person to take a physical or mental examination 15
or an examination of his or her competence to practice homeopathic 16
medicine or naturopathic medicine or to practice as an advanced 17
practitioner of homeopathy , [or as a] homeopathic assistant [,] or 18
naturopathic assistant, as applicable. 19
(k) Require the person to fulfill certain training or educational 20
requirements. 21
3. The Board shall not administer a private reprimand. 22
4. An order that imposes discipline and the findings of fact and 23
conclusions of law supporting that order are public records. 24
Sec. 66. NRS 630A.520 is hereby amended to read as follows: 25
630A.520 1. Any person aggrieved by a final order of the 26
Board is entitled to judicial review of the Board’s order as provided 27
by law. 28
2. Every order of the Board which limits the practice of 29
homeopathic medicine or naturopathic medicine or the practice of 30
an advanced practitioner of homeopathy , [or of a] homeopathic 31
assistant or naturopathic assistant or suspends or revokes a license 32
or certificate is effective from the date the Secretary-Treasurer of 33
the Board certifies the order until the date the order is modified or 34
reversed by a final judgment of the court. The court shall not stay 35
the order of the Board pending a final determination by the court. 36
3. The district court shall give a petition for judicial review of 37
the Board’s order priority over other civil matters which are not 38
expressly given priority by law. 39
Sec. 67. NRS 630A.530 is hereby amended to read as follows: 40
630A.530 1. Any person: 41
(a) Whose practice of homeopathic medicine or naturopathic 42
medicine has been limited; or 43
(b) Whose license to practice homeopathic medicine or 44
naturopathic medicine or certificate to practice as an advanced 45
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practitioner of homeopathy , [or as a] homeopathic assistant or 1
naturopathic assistant has been: 2
(1) Suspended until further order; or 3
(2) Revoked, 4
may apply to the Board for removal of the limitation or 5
suspension or may apply to the Board pursuant to the provisions of 6
chapter 622A of NRS for reinstatement of the revoked license or 7
certificate. 8
2. In hearing the application, the Board or a committee of 9
members of the Board: 10
(a) May require the applicant to submit to a mental or physical 11
examination or an examination of his or her competence to practice 12
homeopathic medicine or naturopathic medicine or to practice as 13
an advanced practitioner of homeopathy , [or as a] homeopathic 14
assistant [,] or naturopathic assistant, as applicable, by physicians 15
or other persons whom it designates and submit such other evidence 16
of changed conditions and of fitness as it deems proper. 17
(b) Shall determine whether under all the circumstances the time 18
of the application is reasonable. 19
(c) May deny the application or modify or rescind its order as it 20
deems the evidence and the public safety warrants. 21
3. The applicant has the burden of proving by clear and 22
convincing evidence that the requirements for reinstatement of the 23
license or certificate or removal of the limitation or suspension have 24
been met. 25
4. The Board shall not reinstate a license or certificate unless it 26
is satisfied that the applicant has complied with all of the terms and 27
conditions set forth in the final order of the Board and that the 28
applicant is capable of practicing homeopathic medicine or 29
naturopathic medicine or practicing as an advanced practitioner of 30
homeopathy , [or as a] homeopathic assistant [,] or naturopathic 31
assistant, as applicable, with reasonable skill and safety to patients. 32
5. In addition to any other requirements set forth in chapter 33
622A of NRS, to reinstate a license or certificate that has been 34
revoked by the Board, a person must apply for a license or 35
certificate and take an examination as though the person had never 36
been licensed or certified under this chapter. 37
Sec. 68. NRS 630A.540 is hereby amended to read as follows: 38
630A.540 1. In addition to any other immunity provided by 39
the provisions of chapter 622A of NRS: 40
(a) Any person who furnishes information to the Board, in good 41
faith in accordance with the provisions of this chapter, concerning a 42
person who is licensed or certified or applies for a license or 43
certificate under this chapter is immune from civil liability for 44
furnishing that information. 45
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(b) The Board and its members, staff, counsel, investigators, 1
experts, committees, panels, hearing officers and consultants are 2
immune from civil liability for any decision or action taken in good 3
faith in response to information received by the Board. 4
(c) The Board and any of its members are immune from civil 5
liability for disseminating information concerning a person who is 6
licensed or certified or applies for a license or certificate under this 7
chapter to the Attorney General or any board or agency of the State, 8
hospital, medical society, insurer, employer, patient or patient’s 9
family or law enforcement agency. 10
2. The Board shall not commence an investigation, impose any 11
disciplinary action or take any other adverse action against a 12
homeopathic physician or naturopathic physician for: 13
(a) Disclosing to a governmental entity a violation of any law, 14
rule or regulation by an applicant for a license to practice 15
homeopathic medicine or naturopathic medicine or by a 16
homeopathic physician [;] or naturopathic physician; or 17
(b) Cooperating with a governmental entity that is conducting an 18
investigation, hearing or inquiry into such a violation, including, 19
without limitation, providing testimony concerning the violation. 20
3. As used in this section, “governmental entity” includes, 21
without limitation: 22
(a) A federal, state or local officer, employee, agency, 23
department, division, bureau, board, commission, council, authority 24
or other subdivision or entity of a public employer; 25
(b) A federal, state or local employee, committee, member or 26
commission of the Legislative Branch of Government; 27
(c) A federal, state or local representative, member or employee 28
of a legislative body or a county, town, village or any other political 29
subdivision or civil division of the State; 30
(d) A federal, state or local law enforcement agency or 31
prosecutorial office, or any member or employee thereof, or police 32
or peace officer; and 33
(e) A federal, state or local judiciary, or any member or 34
employee thereof, or grand or petit jury. 35
Sec. 69. NRS 630A.543 is hereby amended to read as follows: 36
630A.543 1. If the Board receives a copy of a court order 37
issued pursuant to NRS 425.540 that provides for the suspension of 38
all professional, occupational and recreational licenses, certificates 39
and permits issued to a person who is the holder of a license [to 40
practice homeopathic medicine] or a certificate [to practice as an 41
advanced practitioner of homeopathy or as a homeopathic assistant,] 42
issued pursuant to this chapter, the Board shall deem the license or 43
certificate issued to that person to be suspended at the end of the 44
30th day after the date on which the court order was issued unless 45
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the Board receives a letter issued to the holder of the license or 1
certificate by the district attorney or other public agency pursuant to 2
NRS 425.550 stating that the holder of the license or certificate has 3
complied with the subpoena or warrant or has satisfied the arrearage 4
pursuant to NRS 425.560. 5
2. The Board shall reinstate a license [to practice homeopathic 6
medicine] or a certificate [to practice as an advanced practitioner of 7
homeopathy or a homeopathic assistant] that has been suspended by 8
a district court pursuant to NRS 425.540 if: 9
(a) The Board receives a letter issued by the district attorney or 10
other public agency pursuant to NRS 425.550 to the person whose 11
license or certificate was suspended stating that the person whose 12
license or certificate was suspended has complied with the subpoena 13
or warrant or has satisfied the arrearage pursuant to NRS 425.560; 14
and 15
(b) The person whose license or certificate was suspended pays 16
the fee prescribed in NRS 630A.330 for the reinstatement of a 17
suspended license or certificate. 18
Sec. 70. NRS 630A.550 is hereby amended to read as follows: 19
630A.550 The filing and review of a complaint, its dismissal 20
without further action or its transmittal to the Attorney General, and 21
any subsequent disposition by the Board, the Attorney General or 22
any reviewing court do not preclude: 23
1. Any measure by a hospital or other institution or medical 24
society to limit or terminate the privileges of a homeopathic 25
physician, naturopathic physician, advanced practitioner of 26
homeopathy , [or] homeopathic assistant or naturopathic assistant 27
according to its rules or the custom of the profession. No civil 28
liability attaches to any such action taken without malice even if the 29
ultimate disposition of the complaint is in favor of the homeopathic 30
physician, naturopathic physician, advanced practitioner of 31
homeopathy , [or] homeopathic assistant [.] or naturopathic 32
assistant. 33
2. Any appropriate criminal prosecution by the Attorney 34
General or a district attorney based upon the same or other facts. 35
Sec. 71. NRS 630A.557 is hereby amended to read as follows: 36
630A.557 Any member or agent of the Board may enter any 37
premises in this State where a person who holds a license or 38
certificate issued pursuant to the provisions of this chapter practices 39
homeopathic medicine or naturopathic medicine and inspect it to 40
determine whether a violation of any provision of this chapter has 41
occurred, including, without limitation, an inspection to determine 42
whether any person at the premises is practicing homeopathic 43
medicine or naturopathic medicine without the appropriate license 44
or certificate issued pursuant to the provisions of this chapter. 45
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Sec. 72. NRS 630A.565 is hereby amended to read as follows: 1
630A.565 1. In addition to any other remedy provided by 2
law, the Board, through its President or Secretary-Treasurer or the 3
Attorney General, may apply to any court of competent jurisdiction 4
to: 5
(a) Enjoin any prohibited act or other conduct of a homeopathic 6
physician or naturopathic physician which is harmful to the public; 7
(b) Enjoin any person who is not licensed under this chapter 8
from practicing homeopathic medicine [;] or naturopathic 9
medicine; or 10
(c) Limit a homeopathic physician’s or naturopathic 11
physician’s practice or suspend his or her license to practice 12
homeopathic medicine [.] or naturopathic medicine, as applicable. 13
2. The court in a proper case may issue a temporary restraining 14
order or a preliminary injunction for the purposes of subsection 1: 15
(a) Without proof of actual damage sustained by any person; 16
(b) Without relieving any person from criminal prosecution for 17
engaging in the practice of homeopathic medicine or naturopathic 18
medicine without a license; and 19
(c) Pending proceedings for disciplinary action by the Board. 20
Sec. 73. NRS 630A.570 is hereby amended to read as follows: 21
630A.570 1. The Board through its President or Secretary-22
Treasurer or the Attorney General may maintain in any court of 23
competent jurisdiction a suit for an injunction against any person or 24
persons practicing homeopathic medicine or naturopathic medicine 25
without a license or practicing as an advanced practitioner of 26
homeopathy , [or as a] homeopathic assistant or naturopathic 27
assistant without the appropriate certificate. 28
2. Such an injunction: 29
(a) May be issued without proof of actual damage sustained by 30
any person, this provision being a preventive as well as a punitive 31
measure. 32
(b) Does not relieve such person from criminal prosecution for 33
practicing without a license or certificate. 34
Sec. 74. NRS 630A.580 is hereby amended to read as follows: 35
630A.580 In seeking injunctive relief against any person for an 36
alleged violation of this chapter by practicing homeopathic medicine 37
or naturopathic medicine without a license or practicing as an 38
advanced practitioner of homeopathy , [or as a] homeopathic 39
assistant or naturopathic assistant without the appropriate 40
certificate, it is sufficient to allege that the person did, upon a certain 41
day, and in a certain county of this State, engage in the practice of 42
homeopathic medicine or naturopathic medicine or in the practice 43
of an advanced practitioner of homeopathy , [or of a] homeopathic 44
assistant or naturopathic assistant without having the appropriate 45
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license or certificate to do so, without alleging any further or more 1
particular facts concerning the matter. 2
Sec. 75. NRS 630A.590 is hereby amended to read as follows: 3
630A.590 A person who: 4
1. Presents to the Board as his or her own the diploma, license, 5
certificate or credentials of another; 6
2. Gives either false or forged evidence of any kind to the 7
Board; 8
3. Practices homeopathic medicine or naturopathic medicine 9
or practices as an advanced practitioner of homeopathy , [or as a] 10
homeopathic assistant or naturopathic assistant under a false or 11
assumed name; [or] 12
4. Represents that a school or college is an approved school 13
of naturopathic medicine if the Board has not determined that the 14
school or college is an approved school of naturopathic medicine; 15
or 16
5. Except as otherwise provided in NRS 629.091, or unless a 17
greater penalty is provided pursuant to NRS 200.830 or 200.840, 18
practices homeopathic medicine or naturopathic medicine or 19
practices as an advanced practitioner of homeopathy , [or as a] 20
homeopathic assistant or naturopathic assistant without being 21
appropriately licensed or certified under this chapter, 22
is guilty of a category D felony and shall be punished as provided 23
in NRS 193.130. 24
Sec. 76. NRS 630A.600 is hereby amended to read as follows: 25
630A.600 1. Except as otherwise provided in NRS 629.091, a 26
person who practices homeopathic medicine or naturopathic 27
medicine or who practices as an advanced practitioner of 28
homeopathy , [or as a] homeopathic assistant or naturopathic 29
assistant without the appropriate license or certificate issued 30
pursuant to this chapter is guilty of a category D felony and shall be 31
punished as provided in NRS 193.130, unless a greater penalty is 32
provided pursuant to NRS 200.830 or 200.840. 33
2. In addition to any other penalty prescribed by law, if the 34
Board determines that a person is practicing homeopathic medicine 35
or naturopathic medicine without a license or certificate issued 36
pursuant to this chapter, the Board may: 37
(a) Issue and serve on the person an order to cease and desist 38
until the person obtains from the Board the proper license or 39
certificate or otherwise demonstrates that he or she is no longer in 40
violation of subsection 1. An order to cease and desist must include 41
a telephone number with which the person may contact the Board. 42
(b) Issue a citation to the person. A citation issued pursuant to 43
this paragraph must be in writing, describe with particularity the 44
nature of the violation and inform the person of the provisions of 45
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this paragraph. Each activity in which the person is engaged 1
constitutes a separate offense for which a separate citation may be 2
issued. To appeal a citation, the person must submit a written 3
request for a hearing to the Board not later than 30 days after the 4
date of issuance of the citation. 5
(c) Assess against the person an administrative fine of not more 6
than $5,000. 7
(d) Impose any combination of the penalties set forth in 8
paragraphs (a), (b) and (c). 9
Sec. 77. NRS 633.171 is hereby amended to read as follows: 10
633.171 1. This chapter does not apply to: 11
(a) The practice of medicine or perfusion pursuant to chapter 12
630 of NRS, naturopathic medicine, dentistry, chiropractic, 13
naprapathy, podiatry, optometry, respiratory care, faith or Christian 14
Science healing, nursing, veterinary medicine or fitting hearing aids. 15
(b) A medical officer of the Armed Forces or a medical officer 16
of any division or department of the United States in the discharge 17
of his or her official duties, including, without limitation, providing 18
medical care in a hospital in accordance with an agreement entered 19
into pursuant to NRS 449.2455. 20
(c) Osteopathic physicians who are called into this State, other 21
than on a regular basis, for consultation or assistance to a physician 22
licensed in this State, and who are legally qualified to practice in the 23
state where they reside. 24
(d) Osteopathic physicians who are temporarily exempt from 25
licensure pursuant to NRS 633.420 and are practicing osteopathic 26
medicine within the scope of the exemption. 27
(e) The performance of medical services by a student enrolled in 28
an educational program for a physician assistant which is accredited 29
by the Accreditation Review Commission on Education for the 30
Physician Assistant, Inc., or its successor organization, as part of 31
such a program. 32
(f) A physician assistant of any division or department of the 33
United States in the discharge of his or her official duties unless 34
licensure by a state is required by the division or department of the 35
United States. 36
(g) Any person permitted to practice any other healing art under 37
this title who does so within the scope of that authority. 38
2. This chapter does not repeal or affect any law of this State 39
regulating or affecting any other healing art. 40
3. This chapter does not prohibit: 41
(a) Gratuitous services of a person in cases of emergency. 42
(b) The domestic administration of family remedies. 43
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Sec. 78. NRS 634A.025 is hereby amended to read as follows: 1
634A.025 1. This chapter does not apply to Oriental 2
physicians who are: 3
(a) Called into this State for consultation; or 4
(b) Temporarily exempt from licensure pursuant to NRS 5
634A.163 and are practicing Oriental medicine within the scope of 6
the exemption. 7
2. This chapter does not apply to a practitioner of acupuncture: 8
(a) Who is employed by an accredited school of Oriental 9
medicine located in this State; 10
(b) Who is licensed to practice acupuncture in another state or 11
jurisdiction; and 12
(c) Whose practice of acupuncture in this State: 13
(1) Is limited to teaching, supervising or demonstrating the 14
methods and practices of acupuncture to students in a clinical 15
setting; and 16
(2) Does not involve the acceptance of payment from any 17
patient for services relating to his or her practice of acupuncture. 18
3. This chapter does not apply to a physician who is licensed 19
pursuant to chapter 630 or 633 of NRS [.] or a naturopathic 20
physician who is licensed pursuant to chapter 630A of NRS. 21
4. This chapter does not prohibit: 22
(a) Gratuitous services of druggists or other persons in cases of 23
emergency. 24
(b) The domestic administration of family remedies. 25
(c) Any person from assisting any person in the practice of the 26
healing arts licensed under this chapter, except that such person may 27
not insert needles into the skin or prescribe herbal medicine. 28
5. For the purposes of this section, “accredited school of 29
Oriental medicine” means a school that has received at least 30
candidacy status for institutional accreditation from the 31
Accreditation Commission for Acupuncture and Oriental Medicine, 32
or its successor organization. 33
Sec. 79. NRS 640.190 is hereby amended to read as follows: 34
640.190 This chapter does not authorize a physical therapist, 35
whether licensed or not, to practice medicine, osteopathic medicine, 36
naprapathy, homeopathic medicine, naturopathic medicine, 37
chiropractic or any other form or method of healing. 38
Sec. 80. NRS 640B.085 is hereby amended to read as follows: 39
640B.085 “Physician” means: 40
1. A physician licensed pursuant to chapter 630 of NRS; 41
2. An osteopathic physician licensed pursuant to chapter 633 of 42
NRS; 43
3. A homeopathic physician or naturopathic physician 44
licensed pursuant to chapter 630A of NRS; 45
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4. A chiropractic physician licensed pursuant to chapter 634 of 1
NRS; 2
5. A naprapath licensed pursuant to chapter 634B of NRS; or 3
6. A podiatric physician licensed pursuant to chapter 635 of 4
NRS. 5
Sec. 81. NRS 641C.130 is hereby amended to read as follows: 6
641C.130 The provisions of this chapter do not apply to: 7
1. A physician who is licensed pursuant to the provisions of 8
chapter 630 or 633 of NRS [;] or a naturopathic physician licensed 9
pursuant to chapter 630A of NRS; 10
2. A nurse who is licensed pursuant to the provisions of chapter 11
632 of NRS and is authorized by the State Board of Nursing to 12
engage in the practice of counseling persons with alcohol and other 13
substance use disorders or the practice of counseling persons with 14
