requires two-thirds majority vote (§ 11)                                                 

                                                                                                  

 

Assembly Bill No. 290–Committee on Commerce and Labor

 

(On Behalf of Nevada State Board of Osteopathic Medicine)

 

March 6, 2001

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Revises provisions relating to osteopathic medicine. (BDR 54‑570)

 

FISCAL NOTE:            Effect on Local Government: No.

                                    Effect on the State: No.

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to osteopathic medicine; revising the provisions governing the requirements for licensure as an osteopathic physician; revising the provisions governing the filing of a complaint against a practitioner of osteopathic medicine with the state board of osteopathic medicine; requiring a member of the board to review and investigate such a complaint; 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 and 3 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 filed with the board

1-6  pursuant to the provisions of NRS 633.541.

1-7    Sec. 4.  NRS 633.011 is hereby amended to read as follows:

1-8    633.011  As used in this chapter, unless the context otherwise requires,

1-9  the words and terms defined in NRS 633.021 to 633.131, inclusive, and

1-10  sections 2 and 3 of this act have the meanings ascribed to them in those

1-11  sections.

1-12    Sec. 5.  NRS 633.271 is hereby amended to read as follows:

1-13    633.271  The board may:

1-14    1.  Appoint an executive director who is entitled to such

1-15  compensation as determined by the board.

1-16    2.  Maintain offices in as many localities in the state as it finds

1-17  necessary to carry out the provisions of this chapter.

1-18    [2.] 3. Employ attorneys, investigators and other professional

1-19  consultants and clerical personnel necessary to the discharge of its duties.

2-1    Sec. 6.  NRS 633.311 is hereby amended to read as follows:

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

2-3  for a license to practice osteopathic medicine may be issued a license by

2-4  the board if [he:

2-5    1.  Is] :

2-6    1.  He is 21 years of age or older;

2-7    2.  [Is] He is a citizen of the United States or is lawfully entitled to

2-8  remain and work in the United States;

2-9    3.  [Is] He is a graduate of a school of osteopathic medicine;

2-10    4.  [Has completed:] He:

2-11    (a) Has graduated from a school of osteopathic medicine before 1995

2-12  and has completed:

2-13      (1) A hospital internship; or

2-14      (2) One year of postgraduate training that complies with the

2-15  standards of intern training established by the American Osteopathic

2-16  Association;

2-17    (b) [Three] Has completed 3 years of [graduate] postgraduate medical

2-18  education as a resident in the United States or Canada in a program

2-19  approved by the board, the Bureau of Professional Education of the

2-20  American Osteopathic Association or the Accreditation Council for

2-21  Graduate Medical Education; or

2-22    (c) [Postgraduate training in the United States or Canada approved by

2-23  the board, the Bureau of Professional Education of the American

2-24  Osteopathic Association or the Accreditation Council for Graduate Medical

2-25  Education;

2-26    5.  Applies] Is a resident who is enrolled in a postgraduate training

2-27  program in this state, has completed 24 months of the program and has

2-28  committed, in writing, that he will complete the program;

2-29    5.  He applies for the license as provided by law;

2-30    6.  [Passes:] He passes:

2-31    (a) All parts of the licensing examination [prescribed by] of the

2-32  National Board of Osteopathic Medical Examiners;

2-33    (b) All parts of the licensing examination of the Federation of State

2-34  Medical Boards of the United States, Inc.;

2-35    (c) All parts of the licensing examination of the board, a state,

2-36  territory or possession of the United States or the District of Columbia,

2-37  and he is certified by a specialty board of the American Osteopathic

2-38  Association or by the American Board of Medical Specialties; or

2-39    (d) A combination of the parts of the licensing examinations specified

2-40  in paragraphs (a), (b) and (c) of this subsection that is approved by the

2-41  board;

2-42    7.  [Submits] He submits the statement required pursuant to the

2-43  provisions of NRS 633.326; and

2-44    8.  [Pays] He pays the fees provided for in this chapter.

