Senate Bill No. 199–Committee on Commerce and Labor

(On Behalf of Board of Osteopathic Medicine)

February 16, 1999

____________

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.

~

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; revising the fees that may be charged and collected by the board; 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 633.321 is hereby amended to read as follows:

3-11 633.321 1. Every applicant for a license shall:

3-12 (a) File an application with the board in the manner prescribed by

3-13 regulations of the board;

3-14 (b) Submit verified proof satisfactory to the board that he meets the age,

3-15 citizenship and educational requirements prescribed by this chapter; and

3-16 (c) Pay in advance to the board the application and initial license fee

3-17 specified in this chapter.

3-18 2. An application filed with the board pursuant to subsection 1 must

3-19 include the social security number of the applicant.

3-20 3. The board may hold hearings and conduct investigations into any

3-21 matter related to the application and, in addition to the proofs required by

3-22 subsection 1, may take such further evidence and require such other

3-23 documents or proof of qualifications as it deems proper.

3-24 4. The board may reject an application if it appears that any credential

3-25 submitted is false.

3-26 Sec. 9. NRS 633.341 is hereby amended to read as follows:

3-27 633.341 1. If an applicant fails in a first examination, he may be re-

3-28 examined after not less than 6 months.

3-29 2. If he fails in a second examination, he is not thereafter entitled to

3-30 another examination within less than 1 year after the date of the second

3-31 examination, and prior thereto he shall furnish proof to the board of further

3-32 postgraduate study following the second examination satisfactory to the

3-33 board.

3-34 3. Each applicant who fails an examination and who is permitted to be

3-35 re-examined shall pay for each re-examination the re-examination fee

3-36 specified in this chapter.

3-37 4. If an applicant does not appear for examination, for any reason

3-38 deemed sufficient by the board, the board may refund a portion of the

3-39 application and initial license fee not to exceed $100 upon the request of

3-40 the applicant. [There shall be no] An applicant is not entitled to a refund of

3-41 the application and initial license fee if [an applicant] he appears for

3-42 examination.

4-1 Sec. 10. NRS 633.361 is hereby amended to read as follows:

4-2 633.361 1. Except as otherwise provided in NRS 633.315, the board

4-3 may issue a license without examination to a person:

4-4 (a) Who has completed a hospital internship and is licensed in any

4-5 country, state, territory or province to practice osteopathic medicine, if the

4-6 licensing requirements of that country, state, territory or province at the

4-7 time the license was issued are deemed by the board to be practically

4-8 equivalent to the licensing requirements in force in this state at that time.

4-9 (b) Who is a graduate of a school of osteopathic medicine, has

4-10 completed a hospital internship and passed an examination for admission

4-11 into the medical corps of any of the Armed Forces of the United States or

4-12 the United States Public Health Service or who possesses a certificate from

4-13 the National Board of Examiners for Osteopathic Physicians and Surgeons.

4-14 2. Any person applying for a license under the provisions of subsection

4-15 1 shall:

4-16 (a) Furnish to the board such proof of qualifications and pass an oral

4-17 examination as the board may require; and

4-18 (b) Pay in advance to the board the application and initial license fee

4-19 specified in this chapter.

4-20 Sec. 11. NRS 633.401 is hereby amended to read as follows:

4-21 633.401 1. Except as otherwise provided in NRS 633.315, the board

4-22 may issue a special license:

4-23 (a) To authorize a person who is licensed to practice osteopathic

4-24 medicine in an adjoining state to come into [Nevada] this state to care for

4-25 or assist in the treatment of his own patients in association with an

4-26 osteopathic physician in this state who has primary care of the patients.

4-27 (b) To a resident [or fellow] while he is enrolled in a [graduate

4-28 education program or] postgraduate training program required pursuant to

4-29 the provisions of paragraph (d) of subsection 4 of NRS 633.311.

4-30 (c) For a specified period and for specified purposes to a person who is

4-31 licensed to practice osteopathic medicine in another jurisdiction.

4-32 2. A special license issued under this section may be renewed by the

4-33 board upon application of the licensee.

4-34 3. Every person who applies for or renews a special license under this

4-35 section shall pay respectively the special license fee or special license

4-36 renewal fee specified in this chapter.