an addictive disorder related to gambling; 15
3. A psychologist who is licensed pursuant to the provisions of 16
chapter 641 of NRS or authorized to practice psychology in this 17
State pursuant to the Psychology Interjurisdictional Compact 18
enacted in NRS 641.227; 19
4. A clinical professional counselor or clinical professional 20
counselor intern who is licensed pursuant to chapter 641A of NRS; 21
5. A marriage and family therapist or marriage and family 22
therapist intern who is licensed pursuant to the provisions of chapter 23
641A of NRS and is authorized by the Board of Examiners for 24
Marriage and Family Therapists and Clinical Professional 25
Counselors to engage in the practice of counseling persons with 26
alcohol and other substance use disorders or the practice of 27
counseling persons with an addictive disorder related to gambling; 28
6. A person who is: 29
(a) Licensed as: 30
(1) A clinical social worker pursuant to the provisions of 31
chapter 641B of NRS; or 32
(2) A master social worker or an independent social worker 33
pursuant to the provisions of chapter 641B of NRS and is engaging 34
in clinical social work as part of an internship program approved by 35
the Board of Examiners for Social Workers; and 36
(b) Authorized by the Board of Examiners for Social Workers to 37
engage in the practice of counseling persons with alcohol and other 38
substance use disorders or the practice of counseling persons with 39
an addictive disorder related to gambling; or 40
7. A person who provides or supervises the provision of peer 41
recovery support services in accordance with NRS 433.622 to 42
433.641, inclusive. 43
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Sec. 82. NRS 641C.430 is hereby amended to read as follows: 1
641C.430 The Board may issue a certificate as a problem 2
gambling counselor to: 3
1. A person who: 4
(a) Is not less than 21 years of age; 5
(b) Has received a bachelor’s degree, master’s degree or a 6
doctoral degree from an accredited college or university in a field of 7
social science approved by the Board; 8
(c) Has completed not less than 60 hours of training specific to 9
problem gambling approved by the Board; 10
(d) Has completed at least 2,000 hours of supervised counseling 11
of persons with an addictive disorder related to gambling in a setting 12
approved by the Board; 13
(e) Passes the written and oral examination prescribed by the 14
Board pursuant to NRS 641C.290; 15
(f) Presents himself or herself when scheduled for an interview 16
at a meeting of the Board; 17
(g) Pays the fees required pursuant to NRS 641C.470; and 18
(h) Submits all information required to complete an application 19
for a certificate. 20
2. A person who: 21
(a) Is not less than 21 years of age; 22
(b) Is licensed as: 23
(1) A clinical social worker pursuant to chapter 641B of 24
NRS; 25
(2) A clinical professional counselor pursuant to chapter 26
641A of NRS; 27
(3) A marriage and family therapist pursuant to chapter 641A 28
of NRS; 29
(4) A physician pursuant to chapter 630 or 633 of NRS [;] or 30
a naturopathic physician licensed pursuant to chapter 630A of 31
NRS; 32
(5) A nurse pursuant to chapter 632 of NRS and has received 33
a master’s degree or a doctoral degree from an accredited college or 34
university; 35
(6) A psychologist pursuant to chapter 641 of NRS; 36
(7) An alcohol and drug counselor pursuant to this chapter; 37
or 38
(8) A clinical alcohol and drug counselor pursuant to this 39
chapter; 40
(c) Has completed not less than 60 hours of training specific to 41
problem gambling approved by the Board; 42
(d) Has completed at least 1,000 hours of supervised counseling 43
of persons with an addictive disorder related to gambling in a setting 44
approved by the Board; 45
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(e) Passes the written and oral examination prescribed by the 1
Board pursuant to NRS 641C.290; 2
(f) Pays the fees required pursuant to NRS 641C.470; and 3
(g) Submits all information required to complete an application 4
for a certificate. 5
Sec. 83. NRS 644A.150 is hereby amended to read as follows: 6
644A.150 1. The following persons are exempt from the 7
provisions of this chapter: 8
(a) Except for those provisions relating to advanced estheticians, 9
all persons authorized by the laws of this State to practice nursing, 10
medicine, naturopathic medicine, dentistry, osteopathic medicine, 11
chiropractic, naprapathy or podiatry. 12
(b) Commissioned medical officers of the Armed Forces of the 13
United States when engaged in the actual performance of their 14
official duties, and attendants attached to a unit in a branch of the 15
Armed Forces of the United States that provides medical services. 16
(c) Barbers, insofar as their usual and ordinary vocation and 17
profession is concerned, when engaged in any of the following 18
practices: 19
(1) Cleansing or singeing the hair of any person. 20
(2) Massaging, cleansing, stimulating, exercising or similar 21
work upon the scalp, face or neck of any person, with the hands or 22
with mechanical or electrical apparatus or appliances, or by the use 23
of cosmetic preparations, antiseptics, tonics, lotions or creams. 24
(d) Retailers, at a retail establishment, insofar as their usual and 25
ordinary vocation and profession is concerned, when engaged in the 26
demonstration of cosmetics if: 27
(1) The demonstration is without charge to the person to 28
whom the demonstration is given; and 29
(2) The retailer does not advertise or provide a service 30
relating to the practice of cosmetology except cosmetics and 31
fragrances. 32
(e) Photographers or their employees, insofar as their usual and 33
ordinary vocation and profession is concerned, if the photographer 34
or his or her employee does not advertise cosmetological services or 35
the practice of makeup artistry and provides cosmetics without 36
charge to the customer. 37
2. Any school of cosmetology conducted as part of the 38
vocational rehabilitation training program of the Department of 39
Corrections or the Caliente Youth Center: 40
(a) Is exempt from the requirements of paragraph (c) of 41
subsection 2 of NRS 644A.740. 42
(b) Notwithstanding the provisions of NRS 644A.735, shall 43
maintain a staff of at least one licensed instructor. 44
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3. Any health care professional, as defined in NRS 453C.030, 1
is exempt from the provisions of this chapter relating to advanced 2
estheticians. 3
Sec. 84. NRS 653.430 is hereby amended to read as follows: 4
653.430 The provisions of this chapter do not apply to: 5
1. A physician or physician assistant licensed pursuant to 6
chapter 630 or 633 of NRS. 7
2. A naturopathic physician licensed pursuant to chapter 8
630A of NRS. 9
3. A dentist, dental hygienist, dental therapist or expanded 10
function dental assistant licensed pursuant to chapter 631 of NRS or 11
a dental assistant working within the scope of his or her employment 12
under the direct supervision of: 13
(a) A dentist; or 14
(b) Where authorized by NRS 631.287, a dental hygienist who 15
holds a special endorsement to practice public health dental hygiene. 16
[3.] 4. A chiropractic physician or chiropractic assistant 17
licensed pursuant to chapter 634 of NRS. 18
[4.] 5. A person training to become a chiropractic assistant or a 19
student practicing in the preceptor program established by the 20
Chiropractic Physicians’ Board of Nevada pursuant to 21
NRS 634.1375. 22
[5.] 6. A podiatric physician or podiatry hygienist licensed 23
pursuant to chapter 635 of NRS, or a person training to be a podiatry 24
hygienist. 25
[6.] 7. A veterinarian or veterinary technician licensed 26
pursuant to chapter 638 of NRS or any other person performing 27
tasks under the supervision of a veterinarian or veterinary technician 28
as authorized by regulation of the Nevada State Board of Veterinary 29
Medical Examiners. 30
[7.] 8. The performance of mammography in accordance with 31
NRS 457.182 to 457.187, inclusive. 32
[8.] 9. Any employee of the Armed Forces of the United States 33
or any division or department of the United States who engages in 34
radiologic imaging or radiation therapy in the discharge of his or her 35
official duties, including, without limitation, while providing care in 36
a hospital in accordance with an agreement entered into pursuant to 37
NRS 449.2455. 38
Sec. 85. NRS 0.040 is hereby amended to read as follows: 39
0.040 1. Except as otherwise provided in subsection 2, 40
“physician” means a person who engages in the practice of 41
medicine, including osteopathy , [and] homeopathy [.] and 42
naturopathy. 43
2. The terms “physician,” “osteopathic physician,” 44
“homeopathic physician,” “naturopathic physician,” “chiropractic 45
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physician” and “podiatric physician” are used in chapters 630, 1
630A, 633, 634 and 635 of NRS in the limited senses prescribed by 2
those chapters respectively. 3
Sec. 86. NRS 7.095 is hereby amended to read as follows: 4
7.095 1. An attorney shall not contract for or collect a fee 5
contingent on the amount of recovery for representing a person 6
seeking damages in connection with an action for injury or death 7
against a provider of health care based upon professional negligence 8
in excess of 35 percent of the amount recovered. 9
2. The limitations set forth in subsection 1 apply to all forms of 10
recovery, including, without limitation, settlement, arbitration and 11
judgment. 12
3. For the purposes of this section, “recovered” means the net 13
sum recovered by the plaintiff after deducting any disbursements or 14
costs incurred in connection with the prosecution or settlement of 15
the claim. Costs of medical care incurred by the plaintiff and general 16
and administrative expenses incurred by the office of the attorney 17
are not deductible disbursements or costs. 18
4. As used in this section: 19
(a) “Professional negligence” means a negligent act or omission 20
to act by a provider of health care in the rendering of professional 21
services, which act or omission is the proximate cause of a personal 22
injury or wrongful death. The term does not include services that are 23
outside the scope of services for which the provider of health care is 24
licensed or services for which any restriction has been imposed by 25
the applicable regulatory board or health care facility. 26
(b) “Provider of health care” means a physician licensed under 27
chapter 630 or 633 of NRS, dentist, naturopathic physician 28
licensed under chapter 630A of NRS, registered nurse, dispensing 29
optician, optometrist, registered physical therapist, podiatric 30
physician, licensed psychologist, chiropractic physician, naprapath, 31
doctor of Oriental medicine, holder of a license or a limited license 32
issued under the provisions of chapter 653 of NRS, medical 33
laboratory director or technician, licensed dietitian or a licensed 34
hospital and its employees. 35
Sec. 87. NRS 41.505 is hereby amended to read as follows: 36
41.505 1. Any person licensed under the provisions of 37
chapter 630, 632 or 633 of NRS , or licensed as a naturopathic 38
physician under the provisions of chapter 630A of NRS, and any 39
person who holds an equivalent license issued by another state, who 40
renders emergency care or assistance, including, without limitation, 41
emergency obstetrical care or assistance, in an emergency, 42
gratuitously and in good faith, is not liable for any civil damages as 43
a result of any act or omission, not amounting to gross negligence, 44
by that person in rendering the emergency care or assistance or as a 45
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result of any failure to act, not amounting to gross negligence, to 1
provide or arrange for further medical treatment for the injured or ill 2
person. This section does not excuse a physician, physician 3
assistant, anesthesiologist assistant or nurse from liability for 4
damages resulting from that person’s acts or omissions which occur 5
in a licensed medical facility relative to any person with whom there 6
is a preexisting relationship as a patient. 7
2. Any person licensed under the provisions of chapter 630, 8
632 or 633 of NRS , or licensed as a naturopathic physician under 9
the provisions of chapter 630A of NRS, and any person who holds 10
an equivalent license issued by another state who: 11
(a) Is retired or otherwise does not practice on a full-time basis; 12
and 13
(b) Gratuitously and in good faith, renders medical care within 14
the scope of that person’s license to an indigent person, 15
is not liable for any civil damages as a result of any act or 16
omission by that person, not amounting to gross negligence or 17
reckless, willful or wanton conduct, in rendering that care. 18
3. Any person licensed to practice medicine under the 19
provisions of chapter 630 or 633 of NRS , or licensed to practice 20
naturopathic medicine under the provisions of chapter 630A of 21
NRS or licensed to practice dentistry under the provisions of chapter 22
631 of NRS who renders care or assistance to a patient for a 23
governmental entity or a nonprofit organization is not liable for any 24
civil damages as a result of any act or omission by that person in 25
rendering that care or assistance if the care or assistance is rendered 26
gratuitously, in good faith and in a manner not amounting to gross 27
negligence or reckless, willful or wanton conduct. 28
4. As used in this section, “gratuitously” has the meaning 29
ascribed to it in NRS 41.500. 30
Sec. 88. NRS 41.506 is hereby amended to read as follows: 31
41.506 1. Any person licensed under the provisions of 32
chapter 630, 632 or 633 of NRS , or any person licensed as a 33
naturopathic physician under the provisions of chapter 630A of 34
NRS, and any person who holds an equivalent license issued by 35
another state who renders emergency obstetrical care or assistance 36
to a pregnant woman during labor or the delivery of the child is not 37
liable for any civil damages as a result of any act or omission by that 38
person in rendering that care or assistance if: 39
(a) The care or assistance is rendered in good faith and in a 40
manner not amounting to gross negligence or reckless, willful or 41
wanton conduct; 42
(b) The person has not previously provided prenatal or 43
obstetrical care to the woman; and 44
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(c) The damages are reasonably related to or primarily caused 1
by a lack of prenatal care received by the woman. 2
2. A licensed medical facility in which such care or assistance 3
is rendered is not liable for any civil damages as a result of any act 4
or omission by the person in rendering that care or assistance if that 5
person is not liable for any civil damages pursuant to subsection 1 6
and the actions of the medical facility relating to the rendering of 7
that care or assistance do not amount to gross negligence or 8
reckless, willful or wanton conduct. 9
Sec. 89. NRS 41A.017 is hereby amended to read as follows: 10
41A.017 “Provider of health care” means a physician licensed 11
pursuant to chapter 630 or 633 of NRS, physician assistant, 12
anesthesiologist assistant, naturopathic physician, dentist, licensed 13
nurse, dispensing optician, optometrist, registered physical therapist, 14
podiatric physician, licensed psychologist, chiropractic physician, 15
naprapath, doctor of Oriental medicine, holder of a license or a 16
limited license issued under the provisions of chapter 653 of NRS, 17
medical laboratory director or technician, licensed dietitian or a 18
licensed hospital, clinic, surgery center, physicians’ professional 19
corporation or group practice that employs any such person and its 20
employees. 21
Sec. 90. NRS 41A.110 is hereby amended to read as follows: 22
41A.110 Except as otherwise provided in subsection 3 of NRS 23
442.253, a physician licensed to practice medicine under the 24
provisions of chapter 630 or 633 of NRS, a naturopathic physician 25
licensed under the provisions of chapter 630A of NRS or a dentist 26
licensed to practice dentistry under the provisions of chapter 631 of 27
NRS, has conclusively obtained the consent of a patient for a 28
medical, surgical or dental procedure, as appropriate, if the 29
physician or dentist has done the following: 30
1. Explained to the patient in general terms, without specific 31
details, the procedure to be undertaken; 32
2. Explained to the patient alternative methods of treatment, if 33
any, and their general nature; 34
3. Explained to the patient that there may be risks, together 35
with the general nature and extent of the risks involved, without 36
enumerating such risks; and 37
4. Obtained the signature of the patient to a statement 38
containing an explanation of the procedure, alternative methods of 39
treatment and risks involved, as provided in this section. 40
Sec. 91. NRS 42.021 is hereby amended to read as follows: 41
42.021 1. In an action for injury or death against a provider 42
of health care based upon professional negligence, if the defendant 43
so elects, the defendant may introduce evidence of any amount 44
payable as a benefit to the plaintiff as a result of the injury or death 45
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pursuant to the United States Social Security Act, any state or 1
federal income disability or worker’s compensation act, any health, 2
sickness or income-disability insurance, accident insurance that 3
provides health benefits or income-disability coverage, and any 4
contract or agreement of any group, organization, partnership or 5
corporation to provide, pay for or reimburse the cost of medical, 6
hospital, dental or other health care services. If the defendant elects 7
to introduce such evidence, the plaintiff may introduce evidence of 8
any amount that the plaintiff has paid or contributed to secure the 9
plaintiff’s right to any insurance benefits concerning which the 10
defendant has introduced evidence. 11
2. A source of collateral benefits introduced pursuant to 12
subsection 1 may not: 13
(a) Recover any amount against the plaintiff; or 14
(b) Be subrogated to the rights of the plaintiff against a 15
defendant. 16
3. In an action for injury or death against a provider of health 17
care based upon professional negligence, a district court shall, at the 18
request of either party, enter a judgment ordering that money 19
damages or its equivalent for future damages of the judgment 20
creditor be paid in whole or in part by periodic payments rather than 21
by a lump-sum payment if the award equals or exceeds $50,000 in 22
future damages. 23
4. In entering a judgment ordering the payment of future 24
damages by periodic payments pursuant to subsection 3, the court 25
shall make a specific finding as to the dollar amount of periodic 26
payments that will compensate the judgment creditor for such future 27
damages. As a condition to authorizing periodic payments of future 28
damages, the court shall require a judgment debtor who is not 29
adequately insured to post security adequate to assure full payment 30
of such damages awarded by the judgment. Upon termination of 31
periodic payments of future damages, the court shall order the return 32
of this security, or so much as remains, to the judgment debtor. 33
5. A judgment ordering the payment of future damages by 34
periodic payments entered pursuant to subsection 3 must specify the 35
recipient or recipients of the payments, the dollar amount of the 36
payments, the interval between payments, and the number of 37
payments or the period of time over which payments will be made. 38
Such payments must only be subject to modification in the event of 39
the death of the judgment creditor. Money damages awarded for loss 40
of future earnings must not be reduced or payments terminated by 41
reason of the death of the judgment creditor, but must be paid to 42
persons to whom the judgment creditor owed a duty of support, as 43
provided by law, immediately before the judgment creditor’s death. 44
In such cases, the court that rendered the original judgment may, 45
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upon petition of any party in interest, modify the judgment to award 1
and apportion the unpaid future damages in accordance with this 2
subsection. 3
6. If the court finds that the judgment debtor has exhibited a 4
continuing pattern of failing to make the periodic payments as 5
specified pursuant to subsection 5, the court shall find the judgment 6
debtor in contempt of court and, in addition to the required periodic 7
payments, shall order the judgment debtor to pay the judgment 8
creditor all damages caused by the failure to make such periodic 9
payments, including, but not limited to, court costs and attorney’s 10
fees. 11
7. Following the occurrence or expiration of all obligations 12
specified in the periodic payment judgment, any obligation of the 13
judgment debtor to make further payments ceases and any security 14
given pursuant to subsection 4 reverts to the judgment debtor. 15
8. As used in this section: 16
(a) “Future damages” includes damages for future medical 17
treatment, care or custody, loss of future earnings, loss of bodily 18
function, or future pain and suffering of the judgment creditor. 19
(b) “Periodic payments” means the payment of money or 20
delivery of other property to the judgment creditor at regular 21
