Today is day 49 of the 120-day session for the Nevada Legislature and activity is starting to pick up as more bills are introduced, hearings are held, and floor votes are recorded. The Capitol Building remains closed to all but legislators, staff, and a small group of journalists due to COVID restrictions. There is still no official word on when the building may open to the general public or the lobbying corps. For now, we continue to track bill introductions, monitor hearings via the internet, and provide input to legislators via email.
The NOMA Board conducts biweekly legislative update calls to discuss the proposed bills that may have an impact on our profession and patients. To date, 1,139 bill draft requests (BDRs) were submitted by individual legislators, committees, and executive branch agencies. Of that number, we are currently tracking 78, 26 of which have actual bill text and are summarized below (bill numbers are hyperlinked so you can read them if you wish), along with NOMA's position:
Removes restriction in NRS 629.450 preventing a provider of health care who is licensed or certified in this State or another state or territory of the United States to provide voluntary health care service in this State in association with a sponsoring organization if he or she has not continuously practiced for the immediately preceding 3 years.
Requires Chief Health Officer to issue a standing order that permits pharmacists to dispense “self-administered hormonal contraceptives” to a patient upon request. (OPPOSE)
1) Establishes, in order of priority, the persons who are authorized to consent or withhold consent to health care on behalf of a patient who is unconscious or otherwise lacks the capacity to provide or withhold such consent.
2) Prohibits a medical facility from refusing to allow such a person inside the facility solely because circumstances exist under which the public is prohibited from entering the facility.
(SUPPORT)
Adds a requirement to the informed consent for an abortion that the provider give the pregnant woman a list of providers of health care, medical facilities and other persons and entities that perform ultrasonography free of charge, and if the woman undergoes ultrasonography before the abortion or the attending physician uses ultrasonography during the abortion, the woman must be orally informed that she may view or decline to view a sonogram of the fetus
1) Maintains requirement for parental notification for abortion in certain cases, but requires a 48 hour waiting period btw time of notification and performing abortion 2) Requires District Court to hear petitions within 3 judicial days and issue ruling within 1 day of hearing.
Authorizes health care professionals to issue an order for opioid antagonists to a public or private school; 2) Provides liability protection for prescribing and administration
(SUPPORT)
1) Prescribes regulations for business entity that employs chiropractors; 2) changes “Chiropractor” to “Chiropractic Physicians”; 3) Allows Chiropractor to recommend, dispense or administer any drug or device for which the prescription or order of a practitioner is not required by federal or state law.
(OPPOSE)
Provides for the issuance of special endorsements for a dentist, dental hygienist or dental therapist to administer immunizations
Requires DHHS to develop data request from physicians and licensing boards to make request available upon renewal; allows boards to refuse to renew for failure to complete; makes information confidential. Info to collect includes: (a)Whether the applicant is employed by a hospital or an entity owned by a health system or practices independently; (b) the name of the hospital or the entity and the health system if employed by one; (c)If the applicant is employed by an entity other than a hospital or an entity owned by a health system, the name of the legal entity which owns the practice and any assumed or fictitious name of that entity; (d)Whether the applicant practices as a solo practitioner or with at least one other physician; (e)If the applicant practices with at least one other physician, the number of other physicians with which the applicant practices and the specialty areas of those physicians; (f)The number of locations at which the physician practices; (g)If the applicant practices with at least one other physician, the number of locations at which the physicians in the group practice.
(OPPOSE)
Removes 1) an agency to provide nursing in the home; (2) a facility for hospice care; (3) a facility for intermediate care; (4) a facility for skilled nursing; (5) a hospital; or (6) an independent center for emergency medical care from exclusion against receiving immunity from civil liability under certain circumstances
(SUPPORT)
Includes in definition of telehealth the delivery of services through the use of a standard telephone and requires insurers to cover to the same extent, but not the same amount, for such services
1) Authorizes the Patient Protection Commission to request reports concerning certain issues relating to health care from a state or local governmental entity.
2) Requires the DHHS to establish an all-payer claims database of information relating to health insurance claims resulting from medical, dental or pharmacy benefits provided in this State, and further requires any public or private insurer that provides health benefits and is regulated under state law to submit data to the database.
