Nac: Chapter 630 - Physicians, Perfusionists, Physician Assistants And Practitioners Of Respiratory Care (United States)

Nac: Chapter 630 - Physicians, Perfusionists, Physician Assistants And Practitioners Of Respiratory Care

Published: 2015

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NAC: CHAPTER 630 - PHYSICIANS, PHYSICIAN ASSISTANTS, MEDICAL ASSISTANTS, PERFUSIONISTS AND PRACTITIONERS OF RESPIRATORY CARE

[Rev. 3/31/2020 5:59:29 PM]

[NAC-630 Revised Date: 3-20]

CHAPTER 630 - PHYSICIANS, PHYSICIAN ASSISTANTS, MEDICAL ASSISTANTS, PERFUSIONISTS AND PRACTITIONERS OF RESPIRATORY CARE

GENERAL PROVISIONS

630.010 Definitions.

630.025 “Controlled substance” defined.

630.040 “Malpractice” interpreted.

630.043 “State” interpreted.

630.045 Submission of documents to Board: Signature required.

LICENSING

630.050 Application: Restrictions; filing; contents; fee.

630.055 Qualifications: “Progressive postgraduate education” interpreted.

630.080 Examinations.

630.130 Limited license for graduate program of training.

630.135 Renewal of limited license for graduate program of training; annual report required; grounds for disciplinary action or denial or revocation of license.

630.145 Restricted license: “Medically underserved area” defined.

630.147 Special event license to demonstrate medical techniques and procedures: Application.

630.149 Special event license to demonstrate medical techniques and procedures: Validity; limitations on conduct of demonstrations.

630.153 Continuing education: General requirements; exemption; failure to comply; credit for medical review.

630.154 Continuing education: Course of instruction relating to medical consequences of act of terrorism involving use of weapon of mass destruction.

630.155 Continuing education: Credit for continuing education course on geriatrics and gerontology or Alzheimer’s disease or other forms of dementia.

630.156 Continuing education: Training required for certain physicians relating to persons with substance use and other addictive disorders and prescribing of opioids; credit for training.

630.157 Continuing education: Licensing after beginning of period of biennial registration; change of status to active.

630.162 Temporary license: “Community” interpreted.

630.165 Effect of revocation of license in another jurisdiction: “Gross medical negligence” defined.

630.170 Termination of license issued to alien.

630.175 Fee for biennial registration: Payment; refund.

630.178 Change in status of license after expiration for nonpayment of fee.

630.180 Refund of fee for application; rejection of application.

STANDARDS OF PRACTICE

630.185 Standards established.

630.187 Adoption by reference of Guidelines for the Chronic Use of Opioid Analgesics.

630.190 Prohibited advertising.

630.210 Consultation with another provider of health care.

630.225 Reporting of physician brought into this State for consultation with or assistance to licensed physician.

630.230 Prohibited professional conduct.

REPORTS

630.235 Annual reports of certain information concerning surgeries: Submission; form.

630.237 Annual reports of certain information concerning surgeries: Administrative penalty.

DISCIPLINARY ACTION

630.240 Voluntary surrender of license.

630.243 Procedure for dealing with findings of exposure to human immunodeficiency virus.

630.251 Grounds: “Gross malpractice” interpreted.

630.255 Exemption from grounds: “Intractable pain” defined.

630.258 Violation by licensee of certain provisions relating to prescriptions for controlled substances: Additional continuing education required; determination of violation and imposition of disciplinary action by Board.

630.260 Notice of technical or scientific facts.

630.270 Disposition of findings and order of Board.

630.275 Confidentiality of certain information regarding physicians, physician assistants, practitioners of respiratory care and perfusionists.

PHYSICIAN ASSISTANTS

630.280 Qualifications of applicants.

630.290 Application for license.

630.310 Rejection of application.

630.315 Denial of application.

630.320 Temporary license.

630.325 Locum tenens license.

630.330 Contents of license.

630.340 Period of validity of license; notification of practice; termination of supervision; disciplinary action; refusal to license.

630.350 Renewal, expiration and reinstatement of license.

630.353 Continuing education: Course of instruction relating to medical consequences of act of terrorism involving use of weapon of mass destruction.

630.357 Continuing education: Credit for continuing education course on geriatrics and gerontology or Alzheimer’s disease or other forms of dementia.

630.358 Continuing education: Training required for certain physician assistants relating to persons with substance use and other addictive disorders and prescribing of opioids; credit for training.

630.360 Performance of authorized medical services; identification; misrepresentation; notification of change regarding supervising physician.

630.370 Supervising physician: Duties; qualifications.

630.375 Physician assistant deemed to be agent of supervising physician; performance of emergency medical services without supervision.