intervals. 22
(c) “Professional negligence” means a negligent act or omission 23
to act by a provider of health care in the rendering of professional 24
services, which act or omission is the proximate cause of a personal 25
injury or wrongful death. The term does not include services that are 26
outside the scope of services for which the provider of health care is 27
licensed or services for which any restriction has been imposed by 28
the applicable regulatory board or health care facility. 29
(d) “Provider of health care” means a physician licensed under 30
chapter 630 or 633 of NRS, naturopathic physician, dentist, 31
licensed nurse, dispensing optician, optometrist, registered physical 32
therapist, podiatric physician, naprapath, licensed psychologist, 33
chiropractic physician, doctor of Oriental medicine, holder of a 34
license or a limited license issued under the provisions of chapter 35
653 of NRS, medical laboratory director or technician, licensed 36
dietitian or a licensed hospital and its employees. 37
Sec. 92. NRS 49.215 is hereby amended to read as follows: 38
49.215 As used in NRS 49.215 to 49.245, inclusive: 39
1. A communication is “confidential” if it is not intended to be 40
disclosed to third persons other than: 41
(a) Those present to further the interest of the patient in the 42
consultation, examination or interview; 43
(b) Persons reasonably necessary for the transmission of the 44
communication; or 45
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(c) Persons who are participating in the diagnosis and treatment 1
under the direction of the doctor, including members of the patient’s 2
family. 3
2. “Doctor” means a person licensed to practice medicine, 4
naturopathic medicine, dentistry , [or] osteopathic medicine, 5
chiropractic or naprapathy in any state or nation, or a person who is 6
reasonably believed by the patient to be so licensed, and in addition 7
includes a person employed by a public or private agency as a 8
psychiatric social worker, or someone under his or her guidance, 9
direction or control, while engaged in the examination, diagnosis or 10
treatment of a patient for a mental condition. 11
3. “Patient” means a person who consults or is examined or 12
interviewed by a doctor for purposes of diagnosis or treatment. 13
Sec. 93. NRS 89.050 is hereby amended to read as follows: 14
89.050 1. Except as otherwise provided in subsection 2, a 15
professional entity may be organized only for the purpose of 16
rendering one specific type of professional service and may not 17
engage in any business other than rendering the professional service 18
for which it was organized and services reasonably related thereto, 19
except that a professional entity may own real and personal property 20
appropriate to its business and may invest its money in any form of 21
real property, securities or any other type of investment. 22
2. A professional entity may be organized to render a 23
professional service relating to: 24
(a) Architecture, interior design, residential design, engineering 25
and landscape architecture, or any combination thereof, and may be 26
composed of persons: 27
(1) Engaged in the practice of architecture as provided in 28
chapter 623 of NRS; 29
(2) Practicing as a registered interior designer as provided in 30
chapter 623 of NRS; 31
(3) Engaged in the practice of residential design as provided 32
in chapter 623 of NRS; 33
(4) Engaged in the practice of landscape architecture as 34
provided in chapter 623A of NRS; and 35
(5) Engaged in the practice of professional engineering as 36
provided in chapter 625 of NRS. 37
(b) Medicine, homeopathy, naturopathic medicine, osteopathy, 38
naprapathy, chiropractic and psychology, or any combination 39
thereof, and may be composed of persons engaged in the practice of: 40
(1) Medicine as provided in chapter 630 of NRS; 41
(2) Homeopathic medicine or naturopathic medicine as 42
provided in chapter 630A of NRS; 43
(3) Osteopathic medicine as provided in chapter 633 of NRS; 44
(4) Chiropractic as provided in chapter 634 of NRS; 45
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(5) Naprapathy as provided in chapter 634B of NRS; and 1
(6) Psychology and licensed to provide services pursuant to 2
chapter 641 of NRS. 3
Such a professional entity may market and manage additional 4
professional entities which are organized to render a professional 5
service relating to medicine, homeopathy, osteopathy, naprapathy, 6
chiropractic and psychology. 7
(c) Mental health services, and may be composed of the 8
following persons, in any number and in any combination: 9
(1) Any psychologist who is licensed to practice in this State; 10
(2) Any social worker who holds a master’s degree in social 11
work and who is licensed by this State as a clinical social worker; 12
(3) Any registered nurse who is licensed to practice 13
professional nursing in this State and who holds a master’s degree in 14
the field of psychiatric nursing; 15
(4) Any marriage and family therapist who is licensed by this 16
State pursuant to chapter 641A of NRS; and 17
(5) Any clinical professional counselor who is licensed by 18
this State pursuant to chapter 641A of NRS. 19
Such a professional entity may market and manage additional 20
professional entities which are organized to render a professional 21
service relating to mental health services pursuant to this paragraph. 22
3. A professional entity may render a professional service only 23
through its officers, managers and employees who are licensed or 24
otherwise authorized by law to render the professional service. 25
Sec. 94. NRS 200.471 is hereby amended to read as follows: 26
200.471 1. As used in this section: 27
(a) “Assault” means: 28
(1) Unlawfully attempting to use physical force against 29
another person; or 30
(2) Intentionally placing another person in reasonable 31
apprehension of immediate bodily harm. 32
(b) “Fire-fighting agency” has the meaning ascribed to it in 33
NRS 239B.020. 34
(c) “Health care facility” means a facility licensed pursuant to 35
chapter 449 of NRS, an office of a person listed in NRS 629.031, a 36
clinic or any other location, other than a residence, where health 37
care is provided. 38
(d) “Officer” means: 39
(1) A person who possesses some or all of the powers of a 40
peace officer; 41
(2) A person employed in a full-time salaried occupation of 42
fire fighting for the benefit or safety of the public; 43
(3) A member of a volunteer fire department; 44
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(4) A jailer, guard or other correctional officer of a city or 1
county jail; 2
(5) A prosecuting attorney of an agency or political 3
subdivision of the United States or of this State; 4
(6) A justice of the Supreme Court, judge of the Court of 5
Appeals, district judge, justice of the peace, municipal judge, 6
magistrate, court commissioner, master or referee, including a 7
person acting pro tempore in a capacity listed in this subparagraph; 8
(7) An employee of this State or a political subdivision of 9
this State whose official duties require the employee to make home 10
visits; 11
(8) A civilian employee or a volunteer of a law enforcement 12
agency whose official duties require the employee or volunteer to: 13
(I) Interact with the public; 14
(II) Perform tasks related to law enforcement; and 15
(III) Wear identification, clothing or a uniform that 16
identifies the employee or volunteer as working or volunteering for 17
the law enforcement agency; 18
(9) A civilian employee or a volunteer of a fire-fighting 19
agency whose official duties require the employee or volunteer to: 20
(I) Interact with the public; 21
(II) Perform tasks related to fire fighting or fire 22
prevention; and 23
(III) Wear identification, clothing or a uniform that 24
identifies the employee or volunteer as working or volunteering for 25
the fire-fighting agency; or 26
(10) A civilian employee or volunteer of this State or a 27
political subdivision of this State whose official duties require the 28
employee or volunteer to: 29
(I) Interact with the public; 30
(II) Perform tasks related to code enforcement; and 31
(III) Wear identification, clothing or a uniform that 32
identifies the employee or volunteer as working or volunteering for 33
this State or a political subdivision of this State. 34
(e) “Provider of health care” means: 35
(1) A physician, a medical student, a perfusionist, an 36
anesthesiologist assistant or a physician assistant licensed pursuant 37
to chapter 630 of NRS, a practitioner of respiratory care, a 38
homeopathic physician, a naturopathic physician, an advanced 39
practitioner of homeopathy, a homeopathic assistant, a naturopathic 40
assistant, an osteopathic physician, a physician assistant or 41
anesthesiologist assistant licensed pursuant to chapter 633 of NRS, a 42
podiatric physician, a podiatry hygienist, a physical therapist, a 43
medical laboratory technician, an optometrist, a chiropractic 44
physician, a chiropractic assistant, a naprapath, a doctor of Oriental 45
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medicine, a nurse, a student nurse, a certified nursing assistant, a 1
nursing assistant trainee, a medication aide - certified, a person who 2
provides health care services in the home for compensation, a 3
dentist, a dental student, a dental hygienist, a dental hygienist 4
student, an expanded function dental assistant, an expanded function 5
dental assistant student, a pharmacist, a pharmacy student, an intern 6
pharmacist, an attendant on an ambulance or air ambulance, a 7
psychologist, a social worker, a marriage and family therapist, a 8
marriage and family therapist intern, a clinical professional 9
counselor, a clinical professional counselor intern, a behavior 10
analyst, an assistant behavior analyst, a registered behavior 11
technician, a mental health technician, a licensed dietitian, the 12
holder of a license or a limited license issued under the provisions of 13
chapter 653 of NRS, a public safety officer at a health care facility, 14
an emergency medical technician, an advanced emergency medical 15
technician, a paramedic or a participant in a program of training to 16
provide emergency medical services; or 17
(2) An employee of or volunteer for a health care facility 18
who: 19
(I) Interacts with the public; 20
(II) Performs tasks related to providing health care; and 21
(III) Wears identification, clothing or a uniform that 22
identifies the person as an employee or volunteer of the health care 23
facility. 24
(f) “School employee” means a licensed or unlicensed person 25
employed by a board of trustees of a school district pursuant to NRS 26
391.100 or 391.281. 27
(g) “Sporting event” has the meaning ascribed to it in 28
NRS 41.630. 29
(h) “Sports official” has the meaning ascribed to it in 30
NRS 41.630. 31
(i) “Taxicab” has the meaning ascribed to it in NRS 706.8816. 32
(j) “Taxicab driver” means a person who operates a taxicab. 33
(k) “Transit operator” means a person who operates a bus or 34
other vehicle as part of a public mass transportation system. 35
(l) “Utility worker” means an employee of a public utility as 36
defined in NRS 704.020 whose official duties require the employee 37
to: 38
(1) Interact with the public; 39
(2) Perform tasks related to the operation of the public 40
utility; and 41
(3) Wear identification, clothing or a uniform that identifies 42
the employee as working for the public utility. 43
2. A person convicted of an assault shall be punished: 44
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(a) If paragraph (c) or (d) does not apply to the circumstances of 1
the crime and the assault is not made with the use of a deadly 2
weapon or the present ability to use a deadly weapon, for a 3
misdemeanor. 4
(b) If the assault is made with the use of a deadly weapon or the 5
present ability to use a deadly weapon, for a category B felony by 6
imprisonment in the state prison for a minimum term of not less 7
than 1 year and a maximum term of not more than 6 years, or by a 8
fine of not more than $5,000, or by both fine and imprisonment. 9
(c) If paragraph (d) does not apply to the circumstances of the 10
crime and if the assault: 11
(1) Is committed upon: 12
(I) An officer, a school employee, a taxicab driver, a 13
transit operator or a utility worker who is performing his or her 14
duty; 15
(II) A provider of health care while the provider of health 16
care is performing his or her duty or is on the premises where he or 17
she performs that duty; or 18
(III) A sports official based on the performance of his or 19
her duties at a sporting event; and 20
(2) The person charged knew or should have known that the 21
victim was an officer, a provider of health care, a school employee, 22
a taxicab driver, a transit operator, a utility worker or a sports 23
official, 24
for a gross misdemeanor, unless the assault is made with the use 25
of a deadly weapon or the present ability to use a deadly weapon, 26
then for a category B felony by imprisonment in the state prison for 27
a minimum term of not less than 1 year and a maximum term of not 28
more than 6 years, or by a fine of not more than $5,000, or by both 29
fine and imprisonment. 30
(d) If the assault: 31
(1) Is committed by a probationer, a prisoner who is in 32
lawful custody or confinement or a parolee upon: 33
(I) An officer, a school employee, a taxicab driver, a 34
transit operator or a utility worker who is performing his or her 35
duty; 36
(II) A provider of health care while the provider of health 37
care is performing his or her duty or is on the premises where he or 38
she performs that duty; or 39
(III) A sports official based on the performance of his or 40
her duties at a sporting event; and 41
(2) The probationer, prisoner or parolee charged knew or 42
should have known that the victim was an officer, a provider of 43
health care, a school employee, a taxicab driver, a transit operator, a 44
utility worker or a sports official, 45
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for a category D felony as provided in NRS 193.130, unless the 1
assault is made with the use of a deadly weapon or the present 2
ability to use a deadly weapon, then for a category B felony by 3
imprisonment in the state prison for a minimum term of not less 4
than 1 year and a maximum term of not more than 6 years, or by a 5
fine of not more than $5,000, or by both fine and imprisonment. 6
Sec. 95. NRS 200.5093 is hereby amended to read as follows: 7
200.5093 1. Any person who is described in subsection 4 and 8
who, in a professional or occupational capacity, knows or has 9
reasonable cause to believe that an older person or vulnerable 10
person has been abused, neglected, exploited, isolated or abandoned 11
shall: 12
(a) Except as otherwise provided in subsection 2, report the 13
abuse, neglect, exploitation, isolation or abandonment of the older 14
person or vulnerable person to: 15
(1) The local office of the Aging and Disability Services 16
Division of the Department of Health and Human Services; 17
(2) A police department or sheriff’s office; or 18
(3) A toll-free telephone service designated by the Aging and 19
Disability Services Division of the Department of Health and 20
Human Services; and 21
(b) Make such a report as soon as reasonably practicable but not 22
later than 24 hours after the person knows or has reasonable cause to 23
believe that the older person or vulnerable person has been abused, 24
neglected, exploited, isolated or abandoned. 25
2. If a person who is required to make a report pursuant to 26
subsection 1 knows or has reasonable cause to believe that the 27
abuse, neglect, exploitation, isolation or abandonment of the older 28
person or vulnerable person involves an act or omission of the 29
Aging and Disability Services Division, another division of the 30
Department of Health and Human Services or a law enforcement 31
agency, the person shall make the report to an agency other than the 32
one alleged to have committed the act or omission. 33
3. Each agency, after reducing a report to writing, shall forward 34
a copy of the report to the Aging and Disability Services Division of 35
the Department of Health and Human Services and the Unit for the 36
Investigation and Prosecution of Crimes. 37
4. A report must be made pursuant to subsection 1 by the 38
following persons: 39
(a) Every physician, dentist, dental hygienist, expanded function 40
dental assistant, chiropractic physician, naprapath, optometrist, 41
podiatric physician, medical examiner, resident, intern, professional 42
or practical nurse, physician assistant licensed pursuant to chapter 43
630 or 633 of NRS, anesthesiologist assistant, naturopathic 44
assistant, homeopathic assistant, perfusionist, psychiatrist, 45
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psychologist, marriage and family therapist, clinical professional 1
counselor, clinical alcohol and drug counselor, alcohol and drug 2
counselor, music therapist, athletic trainer, driver of an ambulance, 3
paramedic, licensed dietitian, holder of a license or a limited license 4
issued under the provisions of chapter 653 of NRS, behavior 5
analyst, assistant behavior analyst, registered behavior technician, 6
peer recovery support specialist, as defined in NRS 433.627, peer 7
recovery support specialist supervisor, as defined in NRS 433.629, 8
or other person providing medical services licensed or certified to 9
practice in this State, who examines, attends or treats an older 10
person or vulnerable person who appears to have been abused, 11
neglected, exploited, isolated or abandoned. 12
(b) Any personnel of a hospital or similar institution engaged in 13
the admission, examination, care or treatment of persons or an 14
administrator, manager or other person in charge of a hospital or 15
similar institution upon notification of the suspected abuse, neglect, 16
exploitation, isolation or abandonment of an older person or 17
vulnerable person by a member of the staff of the hospital. 18
(c) A coroner. 19
(d) Every person who maintains or is employed by an agency to 20
provide personal care services in the home. 21
(e) Every person who maintains or is employed by an agency to 22
provide nursing in the home. 23
(f) Every person who operates, who is employed by or who 24
contracts to provide services for an intermediary service 25
organization as defined in NRS 449.4304. 26
(g) Any employee of the Department of Health and Human 27
Services, except the State Long-Term Care Ombudsman appointed 28
pursuant to NRS 427A.125 and any of his or her advocates or 29
volunteers where prohibited from making such a report pursuant to 30
45 C.F.R. § 1321.11. 31
(h) Any employee of a law enforcement agency or a county’s 32
office for protective services or an adult or juvenile probation 33
officer. 34
(i) Any person who maintains or is employed by a facility or 35
establishment that provides care for older persons or vulnerable 36
persons. 37
(j) Any person who maintains, is employed by or serves as a 38
volunteer for an agency or service which advises persons regarding 39
the abuse, neglect, exploitation, isolation or abandonment of an 40
older person or vulnerable person and refers them to persons and 41
agencies where their requests and needs can be met. 42
(k) Every social worker. 43
(l) Any person who owns or is employed by a funeral home or 44
mortuary. 45
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(m) Every person who operates or is employed by a community 1
health worker pool, as defined in NRS 449.0028, or with whom a 2
community health worker pool contracts to provide the services of a 3
community health worker, as defined in NRS 449.0027. 4
(n) Every person who is enrolled with the Division of Health 5
Care Financing and Policy of the Department of Health and Human 6
Services to provide doula services to recipients of Medicaid 7
pursuant to NRS 422.27177. 8
5. A report may be made by any other person. 9
6. If a person who is required to make a report pursuant to 10
subsection 1 knows or has reasonable cause to believe that an older 11
person or vulnerable person has died as a result of abuse, neglect, 12
isolation or abandonment, the person shall, as soon as reasonably 13
practicable, report this belief to the appropriate medical examiner or 14
coroner, who shall investigate the cause of death of the older person 15
or vulnerable person and submit to the appropriate local law 16
enforcement agencies, the appropriate prosecuting attorney, the 17
Aging and Disability Services Division of the Department of Health 18
and Human Services and the Unit for the Investigation and 19
Prosecution of Crimes his or her written findings. The written 20
findings must include the information required pursuant to the 21
provisions of NRS 200.5094, when possible. 22
7. A division, office or department which receives a report 23
pursuant to this section shall cause the investigation of the report to 24
commence within 3 working days. A copy of the final report of the 25
investigation conducted by a division, office or department, other 26
than the Aging and Disability Services Division of the Department 27
of Health and Human Services, must be forwarded within 30 days 28
after the completion of the report to the: 29
(a) Aging and Disability Services Division; 30
(b) Repository for Information Concerning Crimes Against 31
