SB34 - Revises provisions relating to certain providers of health care. (BDR 54-449)

REQUIRES TWO-THIRDS MAJORITY VOTE (§§ 1, 10, 21, 23, 26) S.B. 34 - *SB34* SENATE BILL NO. 34–COMMITTEE ON COMMERCE AND LABOR (ON BEHALF OF THE PATIENT PROTECTION COMMISSION) PREFILED NOVEMBER 15, 2024 ____________ Referred to Committee on Commerce and Labor SUMMARY—Revises provisions relating to certain providers of health care. (BDR 54-449) FISCAL NOTE: Effect on Local Government: No. Effect on the State: Yes. ~ EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. AN ACT relating to health care; entering into interstate compacts that authorize the multistate practice of certain providers of health care under certain conditions; providing professionals practicing in this State under those compacts with the same legal status as persons who are licensed to practice the same professions in this State; authorizing the sharing of certain information with data systems created by those compacts; revising certain terminology; providing for a study of certain impacts of entering into certain interstate compacts; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law provides for the licensure and regulation of physician assistants in 1 this State by the Board of Medical Examiners and the State Board of Osteopathic 2 Medicine. (NRS 630.271-630.2755, 633.432-633.469) Section 1 of this bill enacts 3 the PA Licensure Compact, which allows a person who is licensed as a physician 4 assistant in a state that is a member of the Compact to practice as a physician 5 assistant in other states that are members of the Compact. In order to practice as a 6 physician assistant under the Compact, the Compact requires a physician assistant 7 to: (1) have graduated from certain programs for the education of physician 8 assistants; (2) hold current certification issued by the National Commission on 9 Certification of Physician Assistants; (3) have no felony or misdemeanor 10 convictions; (4) have never had a license, permit or registration relating to 11 controlled substances suspended or revoked; (5) have a unique identifier, as 12 prescribed by the PA Licensure Compact Commission, a joint public body 13 – 2 – - *SB34* established by the Compact; (6) hold an unrestricted license in his or her home 14 state; (7) currently have no limitations or restrictions on his or her license and have 15 had no adverse actions taken against any license or authority to practice under the 16 Compact within the previous 2 years, with certain exceptions; (8) notify the 17 Commission that he or she is seeking to practice under the Compact in another 18 state; (9) pay any applicable fees; (10) meet any requirement in the state in which 19 he or she seeks to practice under the Compact to pass an assessment of his or her 20 knowledge of the applicable laws and rules of that state; and (11) report any 21 adverse action taken against him or her within 30 days after the date the adverse 22 action is taken. 23 Existing law provides for the licensure and regulation of nurses in this State. 24 (Chapter 632 of NRS) Section 10 of this bill enacts the Nurse Licensure Compact, 25 which allows a person who is licensed as a nurse in a state that is a party to the 26 Compact to obtain a multistate license to practice as a nurse in other states that are 27 parties to the Compact. The Compact regulates the licensure and discipline of 28 nurses who hold multistate licenses through the Compact. To obtain a multistate 29 license, the Compact requires a nurse to: (1) meet the qualifications of his or her 30 home state for licensure; (2) graduate from or be eligible to graduate from a 31 registered nurse or licensed practical/vocational nurse program; (3) pass an English 32 proficiency examination if the applicant is a graduate of a foreign prelicensure 33 education program not taught in English or if English is not the applicant’s native 34 language; (4) pass an NCLEX-RN or NCLEX-PN examination; (5) hold or be 35 eligible to hold an active license in his or her home state; (6) undergo a fingerprint 36 or other biometric-based criminal background check; (7) not have been convicted 37 or found guilty of a felony or a misdemeanor offense related to nursing; (8) not be 38 currently enrolled in certain monitoring programs; (9) disclose to the licensing 39 authority in his or her home state whether he or she is participating in such a 40 program; and (10) have a valid social security number. 