630.380 Disciplinary action: Grounds; institution; exception.

630.390 Disciplinary action: Notice of charges.

630.400 Examination to determine fitness to practice.

630.410 Determination after notice and hearing: Sanctions or dismissal of charges.

630.415 Advisory committee.

PETITIONS, ORDERS, OPINIONS AND RULES OF PRACTICE

630.420 Petition for amendment or repeal of regulation.

630.430 Filing of petition; copies.

630.440 Submission, consideration and disposition of petitions.

630.450 Declaratory orders and advisory opinions.

630.455 Time limit for request to Board for consideration or action upon matter at meeting.

630.460 Hearings: Appearance; pleadings; motions; documents.

630.465 Hearings: Prehearing conference.

630.470 Hearings: Procedure.

630.475 Subpoenas.

COLLABORATING OR SUPERVISING PHYSICIANS

630.490 Collaboration with advanced practice registered nurse.

630.495 Restrictions on simultaneous supervision of physician assistants and collaboration with advanced practice registered nurses.

PRACTITIONERS OF RESPIRATORY CARE

630.500 Qualifications of applicants.

630.505 Application for license.

630.510 Grounds for rejection of application.

630.515 Temporary license to practice as intern.

630.520 Contents of license.

630.525 Fee for biennial registration; cause for disciplinary action or refusal to issue license.

630.530 Renewal of license; notification of withdrawal of certification; expiration and reinstatement of license.

630.535 Suspension upon loss of certification.

630.540 Grounds for discipline or denial of licensure.

630.545 Disciplinary action: Notice of charges.

630.550 Examination to determine fitness to practice.

630.555 Determination after notice and hearing: Sanctions or dismissal of charges.

630.560 Advisory committee.

USE OF MEANS OR INSTRUMENTALITIES OF TREATMENT OTHER THAN CONVENTIONAL TREATMENT

630.600 “Conventional treatment” defined.

630.605 Provisional approval; disciplinary action for violation.

630.610 Use of certain means or instrumentalities prohibited.

630.615 Assessment of patient; contents of assessment.

630.620 Documented treatment plan.

630.625 Periodic reviews of care of patient.

630.630 Records of care provided to patient.

PERFUSIONISTS

630.700 Application for license.

630.710 Grounds for rejection of application.

630.720 Contents of license.

630.730 Primary location of practice.

630.740 Renewal of license; continuing education; notice of renewal.

630.750 Fee for reinstatement of expired license.

630.760 Performance of authorized services; identification; misrepresentation.

630.770 Grounds for discipline or denial of licensure.

630.780 Examination to determine fitness to practice.

630.790 Advisory committee.

SUPERVISION OF MEDICAL ASSISTANTS

630.800 “Delegating practitioner” defined.

630.810 Delegation of tasks to medical assistant.

630.820 Remote supervision of medical assistant.

630.830 Prohibited activities by delegating practitioner.

GENERAL PROVISIONS

NAC 630.010 Definitions. (NRS 630.130) As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 630.005 to 630.026, inclusive, and NAC 630.025 have the meanings ascribed to them in those sections.

[Bd. of Medical Exam’rs, § 630.010, eff. 12-20-79] — (NAC A 6-23-86; 9-12-91; R007-99, 9-27-99; R089-00, 7-19-2000)

NAC 630.025 “Controlled substance” defined. (NRS 630.130) “Controlled substance” has the meaning ascribed to it in NRS 0.031.

(Added to NAC by Bd. of Medical Exam’rs by R007-99, eff. 9-27-99)

NAC 630.040 “Malpractice” interpreted. (NRS 630.130) For the purposes of chapter 630 of NRS, “malpractice” means the failure of a physician, in treating a patient, to use the reasonable care, skill, or knowledge ordinarily used under similar circumstances.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96) — (Substituted in revision for NAC 630.245)

NAC 630.043 “State” interpreted. (NRS 630.130, 630.266) For the purposes of NRS 630.266 and NAC 630.147 and 630.149, the Board will interpret the term “state,” when referring to a state other than this State, to mean a state of the United States other than Nevada, the District of Columbia, Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject to the jurisdiction of the United States.

(Added to NAC by Bd. of Medical Exam’rs by R146-10, eff. 10-26-2011)

NAC 630.045 Submission of documents to Board: Signature required. (NRS 630.130, 630.269, 630.275, 630.279)

1. Any document submitted to the Board by a licensee or an applicant for a license to practice medicine, to practice as a physician assistant, to practice as a practitioner of respiratory care or to practice as a perfusionist must bear the original signature of the licensee or applicant.

2. The Board may refuse to accept any document submitted by a licensee or an applicant for a license that does not bear the original signature of the licensee or applicant.

3. As used in this section, “document” means any written submission, notification or communication, including, without limitation:

(a) An application for a license;

(b) A request for renewal of a license;

(d) A notification of a change of address.

(Added to NAC by Bd. of Medical Exam’rs by R006-07, eff. 10-31-2007; A by R061-11, 5-30-2012)

LICENSING

NAC 630.050 Application: Restrictions; filing; contents; fee. (NRS 630.130)

1. The Board will not accept any application for any type of license to practice medicine in this State if the Board cannot substantiate that the medical school from which the applicant graduated provided the applicant with a resident course of professional instruction equivalent to that provided in the United States or a Canadian medical school approved by either the Liaison Committee on Medical Education of the American Medical Association and the Association of American Medical Colleges or by the Committee on Accreditation of Canadian Medical Schools.