Older Persons or Vulnerable Persons created by NRS 179A.450; 32
and 33
(c) Unit for the Investigation and Prosecution of Crimes. 34
8. If the investigation of a report results in the belief that an 35
older person or vulnerable person is abused, neglected, exploited, 36
isolated or abandoned, the Aging and Disability Services Division 37
of the Department of Health and Human Services or the county’s 38
office for protective services may provide protective services to the 39
older person or vulnerable person if the older person or vulnerable 40
person is able and willing to accept them. 41
9. A person who knowingly and willfully violates any of the 42
provisions of this section is guilty of a misdemeanor. 43
10. As used in this section, “Unit for the Investigation and 44
Prosecution of Crimes” means the Unit for the Investigation and 45
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Prosecution of Crimes Against Older Persons or Vulnerable Persons 1
in the Office of the Attorney General created pursuant to 2
NRS 228.265. 3
Sec. 96. NRS 232.8415 is hereby amended to read as follows: 4
232.8415 1. The Office of Nevada Boards, Commissions and 5
Councils Standards shall be responsible for: 6
(a) Centralized administration; 7
(b) A uniform set of standards for investigations, licensing 8
and discipline, including, without limitation, separating the roles and 9
responsibilities for occupational licensure from the roles and 10
responsibilities for occupational discipline; 11
(c) A uniform set of standards for internal controls; 12
(d) A uniform set of standards for legal representation; 13
(e) A consistent set of structural standards for boards and 14
commissions; 15
(f) Transparency and consumer protection; and 16
(g) Efficacy and efficiency. 17
2. To the extent permitted by the Nevada Constitution and 18
federal law, all professional and occupational licensing boards 19
created by the Legislature shall be under the purview of the Office, 20
including, without limitation: 21
(a) The Nevada State Board of Accountancy created by 22
NRS 628.035. 23
(b) The Board of Examiners for Alcohol, Drug and Gambling 24
Counselors created by NRS 641C.150. 25
(c) The State Board of Architecture, Interior Design and 26
Residential Design created by NRS 623.050. 27
(d) The Board of Athletic Trainers created by NRS 640B.170. 28
(e) The State Barbers’ Health and Sanitation Board created by 29
NRS 643.020. 30
(f) The Board of Applied Behavior Analysis created by 31
NRS 641D.200. 32
(g) The Chiropractic Physicians’ Board of Nevada created by 33
NRS 634.020. 34
(h) The State Contractors’ Board created by NRS 624.040. 35
(i) The Commission on Construction Education created by 36
NRS 624.570. 37
(j) The State Board of Cosmetology created by NRS 644A.200. 38
(k) The Certified Court Reporters’ Board of Nevada created by 39
NRS 656.040. 40
(l) The Board of Dental Examiners of Nevada created by 41
NRS 631.120. 42
(m) The Committee on Dental Hygiene and Dental Therapy 43
created by NRS 631.205. 44
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(n) The State Board of Professional Engineers and Land 1
Surveyors created by NRS 625.100. 2
(o) The Nevada Funeral and Cemetery Services Board created 3
by NRS 642.020. 4
(p) The Nevada Board of Homeopathic and Naturopathic 5
Medical Examiners created pursuant to NRS 630A.100. 6
(q) The State Board of Landscape Architecture created by 7
NRS 623A.080. 8
(r) The Board of Examiners for Marriage and Family Therapists 9
and Clinical Professional Counselors created by NRS 641A.090. 10
(s) The Board of Massage Therapy created by NRS 640C.150. 11
(t) The Board of Medical Examiners created pursuant to 12
NRS 630.050. 13
(u) The State Board of Nursing created by NRS 632.020. 14
(v) The Advisory Committee on Nursing Assistants and 15
Medication Aides created by NRS 632.072. 16
(w) The Board of Occupational Therapy created by 17
NRS 640A.080. 18
(x) The Board of Dispensing Opticians created by NRS 637.030. 19
(y) The Nevada State Board of Optometry created by 20
NRS 636.030. 21
(z) The State Board of Oriental Medicine created by 22
NRS 634A.030. 23
(aa) The State Board of Osteopathic Medicine created pursuant 24
to NRS 633.181. 25
(bb) The Commission on Postsecondary Education created by 26
NRS 394.383. 27
(cc) The State Board of Pharmacy created by NRS 639.020. 28
(dd) The Nevada Physical Therapy Board created by 29
NRS 640.030. 30
(ee) The State Board of Podiatry created by NRS 635.020. 31
(ff) The Private Investigator’s Licensing Board created by 32
NRS 648.020. 33
(gg) The Board of Psychological Examiners created by 34
NRS 641.030. 35
(hh) The Board of Environmental Health Specialists created by 36
NRS 625A.030. 37
(ii) The Board of Examiners for Social Workers created 38
pursuant to NRS 641B.100. 39
(jj) The Speech-Language Pathology, Audiology and Hearing 40
Aid Dispensing Board created by NRS 637B.100. 41
(kk) The Nevada State Board of Veterinary Medical Examiners 42
created by NRS 638.020. 43
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Sec. 97. NRS 287.020 is hereby amended to read as follows: 1
287.020 1. The governing body of any county, school 2
district, municipal corporation, political subdivision, public 3
corporation or other local governmental agency of the State of 4
Nevada may adopt and carry into effect a system of medical or 5
hospital service, or a combination thereof, through nonprofit 6
membership corporations defraying the cost of medical service or 7
hospital care, or both, open to participation by all licentiates of the 8
particular class, whether doctors of medicine, doctors of 9
naturopathic medicine, doctors of osteopathy, doctors of 10
naprapathy or doctors of chiropractic, offering services through such 11
a nonprofit membership corporation, for the benefit of such of their 12
officers and employees, and the dependents of such officers and 13
employees, as may elect to accept membership in such nonprofit 14
corporation and who have authorized the governing body to make 15
deductions from their compensation for the payment of membership 16
dues. 17
2. A part, not to exceed 50 percent, of the cost of such 18
membership dues may be defrayed by such governing body by 19
contribution. The money for such contributions must be budgeted 20
for in accordance with the laws governing such county, school 21
district, municipal corporation, political subdivision, public 22
corporation or other local governmental agency of the State of 23
Nevada. 24
3. The power conferred in this section, with respect to the 25
rendition of medical or hospital service, or a combination thereof, is 26
coextensive with the power conferred in NRS 287.010 with respect 27
to insurance companies. 28
4. If a school district offers coverage for medical service or 29
hospital care, or both, to its officers and employees pursuant to this 30
section, members of the board of trustees of the school district must 31
not be excluded from participating in the coverage. If the amount of 32
the deductions from compensation required to pay for the coverage 33
exceeds the compensation to which a trustee is entitled, the 34
difference must be paid by the trustee. 35
Sec. 98. NRS 288.140 is hereby amended to read as follows: 36
288.140 1. It is the right of every local government 37
employee, subject to the limitations provided in subsections 3, 4 and 38
5, to join any employee organization of the employee’s choice or to 39
refrain from joining any employee organization. A local government 40
employer shall not discriminate in any way among its employees on 41
account of membership or nonmembership in an employee 42
organization. 43
2. The recognition of an employee organization for negotiation, 44
pursuant to this chapter, does not preclude any local government 45
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employee who is not a member of that employee organization from 1
acting for himself or herself with respect to any condition of his or 2
her employment, but any action taken on a request or in adjustment 3
of a grievance shall be consistent with the terms of an applicable 4
negotiated agreement, if any. 5
3. A police officer, sheriff, deputy sheriff or other law 6
enforcement officer may be a member of an employee organization 7
only if such employee organization is composed exclusively of law 8
enforcement officers. 9
4. A civilian employee of a metropolitan police department 10
which is organized pursuant to chapter 280 of NRS may be a 11
member of an employee organization only if such employee 12
organization is composed exclusively of civilian employees of a 13
metropolitan police department which is organized pursuant to 14
chapter 280 of NRS. 15
5. The following persons may not be a member of an employee 16
organization: 17
(a) A supervisory employee described in paragraph (b) of 18
subsection 1 of NRS 288.138, including but not limited to appointed 19
officials and department heads who are primarily responsible for 20
formulating and administering management, policy and programs. 21
(b) A doctor or physician who is employed by a local 22
government employer. 23
(c) Except as otherwise provided in this paragraph, an attorney 24
who is employed by a local government employer and who is 25
assigned to a civil law division, department or agency. The 26
provisions of this paragraph do not apply with respect to an attorney 27
for the duration of a collective bargaining agreement to which the 28
attorney is a party as of July 1, 2011. 29
6. As used in this section, “doctor or physician” means a 30
doctor, physician, homeopathic physician, naturopathic physician, 31
osteopathic physician, naprapath, chiropractic physician, 32
practitioner of Oriental medicine, podiatric physician or practitioner 33
of optometry, as those terms are defined or used, respectively, in 34
NRS 630.014, 630A.050, 633.091, chapter 634 of NRS, chapter 35
634A of NRS, NRS 634B.050, chapter 635 of NRS or chapter 636 36
of NRS [.] and section 12 of this act. 37
Sec. 99. NRS 441A.110 is hereby amended to read as follows: 38
441A.110 “Provider of health care” means a physician, 39
naturopathic physician, nurse, anesthesiologist assistant or 40
veterinarian licensed in accordance with state law, a physician 41
assistant licensed pursuant to chapter 630 or 633 of NRS or a 42
pharmacist registered pursuant to chapter 639 of NRS. 43
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Sec. 100. NRS 441A.315 is hereby amended to read as 1
follows: 2
441A.315 1. Except as otherwise provided in subsection 3, a 3
physician, naturopathic physician, physician assistant, advanced 4
practice registered nurse or midwife who provides or supervises the 5
provision of emergency medical services in a hospital or primary 6
care to a patient who is 15 years of age or older shall, in accordance 7
with the regulations adopted pursuant to subsection 4: 8
(a) Consult with the patient to ascertain whether he or she 9
wishes to be tested for sexually transmitted diseases, including, 10
without limitation, the human immunodeficiency virus, and to 11
determine which tests, if any, are medically indicated for the patient; 12
and 13
(b) If the patient wishes to be tested, conduct any test which is 14
medically indicated for the patient or assist the patient with 15
obtaining any such test, to the extent practicable for the physician, 16
naturopathic physician, physician assistant, advanced practice 17
registered nurse or midwife. 18
2. Except as otherwise provided in subsection 3, a hospital that 19
provides emergency medical services or primary care to a patient 20
who is 15 years of age or older shall, in accordance with the 21
regulations adopted pursuant to subsection 4: 22
(a) Ensure that the patient is consulted to ascertain whether he or 23
she wishes to be tested for sexually transmitted diseases, including, 24
without limitation, the human immunodeficiency virus, and to 25
determine which tests, if any, are medically indicated for the patient; 26
and 27
(b) If the patient wishes to be tested, ensure that any test which 28
is medically indicated for the patient is conducted or that the patient 29
is assisted with obtaining any such test, to the extent practicable for 30
the hospital. 31
3. A physician, naturopathic physician, physician assistant, 32
advanced practice registered nurse, midwife or hospital is not 33
required to comply with the requirements of subsection 1 or 2 if the 34
physician, naturopathic physician, physician assistant, advanced 35
practice registered nurse or midwife or a provider of health care who 36
provides emergency medical services or primary care to the patient 37
at the hospital, as applicable, reasonably believes that the patient: 38
(a) Is being treated for a life-threatening emergency; 39
(b) Has recently been offered or has been the subject of a test for 40
the human immunodeficiency virus or other sexually transmitted 41
diseases; or 42
(c) Lacks capacity to consent to such testing. 43
4. The Board shall adopt regulations to ensure that: 44
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(a) Any test which is administered to a patient or for which a 1
patient is assisted in obtaining pursuant to this section is medically 2
indicated for that patient; and 3
(b) Communications concerning testing pursuant to this section 4
are made in a culturally competent manner and, to the extent 5
practicable, in a language that is easily understood by the patient. 6
5. A physician, naturopathic physician, physician assistant, 7
advanced practice registered nurse, midwife or hospital that fails to 8
comply with the provisions of this section: 9
(a) Is not subject to a criminal penalty or an administrative fine 10
pursuant to this chapter; and 11
(b) Is subject to disciplinary action, where applicable. 12
6. As used in this section: 13
(a) “Primary care” means the practice of family medicine, 14
pediatrics, internal medicine, obstetrics and gynecology and 15
midwifery. 16
(b) “Provider of health care” has the meaning ascribed to it in 17
NRS 629.031. 18
Sec. 101. NRS 442.003 is hereby amended to read as follows: 19
442.003 As used in this chapter, unless the context requires 20
otherwise: 21
1. “Advisory Board” means the Advisory Board on Maternal 22
and Child Health. 23
2. “Department” means the Department of Health and Human 24
Services. 25
3. “Director” means the Director of the Department. 26
4. “Division” means the Division of Public and Behavioral 27
Health of the Department. 28
5. “Fetal alcohol spectrum disorder” has the meaning ascribed 29
to it in NRS 432B.0655. 30
6. “Freestanding birthing center” has the meaning ascribed to it 31
in NRS 449.0065. 32
7. “Laboratory” has the meaning ascribed to it in 33
NRS 652.040. 34
8. “Midwife” means: 35
(a) A person certified as: 36
(1) A Certified Professional Midwife by the North American 37
Registry of Midwives, or its successor organization; or 38
(2) A Certified Nurse-Midwife by the American Midwifery 39
Certification Board, or its successor organization; or 40
(b) Any other type of midwife. 41
9. “Provider of health care or other services” means: 42
(a) A clinical alcohol and drug counselor who is licensed, or an 43
alcohol and drug counselor who is licensed or certified, pursuant to 44
chapter 641C of NRS; 45
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(b) A physician or a physician assistant who is licensed pursuant 1
to chapter 630 or 633 of NRS and who practices in the area of 2
obstetrics and gynecology, family practice, internal medicine, 3
pediatrics or psychiatry; 4
(c) A naturopathic physician; 5
(d) A licensed nurse; 6
[(d)] (e) A licensed psychologist; 7
[(e)] (f) A licensed marriage and family therapist; 8
[(f)] (g) A licensed clinical professional counselor; 9
[(g)] (h) A licensed social worker; 10
[(h)] (i) A licensed dietitian; or 11
[(i)] (j) The holder of a certificate of registration as a 12
pharmacist. 13
Sec. 102. NRS 453C.030 is hereby amended to read as 14
follows: 15
453C.030 1. “Health care professional” means a physician, a 16
physician assistant or an advanced practice registered nurse. 17
2. As used in this section: 18
(a) “Advanced practice registered nurse” has the meaning 19
ascribed to it in NRS 632.012. 20
(b) “Physician” means a physician licensed pursuant to chapter 21
630 or 633 of NRS [.] or a naturopathic physician licensed 22
pursuant to chapter 630A of NRS. 23
(c) “Physician assistant” means a physician assistant licensed 24
pursuant to chapter 630 or 633 of NRS. 25
Sec. 103. NRS 454.361 is hereby amended to read as follows: 26
454.361 A conviction of the violation of any of the provisions 27
of NRS 454.181 to 454.371, inclusive, constitutes grounds for the 28
suspension or revocation of any license issued to such person 29
pursuant to the provisions of chapters 630, 630A, 631, 633, 635, 30
636, 638, 639 or 653 of NRS. 31
Sec. 104. NRS 457.301 is hereby amended to read as follows: 32
457.301 1. A primary care provider shall: 33
(a) Attempt to determine whether each adult woman to whom he 34
or she provides care has a personal or family history of breast, 35
ovarian, tubal or peritoneal cancer or an ancestry associated with a 36
harmful mutation in the BRCA gene or meets any other criteria 37
under which the United States Preventive Services Task Force has 38
recommended screening for a risk of such a mutation; and 39
(b) If the primary care provider determines that an adult woman 40
to whom he or she provides care meets the criteria described in 41
paragraph (a) and has not previously undergone genetic testing for a 42
harmful mutation in the BRCA gene, use an appropriate brief 43
familial risk assessment tool to screen for a risk of such a mutation. 44
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2. If such a screening indicates that a woman is at risk of a 1
harmful mutation in the BRCA gene, the primary care provider 2
must: 3
(a) Provide the woman with written notice of the need to discuss 4
genetic counseling and testing with the provider; 5
(b) Provide genetic counseling to the woman or ensure that the 6
woman is referred for genetic counseling; and 7
(c) If a genetic test for harmful mutations in the BRCA gene is 8
clinically indicated as a result of the genetic counseling, administer 9
such a test to the woman or ensure that the woman is referred for 10
such testing. 11
3. A primary care provider who fails to comply with this 12
section is not subject to criminal penalties or professional discipline 13
for such failure to comply. 14
4. As used in this section, “primary care provider” means: 15
(a) A physician, physician assistant licensed pursuant to chapter 16
630 or 633 of NRS , a naturopathic physician licensed pursuant to 17
chapter 630A of NRS, or advanced practice registered nurse who 18
specializes in primary care, family medicine, internal medicine or 19
obstetrics and gynecology; or 20
(b) A midwife. 21
Sec. 105. NRS 686B.040 is hereby amended to read as 22
follows: 23
686B.040 1. Except as otherwise provided in subsection 2, 24
the Commissioner may by rule exempt any person or class of 25
persons or any market segment from any or all of the provisions of 26
NRS 686B.010 to 686B.1799, inclusive, if and to the extent that the 27
Commissioner finds their application unnecessary to achieve the 28
purposes of those sections. 29
2. The Commissioner may not, by rule or otherwise, exempt an 30
insurer from the provisions of NRS 686B.010 to 686B.1799, 31
inclusive, with regard to insurance covering the liability of a 32
practitioner licensed pursuant to chapter 630, 631, 632 or 633 of 33
NRS or as a naturopathic physician licensed pursuant to chapter 34
630A of NRS for a breach of the practitioner’s professional duty 35
toward a patient. 36
Sec. 106. NRS 686B.070 is hereby amended to read as 37
follows: 38
686B.070 1. Every authorized insurer and every rate service 39
organization licensed under NRS 686B.140 which has been 40
designated by any insurer for the filing of rates under subsection 2 41
of NRS 686B.090 shall file with the Commissioner all: 42
(a) Rates and proposed increases thereto; 43
(b) Forms of policies to which the rates apply; 44
(c) Supplementary rate information; and 45
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(d) Changes and amendments thereof, 1
made by it for use in this state. 2
2. A filing made pursuant to this section must include a 3
proposed effective date and must be filed not less than 30 days 4
before that proposed effective date, except that a filing for a 5
proposed increase or decrease in a rate may include a request that 6
the Commissioner authorize an effective date that is earlier than the 7
proposed effective date. 8
3. If an insurer makes a filing for a proposed increase in a rate 9
for insurance covering the liability of a practitioner licensed 10
pursuant to chapter 630, 631, 632 or 633 of NRS or as a 11
naturopathic physician licensed pursuant to chapter 630A of NRS 12
for a breach of the practitioner’s professional duty toward a patient, 13
the insurer shall not include in the filing any component that is 14
directly or indirectly related to the following: 15
(a) Capital losses, diminished cash flow from any dividends, 16
interest or other investment returns, or any other financial loss that 17
is materially outside of the claims experience of the professional 18
liability insurance industry, as determined by the Commissioner. 19
(b) Losses that are the result of any criminal or fraudulent 20