4-37 Sec. 12. NRS 633.501 is hereby amended to read as follows:

4-38 633.501 The board shall charge and collect [only the following fees:]

4-39 fees not to exceed the following amounts:

4-40 1. [Initial] Application and initial license fee [$200] $500

4-41 2. Annual license renewal fee [100] 300

4-42 3. Temporary license fee [50] 100

5-1 4. Special license fee [50] 100

5-2 5. Special license renewal fee [50] 100

5-3 6. Re-examination fee 200

5-4 7. Late payment fee [35] 100

5-5 8. For a certificate as an osteopathic physician’s

5-6 assistant [100] 200

5-7 9. Renewal of a certificate as an osteopathic physician’s

5-8 assistant [50] 100

5-9 10. For an application to employ an osteopathic

5-10 physician’s assistant [100] 200

5-11 Sec. 13. NRS 633.531 is hereby amended to read as follows:

5-12 633.531 The board or any of its members, any medical review panel of

5-13 a hospital or medical society which becomes aware that any one or

5-14 combination of the grounds for initiating disciplinary action may exist as to

5-15 a person practicing osteopathic medicine in this state shall, and any other

5-16 person who is so aware may, file a written complaint specifying the

5-17 relevant facts with the board . [or with the osteopathic medical society of

5-18 the county in which the person charged has his office if there is an

5-19 osteopathic medical society in the county.]

5-20 Sec. 14. NRS 633.541 is hereby amended to read as follows:

5-21 633.541 1. [When] If a complaint is filed [:

5-22 (a) With] with the board, it [shall] must be reviewed by the executive

5-23 director of the board or a member of the board [.

5-24 (b) With a county osteopathic medical society, the society shall forward

5-25 a copy of the complaint to the board for review.] designated by the

5-26 executive director.

5-27 2. If, from the complaint or from other official records, [it appears] the

5-28 executive director or member of the board determines that the complaint

5-29 is not frivolous and the complaint charges:

5-30 (a) Unprofessional conduct, a conviction or the suspension or revocation

5-31 of a license to practice osteopathic medicine, an investigation of the

5-32 complaint must be conducted by:

5-33 (1) A member of the board [shall proceed with appropriate

5-34 disciplinary action.] designated by the executive director;

5-35 (2) A private investigator who is licensed pursuant to chapter 648 of

5-36 NRS and designated by the executive director; or

5-37 (3) The attorney general, upon the request of the board.

5-38 (b) Gross or repeated malpractice or professional incompetence, an

5-39 investigation of the complaint must be conducted by a committee

5-40 appointed by the board . [shall transmit the original complaint, along with

5-41 further facts or information derived from its own review, to the attorney

5-42 general.] The committee must include at least one member of the board.

6-1 3. If the investigator, attorney general or the committee determines

6-2 that there is a reasonable basis for the complaint, the investigator,

6-3 attorney general or committee shall file a report of the results of its

6-4 investigation with the board. The report must include a copy of the

6-5 complaint.

6-6 Sec. 15. NRS 633.551 is hereby amended to read as follows:

6-7 633.551 1. The [attorney general shall conduct an investigation of

6-8 each complaint transmitted to him to determine whether it warrants

6-9 proceedings for modification, suspension or revocation of license. If he

6-10 determines that such further proceedings are warranted, he shall report the

6-11 results of his investigation together with his recommendation to the board

6-12 in a manner which does not violate the right of the person charged in the

6-13 complaint to due process in any later hearing before the board.

6-14 2. The] board shall promptly [make a determination] determine the

6-15 action it will take with respect to each [complaint reported to it by the

6-16 attorney general as to what action shall be pursued.] report. The board

6-17 shall:

6-18 (a) Dismiss the complaint; or

6-19 (b) Proceed with appropriate disciplinary action.

6-20 2. If the board proceeds with disciplinary action, it shall prepare a

6-21 formal complaint specifying the grounds for proceeding with disciplinary

6-22 action.

6-23 Sec. 16. NRS 633.561 is hereby amended to read as follows:

6-24 633.561 1. [If the board determines that a complaint is not frivolous,

6-25 the] The board may require the person charged in [the] a formal complaint

6-26 to submit to a mental or physical examination by physicians designated by

6-27 the board.

6-28 2. For the purposes of this section:

6-29 (a) Every physician who is licensed under this chapter who accepts the

6-30 privilege of practicing osteopathic medicine in this state shall be deemed to

6-31 have given his consent to submit to a mental or physical examination

6-32 [when] if directed to do so in writing by the board.