2. Except as otherwise provided in NAC 630.130, an applicant for any license to practice medicine must file his or her sworn application with the Board. The application must include or indicate the following:

(a) If the applicant is not a citizen of the United States, satisfactory evidence from the United States Citizenship and Immigration Services of the Department of Homeland Security that he or she is lawfully entitled to remain and work in the United States.

(b) All documentation required by the application.

3. The application must be accompanied by the applicable fee.

4. If the Board denies an application for any type of license to practice medicine in this State, the Board may prohibit the person whose application was denied from reapplying for a period of 1 year to 3 years after the date of the denial.

[Bd. of Medical Exam’rs, § 630.050, eff. 12-20-79] — (NAC A 6-23-86; 3-19-87; R149-97, 3-30-98; R080-05, 10-31-2005)

NAC 630.055 Qualifications: “Progressive postgraduate education” interpreted. (NRS 630.130, 630.160) As used in paragraph (d) of subsection 2 of NRS 630.160, the term “progressive postgraduate education” does not include training received in the program commonly referred to as the “fifth pathway program,” which was established by the American Medical Association in 1971 to allow entry into the first year of graduate medical education in the United States to citizens of the United States who study at foreign medical schools.

(Added to NAC by Bd. of Medical Exam’rs by R007-99, eff. 9-27-99; A by R145-03, 12-16-2003)

NAC 630.080 Examinations. (NRS 630.130, 630.160, 630.180, 630.318)

1. For the purposes of paragraph (e) of subsection 2 of NRS 630.160, an applicant for a license to practice medicine must pass:

(a) A written examination concerning the statutes and regulations relating to the practice of medicine in this State; and

(b) Except as otherwise provided in subsection 2, an examination, designated by the Board, to test the competency of the applicant to practice medicine, including, without limitation:

(1) The Special Purpose Examination;

(2) An examination testing competence to practice medicine conducted by physicians; or

(3) Any other examination designed to test the competence of the applicant to practice medicine.

2. The Board will deem an applicant to have satisfied the requirements of paragraph (b) of subsection 1 if:

(a) Within 10 years before the date of an application for a license to practice medicine in this State, the applicant has passed:

(1) Part III of the examination given by the National Board of Medical Examiners;

(2) Component II of the Federation Licensing Examination;

(3) Step 3 of the United States Medical Licensing Examination;

(4) All parts of the examination to become a licentiate of the Medical Council of Canada;

(5) The examination for primary certification or recertification by a specialty board of the American Board of Medical Specialties and received primary certification from that board; or

(6) The Special Purpose Examination; or

(b) The applicant is currently certified and was certified prior to recertification or maintenance of certification requirements by a specialty board of the American Board of Medical Specialties, agrees to maintain that certification throughout any period of licensure in this State and has actively practiced clinical medicine for the past 5 years in any state or country in which the applicant is licensed or officially authorized to practice.

3. For the purposes of subparagraph (3) of paragraph (c) of subsection 2 of NRS 630.160:

(a) An applicant for a license to practice medicine must pass Step 1, Step 2 and Step 3 of the United States Medical Licensing Examination in not more than a total of nine attempts and must pass Step 3 in not more than a total of three attempts; and

(b) An applicant:

(1) Who holds a degree of doctor of medicine must pass all steps of the examination within 7 years after the date on which the applicant first passes any step of the examination; or

(2) Who holds a degree of doctor of medicine and a degree of doctor of philosophy must pass all steps of the examination within 10 years after the date on which the applicant first passes any step of the examination.

4. For any examination conducted by the Board for a license to practice medicine, an applicant must answer correctly at least 75 percent of the questions propounded. The Board will use the weighted average score of 75, as determined by the Federation of State Medical Boards of the United States, Inc., to satisfy the required score of 75 percent for passage of the Special Purpose Examination and the United States Medical Licensing Examination.

5. The Board will authorize the Federation of State Medical Boards of the United States, Inc., to administer the Special Purpose Examination or the United States Medical Licensing Examination on behalf of the Board.

6. An applicant for a license to practice medicine and a person who holds a license to practice medicine must pay the reasonable costs of any examination required for licensure and any examination ordered pursuant to NRS 630.318.

[Bd. of Medical Exam’rs, § 630.080, eff. 12-20-79] — (NAC A 6-23-86; 3-19-87; 11-21-88; 3-7-90; 9-12-91; R149-97, 3-30-98; R007-99, 9-27-99; R167-99, 1-19-2000; R145-03, 12-16-2003; R054-05, 10-31-2005; R150-07 & R151-07, 6-17-2008; R134-14, 6-26-2015)

NAC 630.130 Limited license for graduate program of training. (NRS 630.130, 630.265)

1. The applicant for a limited license to practice medicine as a resident physician in a graduate program of clinical training must file an application with the Board on the standard form for application for a license to practice medicine and submit with the application such proofs and documents as are required on the form to the extent that the proofs and documents are applicable to the issuance of the limited license.

2. The application must be accompanied by written confirmation from the institution sponsoring the graduate program of clinical training that the applicant has been appointed to a position in the program. If the applicant is not a citizen of the United States, the applicant must also provide satisfactory evidence from the United States Citizenship and Immigration Services of the Department of Homeland Security that he or she is lawfully entitled to remain and work in the United States.