41 Existing law provides for the licensure and regulation of audiologists and 42 speech-language pathologists in this State. (Chapter 637B of NRS) Section 21 of 43 this bill enacts the Audiology and Speech-Language Pathology Interstate Compact, 44 which allows a person who is licensed as an audiologist or speech-language 45 pathologist in a state that is a member of the Compact to practice as an audiologist 46 or speech-language pathologist in other states that are members of the Compact. In 47 order to practice as an audiologist or speech-language pathologist under the 48 Compact, the Compact requires an audiologist or speech-language pathologist to: 49 (1) hold a license in his or her home state; (2) have no encumbrances on his or her 50 license; (3) meet certain other requirements for eligibility; (4) have had no adverse 51 actions taken against any license or authority to practice under the Compact within 52 the previous 2 years; (5) notify the Audiology and Speech-Language Pathology 53 Compact Commission, a joint public body established by the Compact, that he or 54 she is seeking to practice under the Compact in another state; (6) pay any 55 applicable fees; and (7) report any adverse action taken against him or her within 56 30 days after the date the adverse action is taken. The Compact additionally 57 requires a member state to recognize the right of an audiologist or speech-language 58 pathologist who is licensed by any member state to practice audiology or speech- 59 language pathology, as applicable, through telehealth in any member state under 60 conditions prescribed by the Commission. 61 Existing law provides for the licensure and regulation of physical therapists and 62 physical therapist assistants in this State. (Chapter 640 of NRS) Section 23 of this 63 bill enacts the Physical Therapy Licensure Compact, which allows a person who is 64 licensed as a physical therapist or physical therapist assistant in a state that is a 65 member of the Compact to practice as a physical therapist or physical therapist 66 assistant in other states that are members of the Compact. In order to practice as a 67 physical therapist or physical therapist assistant under the Compact, the Compact 68 – 3 – - *SB34* requires a physical therapist or physical therapist assistant to: (1) hold a license in 69 his or her home state; (2) have no encumbrances on his or her license; (3) meet 70 certain other requirements for eligibility; (4) have had no adverse actions taken 71 against any license or authority to practice under the Compact within the previous 2 72 years; (5) notify the Physical Therapy Compact Commission, a joint public body 73 established by the Compact, that he or she is seeking to practice under the Compact 74 in another state; (6) pay any applicable fees; (7) meet any requirements in the state 75 in which he or she seeks to practice under the Compact; and (8) report any adverse 76 action taken against him or her within 30 days after the date the adverse action is 77 taken. 78 Existing law provides for the licensure and regulation of occupational therapists 79 and occupational therapy assistants in this State. (Chapter 640A of NRS) Section 80 26 of this bill enacts the Occupational Therapy Licensure Compact, which allows a 81 person who is licensed as an occupational therapist or occupational therapy 82 assistant in a state that is a member of the Compact to practice as an occupational 83 therapist or occupational therapy assistant in other states that are members of the 84 Compact. In order to practice as an occupational therapist or occupational therapy 85 assistant under the Compact, the Compact requires an occupational therapist or 86 occupational therapy assistant to: (1) hold a license in his or her home state; (2) 87 have a valid social security number or National Practitioner Identification number; 88 (3) have no encumbrances on his or her license; (4) meet certain other requirements 89 for eligibility; (5) have had no adverse actions taken against any license or authority 90 to practice under the Compact within the previous 2 years; (6) notify the 91 Occupational Therapy Compact Commission, a joint public body established by the 92 Compact, that he or she is seeking to practice under the Compact in another state; 93 (7) pay any applicable fees; (8) complete a fingerprint or other biometric-based 94 criminal background check; (9) meet any requirement in the state in which he or 95 she seeks to practice under the Compact to pass an assessment of his or her 96 knowledge of the applicable laws and rules of that state; and (10) report any 97 adverse action taken against him or her within 30 days after the date the adverse 98 action is taken. 99 Each interstate compact adopted by sections 1, 10, 21, 23 and 26 authorizes a 100 member state to take adverse action against a provider of health care who is 101 practicing in the member state under the Compact. Each such interstate compact 102 authorizes the commission created by the compact to levy and collect assessments 103 from party states to cover the cost of its operations. Each such compact also creates 104 a data system to facilitate the sharing of information among member states. 