activities of a director, officer or employee of the insurer. 21
If the Commissioner determines that a filing includes any such 22
component, the Commissioner shall, pursuant to NRS 686B.110, 23
disapprove the proposed increase, in whole or in part, to the extent 24
that the proposed increase relies upon such a component. 25
4. If an insurer makes a filing for a proposed increase in a rate 26
for a health benefit plan, as that term is defined in NRS 687B.470, 27
the filing must include a unified rate review template, a written 28
description justifying the rate increase and any rate filing 29
documentation. 30
5. As used in this section, “rate filing documentation,” “unified 31
rate review template” and “written description justifying the rate 32
increase” have the meanings ascribed in 45 C.F.R. § 154.215. 33
Sec. 107. NRS 686B.115 is hereby amended to read as 34
follows: 35
686B.115 1. Any hearing held by the Commissioner to 36
determine whether rates comply with the provisions of NRS 37
686B.010 to 686B.1799, inclusive, must be open to members of the 38
public. 39
2. All costs for transcripts prepared pursuant to such a hearing 40
must be paid by the insurer requesting the hearing. 41
3. At any hearing which is held by the Commissioner to 42
determine whether rates comply with the provisions of NRS 43
686B.010 to 686B.1799, inclusive, and which involves rates for 44
insurance covering the liability of a practitioner licensed pursuant to 45
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chapter 630, 631, 632 or 633 of NRS or as a naturopathic 1
physician licensed pursuant to chapter 630A of NRS for a breach 2
of the practitioner’s professional duty toward a patient, if a person is 3
not otherwise authorized pursuant to this title to become a party to 4
the hearing by intervention, the person is entitled to provide 5
testimony at the hearing if, not later than 2 days before the date set 6
for the hearing, the person files with the Commissioner a written 7
statement which states: 8
(a) The name and title of the person; 9
(b) The interest of the person in the hearing; and 10
(c) A brief summary describing the purpose of the testimony the 11
person will offer at the hearing. 12
4. If a person provides testimony at a hearing in accordance 13
with subsection 3: 14
(a) The Commissioner may, if the Commissioner finds it 15
necessary to preserve order, prevent inordinate delay or protect the 16
rights of the parties at the hearing, place reasonable limitations on 17
the duration of the testimony and prohibit the person from providing 18
testimony that is not relevant to the issues raised at the hearing. 19
(b) The Commissioner shall consider all relevant testimony 20
provided by the person at the hearing in determining whether the 21
rates comply with the provisions of NRS 686B.010 to 686B.1799, 22
inclusive. 23
Sec. 108. NRS 686B.117 is hereby amended to read as 24
follows: 25
686B.117 If a filing made with the Commissioner pursuant to 26
paragraph (a) of subsection 1 of NRS 686B.070 pertains to 27
insurance covering the liability of a practitioner licensed pursuant 28
to chapter 630, 631, 632 or 633 of NRS or as a naturopathic 29
physician licensed pursuant to chapter 630A of NRS for a breach 30
of the practitioner’s professional duty toward a patient, any 31
interested person, and any association of persons or organization 32
whose members may be affected, may intervene as a matter of right 33
in any hearing or other proceeding conducted to determine whether 34
the applicable rate or proposed increase thereto: 35
1. Complies with the standards set forth in NRS 686B.050 and 36
subsection 3 of NRS 686B.070. 37
2. Should be approved or disapproved. 38
Sec. 109. NRS 689A.035 is hereby amended to read as 39
follows: 40
689A.035 1. An insurer shall not charge a provider of health 41
care a fee to include the name of the provider on a list of providers 42
of health care given by the insurer to its insureds. 43
2. An insurer shall not contract with a provider of health care 44
to provide health care to an insured unless the insurer uses the form 45
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prescribed by the Commissioner pursuant to NRS 629.095 to obtain 1
any information related to the credentials of the provider of health 2
care. 3
3. A contract between an insurer and a provider of health care 4
may be modified: 5
(a) At any time pursuant to a written agreement executed by 6
both parties. 7
(b) Except as otherwise provided in this paragraph, by the 8
insurer upon giving to the provider 45 days’ written notice of the 9
modification of the insurer’s schedule of payments, including any 10
changes to the fee schedule applicable to the provider’s practice. If 11
the provider fails to object in writing to the modification within the 12
45-day period, the modification becomes effective at the end of that 13
period. If the provider objects in writing to the modification within 14
the 45-day period, the modification must not become effective 15
unless agreed to by both parties as described in paragraph (a). 16
4. If an insurer contracts with a provider of health care to 17
provide health care to an insured, the insurer shall: 18
(a) If requested by the provider of health care at the time the 19
contract is made, submit to the provider of health care the schedule 20
of payments applicable to the provider of health care; or 21
(b) If requested by the provider of health care at any other time, 22
submit to the provider of health care the schedule of payments, 23
including any changes to the fee schedule applicable to the 24
provider’s practice, specified in paragraph (a) within 7 days after 25
receiving the request. 26
5. As used in this section, “provider of health care” means a 27
provider of health care who is licensed pursuant to chapter 630, 631, 28
632 or 633 of NRS [.] or a naturopathic physician who is licensed 29
pursuant to chapter 630A of NRS. 30
Sec. 110. NRS 689A.04033 is hereby amended to read as 31
follows: 32
689A.04033 1. A policy of health insurance must provide 33
coverage for medical treatment which a policyholder or subscriber 34
receives as part of a clinical trial or study if: 35
(a) The medical treatment is provided in a Phase I, Phase II, 36
Phase III or Phase IV study or clinical trial for the treatment of 37
cancer or in a Phase II, Phase III or Phase IV study or clinical trial 38
for the treatment of chronic fatigue syndrome; 39
(b) The clinical trial or study is approved by: 40
(1) An agency of the National Institutes of Health as set forth 41
in 42 U.S.C. § 281(b); 42
(2) A cooperative group; 43
(3) The Food and Drug Administration as an application for 44
a new investigational drug; 45
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(4) The United States Department of Veterans Affairs; or 1
(5) The United States Department of Defense; 2
(c) In the case of: 3
(1) A Phase I clinical trial or study for the treatment of 4
cancer, the medical treatment is provided at a facility authorized to 5
conduct Phase I clinical trials or studies for the treatment of cancer; 6
or 7
(2) A Phase II, Phase III or Phase IV study or clinical trial 8
for the treatment of cancer or chronic fatigue syndrome, the medical 9
treatment is provided by a provider of health care and the facility 10
and personnel for the clinical trial or study have the experience and 11
training to provide the treatment in a capable manner; 12
(d) There is no medical treatment available which is considered 13
a more appropriate alternative medical treatment than the medical 14
treatment provided in the clinical trial or study; 15
(e) There is a reasonable expectation based on clinical data that 16
the medical treatment provided in the clinical trial or study will be at 17
least as effective as any other medical treatment; 18
(f) The clinical trial or study is conducted in this State; and 19
(g) The policyholder or subscriber has signed, before 20
participating in the clinical trial or study, a statement of consent 21
indicating that the policyholder or subscriber has been informed of, 22
without limitation: 23
(1) The procedure to be undertaken; 24
(2) Alternative methods of treatment; and 25
(3) The risks associated with participation in the clinical trial 26
or study, including, without limitation, the general nature and extent 27
of such risks. 28
2. Except as otherwise provided in subsection 3, the coverage 29
for medical treatment required by this section is limited to: 30
(a) Coverage for any drug or device that is approved for sale by 31
the Food and Drug Administration without regard to whether the 32
approved drug or device has been approved for use in the medical 33
treatment of the policyholder or subscriber. 34
(b) The cost of any reasonably necessary health care services 35
that are required as a result of the medical treatment provided in a 36
Phase II, Phase III or Phase IV clinical trial or study or as a result of 37
any complication arising out of the medical treatment provided in a 38
Phase II, Phase III or Phase IV clinical trial or study, to the extent 39
that such health care services would otherwise be covered under the 40
policy of health insurance. 41
(c) The cost of any routine health care services that would 42
otherwise be covered under the policy of health insurance for a 43
policyholder or subscriber participating in a Phase I clinical trial or 44
study. 45
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(d) The initial consultation to determine whether the 1
policyholder or subscriber is eligible to participate in the clinical 2
trial or study. 3
(e) Health care services required for the clinically appropriate 4
monitoring of the policyholder or subscriber during a Phase II, 5
Phase III or Phase IV clinical trial or study. 6
(f) Health care services which are required for the clinically 7
appropriate monitoring of the policyholder or subscriber during a 8
Phase I clinical trial or study and which are not directly related to 9
the clinical trial or study. 10
Except as otherwise provided in NRS 689A.04036, the services 11
provided pursuant to paragraphs (b), (c), (e) and (f) must be covered 12
only if the services are provided by a provider with whom the 13
insurer has contracted for such services. If the insurer has not 14
contracted for the provision of such services, the insurer shall pay 15
the provider the rate of reimbursement that is paid to other providers 16
with whom the insurer has contracted for similar services and the 17
provider shall accept that rate of reimbursement as payment in full. 18
3. Particular medical treatment described in subsection 2 and 19
provided to a policyholder or subscriber is not required to be 20
covered pursuant to this section if that particular medical treatment 21
is provided by the sponsor of the clinical trial or study free of charge 22
to the policyholder or subscriber. 23
4. The coverage for medical treatment required by this section 24
does not include: 25
(a) Any portion of the clinical trial or study that is customarily 26
paid for by a government or a biotechnical, pharmaceutical or 27
medical industry. 28
(b) Coverage for a drug or device described in paragraph (a) of 29
subsection 2 which is paid for by the manufacturer, distributor or 30
provider of the drug or device. 31
(c) Health care services that are specifically excluded from 32
coverage under the policyholder’s or subscriber’s policy of health 33
insurance, regardless of whether such services are provided under 34
the clinical trial or study. 35
(d) Health care services that are customarily provided by the 36
sponsors of the clinical trial or study free of charge to the 37
participants in the trial or study. 38
(e) Extraneous expenses related to participation in the clinical 39
trial or study including, without limitation, travel, housing and other 40
expenses that a participant may incur. 41
(f) Any expenses incurred by a person who accompanies the 42
policyholder or subscriber during the clinical trial or study. 43
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(g) Any item or service that is provided solely to satisfy a need 1
or desire for data collection or analysis that is not directly related to 2
the clinical management of the policyholder or subscriber. 3
(h) Any costs for the management of research relating to the 4
clinical trial or study. 5
5. An insurer who delivers or issues for delivery a policy of 6
health insurance specified in subsection 1 may require copies of the 7
approval or certification issued pursuant to paragraph (b) of 8
subsection 1, the statement of consent signed by the policyholder or 9
subscriber, protocols for the clinical trial or study and any other 10
materials related to the scope of the clinical trial or study relevant to 11
the coverage of medical treatment pursuant to this section. 12
6. An insurer who delivers or issues for delivery a policy 13
specified in subsection 1 shall: 14
(a) Include in any disclosure of the coverage provided by the 15
policy notice to each policyholder and subscriber under the policy of 16
the availability of the benefits required by this section. 17
(b) Provide the coverage required by this section subject to the 18
same deductible, copayment, coinsurance and other such conditions 19
for coverage that are required under the policy. 20
7. A policy of health insurance subject to the provisions of this 21
chapter that is delivered, issued for delivery or renewed on or after 22
January 1, [2006,] 2026, has the legal effect of including the 23
coverage required by this section, and any provision of the policy 24
that conflicts with this section is void. 25
8. An insurer who delivers or issues for delivery a policy 26
specified in subsection 1 is immune from liability for: 27
(a) Any injury to a policyholder or subscriber caused by: 28
(1) Any medical treatment provided to the policyholder or 29
subscriber in connection with his or her participation in a clinical 30
trial or study described in this section; or 31
(2) An act or omission by a provider of health care who 32
provides medical treatment or supervises the provision of medical 33
treatment to the policyholder or subscriber in connection with his or 34
her participation in a clinical trial or study described in this section. 35
(b) Any adverse or unanticipated outcome arising out of a 36
policyholder’s or subscriber’s participation in a clinical trial or study 37
described in this section. 38
9. As used in this section: 39
(a) “Cooperative group” means a network of facilities that 40
collaborate on research projects and has established a peer review 41
program approved by the National Institutes of Health. The term 42
includes: 43
(1) The Clinical Trials Cooperative Group Program; and 44
(2) The Community Clinical Oncology Program. 45
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(b) “Facility authorized to conduct Phase I clinical trials or 1
studies for the treatment of cancer” means a facility or an affiliate of 2
a facility that: 3
(1) Has in place a Phase I program which permits only 4
selective participation in the program and which uses clear-cut 5
criteria to determine eligibility for participation in the program; 6
(2) Operates a protocol review and monitoring system which 7
conforms to the standards set forth in the “Policies and Guidelines 8
Relating to the Cancer Center Support Grant” published by the 9
Cancer Centers Branch of the National Cancer Institute; 10
(3) Employs at least two researchers and at least one of those 11
researchers receives funding from a federal grant; 12
(4) Employs at least three clinical investigators who have 13
experience working in Phase I clinical trials or studies conducted at 14
a facility designated as a comprehensive cancer center by the 15
National Cancer Institute; 16
(5) Possesses specialized resources for use in Phase I clinical 17
trials or studies, including, without limitation, equipment that 18
facilitates research and analysis in proteomics, genomics and 19
pharmacokinetics; 20
(6) Is capable of gathering, maintaining and reporting 21
electronic data; and 22
(7) Is capable of responding to audits instituted by federal 23
and state agencies. 24
(c) “Provider of health care” means: 25
(1) A hospital; or 26
(2) A person licensed pursuant to chapter 630, 631 or 633 of 27
NRS [.] or a naturopathic physician licensed pursuant to chapter 28
630A of NRS. 29
Sec. 111. NRS 689B.015 is hereby amended to read as 30
follows: 31
689B.015 1. An insurer that issues a policy of group health 32
insurance shall not charge a provider of health care a fee to include 33
the name of the provider on a list of providers of health care given 34
by the insurer to its insureds. 35
2. An insurer specified in subsection 1 shall not contract with a 36
provider of health care to provide health care to an insured unless 37
the insurer uses the form prescribed by the Commissioner pursuant 38
to NRS 629.095 to obtain any information related to the credentials 39
of the provider of health care. 40
3. A contract between an insurer specified in subsection 1 and 41
a provider of health care may be modified: 42
(a) At any time pursuant to a written agreement executed by 43
both parties. 44
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(b) Except as otherwise provided in this paragraph, by the 1
insurer upon giving to the provider 45 days’ written notice of the 2
modification of the insurer’s schedule of payments, including any 3
changes to the fee schedule applicable to the provider’s practice. If 4
the provider fails to object in writing to the modification within the 5
45-day period, the modification becomes effective at the end of that 6
period. If the provider objects in writing to the modification within 7
the 45-day period, the modification must not become effective 8
unless agreed to by both parties as described in paragraph (a). 9
4. If an insurer specified in subsection 1 contracts with a 10
provider of health care to provide health care to an insured, the 11
insurer shall: 12
(a) If requested by the provider of health care at the time the 13
contract is made, submit to the provider of health care the schedule 14
of payments applicable to the provider of health care; or 15
(b) If requested by the provider of health care at any other time, 16
submit to the provider of health care the schedule of payments, 17
including any changes to the fee schedule applicable to the 18
provider’s practice, specified in paragraph (a) within 7 days after 19
receiving the request. 20
5. As used in this section, “provider of health care” means a 21
provider of health care who is licensed pursuant to chapter 630, 631, 22
632 or 633 of NRS [.] or a naturopathic physician who is licensed 23
pursuant to chapter 630A of NRS. 24
Sec. 112. NRS 689B.0306 is hereby amended to read as 25
follows: 26
689B.0306 1. A policy of group health insurance must 27
provide coverage for medical treatment which a person insured 28
under the group policy receives as part of a clinical trial or study if: 29
(a) The medical treatment is provided in a Phase I, Phase II, 30
Phase III or Phase IV study or clinical trial for the treatment of 31
cancer or in a Phase II, Phase III or Phase IV study or clinical trial 32
for the treatment of chronic fatigue syndrome; 33
(b) The clinical trial or study is approved by: 34
(1) An agency of the National Institutes of Health as set forth 35
in 42 U.S.C. § 281(b); 36
(2) A cooperative group; 37
(3) The Food and Drug Administration as an application for 38
a new investigational drug; 39
(4) The United States Department of Veterans Affairs; or 40
(5) The United States Department of Defense; 41
(c) In the case of: 42
(1) A Phase I clinical trial or study for the treatment of 43
cancer, the medical treatment is provided at a facility authorized to 44
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conduct Phase I clinical trials or studies for the treatment of cancer; 1
or 2
(2) A Phase II, Phase III or Phase IV study or clinical trial 3
for the treatment of cancer or chronic fatigue syndrome, the medical 4
treatment is provided by a provider of health care and the facility 5
and personnel for the clinical trial or study have the experience and 6
training to provide the treatment in a capable manner; 7
(d) There is no medical treatment available which is considered 8
a more appropriate alternative medical treatment than the medical 9
treatment provided in the clinical trial or study; 10
(e) There is a reasonable expectation based on clinical data that 11
the medical treatment provided in the clinical trial or study will be at 12
least as effective as any other medical treatment; 13
(f) The clinical trial or study is conducted in this State; and 14
(g) The insured has signed, before participating in the clinical 15
trial or study, a statement of consent indicating that the insured has 16
been informed of, without limitation: 17
(1) The procedure to be undertaken; 18
(2) Alternative methods of treatment; and 19
(3) The risks associated with participation in the clinical trial 20
or study, including, without limitation, the general nature and extent 21
of such risks. 22
2. Except as otherwise provided in subsection 3, the coverage 23
for medical treatment required by this section is limited to: 24
(a) Coverage for any drug or device that is approved for sale by 25
the Food and Drug Administration without regard to whether the 26
approved drug or device has been approved for use in the medical 27