3. The Board will review the application and, upon approval, issue the limited license. An applicant for a limited license may be required to appear before the Board or one of its members for an oral interview before the issuance of the limited license.

4. A limited license issued under this section will state on its face that it is a limited license to practice medicine as a resident physician in a graduate program of clinical training, and the period during which it is valid. If the licensee is not a citizen of the United States, a limited license is valid only as long as the licensee is lawfully entitled to remain and work in the United States.

[Bd. of Medical Exam’rs, § 630.130, eff. 12-20-79] — (NAC A 6-23-86; R042-12, 2-20-2013)

NAC 630.135 Renewal of limited license for graduate program of training; annual report required; grounds for disciplinary action or denial or revocation of license. (NRS 630.130, 630.265)

1. A resident physician who wishes to renew a limited license to practice medicine as a resident physician in a graduate program of clinical training must file an application for renewal with the Board.

2. The application must be:

(a) Completed by the applicant; and

(b) Certified by the director of the program of clinical training.

3. As a condition of renewal of a limited license to practice medicine as a resident physician in a graduate program of clinical training, the licensee shall submit an annual report signed by the director of the program of clinical training that has been:

(a) Submitted on a form supplied by the Board; and

(b) Signed by the chair of the Graduate Medical Education Committee.

4. The holder of a limited license may be disciplined if information supplied to the Board by the director of the program of clinical training constitutes grounds for:

(a) Disciplinary action pursuant to NRS 630.301 to 630.3065, inclusive; or

(b) Denial or revocation of a license pursuant to NRS 630.161.

5. The Board may deny the application for any of the reasons set forth as grounds for the denial of a license to practice medicine pursuant to NRS 630.200.

(Added to NAC by Bd. of Medical Exam’rs by R149-97, eff. 3-30-98; A by R108-01, 11-29-2001)

NAC 630.145 Restricted license: “Medically underserved area” defined. (NRS 630.130, 630.264) For the purposes of subsection 1 of NRS 630.264, “medically underserved area” means any geographic area designated by the Board with a population to primary care physician ratio of 2,500:1. When designating a geographic area as medically underserved, the Board may consider any additional criteria proposed by the Officer of Rural Health of the University of Nevada School of Medicine or a board of county commissioners.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001) — (Substituted in revision for NAC 630.035)

NAC 630.147 Special event license to demonstrate medical techniques and procedures: Application. (NRS 630.130, 630.266, 630.268) An applicant for a special event license issued pursuant to NRS 630.266 must, not later than 30 days before the requested effective date described in subsection 1, submit to the Board or, where appropriate, cause to be submitted to the Board:

1. An application for a special event license on a form approved by the Board. The application must include, without limitation, the date on which the applicant wishes the special event license to become effective. To ensure compliance with NRS 630.266, the application must also include:

(a) Verification that the applicant is currently licensed as a physician in another state and is in good standing in that state;

(b) The dates and locations of the demonstrations of medical techniques or procedures that the applicant plans to conduct pursuant to the special event license; and

2. The documentation and information, other than an application, that an applicant for a license to practice medicine is required to submit to the Board pursuant to NRS 630.165 to 630.173, inclusive, 630.195 and 630.197.

3. The applicable fee for the application for and issuance of the special event license as prescribed by the Board pursuant to subsection 1 of NRS 630.268.

4. Such other pertinent information as the Board may require.

(Added to NAC by Bd. of Medical Exam’rs by R146-10, eff. 10-26-2011)

NAC 630.149 Special event license to demonstrate medical techniques and procedures: Validity; limitations on conduct of demonstrations. (NRS 630.130, 630.266)

1. If the Board issues a special event license pursuant to NRS 630.266, the Board will provide the period for which the special event license is valid. The period of validity will not exceed 15 days after the effective date of the special event license as established by the Board.

2. A holder of a special event license issued pursuant to NRS 630.266 may, pursuant to the special event license:

(a) Conduct only those demonstrations of medical techniques or procedures approved by the Board; and

(b) Conduct those demonstrations only on the dates and at the locations approved by the Board.

(Added to NAC by Bd. of Medical Exam’rs by R146-10, eff. 10-26-2011)

NAC 630.153 Continuing education: General requirements; exemption; failure to comply; credit for medical review. (NRS 630.130, 630.253)

1. Except as otherwise provided in subsection 2 and NAC 630.157, each holder of a license to practice medicine shall, at the time of the biennial registration, submit to the Board by the final date set by the Board for submitting applications for biennial registration evidence, in such form as the Board requires, that he or she has completed 40 hours of continuing medical education during the preceding 2 years in one or more educational programs, 2 hours of which must be in medical ethics and 20 hours of which must be in the scope of practice or specialty of the holder of the license. Each educational program must:

(a) Offer, upon successful completion of the program, a certificate of Category 1 credit as recognized by the American Medical Association to the holder of the license;

(b) Be approved by the Board; and

(c) Be sponsored in whole or in part by an organization accredited or deemed to be an equivalent organization to offer such programs by the American Medical Association or the Accreditation Council for Continuing Medical Education.

