Senate Bill No. 199–Committee on Commerce and Labor

(On Behalf of Board of Osteopathic Medicine)

February 16, 1999

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Referred to Committee on Commerce and Labor

 

SUMMARY—Revises provisions relating to osteopathic medicine. (BDR 54-402)

FISCAL NOTE: Effect on Local Government: No.

Effect on the State or on Industrial Insurance: No.

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

 

AN ACT relating to osteopathic medicine; revising the provisions governing the requirements for licensure as an osteopathic physician; requiring that a complaint against a practitioner of osteopathic medicine be filed with the state board of osteopathic medicine; requiring certain persons to review and investigate such a complaint; requiring those persons to file a report of the results of their investigation; requiring the state board of osteopathic medicine to establish the amount of fees by regulation; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

1-1 Section 1. Chapter 633 of NRS is hereby amended by adding thereto

1-2 the provisions set forth as sections 2, 3 and 4 of this act.

1-3 Sec. 2. "Complaint" means a written complaint filed with the board

1-4 pursuant to the provisions of NRS 633.531.

1-5 Sec. 3. "Formal complaint" means a complaint prepared by the

1-6 board pursuant to the provisions of NRS 633.551.

1-7 Sec. 4. "Report" means a report filed with the board pursuant to the

1-8 provisions of NRS 633.541.

1-9 Sec. 5. NRS 633.011 is hereby amended to read as follows:

1-10 633.011 As used in this chapter, unless the context otherwise requires,

1-11 the words and terms defined in NRS 633.021 to 633.131, inclusive, and

1-12 sections 2, 3 and 4 of this act have the meanings ascribed to them in those

1-13 sections.

2-1 Sec. 6. NRS 633.271 is hereby amended to read as follows:

2-2 633.271 The board may:

2-3 1. Appoint an executive director who is entitled to such compensation

2-4 as determined by the board.

2-5 2. Maintain offices in as many localities in the state as it finds

2-6 necessary to carry out the provisions of this chapter.

2-7 [2.] 3. Employ attorneys, investigators and other professional

2-8 consultants and clerical personnel necessary to the discharge of its duties.

2-9 Sec. 7. NRS 633.311 is hereby amended to read as follows:

2-10 633.311 Except as otherwise provided in NRS 633.315, an applicant

2-11 for a license to practice osteopathic medicine may be issued a license by

2-12 the board if [he:

2-13 1. Is] :

2-14 1. He is 21 years of age or older;

2-15 2. [Is] He is a citizen of the United States or is lawfully entitled to

2-16 remain and work in the United States;

2-17 3. [Is] He is a graduate of a school of osteopathic medicine;

2-18 4. [Has completed:] He:

2-19 (a) Graduated from a school of osteopathic medicine before 1995, and

2-20 has completed:

2-21 (1) A hospital internship; or

2-22 (2) One year of postgraduate training that complies with the

2-23 standards of intern training established by the American Osteopathic

2-24 Association;

2-25 (b) [Three] Has completed 3 years of [graduate] postgraduate medical

2-26 education as a resident in the United States or Canada in a program

2-27 approved by the board, the Bureau of Professional Education of the

2-28 American Osteopathic Association or the Accreditation Council for

2-29 Graduate Medical Education; or

2-30 (c) [Postgraduate training in the United States or Canada approved by

2-31 the board, the Bureau of Professional Education of the American

2-32 Osteopathic Association or the Accreditation Council for Graduate Medical

2-33 Education;

2-34 5. Applies] Is a resident presently enrolled in a postgraduate training

2-35 program in this state, has completed 24 months of the training program

2-36 and has committed, in writing, to completing the training program;

2-37 5. He applies for the license as provided by law;

2-38 6. [Passes] He passes:

2-39 (a) All parts of the licensing examination [prescribed] of the National

2-40 Board of Osteopathic Medical Examiners;

2-41 (b) All parts of the licensing examination of the Federation of

2-42 Medical Examiners;

3-1 (c) All parts of the licensing examination of the board, a state,

3-2 territory or possession of the United States, or the District of Columbia,

3-3 and he is certified by a specialty board of the American Osteopathic

3-4 Association or by the American Board of Medical Specialties; or

3-5 (d) A combination of the parts of the licensing examinations described

3-6 in paragraphs (a), (b) and (c) that is approved by the board;

3-7 7. [Submits] He submits the statement required pursuant to the

3-8 provisions of NRS 633.326; and

3-9 8. [Pays] He pays the fees provided for in this chapter.

3-10 Sec. 8. NRS 633.401 is hereby amended to read as follows:

3-11 633.401 1. Except as otherwise provided in NRS 633.315, the board

3-12 may issue a special license:

3-13 (a) To authorize a person who is licensed to practice osteopathic

3-14 medicine in an adjoining state to come into [Nevada] this state to care for

3-15 or assist in the treatment of his own patients in association with an

3-16 osteopathic physician in this state who has primary care of the patients.