treatment of the insured person. 28
(b) The cost of any reasonably necessary health care services 29
that are required as a result of the medical treatment provided in a 30
Phase II, Phase III or Phase IV clinical trial or study or as a result of 31
any complication arising out of the medical treatment provided in a 32
Phase II, Phase III or Phase IV clinical trial or study, to the extent 33
that such health care services would otherwise be covered under the 34
policy of group health insurance. 35
(c) The cost of any routine health care services that would 36
otherwise be covered under the policy of group health insurance for 37
an insured participating in a Phase I clinical trial or study. 38
(d) The initial consultation to determine whether the insured is 39
eligible to participate in the clinical trial or study. 40
(e) Health care services required for the clinically appropriate 41
monitoring of the insured during a Phase II, Phase III or Phase IV 42
clinical trial or study. 43
(f) Health care services which are required for the clinically 44
appropriate monitoring of the insured during a Phase I clinical trial 45
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or study and which are not directly related to the clinical trial or 1
study. 2
Except as otherwise provided in NRS 689B.0303, the services 3
provided pursuant to paragraphs (b), (c), (e) and (f) must be covered 4
only if the services are provided by a provider with whom the 5
insurer has contracted for such services. If the insurer has not 6
contracted for the provision of such services, the insurer shall pay 7
the provider the rate of reimbursement that is paid to other providers 8
with whom the insurer has contracted for similar services and the 9
provider shall accept that rate of reimbursement as payment in full. 10
3. Particular medical treatment described in subsection 2 and 11
provided to a person insured under the group policy is not required 12
to be covered pursuant to this section if that particular medical 13
treatment is provided by the sponsor of the clinical trial or study free 14
of charge to the person insured under the group policy. 15
4. The coverage for medical treatment required by this section 16
does not include: 17
(a) Any portion of the clinical trial or study that is customarily 18
paid for by a government or a biotechnical, pharmaceutical or 19
medical industry. 20
(b) Coverage for a drug or device described in paragraph (a) of 21
subsection 2 which is paid for by the manufacturer, distributor or 22
provider of the drug or device. 23
(c) Health care services that are specifically excluded from 24
coverage under the insured’s policy of group health insurance, 25
regardless of whether such services are provided under the clinical 26
trial or study. 27
(d) Health care services that are customarily provided by the 28
sponsors of the clinical trial or study free of charge to the 29
participants in the trial or study. 30
(e) Extraneous expenses related to participation in the clinical 31
trial or study, including, without limitation, travel, housing and 32
other expenses that a participant may incur. 33
(f) Any expenses incurred by a person who accompanies the 34
insured during the clinical trial or study. 35
(g) Any item or service that is provided solely to satisfy a need 36
or desire for data collection or analysis that is not directly related to 37
the clinical management of the insured. 38
(h) Any costs for the management of research relating to the 39
clinical trial or study. 40
5. An insurer who delivers or issues for delivery a policy of 41
group health insurance specified in subsection 1 may require copies 42
of the approval or certification issued pursuant to paragraph (b) of 43
subsection 1, the statement of consent signed by the insured, 44
protocols for the clinical trial or study and any other materials 45
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related to the scope of the clinical trial or study relevant to the 1
coverage of medical treatment pursuant to this section. 2
6. An insurer who delivers or issues for delivery a policy of 3
group health insurance specified in subsection 1 shall: 4
(a) Include in any disclosure of the coverage provided by the 5
policy notice to each group policyholder of the availability of the 6
benefits required by this section. 7
(b) Provide the coverage required by this section subject to the 8
same deductible, copayment, coinsurance and other such conditions 9
for coverage that are required under the policy. 10
7. A policy of group health insurance subject to the provisions 11
of this chapter that is delivered, issued for delivery or renewed on or 12
after January 1, [2006,] 2026, has the legal effect of including the 13
coverage required by this section, and any provision of the policy 14
that conflicts with this section is void. 15
8. An insurer who delivers or issues for delivery a policy of 16
group health insurance specified in subsection 1 is immune from 17
liability for: 18
(a) Any injury to the insured caused by: 19
(1) Any medical treatment provided to the insured in 20
connection with his or her participation in a clinical trial or study 21
described in this section; or 22
(2) An act or omission by a provider of health care who 23
provides medical treatment or supervises the provision of medical 24
treatment to the insured in connection with his or her participation in 25
a clinical trial or study described in this section. 26
(b) Any adverse or unanticipated outcome arising out of an 27
insured’s participation in a clinical trial or study described in this 28
section. 29
9. As used in this section: 30
(a) “Cooperative group” means a network of facilities that 31
collaborate on research projects and has established a peer review 32
program approved by the National Institutes of Health. The term 33
includes: 34
(1) The Clinical Trials Cooperative Group Program; and 35
(2) The Community Clinical Oncology Program. 36
(b) “Facility authorized to conduct Phase I clinical trials or 37
studies for the treatment of cancer” means a facility or an affiliate of 38
a facility that: 39
(1) Has in place a Phase I program which permits only 40
selective participation in the program and which uses clear-cut 41
criteria to determine eligibility for participation in the program; 42
(2) Operates a protocol review and monitoring system which 43
conforms to the standards set forth in the “Policies and Guidelines 44
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Relating to the Cancer Center Support Grant” published by the 1
Cancer Centers Branch of the National Cancer Institute; 2
(3) Employs at least two researchers and at least one of those 3
researchers receives funding from a federal grant; 4
(4) Employs at least three clinical investigators who have 5
experience working in Phase I clinical trials or studies conducted at 6
a facility designated as a comprehensive cancer center by the 7
National Cancer Institute; 8
(5) Possesses specialized resources for use in Phase I clinical 9
trials or studies, including, without limitation, equipment that 10
facilitates research and analysis in proteomics, genomics and 11
pharmacokinetics; 12
(6) Is capable of gathering, maintaining and reporting 13
electronic data; and 14
(7) Is capable of responding to audits instituted by federal 15
and state agencies. 16
(c) “Provider of health care” means: 17
(1) A hospital; or 18
(2) A person licensed pursuant to chapter 630, 631 or 633 of 19
NRS [.] or a naturopathic physician who is licensed pursuant to 20
chapter 630A of NRS. 21
Sec. 113. NRS 689C.131 is hereby amended to read as 22
follows: 23
689C.131 1. A carrier serving small employers and a carrier 24
that offers a contract to a voluntary purchasing group shall not 25
charge a provider of health care a fee to include the name of the 26
provider on a list of providers of health care given by the carrier to 27
its insureds. 28
2. A carrier specified in subsection 1 shall not contract with a 29
provider of health care to provide health care to an insured unless 30
the carrier uses the form prescribed by the Commissioner pursuant 31
to NRS 629.095 to obtain any information related to the credentials 32
of the provider of health care. 33
3. A contract between a carrier specified in subsection 1 and a 34
provider of health care may be modified: 35
(a) At any time pursuant to a written agreement executed by 36
both parties. 37
(b) Except as otherwise provided in this paragraph, by the 38
carrier upon giving to the provider 45 days’ written notice of the 39
modification of the carrier’s schedule of payments, including any 40
changes to the fee schedule applicable to the provider’s practice. If 41
the provider fails to object in writing to the modification within the 42
45 day period, the modification becomes effective at the end of that 43
period. If the provider objects in writing to the modification within 44
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the 45 day period, the modification must not become effective 1
unless agreed to by both parties as described in paragraph (a). 2
4. If a carrier specified in subsection 1 contracts with a 3
provider of health care to provide health care to an insured, the 4
carrier shall: 5
(a) If requested by the provider of health care at the time the 6
contract is made, submit to the provider of health care the schedule 7
of payments applicable to the provider of health care; or 8
(b) If requested by the provider of health care at any other time, 9
submit to the provider of health care the schedule of payments, 10
including any changes to the fee schedule applicable to the 11
provider’s practice, specified in paragraph (a) within 7 days after 12
receiving the request. 13
5. As used in this section, “provider of health care” means a 14
provider of health care who is licensed pursuant to chapter 630, 631, 15
632 or 633 of NRS [.] or a naturopathic physician who is licensed 16
pursuant to chapter 630A of NRS. 17
Sec. 114. NRS 690B.270 is hereby amended to read as 18
follows: 19
690B.270 If an insurer declines to issue to a practitioner 20
licensed pursuant to chapter 630, 631, 632 or 633 of NRS or as a 21
naturopathic physician licensed pursuant to chapter 630A of NRS 22
a policy of professional liability insurance, the insurer shall, upon 23
the request of the practitioner, disclose to the practitioner the 24
reasons the insurer declined to issue the policy. 25
Sec. 115. NRS 690B.280 is hereby amended to read as 26
follows: 27
690B.280 If an insurer, for a policy of professional liability 28
insurance for a practitioner licensed pursuant to chapter 630, 631, 29
632 or 633 of NRS [,] or as a naturopathic physician licensed 30
pursuant to chapter 630A of NRS, sets the premium for the policy 31
for the practitioner at a rate that is higher than the standard rate of 32
the insurer for the applicable type of policy and specialty of the 33
practitioner, the insurer shall, upon the request of the practitioner, 34
disclose the reasons the insurer set the premium for the policy at the 35
higher rate. 36
Sec. 116. NRS 690B.290 is hereby amended to read as 37
follows: 38
690B.290 If an insurer offers to issue a claims-made policy to a 39
practitioner licensed pursuant to chapter 630, 631, 632 or 633 of 40
NRS [,] or as a naturopathic physician licensed pursuant to 41
chapter 630A of NRS, the insurer shall: 42
1. Offer to issue an extended reporting endorsement to the 43
practitioner; and 44
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2. Disclose to the practitioner the cost formula that the insurer 1
uses to determine the premium for the extended reporting 2
endorsement. The cost formula must be based on: 3
(a) An amount that is not more than twice the amount of the 4
premium for the claims-made policy at the time of the termination 5
of that policy; and 6
(b) The rates filed by the insurer and approved by the 7
Commissioner. 8
Sec. 117. NRS 690B.300 is hereby amended to read as 9
follows: 10
690B.300 1. Except as otherwise provided in this section, if 11
an insurer issues a policy of professional liability insurance to a 12
practitioner licensed pursuant to chapter 630, 632 or 633 of NRS or 13
as a naturopathic physician licensed pursuant to chapter 630A of 14
NRS who delivers one or more babies per year, the insurer shall not 15
set the premium for the policy at a rate that is different from the rate 16
set for such a policy issued by the insurer to any other practitioner 17
licensed pursuant to chapter 630, 632 or 633 of NRS or as a 18
naturopathic physician licensed pursuant to chapter 630A of NRS 19
who delivers one or more babies per year if the difference in rates is 20
based in whole or in part upon the number of babies delivered per 21
year by the practitioner. 22
2. If an insurer issues a policy of professional liability 23
insurance to a practitioner licensed pursuant to chapter 630, 632 or 24
633 of NRS or as a naturopathic physician licensed pursuant to 25
chapter 630A of NRS who delivers one or more babies per year, the 26
insurer may set the premium for the policy at a rate that is different, 27
based in whole or in part upon the number of babies delivered per 28
year by the practitioner, from the rate set for such a policy issued by 29
the insurer to any other practitioner licensed pursuant to chapter 30
630, 632 or 633 of NRS or as a naturopathic physician licensed 31
pursuant to chapter 630A of NRS who delivers one or more babies 32
per year if the insurer: 33
(a) Bases the difference upon actuarial and loss experience data 34
available to the insurer; and 35
(b) Obtains the approval of the Commissioner for the difference 36
in rates. 37
3. The provisions of this section do not prohibit an insurer from 38
setting the premium for a policy of professional liability insurance 39
issued to a practitioner licensed pursuant to chapter 630, 632 or 633 40
of NRS or as a naturopathic physician licensed pursuant to 41
chapter 630A of NRS who delivers one or more babies per year at a 42
rate that is different from the rate set for such a policy issued by the 43
insurer to any other practitioner licensed pursuant to chapter 630, 44
632 or 633 of NRS or as a naturopathic physician licensed 45
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pursuant to chapter 630A of NRS who delivers one or more babies 1
per year if the difference in rates is based solely upon factors other 2
than the number of babies delivered per year by the practitioner. 3
Sec. 118. NRS 690B.310 is hereby amended to read as 4
follows: 5
690B.310 1. If an agreement settles a claim or action against 6
a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of 7
NRS or as a naturopathic physician licensed pursuant to chapter 8
630A of NRS for a breach of his or her professional duty toward a 9
patient, the following terms of the agreement must not be made 10
confidential: 11
(a) The names of the parties; 12
(b) The date of the incidents or events giving rise to the claim or 13
action; 14
(c) The nature of the claim or action as set forth in the complaint 15
and the answer that is filed with the district court; and 16
(d) The effective date of the agreement. 17
2. Any provision of an agreement to settle a claim or action 18
that conflicts with this section is void. 19
Sec. 119. NRS 690B.330 is hereby amended to read as 20
follows: 21
690B.330 1. In each rating plan of an insurer that issues a 22
policy of professional liability insurance to a practitioner licensed 23
pursuant to chapter 630 or 633 of NRS [,] or as a naturopathic 24
physician licensed pursuant to chapter 630A of NRS, the insurer 25
shall provide for a reduction in the premium for the policy if the 26
practitioner implements a qualified risk management system. The 27
amount of the reduction in the premium must be determined by the 28
Commissioner in accordance with the applicable standards for rates 29
established in NRS 686B.010 to 686B.1799, inclusive. 30
2. A qualified risk management system must comply with all 31
requirements established by the Commissioner. 32
3. The Commissioner shall adopt regulations to: 33
(a) Establish the requirements for a qualified risk management 34
system; and 35
(b) Carry out the provisions of this section. 36
4. The provisions of this section apply to all rating plans which 37
an insurer that issues a policy of professional liability insurance to a 38
practitioner licensed pursuant to chapter 630 or 633 of NRS or as a 39
naturopathic physician licensed pursuant to chapter 630A of NRS 40
files with the Commissioner on and after the effective date of the 41
regulations adopted by the Commissioner pursuant to this section. 42
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Sec. 120. NRS 690B.350 is hereby amended to read as 1
follows: 2
690B.350 1. The requirements of this section apply only if, 3
after a hearing convened at the discretion of the Commissioner, the 4
Commissioner determines that the market for professional liability 5
insurance issued to any class, type or specialty of practitioner 6
licensed pursuant to chapter 630, 631 or 633 of NRS or as a 7
naturopathic physician licensed pursuant to chapter 630A of NRS 8
is not competitive and that such insurance is unavailable or 9
unaffordable for a substantial number of such practitioners. 10
2. If the Commissioner convenes a hearing pursuant to 11
subsection 1 and issues a finding that the market for professional 12
liability insurance issued to any class, type or specialty of 13
practitioner licensed pursuant to chapter 630, 631 or 633 of NRS or 14
as a naturopathic physician licensed pursuant to chapter 630A of 15
NRS is not competitive, the Commissioner may designate that class, 16
type or specialty of practitioner to be an essential medical specialty. 17
3. Except as otherwise provided in this section, if an insurer 18
intends to cancel, terminate or otherwise not renew all policies of 19
professional liability insurance that it has issued to any class, type or 20
specialty of practitioner licensed pursuant to chapter 630, 631 or 633 21
of NRS [,] or as a naturopathic physician licensed pursuant to 22
chapter 630A of NRS, the insurer must provide 120 days’ notice of 23
its intended action to the Commissioner and the practitioners before 24
its intended action becomes effective. 25
4. If an insurer intends to cancel, terminate or otherwise not 26
renew a specific policy of professional liability insurance that it has 27
issued to a practitioner who is practicing in one or more of the 28
essential medical specialties designated by the Commissioner: 29
(a) The insurer must provide 120 days’ notice to the practitioner 30
before its intended action becomes effective; and 31
(b) The Commissioner may require the insurer to delay its 32
intended action for a period of not more than 60 days if the 33
Commissioner determines that a replacement policy is not readily 34
available to the practitioner. 35
5. If an insurer intends to cancel, terminate or otherwise not 36
renew all policies of professional liability insurance that it has 37
issued to practitioners who are practicing in one or more of the 38
essential medical specialties designated by the Commissioner: 39
(a) The insurer must provide 120 days’ notice of its intended 40
action to the Commissioner and the practitioners before its intended 41
action becomes effective; and 42
(b) The Commissioner may require the insurer to delay its 43
intended action for a period of not more than 60 days if the 44
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Commissioner determines that replacement policies are not readily 1
available to the practitioners. 2
6. The Commissioner may adopt any regulations that are 3
necessary to carry out the provisions of this section. 4
Sec. 121. NRS 690B.360 is hereby amended to read as 5
follows: 6
690B.360 1. The Commissioner may collect all information 7
which is pertinent to monitoring whether an insurer that issues 8
professional liability insurance for a practitioner licensed pursuant 9
to chapter 630, 631, 632 or 633 of NRS or as a naturopathic 10
physician licensed pursuant to chapter 630A of NRS is complying 11
with the applicable standards for rates established in NRS 686B.010 12
to 686B.1799, inclusive. Such information may include, without 13
limitation: 14
(a) The amount of gross premiums collected with regard to each 15
medical specialty; 16
(b) Information relating to loss ratios; and 17
(c) Information reported pursuant to NRS 679B.430 and 18
679B.440. 19
2. In addition to the information collected pursuant to 20
subsection 1, the Commissioner may request any additional 21
information from an insurer: 22
(a) Whose rates and credit utilization are materially different 23
from other insurers in the market for professional liability insurance 24
for a practitioner licensed pursuant to chapter 630, 631, 632 or 633 25
of NRS or as a naturopathic physician licensed pursuant to 26
chapter 630A of NRS in this State; 27
(b) Whose credit utilization shows a substantial change from the 28
previous year; or 29
(c) Whose information collected pursuant to subsection 1 30
indicates a potentially adverse trend. 31
3. If the Commissioner requests additional information from an 32
insurer pursuant to subsection 2, the Commissioner may: 33
(a) Determine whether the additional information offers a 34
reasonable explanation for the results described in paragraph (a), (b) 35
or (c) of subsection 2; and 36