2. Any holder of a license who has completed a full year of residency or fellowship in the United States or Canada any time during the period for biennial registration immediately preceding the submission of the application for biennial registration is exempt from the requirements set forth in subsection 1.

3. If the holder of a license fails to submit evidence of his or her completion of continuing medical education within the time and in the manner prescribed by subsection 1, the license will not be renewed. Such a person may not resume the practice of medicine unless, within 2 years after the end of the biennial period of registration, the person:

(a) Pays a fee to the Board which is twice the fee for biennial registration otherwise prescribed by subsection 1 of NRS 630.268;

(b) Submits to the Board, in such form as it requires, evidence that he or she has completed 40 hours of Category 1 continuing medical education as recognized by the American Medical Association within the preceding 2 years; and

(c) Is found by the Board to be otherwise qualified for active status pursuant to the provisions of this chapter and chapter 630 of NRS.

4. The Board may issue up to 20 hours of continuing medical education credit during a single biennial period to a holder of a license to practice medicine if the licensee performs a medical review for the Board. The hours issued by the Board:

(a) May be credited against the 40 hours required for any single biennial registration period pursuant to subsection 1; and

(b) Without exceeding the limit of 20 hours, must be equal to the actual time involved in performing the medical review.

(Added to NAC by Bd. of Medical Exam’rs, 7-31-85, eff. 8-1-85; A 6-23-86; 11-21-88; 9-12-91; R149-97, 3-30-98; R108-01, 11-29-2001)

NAC 630.154 Continuing education: Course of instruction relating to medical consequences of act of terrorism involving use of weapon of mass destruction. (NRS 630.130, 630.253)

1. Pursuant to the provisions of NRS 630.253, a holder of a license to practice medicine shall complete a course of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction:

(a) If the holder of a license to practice medicine was initially licensed by the Board on or after October 1, 2003, within 2 years of initial licensure.

(b) If the holder of a license to practice medicine was initially licensed by the Board before October 1, 2003, on or before September 30, 2005.

2. In addition to the requirements provided pursuant to NRS 630.253, a course of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction:

(a) Except as otherwise provided in subsection 3, must offer, upon successful completion of the program, a certificate of Category 1 credit as recognized by the American Medical Association to the holder of the license; and

(b) Is in addition to the continuing education required pursuant to NAC 630.153.

3. A course of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction will be deemed to satisfy the requirements of paragraph (a) of subsection 2 if the course was provided to a holder of a license to practice medicine:

(a) After January 1, 2002; and

(b) As a part of the training the holder of the license to practice medicine received:

(1) While serving in the military; or

(2) While serving as a public health officer.

(Added to NAC by Bd. of Medical Exam’rs by R145-03, eff. 12-16-2003)

NAC 630.155 Continuing education: Credit for continuing education course on geriatrics and gerontology or Alzheimer’s disease or other forms of dementia. (NRS 630.130, 630.253)

1. Except as otherwise provided in subsections 3 and 4, if a holder of a license to practice medicine takes a continuing education course on geriatrics and gerontology, the holder of the license is entitled to receive credit towards the continuing medical education required pursuant to NAC 630.153 equal to twice the number of hours the holder of the license actually spends in the continuing education course on geriatrics and gerontology.

2. Except as otherwise provided in subsections 3 and 4, if a holder of a license to practice medicine takes a continuing education course on the recent developments, research and treatment of Alzheimer’s disease or other forms of dementia, the holder of the license is entitled to receive credit towards the continuing medical education required pursuant to NAC 630.153 equal to twice the number of hours the holder of the license actually spends in the continuing education course on the recent developments, research and treatment of Alzheimer’s disease or other forms of dementia.

3. During any biennial licensing period, a holder of a license to practice medicine may receive a maximum credit pursuant to this section of 8 hours of continuing medical education for 4 hours of time spent in a continuing education course described in subsection 1 or 2, or both.

4. A holder of a license to practice medicine is only entitled to receive the additional credit for a continuing education course pursuant to either subsection 1 or 2, but not both.

(Added to NAC by Bd. of Medical Exam’rs by R145-03, eff. 12-16-2003; A by R103-15, 4-4-2016)

NAC 630.156 Continuing education: Training required for certain physicians relating to persons with substance use and other addictive disorders and prescribing of opioids; credit for training. (NRS 630.130, 630.2535)

1. Pursuant to the provisions of NRS 630.2535, a holder of a license to practice medicine who is registered to dispense controlled substances pursuant to NRS 453.231 shall, during each period for biennial registration, complete at least 2 hours of continuing medical education relating specifically to persons with substance use and other addictive disorders and the prescribing of opioids.

2. A program of continuing medical education relating specifically to persons with substance use and other addictive disorders and the prescribing of opioids must offer, upon successful completion of the program, a certificate of Category 1 credit as recognized by the American Medical Association to the holder of the license.

3. A holder of a license to practice medicine who is registered to dispense controlled substances pursuant to NRS 453.231 is entitled to receive credit towards the continuing medical education required pursuant to subsection 1 of NAC 630.153 for each hour of continuing medical education completed pursuant to subsection 1.