3-17 (b) To a resident [or fellow] while he is enrolled in a [graduate

3-18 education program or] postgraduate training program required pursuant to

3-19 the provisions of paragraph (d) of subsection 4 of NRS 633.311.

3-20 (c) For a specified period and for specified purposes to a person who is

3-21 licensed to practice osteopathic medicine in another jurisdiction.

3-22 2. A special license issued under this section may be renewed by the

3-23 board upon application of the licensee.

3-24 3. Every person who applies for or renews a special license under this

3-25 section shall pay respectively the special license fee or special license

3-26 renewal fee specified in this chapter.

3-27 Sec. 9. NRS 633.501 is hereby amended to read as follows:

3-28 633.501 The board shall charge and collect [only the following fees:

3-29 1. Initial license fee $200

3-30 2. Annual license renewal fee 100

3-31 3. Temporary license fee 50

3-32 4. Special license fee 50

3-33 5. Special license renewal fee 50

3-34 6. Re-examination fee 200

3-35 7. Late payment fee 35

3-36 8. For a certificate as an osteopathic physician’s assistant 100

3-37 9. Renewal of a certificate as an osteopathic physician’s

3-38 assistant 50

3-39 10. For an application to employ an osteopathic

3-40 physician’s assistant 100]

3-41 such fees as it establishes by regulation.

4-1 Sec. 10. NRS 633.531 is hereby amended to read as follows:

4-2 633.531 The board or any of its members, any medical review panel of

4-3 a hospital or medical society which becomes aware that any one or

4-4 combination of the grounds for initiating disciplinary action may exist as to

4-5 a person practicing osteopathic medicine in this state shall, and any other

4-6 person who is so aware may, file a written complaint specifying the

4-7 relevant facts with the board . [or with the osteopathic medical society of

4-8 the county in which the person charged has his office if there is an

4-9 osteopathic medical society in the county.]

4-10 Sec. 11. NRS 633.541 is hereby amended to read as follows:

4-11 633.541 1. [When] If a complaint is filed [:

4-12 (a) With] with the board, it [shall] must be reviewed by the executive

4-13 director of the board or a member of the board [.

4-14 (b) With a county osteopathic medical society, the society shall forward

4-15 a copy of the complaint to the board for review.] designated by the

4-16 executive director.

4-17 2. If, from the complaint or from other official records, [it appears] the

4-18 executive director or member of the board determines that the complaint

4-19 is not frivolous and the complaint charges:

4-20 (a) Unprofessional conduct, a conviction or the suspension or revocation

4-21 of a license to practice osteopathic medicine, an investigation of the

4-22 complaint must be conducted by:

4-23 (1) A member of the board [shall proceed with appropriate

4-24 disciplinary action.] designated by the executive director;

4-25 (2) A private investigator who is licensed pursuant to chapter 648 of

4-26 NRS and designated by the executive director; or

4-27 (3) The attorney general, upon the request of the board.

4-28 (b) Gross or repeated malpractice or professional incompetence, an

4-29 investigation of the complaint must be conducted by a committee

4-30 appointed by the board . [shall transmit the original complaint, along with

4-31 further facts or information derived from its own review, to the attorney

4-32 general.] The committee must include at least one member of the board.

4-33 3. If the investigator, attorney general or the committee determines

4-34 that there is a reasonable basis for the complaint, the investigator,

4-35 attorney general or committee shall file a report of the results of its

4-36 investigation with the board. The report must include a copy of the

4-37 complaint.

4-38 Sec. 12. NRS 633.551 is hereby amended to read as follows:

4-39 633.551 1. The [attorney general shall conduct an investigation of

4-40 each complaint transmitted to him to determine whether it warrants

4-41 proceedings for modification, suspension or revocation of license. If he

4-42 determines that such further proceedings are warranted, he shall report the

4-43 results of his investigation together with his recommendation to the board

5-1 in a manner which does not violate the right of the person charged in the

5-2 complaint to due process in any later hearing before the board.

5-3 2. The] board shall promptly [make a determination] determine the

5-4 action it will take with respect to each [complaint reported to it by the

5-5 attorney general as to what action shall be pursued.] report. The board

5-6 shall:

5-7 (a) Dismiss the complaint; or

5-8 (b) Proceed with appropriate disciplinary action.

5-9 2. If the board proceeds with disciplinary action, it shall prepare a

5-10 formal complaint specifying the grounds for proceeding with disciplinary

5-11 action.