(b) Take any steps permitted by law that are necessary and 37
appropriate to assure the ongoing stability of the market for 38
professional liability insurance for a practitioner licensed pursuant 39
to chapter 630, 631, 632 or 633 of NRS or as a naturopathic 40
physician licensed pursuant to chapter 630A of NRS in this State. 41
4. On an ongoing basis, the Commissioner may analyze and 42
evaluate the information collected pursuant to this section to 43
determine trends in and measure the health of the market for 44
professional liability insurance for a practitioner licensed pursuant 45
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to chapter 630, 631, 632 or 633 of NRS or as a naturopathic 1
physician licensed pursuant to chapter 630A of NRS in this State. 2
5. If the Commissioner convenes a hearing pursuant to 3
subsection 1 of NRS 690B.350 and determines that the market for 4
professional liability insurance issued to any class, type or specialty 5
of practitioner licensed pursuant to chapter 630, 631 or 633 of NRS 6
or as a naturopathic physician licensed pursuant to chapter 630A 7
of NRS is not competitive and that such insurance is unavailable or 8
unaffordable for a substantial number of such practitioners, the 9
Commissioner shall prepare and submit a report of the 10
Commissioner’s findings and recommendations to the Director of 11
the Legislative Counsel Bureau for transmittal to members of the 12
Legislature. 13
Sec. 122. NRS 695A.095 is hereby amended to read as 14
follows: 15
695A.095 1. A society shall not charge a provider of health 16
care a fee to include the name of the provider on a list of providers 17
of health care given by the society to its insureds. 18
2. A society shall not contract with a provider of health care to 19
provide health care to an insured unless the society uses the form 20
prescribed by the Commissioner pursuant to NRS 629.095 to obtain 21
any information related to the credentials of the provider of health 22
care. 23
3. A contract between a society and a provider of health care 24
may be modified: 25
(a) At any time pursuant to a written agreement executed by 26
both parties. 27
(b) Except as otherwise provided in this paragraph, by the 28
society upon giving to the provider 45 days’ written notice of the 29
modification of the society’s schedule of payments, including any 30
changes to the fee schedule applicable to the provider’s practice. If 31
the provider fails to object in writing to the modification within the 32
45-day period, the modification becomes effective at the end of that 33
period. If the provider objects in writing to the modification within 34
the 45-day period, the modification must not become effective 35
unless agreed to by both parties as described in paragraph (a). 36
4. If a society contracts with a provider of health care to 37
provide health care to an insured, the society shall: 38
(a) If requested by the provider of health care at the time the 39
contract is made, submit to the provider of health care the schedule 40
of payments applicable to the provider of health care; or 41
(b) If requested by the provider of health care at any other time, 42
submit to the provider of health care the schedule of payments, 43
including any changes to the fee schedule applicable to the 44
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provider’s practice, specified in paragraph (a) within 7 days after 1
receiving the request. 2
5. As used in this section, “provider of health care” means a 3
provider of health care who is licensed pursuant to chapter 630, 631, 4
632 or 633 of NRS [.] or a naturopathic physician who is licensed 5
pursuant to chapter 630A of NRS. 6
Sec. 123. NRS 695B.035 is hereby amended to read as 7
follows: 8
695B.035 1. A corporation subject to the provisions of this 9
chapter shall not charge a provider of health care a fee to include the 10
name of the provider on a list of providers of health care given by 11
the corporation to its insureds. 12
2. A corporation specified in subsection 1 shall not contract 13
with a provider of health care to provide health care to an insured 14
unless the corporation uses the form prescribed by the 15
Commissioner pursuant to NRS 629.095 to obtain any information 16
related to the credentials of the provider of health care. 17
3. A contract between a corporation specified in subsection 1 18
and a provider of health care may be modified: 19
(a) At any time pursuant to a written agreement executed by 20
both parties. 21
(b) Except as otherwise provided in this paragraph, by the 22
corporation upon giving to the provider 45 days’ written notice of 23
the modification of the corporation’s schedule of payments, 24
including any changes to the fee schedule applicable to the 25
provider’s practice. If the provider fails to object in writing to the 26
modification within the 45-day period, the modification becomes 27
effective at the end of that period. If the provider objects in writing 28
to the modification within the 45-day period, the modification must 29
not become effective unless agreed to by both parties as described in 30
paragraph (a). 31
4. If a corporation specified in subsection 1 contracts with a 32
provider of health care to provide health care to an insured, the 33
corporation shall: 34
(a) If requested by the provider of health care at the time the 35
contract is made, submit to the provider of health care the schedule 36
of payments applicable to the provider of health care; or 37
(b) If requested by the provider of health care at any other time, 38
submit to the provider of health care the schedule of payments, 39
including any changes to the fee schedule applicable to the 40
provider’s practice, specified in paragraph (a) within 7 days after 41
receiving the request. 42
5. As used in this section, “provider of health care” means a 43
provider of health care who is licensed pursuant to chapter 630, 631, 44
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632 or 633 of NRS [.] or a naturopathic physician who is licensed 1
pursuant to chapter 630A of NRS. 2
Sec. 124. NRS 695B.1903 is hereby amended to read as 3
follows: 4
695B.1903 1. A policy of health insurance issued by a 5
medical services corporation must provide coverage for medical 6
treatment which a person insured under the policy receives as part of 7
a clinical trial or study if: 8
(a) The medical treatment is provided in a Phase I, Phase II, 9
Phase III or Phase IV study or clinical trial for the treatment of 10
cancer or in a Phase II, Phase III or Phase IV study or clinical trial 11
for the treatment of chronic fatigue syndrome; 12
(b) The clinical trial or study is approved by: 13
(1) An agency of the National Institutes of Health as set forth 14
in 42 U.S.C. § 281(b); 15
(2) A cooperative group; 16
(3) The Food and Drug Administration as an application for 17
a new investigational drug; 18
(4) The United States Department of Veterans Affairs; or 19
(5) The United States Department of Defense; 20
(c) In the case of: 21
(1) A Phase I clinical trial or study for the treatment of 22
cancer, the medical treatment is provided at a facility authorized to 23
conduct Phase I clinical trials or studies for the treatment of cancer; 24
or 25
(2) A Phase II, Phase III or Phase IV study or clinical trial 26
for the treatment of cancer or chronic fatigue syndrome, the medical 27
treatment is provided by a provider of health care and the facility 28
and personnel for the clinical trial or study have the experience and 29
training to provide the treatment in a capable manner; 30
(d) There is no medical treatment available which is considered 31
a more appropriate alternative medical treatment than the medical 32
treatment provided in the clinical trial or study; 33
(e) There is a reasonable expectation based on clinical data that 34
the medical treatment provided in the clinical trial or study will be at 35
least as effective as any other medical treatment; 36
(f) The clinical trial or study is conducted in this State; and 37
(g) The insured has signed, before participating in the clinical 38
trial or study, a statement of consent indicating that the insured has 39
been informed of, without limitation: 40
(1) The procedure to be undertaken; 41
(2) Alternative methods of treatment; and 42
(3) The risks associated with participation in the clinical trial 43
or study, including, without limitation, the general nature and extent 44
of such risks. 45
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2. Except as otherwise provided in subsection 3, the coverage 1
for medical treatment required by this section is limited to: 2
(a) Coverage for any drug or device that is approved for sale by 3
the Food and Drug Administration without regard to whether the 4
approved drug or device has been approved for use in the medical 5
treatment of the insured person. 6
(b) The cost of any reasonably necessary health care services 7
that are required as a result of the medical treatment provided in a 8
Phase II, Phase III or Phase IV clinical trial or study or as a result of 9
any complication arising out of the medical treatment provided in a 10
Phase II, Phase III or Phase IV clinical trial or study, to the extent 11
that such health care services would otherwise be covered under the 12
policy of health insurance. 13
(c) The cost of any routine health care services that would 14
otherwise be covered under the policy of health insurance for an 15
insured participating in a Phase I clinical trial or study. 16
(d) The initial consultation to determine whether the insured is 17
eligible to participate in the clinical trial or study. 18
(e) Health care services required for the clinically appropriate 19
monitoring of the insured during a Phase II, Phase III or Phase IV 20
clinical trial or study. 21
(f) Health care services which are required for the clinically 22
appropriate monitoring of the insured during a Phase I clinical trial 23
or study and which are not directly related to the clinical trial or 24
study. 25
Except as otherwise provided in NRS 695B.1901, the services 26
provided pursuant to paragraphs (b), (c), (e) and (f) must be covered 27
only if the services are provided by a provider with whom the 28
medical services corporation has contracted for such services. If the 29
medical services corporation has not contracted for the provision of 30
such services, the medical services corporation shall pay the 31
provider the rate of reimbursement that is paid to other providers 32
with whom the medical services corporation has contracted for 33
similar services and the provider shall accept that rate of 34
reimbursement as payment in full. 35
3. Particular medical treatment described in subsection 2 and 36
provided to a person insured under the policy is not required to be 37
covered pursuant to this section if that particular medical treatment 38
is provided by the sponsor of the clinical trial or study free of charge 39
to the person insured under the policy. 40
4. The coverage for medical treatment required by this section 41
does not include: 42
(a) Any portion of the clinical trial or study that is customarily 43
paid for by a government or a biotechnical, pharmaceutical or 44
medical industry. 45
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(b) Coverage for a drug or device described in paragraph (a) of 1
subsection 2 which is paid for by the manufacturer, distributor or 2
provider of the drug or device. 3
(c) Health care services that are specifically excluded from 4
coverage under the insured’s policy of health insurance, regardless 5
of whether such services are provided under the clinical trial or 6
study. 7
(d) Health care services that are customarily provided by the 8
sponsors of the clinical trial or study free of charge to the 9
participants in the trial or study. 10
(e) Extraneous expenses related to participation in the clinical 11
trial or study, including, without limitation, travel, housing and 12
other expenses that a participant may incur. 13
(f) Any expenses incurred by a person who accompanies the 14
insured during the trial or study. 15
(g) Any item or service that is provided solely to satisfy a need 16
or desire for data collection or analysis that is not directly related to 17
the clinical management of the insured. 18
(h) Any costs for the management of research relating to the 19
clinical trial or study. 20
5. A medical services corporation that delivers or issues for 21
delivery a policy of health insurance specified in subsection 1 may 22
require copies of the approval or certification issued pursuant to 23
paragraph (b) of subsection 1, the statement of consent signed by the 24
insured, protocols for the clinical trial or study and any other 25
materials related to the scope of the clinical trial or study relevant to 26
the coverage of medical treatment pursuant to this section. 27
6. A medical services corporation that delivers or issues for 28
delivery a policy of health insurance specified in subsection 1 shall: 29
(a) Include in any disclosure of the coverage provided by the 30
policy notice to each person insured under the policy of the 31
availability of the benefits required by this section. 32
(b) Provide the coverage required by this section subject to the 33
same deductible, copayment, coinsurance and other such conditions 34
for coverage that are required under the policy. 35
7. A policy of health insurance subject to the provisions of this 36
chapter that is delivered, issued for delivery or renewed on or after 37
January 1, [2006,] 2026, has the legal effect of including the 38
coverage required by this section, and any provision of the policy 39
that conflicts with this section is void. 40
8. A medical services corporation that delivers or issues for 41
delivery a policy of health insurance specified in subsection 1 is 42
immune from liability for: 43
(a) Any injury to the insured caused by: 44
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(1) Any medical treatment provided to the insured in 1
connection with his or her participation in a clinical trial or study 2
described in this section; or 3
(2) An act or omission by a provider of health care who 4
provides medical treatment or supervises the provision of medical 5
treatment to the insured in connection with his or her participation in 6
a clinical trial or study described in this section. 7
(b) Any adverse or unanticipated outcome arising out of an 8
insured’s participation in a clinical trial or study described in this 9
section. 10
9. As used in this section: 11
(a) “Cooperative group” means a network of facilities that 12
collaborate on research projects and has established a peer review 13
program approved by the National Institutes of Health. The term 14
includes: 15
(1) The Clinical Trials Cooperative Group Program; and 16
(2) The Community Clinical Oncology Program. 17
(b) “Facility authorized to conduct Phase I clinical trials or 18
studies for the treatment of cancer” means a facility or an affiliate of 19
a facility that: 20
(1) Has in place a Phase I program which permits only 21
selective participation in the program and which uses clear-cut 22
criteria to determine eligibility for participation in the program; 23
(2) Operates a protocol review and monitoring system which 24
conforms to the standards set forth in the “Policies and Guidelines 25
Relating to the Cancer Center Support Grant” published by the 26
Cancer Centers Branch of the National Cancer Institute; 27
(3) Employs at least two researchers and at least one of those 28
researchers receives funding from a federal grant; 29
(4) Employs at least three clinical investigators who have 30
experience working in Phase I clinical trials or studies conducted at 31
a facility designated as a comprehensive cancer center by the 32
National Cancer Institute; 33
(5) Possesses specialized resources for use in Phase I clinical 34
trials or studies, including, without limitation, equipment that 35
facilitates research and analysis in proteomics, genomics and 36
pharmacokinetics; 37
(6) Is capable of gathering, maintaining and reporting 38
electronic data; and 39
(7) Is capable of responding to audits instituted by federal 40
and state agencies. 41
(c) “Provider of health care” means: 42
(1) A hospital; or 43
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(2) A person licensed pursuant to chapter 630, 631 or 633 of 1
NRS [.] or a naturopathic physician licensed pursuant to chapter 2
630A of NRS. 3
Sec. 125. NRS 695C.125 is hereby amended to read as 4
follows: 5
695C.125 1. A health maintenance organization shall not 6
contract with a provider of health care to provide health care to an 7
insured unless the health maintenance organization uses the form 8
prescribed by the Commissioner pursuant to NRS 629.095 to obtain 9
any information related to the credentials of the provider of health 10
care. 11
2. A contract between a health maintenance organization and a 12
provider of health care may be modified: 13
(a) At any time pursuant to a written agreement executed by 14
both parties. 15
(b) Except as otherwise provided in this paragraph, by the health 16
maintenance organization upon giving to the provider 45 days’ 17
written notice of the modification of the health maintenance 18
organization’s schedule of payments, including any changes to the 19
fee schedule applicable to the provider’s practice. If the provider 20
fails to object in writing to the modification within the 45-day 21
period, the modification becomes effective at the end of that period. 22
If the provider objects in writing to the modification within the 45-23
day period, the modification must not become effective unless 24
agreed to by both parties as described in paragraph (a). 25
3. If a health maintenance organization contracts with a 26
provider of health care to provide health care to an enrollee, the 27
health maintenance organization shall: 28
(a) If requested by the provider of health care at the time the 29
contract is made, submit to the provider of health care the schedule 30
of payments applicable to the provider of health care; or 31
(b) If requested by the provider of health care at any other time, 32
submit to the provider of health care the schedule of payments, 33
including any changes to the fee schedule applicable to the 34
provider’s practice, specified in paragraph (a) within 7 days after 35
receiving the request. 36
4. As used in this section, “provider of health care” means a 37
provider of health care who is licensed pursuant to chapter 630, 631, 38
632 or 633 of NRS [.] or a naturopathic physician who is licensed 39
pursuant to chapter 630A of NRS. 40
Sec. 126. NRS 695C.1693 is hereby amended to read as 41
follows: 42
695C.1693 1. Except as otherwise provided in NRS 43
695C.050, a health care plan issued by a health maintenance 44
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organization must provide coverage for medical treatment which an 1
enrollee receives as part of a clinical trial or study if: 2
(a) The medical treatment is provided in a Phase I, Phase II, 3
Phase III or Phase IV study or clinical trial for the treatment of 4
cancer or in a Phase II, Phase III or Phase IV study or clinical trial 5
for the treatment of chronic fatigue syndrome; 6
(b) The clinical trial or study is approved by: 7
(1) An agency of the National Institutes of Health as set forth 8
in 42 U.S.C. § 281(b); 9
(2) A cooperative group; 10
(3) The Food and Drug Administration as an application for 11
a new investigational drug; 12
(4) The United States Department of Veterans Affairs; or 13
(5) The United States Department of Defense; 14
(c) In the case of: 15
(1) A Phase I clinical trial or study for the treatment of 16
cancer, the medical treatment is provided at a facility authorized to 17
conduct Phase I clinical trials or studies for the treatment of cancer; 18
or 19
(2) A Phase II, Phase III or Phase IV study or clinical trial 20
for the treatment of cancer or chronic fatigue syndrome, the medical 21
treatment is provided by a provider of health care and the facility 22
and personnel for the clinical trial or study have the experience and 23
training to provide the treatment in a capable manner; 24
(d) There is no medical treatment available which is considered 25
a more appropriate alternative medical treatment than the medical 26
treatment provided in the clinical trial or study; 27
(e) There is a reasonable expectation based on clinical data that 28
the medical treatment provided in the clinical trial or study will be at 29
least as effective as any other medical treatment; 30
(f) The clinical trial or study is conducted in this State; and 31
(g) The enrollee has signed, before participating in the clinical 32
trial or study, a statement of consent indicating that the enrollee has 33
been informed of, without limitation: 34
(1) The procedure to be undertaken; 35
(2) Alternative methods of treatment; and 36
(3) The risks associated with participation in the clinical trial 37
or study, including, without limitation, the general nature and extent 38
of such risks. 39
2. Except as otherwise provided in subsection 3, the coverage 40
for medical treatment required by this section is limited to: 41
(a) Coverage for any drug or device that is approved for sale by 42
the Food and Drug Administration without regard to whether the 43
approved drug or device has been approved for use in the medical 44
treatment of the enrollee. 45