(Added to NAC by Bd. of Medical Exam'rs by R163-16, eff. 8-30-2018)

NAC 630.157 Continuing education: Licensing after beginning of period of biennial registration; change of status to active. (NRS 630.130, 630.253)

1. Except as otherwise provided in NAC 630.153, each person licensed after the beginning of a period of biennial registration must, if he or she was licensed during the:

(a) First 6 months of the biennial period of registration, complete 40 hours of Category 1 continuing medical education as recognized by the American Medical Association;

(b) Second 6 months of the biennial period of registration, complete 30 hours of Category 1 continuing medical education as recognized by the American Medical Association;

(c) Third 6 months of the biennial period of registration, complete 20 hours of Category 1 continuing medical education as recognized by the American Medical Association; or

(d) Fourth 6 months of the biennial period of registration, complete 10 hours of Category 1 continuing medical education as recognized by the American Medical Association.

2. An applicant who applies to change his or her status to active status must provide proof of completion of 40 hours of Category 1 continuing medical education as recognized by the American Medical Association within the 24 months immediately preceding such an application.

(Added to NAC by Bd. of Medical Exam’rs, 7-31-85, eff. 8-1-85; A 6-23-86; R149-97, 3-30-98)

NAC 630.162 Temporary license: “Community” interpreted. (NRS 630.130, 630.261) As used in paragraph (d) of subsection 1 of NRS 630.261, “community” means a geographical area or patient service area served by an agency of the State Government.

(Added to NAC by Bd. of Medical Exam’rs, eff. 11-21-88)

NAC 630.165 Effect of revocation of license in another jurisdiction: “Gross medical negligence” defined. (NRS 630.130, 630.161) For the purposes of NRS 630.161, “gross medical negligence” has the meaning:

1. Ascribed to it by the jurisdiction in which the license was revoked; or

2. Ascribed to a term which the Board determines to be substantially similar to “gross medical negligence” by the jurisdiction in which the license was revoked.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96)

NAC 630.170 Termination of license issued to alien. (NRS 630.130) A license issued to an alien automatically terminates if the alien loses his or her entitlement to remain and work in the United States. A license issued to an alien after March 15, 1999, must state in a conspicuous manner:

This license is issued subject to any limitations imposed by the United States Citizenship and Immigration Services of the Department of Homeland Security. This license becomes void immediately upon the termination of the right of the person named hereon to remain and work in the United States lawfully.

[Bd. of Medical Exam’rs, § 630.170, eff. 12-20-79] — (NAC A by R007-99, 9-27-99)

NAC 630.175 Fee for biennial registration: Payment; refund. (NRS 630.130, 630.267) Unless the license has expired for nonpayment of the fee for registration, any person licensed to practice by the Board after July 1 of the second year of a period of biennial registration shall pay one-half of the fee for biennial registration for the current period of biennial registration. Any person licensed to practice by the Board after commencement of a period of biennial registration, but on or before July 1 of the second year of a period of biennial registration, shall pay the full fee for biennial registration. Except as otherwise provided by specific regulation, the fees for biennial registration are not refundable.

(Added to NAC by Bd. of Medical Exam’rs, eff. 6-23-86; A 1-13-94; R141-11, 9-14-2012)

NAC 630.178 Change in status of license after expiration for nonpayment of fee. (NRS 630.130, 630.267) If a person whose license to practice medicine expired pursuant to NRS 630.267 for nonpayment of the fee for biennial registration wishes to change the status of his or her license from active to inactive or from inactive to active, the person must, within 2 years after the date on which the license expired, submit:

1. Twice the amount of the fee for biennial registration applicable to the status of his or her license at the time of the expiration; and

2. Any other information or documentation required to complete that biennial registration.

(Added to NAC by Bd. of Medical Exam’rs by R002-06, eff. 5-21-2007; A by R136-11, 9-14-2012)

NAC 630.180 Refund of fee for application; rejection of application. (NRS 630.130, 630.268)

1. If an applicant:

(a) Does not complete his or her application by providing all the documentation required by the form for application within 6 months after the actual date of filing of the form by the applicant;

(b) Withdraws his or her application; or

Ê the Board will not refund any portion of the fee for application.

2. Applications which are not completed within 6 months will be rejected.

3. If an applicant pays the fee for biennial registration at the time of application, the Board will refund the fee for biennial registration if the Board does not issue a license to the applicant for any reason set forth in subsection 1 or 2.

[Bd. of Medical Exam’rs, § 630.180, eff. 12-20-79] — (NAC A 6-23-86; 11-21-88; 1-13-94; R149-97, 3-30-98; R139-11, 9-14-2012)

STANDARDS OF PRACTICE

NAC 630.185 Standards established. (NRS 630.130) NAC 630.185 to 630.230, inclusive, set forth the standards of practice established by the Board.