105 Sections 8, 9, 11, 12, 18, 20, 22, 24 and 27 of this bill generally authorize the 106 Board of Medical Examiners, the State Board of Nursing, the State Board of 107 Osteopathic Medicine, the Speech-Language Pathology, Audiology and Hearing 108 Aid Dispensing Board, the Nevada Physical Therapy Board and the Board of 109 Occupational Therapy to disclose information to those data systems when required 110 by those compacts. Sections 1, 10, 21, 23, 26 and 33 of this bill provide for the 111 confidentiality of certain information disclosed through a data system. 112 Section 2 of this bill makes a conforming change to reflect that the PA 113 Licensure Compact will be placed in the same chapter as the Interstate Medical 114 Licensure Compact, which relates to physicians. Sections 4 and 14 of this bill 115 define “PA Licensure Compact” to refer to the PA Licensure Compact for the 116 purposes of provisions governing allopathic and osteopathic medicine. Sections 6 117 and 16 of this bill indicate the applicability of those definitions. Sections 5 and 15 118 of this bill prescribe the conditions under which the Board of Medical Examiners or 119 the State Board of Osteopathic Medicine will regulate a physician assistant 120 practicing in this State under the PA Licensure Compact. 121 Section 28 of this bill deems practicing as a physician assistant, audiologist, 122 speech-language pathologist, physical therapist, physical therapist assistant, 123 – 4 – - *SB34* occupational therapist or occupational therapy assistant under the Compact to be 124 equivalent to practicing under a license issued by the applicable professional 125 licensing board, thereby providing such persons with the same authority, duties and 126 legal protections as a licensee. Because the Nurse Licensure Compact enacted by 127 section 10 requires a nurse practicing under the Nurse Licensure Compact to obtain 128 a multistate license, such a nurse would be licensed pursuant to provisions of law 129 governing nursing and would thus also have the same authority as any other nurse 130 who is licensed to practice in this State. Sections 7 and 17 of this bill further clarify 131 that a physician assistant practicing in this State under the PA Licensure Compact 132 has the same legal status as a physician assistant licensed by the Board of Medical 133 Examiners or the State Board of Osteopathic Medicine. Sections 19 and 25 of this 134 bill require an osteopathic physician assistant or physical therapist practicing under 135 the Compact to display proof that he or she is authorized to practice under the 136 Compact in the same manner as a licensed osteopathic physician assistant or 137 licensed physical therapist, as applicable, is required to display his or her license. 138 Sections 29-32, 34-36 and 39 of this bill replace the term “registered physical 139 therapist” with the term “licensed physical therapist” to reflect current terminology 140 used in existing law governing the practice of physical therapy and this bill. 141 Sections 37 and 38 of this bill make further revisions to clarify that physician 142 assistants licensed by the Board of Medical Examiners or the State Board of 143 Osteopathic Medicine and physician assistants practicing in this State under the PA 144 Licensure Compact have the same authority with regard to prescribing, dispensing, 145 administering and possessing controlled substances and dangerous drugs. 146 Section 40 of this bill requires the Department of Health and Human Services 147 to: (1) study the potential impacts of the interstate compacts ratified and entered 148 into in sections 1, 10, 21, 23 and 26 on the availability of relevant health care 149 services in this State; and (2) report the results of the study to the Patient Protection 150 Commission and the Legislature. 151 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 629A of NRS is hereby amended by 1 adding thereto a new section to read as follows: 2 The PA Licensure Compact is hereby ratified and entered into 3 with all other jurisdictions legally joining the Compact, in 4 substantially the form set forth in this section: 5 PA LICENSURE COMPACT 6 7 SECTION 1. PURPOSE 8 9 In order to strengthen access to Medical Services, and in 10 recognition of the advances in the delivery of Medical Services, 11 the Participating States of the PA Licensure Compact have allied 12 in common purpose to develop a comprehensive process that 13 complements the existing authority of State Licensing Boards to 14 license and discipline PAs and seeks to enhance the portability of 15 a License to practice as a PA while safeguarding the safety of 16 patients. This Compact allows Medical Services to be provided by 1 [Text truncated for display. Full text available on LegiScan.]