SB397 - Makes various changes relating to alternative medicine. (BDR 54-117)

REQUIRES TWO-THIRDS MAJORITY VOTE (§§ 18, 20, 22, 50, 51 & NRS 453.221, 639.170) S.B. 397 - *SB397* SENATE BILL NO. 397–SENATOR OHRENSCHALL MARCH 17, 2025 ____________ Referred to Committee on Commerce and Labor SUMMARY—Makes various changes relating to alternative medicine. (BDR 54-117) 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 alternative medicine; providing for the licensure and regulation of naturopathic physicians and naturopathic assistants by the Nevada Board of Homeopathic and Naturopathic Medical Examiners; authorizing homeopathic physicians to dispense, administer and prescribe drugs in certain circumstances; establishing additional grounds for disciplinary action against persons licensed by the Board; revising other provisions relating to the Board; providing penalties; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law provides for the regulation and licensure of homeopathic 1 physicians by the Nevada Board of Homeopathic Medical Examiners. (Chapter 2 630A of NRS) The Board also certifies and regulates advanced practitioners of 3 homeopathy and homeopathic assistants. (NRS 630A.293-630A.299) This bill 4 generally provides for the regulation of naturopathic medicine and the licensure of 5 naturopathic physicians and the certification of naturopathic assistants by the 6 Board. Sections 33, 40 and 96 of this bill revise the name of the board to “Nevada 7 Board of Homeopathic and Naturopathic Medical Examiners” to reflect the new 8 authority and duties of the Board established by this bill. Sections 10 and 12 of this 9 bill define the terms “naturopathic assistant” and “naturopathic physician,” 10 respectively. Sections 11 and 16-18 of this bill: (1) define the practice of 11 naturopathic medicine; (2) set forth the scope of the practice of naturopathic 12 medicine; (3) provide the authorized methods of administration of natural 13 substances that may be administered by a naturopathic physician; (4) set forth the 14 requirements that a naturopathic physician must satisfy before administering 15 intravenous therapy in his or her practice; and (5) authorize a naturopathic 16 physician to dispense natural substances, drugs and devices, including certain 17 controlled substances. Sections 19-27 of this bill require the Board to: (1) license 18 – 2 – - *SB397* naturopathic physicians; (2) certify naturopathic physicians as specialists; (3) 19 certify naturopathic assistants; (4) certify naturopathic medical students who wish 20 to participate in a program of clinical training for naturopathic medicine; and (5) 21 certify graduates of an approved school of naturopathic medicine who wish to 22 participate in an internship, preceptorship or fellowship training program. Sections 23 19-27 also establish certain requirements that an applicant for a license or 24 certificate must satisfy before the Board may issue the applicant such a license or 25 certificate. Section 28 of this bill requires naturopathic physicians to comply with 26 certain legal requirements governing the registration of births and deaths. Section 27 31 of this bill requires a naturopathic physician to take certain actions which are 28 also required of similar providers under existing law to assist a patient with an 29 opioid use disorder in accessing medication-assisted treatment. (NRS 630.3737, 30 632.2383, 633.6947, 641.2293, 641A.299, 641B.360, 641C.620) Section 50 of this 31 bill establishes certain procedures and requirements for renewing a license or 32 certificate, which are consistent with the procedures and requirements currently 33 applicable to practitioners of homeopathic medicine. Section 51 of this bill 34 establishes the fees for the issuance and renewal of a license or certificate issued 35 pursuant to sections 15 and 21-27. Sections 5-9, 13 and 14 of this bill define 36 certain other terms relating to the practice of naturopathic medicine and section 32 37 of this bill establishes the applicability of the definitions set forth in sections 5-14. 38 Sections 34, 36, 37 and 52-76 of this bill make the grounds and procedures that 39 are applicable to the investigation and discipline of homeopathic physicians, 40 advanced practitioners of homeopathy and homeopathic assistants, and the 41 unlicensed or uncertified practice of those professions, also applicable to 42 naturopathic physicians and naturopathic assistants and the unlicensed or 43 uncertified practice of those professions. Section 29 of this bill establishes 44 additional grounds for disciplinary action against all practitioners licensed by the 45 Board relating to medical records and reporting, and section 49 of this bill 46 authorizes the discipline of the holder of a limited license to practice homeopathic 47 medicine on those grounds. Section 75 prohibits misrepresenting that a school or 48 college of naturopathic medicine has been approved by the Board, and sections 43 49 and 76 of this bill prohibit the unlicensed practice of naturopathic medicine and 50 practice as a naturopathic assistant without the proper license or certificate. 