(Added to NAC by Bd. of Medical Exam’rs, eff. 6-23-86; A 7-18-96)

NAC 630.187 Adoption by reference of Guidelines for the Chronic Use of Opioid Analgesics. (NRS 630.130, 630.275)

1. The Board hereby adopts by reference the Guidelines for the Chronic Use of Opioid Analgesics, April 2017, published by the Federation of State Medical Boards of the United States, Inc., and any subsequent revision of the publication that has been approved by the Board for use in this State. Each revision of the publication shall be deemed approved by the Board unless it disapproves of the revision within 180 days after the date of publication of the revision.

2. The most recent publication of the Guidelines for the Chronic Use of Opioid Analgesics that has been approved by the Board will be available for inspection at the office of the Board of Medical Examiners, 9600 Gateway Drive, Reno, Nevada 89521, or may be obtained, free of charge, from the Federation of State Medical Boards of the United States, Inc., 400 Fuller Wiser Road, Euless, Texas 76039, or from the Federation of State Medical Boards of the United States, Inc., at the Internet address http://www.fsmb.org.

3. The Board shall:

(a) Review each revision of the publication described in subsection 1 to ensure its suitability for this State; and

(b) File a copy of each revision of the publication described in subsection 1 that it approves with the Secretary of State and the State Library, Archives and Public Records Administrator.

(Added to NAC by Bd. of Medical Exam’rs by R089-00, eff. 7-19-2000; A by R059-11, 5-30-2012; R001-14, 6-26-2015; R021-15, 12-30-2015; R008-17, 8-21-2019)

NAC 630.190 Prohibited advertising. (NRS 630.130, 630.304)

1. A licensee shall not advertise in such a manner that the advertising:

(a) Claims that a manifestly incurable disease can be permanently cured;

(b) Includes any false claim of a licensee’s medical skill, or the efficacy or value of his or her medicine or treatment;

(c) Claims or implies professional superiority of the performance of any professional service in a manner superior to that of other practitioners;

(d) Guarantees any professional service or the results of any course of treatment or surgical procedure, or the performance of any operation painlessly;

(e) Includes any statement which is known to be false, or through the exercise of reasonable care should be known to be false, deceptive, misleading or harmful, in order to induce any person to purchase, utilize or acquire any professional services or to enter into any obligation or transaction relating thereto;

(f) Includes any extravagant claim, aggrandizement of abilities or self-laudatory statement calculated to attract patients, and which has a tendency to mislead the public or produce unrealistic expectations in particular cases; or

(g) Is false, deceptive or misleading in regard to the price, cost, charge, fee or terms of credit or services performed or to be performed.

2. It is sufficient for disciplinary purposes that any statement or other advertising described in paragraph (e), (f) or (g) of subsection 1 has a tendency to:

(a) Deceive, mislead or harm the public because of its false, deceptive, misleading or harmful character; or

(b) Produce unrealistic expectations in particular cases, even though no member of the public is actually deceived, misled or harmed, or no unrealistic expectations are actually produced by the statement or other advertising.

[Bd. of Medical Exam’rs, § 630.190, eff. 12-20-79] — (NAC A 6-23-86; R138-11, 9-14-2012)

NAC 630.210 Consultation with another provider of health care. (NRS 630.130) A physician shall seek consultation with another provider of health care in doubtful or difficult cases whenever it appears that consultation may enhance the quality of medical services.

[Bd. of Medical Exam’rs, § 630.210, eff. 12-20-79] — (NAC A 6-23-86)

NAC 630.225 Reporting of physician brought into this State for consultation with or assistance to licensed physician. (NRS 630.130)

1. Any physician licensed in this State shall notify the Board if any unlicensed physician comes into this State for consultation with or assistance to the physician licensed in this State and specify the date of the consultation or assistance, whether the unlicensed physician has provided such consultation or assistance, or both, to the licensed physician in the past, and the date of that consultation and assistance.

2. A physician licensed in this State who consults with or receives assistance from a physician licensed in another state pursuant to subsection 1 shall comply with the provisions of chapter 629 of NRS governing the preparation, retention or dissemination of any health care record resulting from the consultation or assistance between the physician licensed in this State and the physician licensed in another state.

(Added to NAC by Bd. of Medical Exam’rs, eff. 6-23-86; A by R045-09, 11-25-2009)

NAC 630.230 Prohibited professional conduct. (NRS 630.130, 630.275)

1. A person who is licensed as a physician or physician assistant shall not:

(a) Falsify records of health care;

(b) Falsify the medical records of a hospital so as to indicate his or her presence at a time when he or she was not in attendance or falsify those records to indicate that procedures were performed by him or her which were in fact not performed by him or her;

(c) Render professional services to a patient while the physician or physician assistant is under the influence of alcohol or any controlled substance or is in any impaired mental or physical condition;

(d) Acquire any controlled substances from any pharmacy or other source by misrepresentation, fraud, deception or subterfuge;

(e) Prescribe anabolic steroids for any person to increase muscle mass for competitive or athletic purposes;

(f) Make an unreasonable additional charge for tests in a laboratory, radiological services or other services for testing which are ordered by the physician or physician assistant and performed outside his or her own office;

(g) Allow any person to act as a medical assistant in the treatment of a patient of the physician or physician assistant, unless the medical assistant has sufficient training to provide the assistance;