Similar to SB5 but limited to behavioral health: Includes in definition of telehealth the delivery of services through the use of a standard telephone and requires coverage of behavioral health services provided by telehealth in the same amount as if those services were provided in person or by other means
1) Changes definition of “chemical restraint”
2) Defines “Emergency Admission”, Involuntary Court-Ordered Admission”, Mental Health Crisis Hold”.
3) Revises provisions for court-ordered involuntary assistant outpatient treatment
Requires an entity responsible for regulating providers of health care that determines as a result of an investigation that there are no reasonable grounds to believe that the provider of health care has committed a violation to refer to the investigation as a “review and evaluation.” Also provides that an investigation recorded as a review and evaluation is not an investigation for purposes related to employment, professional licensure or credentialing, education or liability or health insurance.
(SUPPORT)
Authorizes a physician to prescribe a controlled substance that is designed to end the life of a patient under certain circumstances; Prohibits anyone but patient from administering said substance
Excludes viruses, serums, toxins and analogous products for use in the treatment of domestic animals from regulation under Nevada law governing drugs and medicines.
NOTE: Existing federal law regulates viruses, serums, toxins and analogous products for use in the treatment of domestic animals. (21 U.S.C. § 154) and preempts any state law that regulates viruses, serums, toxins and analogous products for use in the treatment of domestic animals.
This bill changes the existing system for organ donor gifts, in which through the DMV a person must opt in to be a donor, to a system in which a person is a donor unless the person opts out of donation.
1) Issue license to practice after 2 yrs of GME (current law requires 3 years)
2) Multiple changes to PA-C: PA not required to be under supervision if providing care for life-threatening emergencies or in natural/man-made disasters; Allows physician to refuse and/or withdraw supervision; Board to determine number of PA’s a physician can supervise; Allows for remote supervision, except in first 30 days; Specifies required chart reviews; Allows for simultaneous licensing for PA between NBME and NBOME;
Allows for “inactive” status for PAs; Requires passing of the National PA Certifying exam for licensure
(OPPOSE #1; SUPPORT #2)
SAME AS AB 164: Requires Chief Health Officer to issue a standing order that permits pharmacists to dispense “self-administered hormonal contraceptives” to a patient upon request.
Prohibits provider of healthcare from performing pelvic exam on unconscious/anesthetized patients without informed consent, with exceptions
Requires healthcare provider who provides or supervises the provision of emergency medical services in a hospital or primary care to a patient who is at least 15 years of age to ask the patient if he or she wishes to be tested for sexually transmitted diseases. HCP liable for professional discipline if fails to ask
Basically guts all the prior CS prescribing changes under BOP and requires practitioner licensing boards to adopt regulations that establish requirements governing the prescribing, administering and dispensing of a CS for the treatment of pain. Also extends the waiver period from 1 to 2 years for e-prescribing
1) Expands collaborative drug therapy management to outside of medical facilities; 2) Removes current criteria and replaces with “A collaborative practice agreement must not grant a pharmacist the authority to engage in an activity that is outside the scope of the current practice of the practitioner.” 3) Removes requirement for pharmacist to obtain written informed consent from patient; 4) Requires certain content in the written guidelines entered into btw practitioner and pharmacist
Makes an appropriation to the Nevada Health Service Corps to obtain matching federal money for the purpose of encouraging certain medical and dental practitioners to practice in underserved areas
(SUPPORT)
Requires primary care providers to screen women for BRCA gene mutations and provide referrals for genetic counseling and testing; requires notice concerning genetic counseling and testing to be provided with the results of a mammogram;
Provides for penalties for failure to comply
(OPPOSE)
NOMA's position on a piece of legislation may change as the bill is amended or as we work with the sponsor to make changes.
If you have an opinion on any of these issues, please let us know your position by sending an email here.
While we expect to see legislation to amend the malpractice reforms put into place by the 2004 ballot initiative, nothing has yet been introduced.
NOMA is the voice of Osteopathic Medicine in Nevada and we cannot be successful without your participation and support. If you are not yet a NOMA member, please consider joining today!