51 Sections 38, 42, 44, 45, 47 and 48 of this bill make conforming changes to include 52 naturopathic physicians, naturopathic assistants and the practice of naturopathic 53 medicine within existing provisions currently applicable to homeopathic 54 physicians, advanced practitioners of homeopathy, homeopathic assistants and the 55 practice of homeopathic medicine, where appropriate. Section 39 of this bill 56 exempts certain persons from provisions governing homeopathic medicine and 57 naturopathic medicine. Section 46 of this bill limits to homeopathic physicians the 58 applicability of a provision relating to the examination of applicants for licensure as 59 a homeopathic physician. Section 40 expands the membership of the Board from 60 six members to eight members and section 41 of this bill requires that the 61 additional members added to the Board be naturopathic physicians who have 62 certain qualifications. 63 Existing law defines the term “physician” for the entirety of Nevada law, 64 except where specifically provided otherwise, to mean a person who engages in the 65 practice of medicine, including homeopathy. (NRS 0.040) Section 85 of this bill 66 includes within this definition a person who engages in the practice of naturopathic 67 medicine, thereby making certain provisions of existing law that are applicable to 68 all physicians also apply to naturopathic physicians, including provisions 69 concerning controlled substances and dangerous drugs. (Chapters 453 and 454 of 70 NRS) Sections 1 and 105-128 of this bill make revisions to treat naturopathic 71 physicians like other osteopathic and allopathic physicians for certain purposes 72 relating to provisions that require insurers to take, or refrain from taking, certain 73 – 3 – - *SB397* actions with respect to certain policies of health insurance and medical malpractice 74 insurance. 75 Sections 77, 78, 81, 83 and 84 of this bill clarify that provisions of law 76 governing certain other professions do not apply to naturopathic physicians. 77 Sections 2, 3, 79, 80, 82, 86-95 and 97-104 of this bill make revisions to treat 78 naturopathic physicians and naturopathic assistants, where applicable, in the same 79 manner as other similar providers of health care in other certain respects. 80 Existing law defines “homeopathic medicine” to include noninvasive 81 electrodiagnosis, cell therapy, neural therapy, herbal therapy, neuromuscular 82 integration, orthomolecular therapy and nutrition. (NRS 630A.040) Existing 83 regulations interpret “neural therapy” and “orthomolecular therapy” to include the 84 prescription and administration of pharmaceutical preparations. Existing 85 regulations interpret “pharmaceutical preparations” to include narcotic drugs and 86 opiates that are listed as schedule II controlled substances regulated by the State 87 Board of Pharmacy. (NAC 630A.014) Sections 30 and 35 of this bill affirmatively 88 authorize a homeopathic physician to dispense, administer and prescribe certain 89 drugs, including some controlled substances, in the course of providing neural 90 therapy or orthomolecular therapy, so long as the dosage and administration of the 91 drugs conform with the standards of practice for those therapies and the 92 homeopathic physician meets certain other qualifications. Section 30 also clarifies 93 the authority of a homeopathic physician to prescribe, dispense and administer 94 certain controlled substances and dangerous drugs in certain other contexts, so long 95 as the drug is: (1) in an amount suitable for a single use; and (2) only used for the 96 purpose of diluting the drug into a homeopathic preparation in accordance with the 97 standards prescribed in the Homeopathic Pharmacopoeia of the United States. 98 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. NRS 629.095 is hereby amended to read as follows: 1 629.095 1. Except as otherwise provided in subsection 2, the 2 Commissioner of Insurance shall develop, prescribe for use and 3 make available a single, standardized form for use by insurers, 4 carriers, societies, corporations, health maintenance organizations, 5 managed care organizations, hospitals, medical facilities and other 6 facilities that provide health care in obtaining any information 7 related to the credentials of a provider of health care. 8 2. The provisions of subsection 1 do not prohibit the 9 Commissioner of Insurance from developing, prescribing for use 10 and making available: 11 (a) Appropriate variations of the form described in that 12 subsection for use in different geographical regions of this State. 