5-12 Sec. 13. NRS 633.561 is hereby amended to read as follows:

5-13 633.561 1. [If the board determines that a complaint is not frivolous,

5-14 the] The board may require the person charged in [the] a formal complaint

5-15 to submit to a mental or physical examination by physicians designated by

5-16 the board.

5-17 2. For the purposes of this section:

5-18 (a) Every physician who is licensed under this chapter who accepts the

5-19 privilege of practicing osteopathic medicine in this state shall be deemed to

5-20 have given his consent to submit to a mental or physical examination

5-21 [when] if directed to do so in writing by the board.

5-22 (b) The testimony or examination reports of the examining physicians

5-23 are not privileged communications.

5-24 3. Except in extraordinary circumstances, as determined by the board,

5-25 the failure of a physician who is licensed under this chapter to submit to an

5-26 examination [when] if directed as provided in this section constitutes an

5-27 admission of the charges against him.

5-28 Sec. 14. NRS 633.621 is hereby amended to read as follows:

5-29 633.621 If [:

5-30 1. A complaint charging unprofessional conduct, a conviction or the

5-31 suspension or revocation of a license to practice osteopathic medicine is not

5-32 frivolous; or

5-33 2. With respect to a complaint reported by the attorney general,] the

5-34 board [has determined to proceed] proceeds with disciplinary action [,]

5-35 pursuant to the provisions of NRS 633.551, the secretary of the board

5-36 shall fix a time and place for a hearing and cause a notice of the hearing

5-37 and [a] the formal complaint [prepared by the board] to be served on the

5-38 person charged at least 20 days before the date fixed for the hearing. If the

5-39 board receives a report from the attorney general pursuant to the

5-40 provisions of subsection 5 of NRS 228.420, [such a] the hearing must be

5-41 held within 30 days after receiving the report.

6-1 Sec. 15. NRS 633.641 is hereby amended to read as follows:

6-2 633.641 In any disciplinary proceeding before the board:

6-3 1. Proof of actual injury need not be established where the formal

6-4 complaint charges deceptive or unethical professional conduct or medical

6-5 practice harmful to the public.

6-6 2. A certified copy of the record of a court or a licensing agency

6-7 showing a conviction or the suspension or revocation of a license to

6-8 practice osteopathic medicine is conclusive evidence of its occurrence.

6-9 Sec. 16. NRS 633.651 is hereby amended to read as follows:

6-10 633.651 1. The person charged in a formal complaint is entitled to a

6-11 hearing before the board, but the failure of the person charged to attend his

6-12 hearing or his failure to defend himself [shall not serve to] must not delay

6-13 or void the proceedings. The board may, for good cause shown, continue

6-14 any hearing from time to time.

6-15 2. If the board finds the person guilty as charged in the formal

6-16 complaint, it may , by order:

6-17 (a) Place the person on probation for a specified period , or until further

6-18 order of the board.

6-19 (b) Administer to the person a public or private reprimand.

6-20 (c) Limit the practice of the person to, or by the exclusion of, one or

6-21 more specified branches of osteopathic medicine.

6-22 (d) Suspend the license of the person to practice osteopathic medicine

6-23 for a specified period , or until further order of the board.

6-24 (e) Revoke the license of the person to practice osteopathic medicine.

6-25 The order of the board may contain such other terms, provisions or

6-26 conditions as the board deems proper and which are not inconsistent with

6-27 law.

6-28 Sec. 17. NRS 633.691 is hereby amended to read as follows:

6-29 633.691 The [state board of osteopathic medicine,] board, a medical

6-30 review panel of a hospital [, an osteopathic medical society,] or any person

6-31 who or other organization which initiates or assists in any lawful

6-32 investigation or proceeding concerning the discipline of an osteopathic

6-33 physician for gross malpractice, repeated malpractice, professional

6-34 incompetence or unprofessional conduct is immune from any civil action

6-35 for such initiation or assistance or any consequential damages, if the person

6-36 or organization acted without malicious intent.

6-37 Sec. 18. NRS 633.701 is hereby amended to read as follows:

6-38 633.701 The filing , [and] review and investigation of a complaint, its

6-39 dismissal without further action [or its transmittal to the attorney general,]

6-40 and any subsequent disposition by the board [, the attorney general] or any

6-41 reviewing court do not preclude:

7-1 1. Any measure by a hospital or other institution [or osteopathic

7-2 medical society] to limit or terminate the privileges of an osteopathic

7-3 physician according to its rules or the custom of the profession. No civil

7-4 liability attaches to any such action taken without malice even if the

7-5 ultimate disposition of the complaint is in favor of the physician.

7-6 2. Any appropriate criminal prosecution by the attorney general or a

7-7 district attorney based upon the same or other facts.

7-8 Sec. 19. This act becomes effective upon passage and approval.

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