6-33 (b) The testimony or examination reports of the examining physicians

6-34 are not privileged communications.

6-35 3. Except in extraordinary circumstances, as determined by the board,

6-36 the failure of a physician who is licensed under this chapter to submit to an

6-37 examination [when] if directed as provided in this section constitutes an

6-38 admission of the charges against him.

6-39 Sec. 17. NRS 633.621 is hereby amended to read as follows:

6-40 633.621 If [:

6-41 1. A complaint charging unprofessional conduct, a conviction or the

6-42 suspension or revocation of a license to practice osteopathic medicine is not

6-43 frivolous; or

7-1 2. With respect to a complaint reported by the attorney general,] the

7-2 board [has determined to proceed] proceeds with disciplinary action [,]

7-3 pursuant to the provisions of NRS 633.551, the secretary of the board

7-4 shall fix a time and place for a hearing and cause a notice of the hearing

7-5 and [a] the formal complaint [prepared by the board] to be served on the

7-6 person charged at least 20 days before the date fixed for the hearing. If the

7-7 board receives a report from the attorney general pursuant to the

7-8 provisions of subsection 5 of NRS 228.420, [such a] the hearing must be

7-9 held within 30 days after receiving the report.

7-10 Sec. 18. NRS 633.641 is hereby amended to read as follows:

7-11 633.641 In any disciplinary proceeding before the board:

7-12 1. Proof of actual injury need not be established where the formal

7-13 complaint charges deceptive or unethical professional conduct or medical

7-14 practice harmful to the public.

7-15 2. A certified copy of the record of a court or a licensing agency

7-16 showing a conviction or the suspension or revocation of a license to

7-17 practice osteopathic medicine is conclusive evidence of its occurrence.

7-18 Sec. 19. NRS 633.651 is hereby amended to read as follows:

7-19 633.651 1. The person charged in a formal complaint is entitled to a

7-20 hearing before the board, but the failure of the person charged to attend his

7-21 hearing or his failure to defend himself [shall not serve to] must not delay

7-22 or void the proceedings. The board may, for good cause shown, continue

7-23 any hearing from time to time.

7-24 2. If the board finds the person guilty as charged in the formal

7-25 complaint, it may , by order:

7-26 (a) Place the person on probation for a specified period , or until further

7-27 order of the board.

7-28 (b) Administer to the person a public or private reprimand.

7-29 (c) Limit the practice of the person to, or by the exclusion of, one or

7-30 more specified branches of osteopathic medicine.

7-31 (d) Suspend the license of the person to practice osteopathic medicine

7-32 for a specified period , or until further order of the board.

7-33 (e) Revoke the license of the person to practice osteopathic medicine.

7-34 The order of the board may contain such other terms, provisions or

7-35 conditions as the board deems proper and which are not inconsistent with

7-36 law.

7-37 Sec. 20. NRS 633.691 is hereby amended to read as follows:

7-38 633.691 The [state board of osteopathic medicine,] board, a medical

7-39 review panel of a hospital [, an osteopathic medical society,] or any person

7-40 who or other organization which initiates or assists in any lawful

7-41 investigation or proceeding concerning the discipline of an osteopathic

7-42 physician for gross malpractice, repeated malpractice, professional

7-43 incompetence or unprofessional conduct is immune from any civil action

8-1 for such initiation or assistance or any consequential damages, if the person

8-2 or organization acted without malicious intent.

8-3 Sec. 21. NRS 633.701 is hereby amended to read as follows:

8-4 633.701 The filing , [and] review and investigation of a complaint, its

8-5 dismissal without further action [or its transmittal to the attorney general,]

8-6 and any subsequent disposition by the board [, the attorney general] or any

8-7 reviewing court do not preclude:

8-8 1. Any measure by a hospital or other institution [or osteopathic

8-9 medical society] to limit or terminate the privileges of an osteopathic

8-10 physician according to its rules or the custom of the profession. No civil

8-11 liability attaches to any such action taken without malice even if the

8-12 ultimate disposition of the complaint is in favor of the physician.

8-13 2. Any appropriate criminal prosecution by the attorney general or a

8-14 district attorney based upon the same or other facts.

8-15 Sec. 22. This act becomes effective upon passage and approval.

~