2-45    Sec. 7.  NRS 633.321 is hereby amended to read as follows:

2-46    633.321  1.  Every applicant for a license shall:

2-47    (a) File an application with the board in the manner prescribed by

2-48  regulations of the board;

3-1    (b) Submit verified proof satisfactory to the board that he meets the age,

3-2  citizenship and educational requirements prescribed by this chapter; and

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

3-4  specified in this chapter.

3-5    2.  An application filed with the board pursuant to subsection 1 must

3-6  include the social security number of the applicant.

3-7    3.  The board may hold hearings and conduct investigations into any

3-8  matter related to the application and, in addition to the proofs required by

3-9  subsection 1, may take such further evidence and require such other

3-10  documents or proof of qualifications as it deems proper.

3-11    4.  The board may reject an application if it appears that any credential

3-12  submitted is false.

3-13    Sec. 8.  NRS 633.341 is hereby amended to read as follows:

3-14    633.341  1.  If an applicant fails in a first examination, he may be

3-15  reexamined after not less than 6 months.

3-16    2.  If he fails in a second examination, he is not thereafter entitled to

3-17  another examination within less than 1 year after the date of the second

3-18  examination, and prior thereto he shall furnish proof to the board of further

3-19  postgraduate study following the second examination satisfactory to the

3-20  board.

3-21    3.  Each applicant who fails an examination and who is permitted to be

3-22  reexamined shall pay for each reexamination the reexamination fee

3-23  specified in this chapter.

3-24    4.  If an applicant does not appear for examination, for any reason

3-25  deemed sufficient by the board, the board may refund a portion of the

3-26  application and initial license fee not to exceed $100 upon the request of

3-27  the applicant. [There shall be no] An applicant is not entitled to a refund

3-28  of the application and initial license fee if [an applicant] he appears for

3-29  examination.

3-30    Sec. 9.  NRS 633.361 is hereby amended to read as follows:

3-31    633.361  1.  Except as otherwise provided in NRS 633.315, the board

3-32  may issue a license without examination to a person:

3-33    (a) Who has completed a hospital internship and is licensed in any

3-34  country, state, territory or province to practice osteopathic medicine, if the

3-35  licensing requirements of that country, state, territory or province at the

3-36  time the license was issued are deemed by the board to be practically

3-37  equivalent to the licensing requirements in force in this state at that time.

3-38    (b) Who is a graduate of a school of osteopathic medicine, has

3-39  completed a hospital internship and passed an examination for admission

3-40  into the medical corps of any of the Armed Forces of the United States or

3-41  the United States Public Health Service or who possesses a certificate from

3-42  the National Board of Examiners for Osteopathic Physicians and Surgeons.

3-43    2.  Any person applying for a license under the provisions of subsection

3-44  1 shall:

3-45    (a) Furnish to the board such proof of qualifications and pass an oral

3-46  examination as the board may require; and

3-47    (b) Pay in advance to the board the application and initial license fee

3-48  specified in this chapter.

 

4-1    Sec. 10.  NRS 633.401 is hereby amended to read as follows:

4-2    633.401  1.  Except as otherwise provided in NRS 633.315, the board

4-3  may issue a special license:

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

4-5  medicine in an adjoining state to come into Nevada to care for or assist in

4-6  the treatment of his [own] patients in association with an osteopathic

4-7  physician in this state who has primary care of the patients.

4-8    (b) To a resident [or fellow] while he is enrolled in a [graduate

4-9  education program or] postgraduate training program required pursuant to

4-10  the provisions of paragraph (c) of subsection 4 of NRS 633.311.

4-11    (c) For a specified period and for specified purposes to a person who is

4-12  licensed to practice osteopathic medicine in another jurisdiction.

4-13    2.  A special license issued under this section may be renewed by the

4-14  board upon application of the licensee.

4-15    3.  Every person who applies for or renews a special license under this

4-16  section shall pay respectively the special license fee or special license

4-17  renewal fee specified in this chapter.

