AB56 - Revises provisions relating to the licensing of certain providers of health care. (BDR 54-255)

- 83rd Session (2025) Assembly Bill No. 56–Committee on Commerce and Labor CHAPTER.......... AN ACT relating to providers of health care; revising requirements for continuing education and training for certain providers of health care; requiring the Board of Medical Examiners to require a physician assistant on inactive status to pay a biennial registration fee; revising the provisions relating to fees charged and collected by the Board; requiring the Board, if authorized by a licensee, to provide to an employer of the licensee or an entity credentialing the licensee certain documents and information; setting forth certain grounds for the State Board of Osteopathic Medicine to initiate disciplinary action against a licensee or deny licensure to an applicant; revising requirements for the issuance by the Board of a license to practice osteopathic medicine; providing for the biennial renewal of certain licenses issued by the Board; establishing and revising certain fees charged by the Board; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law requires certain providers of health care licensed by the Board of Medical Examiners and the State Board of Osteopathic Medicine to complete certain continuing education as a condition to the renewal of the license. (NRS 630.253, 633.471) Section 1 of this bill eliminates provisions requiring the Board of Medical Examiners to require the completion of a course of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction. Section 12 of this bill increases, from 35 to 40, the number of hours of continuing medical education certain providers of health care licensed by the State Board of Osteopathic Medicine are required to complete during each period of licensure. Existing law requires the Board of Medical Examiners to adopt regulations regarding the licensure of a physician assistant. (NRS 630.275) Existing law establishes a biennial registration fee for a physician assistant licensed by the Board. (NRS 630.268) Under existing law, the Board is required to exempt a physician assistant on inactive status from paying the biennial registration fee. (NRS 630.255) Section 2 of this bill eliminates that exception. Section 4 of this bill instead requires the Board to require a physician assistant on inactive status to pay a fee for biennial registration. Section 3 of this bill sets forth the maximum amount of that fee. Section 3 revises provisions setting forth the maximum amount of various fees charged by the Board. Section 3 increases the maximum amount of certain fees, removes certain fees and establishes the maximum amount of a fee the Board is required to charge for certain services provided by the Board. Existing law authorizes the Board to keep certain information confidential, including, among other information, any statement, evidence, credential or other proof submitted in support of or to verify the contents of an application for a – 2 – - 83rd Session (2025) license. (NRS 630.336) Section 6 of this bill requires the Board, if authorized by a licensee, to provide to an employer of the licensee or an entity credentialing the licensee copies of any documents or other information obtained by the Board during the application process for the issuance of the license of the licensee, including, without limitation, copies of documents and other information verifying the completion by the licensee of any educational program related to licensure and verifying certain other matters concerning the licensee. Existing law sets forth the requirements for the issuance by the State Board of Osteopathic Medicine of a license to practice osteopathic medicine, including, among other requirements, the requirement that an applicant must: (1) have graduated from a school of osteopathic medicine before 1995 and completed a hospital internship or certain postgraduate training; (2) have completed 3 years, or such other length of time as required by certain programs of postgraduate medical education as a resident in the United States or Canada; or (3) be a resident who is enrolled in a postgraduate training program in this State, have completed 24 months of the program and have committed, in writing, that he or she will complete the program. (NRS 633.311) Section 6.7 of this bill revises the requirements for a person who is a resident enrolled in a postgraduate training program to obtain a license to allow a license to be issued to a resident who is enrolled in a postgraduate training program in the United States or Canada that is approved by the Board or certain other organizations who has completed 24 months of the program and who has committed, in writing, that he or she will complete the program. Section 6.7 also provides that if, after issuing a license to practice osteopathic medicine, the Board obtains information that differs from the information provided by the applicant or otherwise received by the Board, the Board may take certain action against the applicant. Section 6.3 of this bill provides that obtaining, maintaining or renewing or attempting to obtain, maintain or renew a license to practice osteopathic medicine by bribery, fraud or misrepresentation or by any false, misleading, inaccurate or incomplete statement constitutes grounds for the Board to initiate disciplinary action against a licensee and to deny licensure to an applicant. Existing law, with certain exceptions, provides for the annual renewal of a license to practice osteopathic medicine issued by the State Board of Osteopathic Medicine and sets forth a renewal date for such a license as January 1 of each calendar year. (NRS 633.471) Section 12 instead provides, with certain exceptions, for the biennial renewal of such a license and establishes the renewal date for such a license as December 31 of each even-numbered year. Existing regulations provide for the annual renewal of a license as a physician assistant issued by the Board. (NAC 633.285) Sections 9 and 10 of this bill instead provide for the biennial renewal of such a license and establish the renewal date as December 31 of each odd-numbered year. Existing law provides for the biennial renewal of a license as an anesthesiologist assistant issued by the Board. (NRS 633.4254) Section 7 of this bill establishes a renewal date for such a license as December 31 of each odd-numbered year. Section 20 of this bill sets forth certain requirements for the renewal of certain licenses issued by the Board which are held by a licensee on December 31, 2025. Existing law sets forth procedures by which a person may be simultaneously licensed as a physician assistant or anesthesiologist assistant by the Board of Medical Examiners and the State Board of Osteopathic Medicine. (NRS 630.2677, 630.26835, 630.2684, 630.26845, 630.2735, 630.2755, 633.4256, 633.4258, 633.426, 633.4332, 633.438, 633.4718) Under existing law, a person who is licensed as a physician assistant or anesthesiologist assistant by the State Board of Osteopathic Medicine and who wishes to be simultaneously licensed by both