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(b) The cost of any reasonably necessary health care services 1
that are required as a result of the medical treatment provided in a 2
Phase II, Phase III or Phase IV clinical trial or study or as a result of 3
any complication arising out of the medical treatment provided in a 4
Phase II, Phase III or Phase IV clinical trial or study, to the extent 5
that such health care services would otherwise be covered under the 6
health care plan. 7
(c) The cost of any routine health care services that would 8
otherwise be covered under the health care plan for an enrollee in a 9
Phase I clinical trial or study. 10
(d) The initial consultation to determine whether the enrollee is 11
eligible to participate in the clinical trial or study. 12
(e) Health care services required for the clinically appropriate 13
monitoring of the enrollee during a Phase II, Phase III or Phase IV 14
clinical trial or study. 15
(f) Health care services which are required for the clinically 16
appropriate monitoring of the enrollee during a Phase I clinical trial 17
or study and which are not directly related to the clinical trial or 18
study. 19
Except as otherwise provided in NRS 695C.1691, the services 20
provided pursuant to paragraphs (b), (c), (e) and (f) must be covered 21
only if the services are provided by a provider with whom the health 22
maintenance organization has contracted for such services. If the 23
health maintenance organization has not contracted for the provision 24
of such services, the health maintenance organization shall pay the 25
provider the rate of reimbursement that is paid to other providers 26
with whom the health maintenance organization has contracted for 27
similar services and the provider shall accept that rate of 28
reimbursement as payment in full. 29
3. Particular medical treatment described in subsection 2 and 30
provided to an enrollee is not required to be covered pursuant to this 31
section if that particular medical treatment is provided by the 32
sponsor of the clinical trial or study free of charge to the enrollee. 33
4. The coverage for medical treatment required by this section 34
does not include: 35
(a) Any portion of the clinical trial or study that is customarily 36
paid for by a government or a biotechnical, pharmaceutical or 37
medical industry. 38
(b) Coverage for a drug or device described in paragraph (a) of 39
subsection 2 which is paid for by the manufacturer, distributor or 40
provider of the drug or device. 41
(c) Health care services that are specifically excluded from 42
coverage under the enrollee’s health care plan, regardless of whether 43
such services are provided under the clinical trial or study. 44
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(d) Health care services that are customarily provided by the 1
sponsors of the clinical trial or study free of charge to the 2
participants in the trial or study. 3
(e) Extraneous expenses related to participation in the clinical 4
trial or study, including, without limitation, travel, housing and 5
other expenses that a participant may incur. 6
(f) Any expenses incurred by a person who accompanies the 7
enrollee during the clinical trial or study. 8
(g) Any item or service that is provided solely to satisfy a need 9
or desire for data collection or analysis that is not directly related to 10
the clinical management of the enrollee. 11
(h) Any costs for the management of research relating to the 12
clinical trial or study. 13
5. A health maintenance organization that delivers or issues for 14
delivery a health care plan specified in subsection 1 may require 15
copies of the approval or certification issued pursuant to paragraph 16
(b) of subsection 1, the statement of consent signed by the enrollee, 17
protocols for the clinical trial or study and any other materials 18
related to the scope of the clinical trial or study relevant to the 19
coverage of medical treatment pursuant to this section. 20
6. A health maintenance organization that delivers or issues for 21
delivery a health care plan specified in subsection 1 shall provide 22
the coverage required by this section subject to the same deductible, 23
copayment, coinsurance and other such conditions for coverage that 24
are required under the plan. 25
7. A health care plan subject to the provisions of this chapter 26
that is delivered, issued for delivery or renewed on or after 27
January 1, [2006,] 2026, has the legal effect of including the 28
coverage required by this section, and any provision of the plan that 29
conflicts with this section is void. 30
8. A health maintenance organization that delivers or issues for 31
delivery a health care plan specified in subsection 1 is immune from 32
liability for: 33
(a) Any injury to an enrollee caused by: 34
(1) Any medical treatment provided to the enrollee in 35
connection with his or her participation in a clinical trial or study 36
described in this section; or 37
(2) An act or omission by a provider of health care who 38
provides medical treatment or supervises the provision of medical 39
treatment to the enrollee in connection with his or her participation 40
in a clinical trial or study described in this section. 41
(b) Any adverse or unanticipated outcome arising out of an 42
enrollee’s participation in a clinical trial or study described in this 43
section. 44
9. As used in this section: 45
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(a) “Cooperative group” means a network of facilities that 1
collaborate on research projects and has established a peer review 2
program approved by the National Institutes of Health. The term 3
includes: 4
(1) The Clinical Trials Cooperative Group Program; and 5
(2) The Community Clinical Oncology Program. 6
(b) “Facility authorized to conduct Phase I clinical trials or 7
studies for the treatment of cancer” means a facility or an affiliate of 8
a facility that: 9
(1) Has in place a Phase I program which permits only 10
selective participation in the program and which uses clear-cut 11
criteria to determine eligibility for participation in the program; 12
(2) Operates a protocol review and monitoring system which 13
conforms to the standards set forth in the “Policies and Guidelines 14
Relating to the Cancer Center Support Grant” published by the 15
Cancer Centers Branch of the National Cancer Institute; 16
(3) Employs at least two researchers and at least one of those 17
researchers receives funding from a federal grant; 18
(4) Employs at least three clinical investigators who have 19
experience working in Phase I clinical trials or studies conducted at 20
a facility designated as a comprehensive cancer center by the 21
National Cancer Institute; 22
(5) Possesses specialized resources for use in Phase I clinical 23
trials or studies, including, without limitation, equipment that 24
facilitates research and analysis in proteomics, genomics and 25
pharmacokinetics; 26
(6) Is capable of gathering, maintaining and reporting 27
electronic data; and 28
(7) Is capable of responding to audits instituted by federal 29
and state agencies. 30
(c) “Provider of health care” means: 31
(1) A hospital; or 32
(2) A person licensed pursuant to chapter 630, 631 or 633 of 33
NRS [.] or a naturopathic physician who is licensed pursuant to 34
chapter 630A of NRS. 35
Sec. 127. NRS 695G.127 is hereby amended to read as 36
follows: 37
695G.127 1. A managed care organization shall not contract 38
with a provider of health care to provide health care to an insured 39
unless the managed care organization uses the form prescribed by 40
the Commissioner pursuant to NRS 629.095 to obtain any 41
information related to the credentials of the provider of health care. 42
2. A contract between a managed care organization and a 43
provider of health care may be modified: 44
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(a) At any time pursuant to a written agreement executed by 1
both parties. 2
(b) Except as otherwise provided in this paragraph, by the 3
managed care organization upon giving to the provider 45 days’ 4
written notice of the modification of the managed care 5
organization’s schedule of payments, including any changes to the 6
fee schedule applicable to the provider’s practice. If the provider 7
fails to object in writing to the modification within the 45-day 8
period, the modification becomes effective at the end of that period. 9
If the provider objects in writing to the modification within the 45-10
day period, the modification must not become effective unless 11
agreed to by both parties as described in paragraph (a). 12
3. If a managed care organization contracts with a provider of 13
health care to provide health care services pursuant to chapter 689A, 14
689B, 689C, 695A, 695B or 695C of NRS, the managed care 15
organization shall: 16
(a) If requested by the provider of health care at the time the 17
contract is made, submit to the provider of health care the schedule 18
of payments applicable to the provider of health care; or 19
(b) If requested by the provider of health care at any other time, 20
submit to the provider of health care the schedule of payments, 21
including any changes to the fee schedule applicable to the 22
provider’s practice, specified in paragraph (a) within 7 days after 23
receiving the request. 24
4. As used in this section, “provider of health care” means a 25
provider of health care who is licensed pursuant to chapter 630, 631, 26
632 or 633 of NRS [.] or a naturopathic physician who is licensed 27
pursuant to chapter 630A of NRS. 28
Sec. 128. NRS 695G.173 is hereby amended to read as 29
follows: 30
695G.173 1. A health care plan issued by a managed care 31
organization must provide coverage for medical treatment which a 32
person insured under the plan receives as part of a clinical trial or 33
study if: 34
(a) The medical treatment is provided in a Phase I, Phase II, 35
Phase III or Phase IV study or clinical trial for the treatment of 36
cancer or in a Phase II, Phase III or Phase IV study or clinical trial 37
for the treatment of chronic fatigue syndrome; 38
(b) The clinical trial or study is approved by: 39
(1) An agency of the National Institutes of Health as set forth 40
in 42 U.S.C. § 281(b); 41
(2) A cooperative group; 42
(3) The Food and Drug Administration as an application for 43
a new investigational drug; 44
(4) The United States Department of Veterans Affairs; or 45
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(5) The United States Department of Defense; 1
(c) In the case of: 2
(1) A Phase I clinical trial or study for the treatment of 3
cancer, the medical treatment is provided at a facility authorized to 4
conduct Phase I clinical trials or studies for the treatment of cancer; 5
or 6
(2) A Phase II, Phase III or Phase IV study or clinical trial 7
for the treatment of cancer or chronic fatigue syndrome, the medical 8
treatment is provided by a provider of health care and the facility 9
and personnel for the clinical trial or study have the experience and 10
training to provide the treatment in a capable manner; 11
(d) There is no medical treatment available which is considered 12
a more appropriate alternative medical treatment than the medical 13
treatment provided in the clinical trial or study; 14
(e) There is a reasonable expectation based on clinical data that 15
the medical treatment provided in the clinical trial or study will be at 16
least as effective as any other medical treatment; 17
(f) The clinical trial or study is conducted in this State; and 18
(g) The insured has signed, before participating in the clinical 19
trial or study, a statement of consent indicating that the insured has 20
been informed of, without limitation: 21
(1) The procedure to be undertaken; 22
(2) Alternative methods of treatment; and 23
(3) The risks associated with participation in the clinical trial 24
or study, including, without limitation, the general nature and extent 25
of such risks. 26
2. Except as otherwise provided in subsection 3, the coverage 27
for medical treatment required by this section is limited to: 28
(a) Coverage for any drug or device that is approved for sale by 29
the Food and Drug Administration without regard to whether the 30
approved drug or device has been approved for use in the medical 31
treatment of the insured. 32
(b) The cost of any reasonably necessary health care services 33
that are required as a result of the medical treatment provided in a 34
Phase II, Phase III or Phase IV clinical trial or study or as a result of 35
any complication arising out of the medical treatment provided in a 36
Phase II, Phase III or Phase IV clinical trial or study, to the extent 37
that such health care services would otherwise be covered under the 38
health care plan. 39
(c) The cost of any routine health care services that would 40
otherwise be covered under the health care plan for an insured in a 41
Phase I clinical trial or study. 42
(d) The initial consultation to determine whether the insured is 43
eligible to participate in the clinical trial or study. 44
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(e) Health care services required for the clinically appropriate 1
monitoring of the insured during a Phase II, Phase III or Phase IV 2
clinical trial or study. 3
(f) Health care services which are required for the clinically 4
appropriate monitoring of the insured during a Phase I clinical trial 5
or study and which are not directly related to the clinical trial or 6
study. 7
Except as otherwise provided in NRS 695G.164, the services 8
provided pursuant to paragraphs (b), (c), (e) and (f) must be covered 9
only if the services are provided by a provider with whom the 10
managed care organization has contracted for such services. If the 11
managed care organization has not contracted for the provision of 12
such services, the managed care organization shall pay the provider 13
the rate of reimbursement that is paid to other providers with whom 14
the managed care organization has contracted for similar services 15
and the provider shall accept that rate of reimbursement as payment 16
in full. 17
3. Particular medical treatment described in subsection 2 and 18
provided to a person insured under the plan is not required to be 19
covered pursuant to this section if that particular medical treatment 20
is provided by the sponsor of the clinical trial or study free of charge 21
to the person insured under the plan. 22
4. The coverage for medical treatment required by this section 23
does not include: 24
(a) Any portion of the clinical trial or study that is customarily 25
paid for by a government or a biotechnical, pharmaceutical or 26
medical industry. 27
(b) Coverage for a drug or device described in paragraph (a) of 28
subsection 2 which is paid for by the manufacturer, distributor or 29
provider of the drug or device. 30
(c) Health care services that are specifically excluded from 31
coverage under the insured’s health care plan, regardless of whether 32
such services are provided under the clinical trial or study. 33
(d) Health care services that are customarily provided by the 34
sponsors of the clinical trial or study free of charge to the 35
participants in the trial or study. 36
(e) Extraneous expenses related to participation in the clinical 37
trial or study, including, without limitation, travel, housing and 38
other expenses that a participant may incur. 39
(f) Any expenses incurred by a person who accompanies the 40
insured during the clinical trial or study. 41
(g) Any item or service that is provided solely to satisfy a need 42
or desire for data collection or analysis that is not directly related to 43
the clinical management of the insured. 44
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(h) Any costs for the management of research relating to the 1
clinical trial or study. 2
5. A managed care organization that delivers or issues for 3
delivery a health care plan specified in subsection 1 may require 4
copies of the approval or certification issued pursuant to paragraph 5
(b) of subsection 1, the statement of consent signed by the insured, 6
protocols for the clinical trial or study and any other materials 7
related to the scope of the clinical trial or study relevant to the 8
coverage of medical treatment pursuant to this section. 9
6. A managed care organization that delivers or issues for 10
delivery a health care plan specified in subsection 1 shall provide 11
the coverage required by this section subject to the same deductible, 12
copayment, coinsurance and other such conditions for coverage that 13
are required under the plan. 14
7. A health care plan subject to the provisions of this chapter 15
that is delivered, issued for delivery or renewed on or after 16
January 1, [2006,] 2026, has the legal effect of including the 17
coverage required by this section, and any provision of the plan that 18
conflicts with this section is void. 19
8. A managed care organization that delivers or issues for 20
delivery a health care plan specified in subsection 1 is immune from 21
liability for: 22
(a) Any injury to an insured caused by: 23
(1) Any medical treatment provided to the insured in 24
connection with his or her participation in a clinical trial or study 25
described in this section; or 26
(2) An act or omission by a provider of health care who 27
provides medical treatment or supervises the provision of medical 28
treatment to the insured in connection with his or her participation in 29
a clinical trial or study described in this section. 30
(b) Any adverse or unanticipated outcome arising out of an 31
insured’s participation in a clinical trial or study described in this 32
section. 33
9. As used in this section: 34
(a) “Cooperative group” means a network of facilities that 35
collaborate on research projects and has established a peer review 36
program approved by the National Institutes of Health. The term 37
includes: 38
(1) The Clinical Trials Cooperative Group Program; and 39
(2) The Community Clinical Oncology Program. 40
(b) “Facility authorized to conduct Phase I clinical trials or 41
studies for the treatment of cancer” means a facility or an affiliate of 42
a facility that: 43
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(1) Has in place a Phase I program which permits only 1
selective participation in the program and which uses clear-cut 2
criteria to determine eligibility for participation in the program; 3
(2) Operates a protocol review and monitoring system which 4
conforms to the standards set forth in the “Policies and Guidelines 5
Relating to the Cancer Center Support Grant” published by the 6
Cancer Centers Branch of the National Cancer Institute; 7
(3) Employs at least two researchers and at least one of those 8
researchers receives funding from a federal grant; 9
(4) Employs at least three clinical investigators who have 10
experience working in Phase I clinical trials or studies conducted at 11
a facility designated as a comprehensive cancer center by the 12
National Cancer Institute; 13
(5) Possesses specialized resources for use in Phase I clinical 14
trials or studies, including, without limitation, equipment that 15
facilitates research and analysis in proteomics, genomics and 16
pharmacokinetics; 17
(6) Is capable of gathering, maintaining and reporting 18
electronic data; and 19
(7) Is capable of responding to audits instituted by federal 20
and state agencies. 21
(c) “Provider of health care” means: 22
(1) A hospital; or 23
(2) A person licensed pursuant to chapter 630, 631 or 633 of 24
NRS [.] or a naturopathic physician who is licensed pursuant to 25
chapter 630A of NRS. 26
Sec. 129. 1. As soon as practicable on or after July 1, 2025, 27
the Governor shall appoint to the Nevada Board of Homeopathic 28
and Naturopathic Medical Examiners created by NRS 630A.100, as 29
amended by section 40 of this act: 30
(a) One new member described in subsection 2 of NRS 31
630A.110, as amended by section 41 of this act, to an initial term 32
that expires on June 30, 2027; and 33
(b) One new member described in subsection 2 of NRS 34
630A.110, as amended by section 41 of this act, to an initial term 35
that expires on June 30, 2029. 36
2. Notwithstanding the provisions of subsection 2 of NRS 37
630A.110, as amended by section 41 of this act, the initial members 38
described in that subsection who are appointed to the Nevada Board 39
of Homeopathic and Naturopathic Medical Examiners pursuant to 40
subsection 1 may be persons who are licensed to practice 41
naturopathic medicine in the District of Columbia or any state or 42
territory of the United States, have been engaged in the practice of 43
naturopathic medicine in that jurisdiction for a period of more than 44
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2 years preceding their respective appointments and are actually 1
engaged in the practice of naturopathic medicine. 2
Sec. 130. 1. This section becomes effective upon passage 3
and approval. 4
2. Sections 33, 40, 41, 96 and 129 of this act become effective 5
on July 1, 2025. 6
3. Sections 1 to 32, inclusive, 34 to 39, inclusive, 42 to 95, 7
inclusive, and 97 to 128, inclusive, of this act become effective: 8
(a) Upon passage and approval for the purpose of adopting any 9
regulations and performing any other preparatory administrative 10
tasks that are necessary to carry out the provisions of this act; and 11
(b) On January 1, 2026, for all other purposes. 12
H