4-18    Sec. 11.  NRS 633.501 is hereby amended to read as follows:

4-19    633.501  The board shall charge and collect [only the following fees:

4-20    1.  Initial] fees not to exceed the following amounts:

4-21    1.  Application and initial license fee...... [$200] $500

4-22    2.  Annual license renewal fee............... [100] 300

4-23    3.  Temporary license fee....................... [50] 100

4-24    4.  Special license fee............................. [50] 100

4-25    5.  Special license renewal fee................. [50] 100

4-26    6.  Reexamination fee.................................... 200

4-27    7.  Late payment fee............................... [35] 100

4-28    8.  For a certificate as an osteopathic physician’s assistant..................... [100] 200

4-29    9.  Renewal of a certificate as an osteopathic physician’s

4-30  assistant..................................... [50] 100

4-31    10.  For an application to employ an osteopathic

4-32  physician’s assistant.................. [100] 200

4-33    Sec. 12.  NRS 633.531 is hereby amended to read as follows:

4-34    633.531  The board or any of its members, any medical review panel of

4-35  a hospital or medical society which becomes aware that any one or

4-36  combination of the grounds for initiating disciplinary action may exist as to

4-37  a person practicing osteopathic medicine in this state shall, and any other

4-38  person who is so aware may, file a written complaint specifying the

4-39  relevant facts with the board . [or with the osteopathic medical society of

4-40  the county in which the person charged has his office if there is an

4-41  osteopathic medical society in the county.]

4-42    Sec. 13.  NRS 633.541 is hereby amended to read as follows:

4-43    633.541  1.  When a complaint is filed[:

4-44    (a) With the board, it shall be reviewed by the board.

4-45    (b) With a county osteopathic medical society, the society shall forward

4-46  a copy of the complaint to the board for review.

4-47    2.  If, from the complaint or from other official records, it appears that

4-48  the complaint is not frivolous and the complaint charges:

5-1    (a) Unprofessional conduct, a conviction or the suspension or

5-2  revocation of a license to practice osteopathic medicine, the board shall

5-3  proceed with appropriate disciplinary action.

5-4    (b) Gross or repeated malpractice or professional incompetence, the

5-5  board shall transmit the original complaint, along with further facts or

5-6  information derived from its own review, to the attorney general.] with the

5-7  board, the board shall designate a member of the board to review the

5-8  complaint.

5-9    2.  If the member of the board determines that the complaint is not

5-10  frivolous, he shall conduct an investigation of the complaint to determine

5-11  whether there is a reasonable basis for the complaint. In performing the

5-12  investigation, the member of the board may request the assistance of the

5-13  attorney general or contract with a private investigator designated by the

5-14  executive director of the board who is licensed pursuant to chapter 648 of

5-15  NRS or any other person designated by the executive director of the

5-16  board.

5-17    3.  If, after conducting the investigation pursuant to subsection 2, the

5-18  member of the board determines that there is a reasonable basis for the

5-19  complaint and that a violation of a provision of this chapter has

5-20  occurred, the member of the board may file a formal complaint with the

5-21  board specifying the grounds for disciplinary action.

5-22    Sec. 14.  NRS 633.561 is hereby amended to read as follows:

5-23    633.561  1.  If the board [determines that a complaint is not frivolous,]

5-24  or a member of the board designated to review a complaint pursuant to

5-25  NRS 633.541 has reason to believe that the conduct of a physician has

5-26  raised a reasonable question as to his competence to practice medicine

5-27  with reasonable skill and safety to patients, the board or the member

5-28  designated by the board may require the person charged in the complaint to

5-29  submit to a mental or physical examination by physicians designated by the

5-30  board.

5-31    2.  For the purposes of this section:

5-32    (a) Every physician who is licensed under this chapter who accepts the

5-33  privilege of practicing osteopathic medicine in this state shall be deemed to

5-34  have given his consent to submit to a mental or physical examination

5-35  [when] if directed to do so in writing by the board.

5-36    (b) The testimony or examination reports of the examining physicians

5-37  are not privileged communications.

5-38    3.  Except in extraordinary circumstances, as determined by the board,

5-39  the failure of a physician who is licensed under this chapter to submit to an

5-40  examination [when] if directed as provided in this section constitutes an

5-41  admission of the charges against him.