13 (b) Addenda or supplements to the form described in that 14 subsection to address, until such time as a new form may be 15 developed, prescribed for use and made available, any requirements 16 newly imposed by the Federal Government, the State or one of its 17 agencies, or a body that accredits hospitals, medical facilities or 18 health care plans. 19 – 4 – - *SB397* 3. With respect to the form described in subsection 1, the 1 Commissioner of Insurance shall: 2 (a) Hold public hearings to seek input regarding the 3 development of the form; 4 (b) Develop the form in consideration of the input received 5 pursuant to paragraph (a); 6 (c) Ensure that the form is developed in such a manner as to 7 accommodate and reflect the different types of credentials 8 applicable to different classes of providers of health care; 9 (d) Ensure that the form is developed in such a manner as to 10 reflect standards of accreditation adopted by national organizations 11 which accredit hospitals, medical facilities and health care plans; 12 and 13 (e) Ensure that the form is developed to be used efficiently and 14 is developed to be neither unduly long nor unduly voluminous. 15 4. As used in this section: 16 (a) “Carrier” has the meaning ascribed to it in NRS 689C.025. 17 (b) “Corporation” means a corporation operating pursuant to the 18 provisions of chapter 695B of NRS. 19 (c) “Health maintenance organization” has the meaning ascribed 20 to it in NRS 695C.030. 21 (d) “Insurer” means: 22 (1) An insurer that issues policies of individual health 23 insurance in accordance with chapter 689A of NRS; and 24 (2) An insurer that issues policies of group health insurance 25 in accordance with chapter 689B of NRS. 26 (e) “Managed care organization” has the meaning ascribed to it 27 in NRS 695G.050. 28 (f) “Provider of health care” means a provider of health care 29 who is licensed pursuant to chapter 630, 631, 632 or 633 of NRS [.] 30 or a naturopathic physician or naturopathic assistant licensed or 31 certified pursuant to chapter 630A of NRS. 32 (g) “Society” has the meaning ascribed to it in NRS 695A.044. 33 Sec. 2. NRS 629.580 is hereby amended to read as follows: 34 629.580 1. A person who provides wellness services in 35 accordance with this section, but who is not licensed, certified or 36 registered in this State as a provider of health care, is not in 37 violation of any law based on the unlicensed practice of health care 38 services or a health care profession unless the person: 39 (a) Performs surgery or any other procedure which punctures the 40 skin of any person; 41 (b) Sets a fracture of any bone of any person; 42 (c) Prescribes or administers X-ray radiation to any person; 43 (d) Prescribes or administers a prescription drug or device or a 44 controlled substance to any person; 45 – 5 – - *SB397* (e) Recommends to a client that he or she discontinue or in any 1 manner alter current medical treatment prescribed by a provider of 2 health care licensed, certified or registered in this State; 3 (f) Makes a diagnosis of a medical disease of any person; 4 (g) Performs a manipulation or a chiropractic adjustment of the 5 articulations of joints or the spine of any person; 6 (h) Treats a person’s health condition in a manner that 7 intentionally or recklessly causes that person recognizable and 8 imminent risk of serious or permanent physical or mental harm; 9 (i) Holds out, states, indicates, advertises or implies to any 10 person that he or she is a provider of health care; 11 (j) Engages in the practice of medicine in violation of chapter 12 630 or 633 of NRS, the practice of homeopathic medicine or 13 naturopathic medicine in violation of chapter 630A of NRS, the 14 practice of naprapathy in violation of chapter 634B of NRS or the 15 practice of podiatry in violation of chapter 635 of NRS, unless 16 otherwise expressly authorized by this section; 17 (k) Performs massage therapy as that term is defined in NRS 18 640C.060, reflexology as that term is defined in NRS 640C.080 or 19 structural integration as that term is defined in NRS 640C.085; 20 (l) Provides mental health services that are exclusive to the 21 scope of practice of a psychiatrist licensed pursuant to chapter 630 22 or 633 of NRS, or a psychologist licensed pursuant to chapter 641 of 23 NRS; or 24 (m) Engages in the practice of applied behavior analysis in 25 violation of chapter 641D of NRS. 26 2. Any person providing wellness servic [Text truncated for display. Full text available on LegiScan.]