the – 3 – - 83rd Session (2025) Board of Medical Examiners and the State Board of Osteopathic Medicine is required to: (1) apply to the Board of Medical Examiners for a license to practice as a physician assistant or anesthesiologist assistant, as applicable; (2) pay all applicable fees, including the fee payable to the Board of Medical Examiners for an application for and the issuance of a simultaneous license as a physician assistant or anesthesiologist assistant, as applicable, and the annual simultaneous registration fee for a physician assistant or biennial simultaneous registration fee for an anesthesiologist assistant, as applicable, payable to the State Board of Osteopathic Medicine; and (3) if the person is applying for simultaneous licensure while renewing his or her license, apply to renew his or her license and indicate in the application that he or she wishes to hold a simultaneous license. (NRS 633.426, 633.438, 633.4718) Sections 8, 11 and 15 of this bill instead require such a person to pay to the State Board of Osteopathic Medicine a biennial simultaneous license renewal fee, rather than an annual or biennial simultaneous license registration fee. Section 14 of this bill similarly eliminates a reference to the biennial registration of a license. Existing law requires the State Board of Osteopathic Medicine to: (1) maintain a list of each licensed osteopathic physician and physician assistant and certain training that each such licensee has received; and (2) update the list at least annually with information received from licensees who renewed their licenses during the preceding year. (NRS 633.4715) Section 13 of this bill requires the Board to instead update the list at least biennially with such information from licensees who renewed their licenses during the preceding biennium. Sections 16 and 17 of this bill revise certain other procedures and requirements relating to licensure to account for the change from an annual to a biennial period of licensure for certain osteopathic physicians and physician assistants. Existing law sets forth a list of maximum fees to be charged and collected by the Board. (NRS 633.501) Section 18 of this bill: (1) revises the descriptions of certain fees; (2) increases the amount of certain fees to account for the change from an annual to a biennial period of licensure for certain osteopathic physicians and physician assistants; and (3) establishes a biennial license renewal fee and a biennial simultaneous license renewal fee for an anesthesiologist assistant. EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. NRS 630.253 is hereby amended to read as follows: 630.253 1. The Board shall, as a prerequisite for the: (a) Renewal of a license as a physician assistant; (b) Renewal of a license as an anesthesiologist assistant; or (c) Biennial registration of the holder of a license to practice medicine,  require each holder to submit evidence of compliance with the requirements for continuing education as set forth in regulations adopted by the Board. 2. These requirements: – 4 – - 83rd Session (2025) (a) May provide for the completion of one or more courses of instruction relating to risk management in the performance of medical services. (b) [Must provide for the completion of a course of instruction, within 2 years after initial licensure, relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction. The course must provide at least 4 hours of instruction that includes instruction in the following subjects: (1) An overview of acts of terrorism and weapons of mass destruction; (2) Personal protective equipment required for acts of terrorism; (3) Common symptoms and methods of treatment associated with exposure to, or injuries caused by, chemical, biological, radioactive and nuclear agents; (4) Syndromic surveillance and reporting procedures for acts of terrorism that involve biological agents; and (5) An overview of the information available on, and the use of, the Health Alert Network. (c)] Must provide for the completion by a holder of a license to practice medicine of a course of instruction within 2 years after initial licensure that provides at least 2 hours of instruction on evidence-based suicide prevention and awareness as described in subsection [6.] 5. [(d)] (c) Must provide for the completion of at least 2 hours of training in the screening, brief intervention and referral to treatment approach to substance use disorder within 2 years after initial licensure. [(e)] (d) Must provide for the biennial completion by each psychiatrist and each physician assistant practicing under the supervision of a psychiatrist of one or more courses of instruction that provide at least 2 hours of instruction relating to cultural competency and diversity, equity and inclusion. Such instruction: (1) May include the training provided pursuant to NRS 449.103, where applicable. (2) Must be based upon a range of research from diverse sources. (3) Must address persons of different cultural backgrounds, including, without limitation: (I) Persons from various gender, racial and ethnic backgrounds; (II) Persons from various religious backgrounds; – 5 – - 83rd Session (2025) (III) Lesbian, gay, bisexual, transgender and questioning persons; (IV) Children and senior citizens; (V) Veterans; (VI) Persons with a mental illness; (VII) Persons with an intellectual disability, developmental disability or physical disability; and (VIII) Persons who are part of any other population that a psychiatrist or a physician assistant practicing under the supervision of a psychiatrist may need to better understand, as determined by the Board. [(f)] (e) Must allow the holder of a license to receive credit toward the total amount of continuing education required by the Board for the completion of a course of instruction relating to genetic counseling and genetic testing. [(g)] (f) Must provide for the completion by a physician or physician assistant who provides or supervises the provision of emergency medical services in a hospital or primary care of at least 2 hours of training in the stigma, discrimination and unrecognized bias toward persons who have acquired or are at a high risk of acquiring human immunodeficiency virus within 2 years after beginning to provide or supervise the provision of such services or care. 3. [The Board may determine whether to include in a program of continuing education courses of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction in addition to the course of instruction required by paragraph (b) of subsection 2. 4.] The Board shall encourage each holder of a license who treats or cares for persons who are more than 60 years of age to receive, as a portion of their continuing education, education in geriatrics and gerontology, including such topics as: (a) The skills and knowledge that the licensee needs to address aging issues; (b) Approaches to providing health care to older persons, including both didactic and clinical approaches; (c) The biological, behavioral, social and emotional aspects of the aging process; [Text truncated for display. Full text available on LegiScan.]