5-42    Sec. 15.  NRS 633.621 is hereby amended to read as follows:

5-43    633.621  If[:

5-44    1.  A complaint charging unprofessional conduct, a conviction or the

5-45  suspension or revocation of a license to practice osteopathic medicine is

5-46  not frivolous; or

5-47    2.  With respect to a complaint reported by the attorney general, the

5-48  board has determined to proceed with disciplinary action,] a formal

5-49  complaint is filed with the board pursuant to NRS 633.541, the secretary

6-1  of the board shall fix a time and place for a hearing and cause a notice of

6-2  the hearing and a formal complaint [prepared by the board] to be served on

6-3  the person charged at least 20 days before the date fixed for the hearing. If

6-4  the board receives a [report pursuant to] formal complaint concerning

6-5  subsection 5 of NRS 228.420, such a hearing must be held within 30 days

6-6  after receiving the [report.] formal complaint.

6-7    Sec. 16.  NRS 633.641 is hereby amended to read as follows:

6-8    633.641  In any disciplinary proceeding before the board:

6-9    1.  Proof of actual injury need not be established where the formal

6-10  complaint charges deceptive or unethical professional conduct or medical

6-11  practice harmful to the public.

6-12    2.  A certified copy of the record of a court or a licensing agency

6-13  showing a conviction or the suspension or revocation of a license to

6-14  practice osteopathic medicine is conclusive evidence of its occurrence.

6-15    Sec. 17.  NRS 633.651 is hereby amended to read as follows:

6-16    633.651  1.  The person charged in a formal complaint is entitled to a

6-17  hearing before the board, but the failure of the person charged to attend his

6-18  hearing or his failure to defend himself [shall not serve to] must not delay

6-19  or void the proceedings. The board may, for good cause shown, continue

6-20  any hearing from time to time.

6-21    2.  If the board finds the person guilty as charged in the formal

6-22  complaint, it may by order:

6-23    (a) Place the person on probation for a specified period or until further

6-24  order of the board.

6-25    (b) Administer to the person a public [or private] reprimand.

6-26    (c) Limit the practice of the person to, or by the exclusion of, one or

6-27  more specified branches of osteopathic medicine.

6-28    (d) Suspend the license of the person to practice osteopathic medicine

6-29  for a specified period or until further order of the board.

6-30    (e) Revoke the license of the person to practice osteopathic
medicine.

6-31  The order of the board may contain such other terms, provisions or

6-32  conditions as the board deems proper and which are not inconsistent with

6-33  law.

6-34    Sec. 18.  NRS 633.691 is hereby amended to read as follows:

6-35    633.691  The [state board of osteopathic medicine,] board, a medical

6-36  review panel of a hospital, [an osteopathic medical society,] or any person

6-37  who or other organization which initiates or assists in any lawful

6-38  investigation or proceeding concerning the discipline of an osteopathic

6-39  physician for gross malpractice, repeated malpractice, professional

6-40  incompetence or unprofessional conduct is immune from any civil action

6-41  for such initiation or assistance or any consequential damages, if the person

6-42  or organization acted without malicious intent.

6-43    Sec. 19.  NRS 633.701 is hereby amended to read as follows:

6-44    633.701  The filing and review of a complaint[, its dismissal without

6-45  further action or its transmittal to the attorney general,] and any subsequent

6-46  disposition by the board,the [attorney general] member designated by the

6-47  board to review a complaint pursuant to NRS 633.541 or any reviewing

6-48  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. 20.  NRS 633.551 is hereby repealed.

 

7-9  TEXT OF REPEALED SECTION

 

7-10    633.551  Investigation of complaint by attorney general; board’s

7-11   determination of further action.

7-12    1.  The attorney general shall conduct an investigation of each

7-13   complaint transmitted to him to determine whether it warrants proceedings

7-14   for modification, suspension or revocation of license. If he determines that

7-15   such further proceedings are warranted, he shall report the results of his

7-16   investigation together with his recommendation to the board in a manner

7-17   which does not violate the right of the person charged in the complaint to

7-18   due process in any later hearing before the board.

7-19    2.  The board shall promptly make a determination with respect to each

7-20   complaint reported to it by the attorney general as to what action shall be

7-21   pursued. The board shall:

7-22    (a) Dismiss the complaint; or

7-23    (b) Proceed with appropriate disciplinary action.

 

7-24  H