(h) Fail to provide adequate supervision of a medical assistant who is employed or supervised by the physician or physician assistant, including, without limitation, supervision provided in the manner described in NAC 630.810 or 630.820;

(i) If the person is a physician, fail to provide adequate supervision of a physician assistant or an advanced practice registered nurse;

(j) Fail to honor the advance directive of a patient without informing the patient or the surrogate or guardian of the patient, and without documenting in the patient’s records the reasons for failing to honor the advance directive of the patient contained therein;

(k) Engage in the practice of writing prescriptions for controlled substances to treat acute pain or chronic pain in a manner that deviates from the policies set forth in the Guidelines for the Chronic Use of Opioid Analgesics adopted by reference in NAC 630.187; or

(l) Administer or use, or allow any person under his or her supervision, direction or control to administer or use, a single-use medical device:

(1) For more than one procedure;

(2) For more than one patient; or

(3) In a manner inconsistent with the manufacturer’s instructions or directions included on or with the single-use medical device.

2. As used in this section:

(a) “Chronic pain” has the meaning ascribed to it in section 3 of the Guidelines for the Chronic Use of Opioid Analgesics adopted by reference in NAC 630.187.

(b) “Single-dose vial” means a vial, including, without limitation, a sealed sterile vial, which may be accessed by insertion of a needle and which, according to the manufacturer’s instructions:

(1) Contains only one dose of a medication; and

(2) May be used for only one patient.

(c) “Single-use medical device” means a medical device that is intended for one use or on a single patient during a single procedure and includes, without limitation, a blade, clip, catheter, implant, insufflator, lancet, needle, sleeve, syringe and single-dose vial.

[Bd. of Medical Exam’rs, § 630.230, eff. 12-20-79] — (NAC A 6-23-86; 9-19-90; 1-13-94; 7-18-96; R007-99, 9-27-99; R089-00, 7-19-2000; R108-01, 11-29-2001; R052-10, 10-15-2010; R059-11, 5-30-2012; R094-12, 2-20-2013; R001-14 & R057-14, 6-26-2015; R008-17, 8-21-2019)

REPORTS

NAC 630.235 Annual reports of certain information concerning surgeries: Submission; form. (NRS 630.130, 630.30665)

1. Each holder of a license to practice medicine shall annually submit a report pursuant to NRS 630.30665, on a form to be provided by the Board. The form must include, without limitation:

(a) The name of the licensee;

(b) The office address of the licensee;

(d) The number and type of surgeries requiring conscious sedation, deep sedation or general anesthesia performed by the licensee at his or her office or any other facility, excluding any surgical care performed:

(1) At a medical facility, as defined in NRS 449.0151; or

(2) Outside of this State; and

(e) Information regarding the occurrence of any sentinel event arising from the type of surgeries described in paragraph (d).

2. As used in this section:

(a) “Conscious sedation” means a minimally depressed level of consciousness, produced by a pharmacologic or nonpharmacologic method, or a combination thereof, in which the patient retains the ability independently and continuously to maintain an airway and to respond appropriately to physical stimulation and verbal commands.

(b) “Deep sedation” means a controlled state of depressed consciousness, produced by a pharmacologic or nonpharmacologic method, or a combination thereof, and accompanied by a partial loss of protective reflexes and the inability to respond purposefully to verbal commands.

(c) “General anesthesia” means a controlled state of unconsciousness, produced by a pharmacologic or nonpharmacologic method, or a combination thereof, and accompanied by partial or complete loss of protective reflexes and the inability independently to maintain an airway and respond purposefully to physical stimulation or verbal commands.

(d) “Sentinel event” means an unexpected occurrence involving death or serious physical or psychological injury or the risk thereof, including, without limitation, any process variation for which a recurrence would carry a significant chance of serious adverse outcome. The term includes loss of limb or function.

(Added to NAC by Bd. of Medical Exam’rs by R169-05, eff. 12-29-2005)

NAC 630.237 Annual reports of certain information concerning surgeries: Administrative penalty. (NRS 630.130, 630.30665)

1. The failure of a holder of a license to practice medicine to submit to the Board a report required pursuant to NRS 630.30665:

(a) In a timely manner; or

(b) In an accurate or complete manner if the holder of the license knowingly misstates or misrepresents:

(1) The number or types of surgeries required to be reported pursuant to that section or NAC 630.235; or

(2) The occurrence or outcome of any reportable sentinel events pursuant to those sections,

Ê constitutes grounds for imposing an administrative penalty against the holder of the license.

2. An administrative penalty imposed pursuant to this section may include the imposition of an administrative fine of not less than $100 or more than $1,000 and recovery by the Board of all costs incurred by the Board because of the violation.

3. Repeated violations of this section are subject to an administrative fine in the amount of $1,000 in addition to recovery by the Board of all costs incurred by the Board because of the violations.

4. Before imposing any administrative penalty pursuant to this section, the Board will:

(a) Consider the totality of the circumstances surrounding the matter;

(b) Consider all evidence before it relating to the matter, including, without limitation, any intentional, volitional or purposeful conduct engaged in by the holder of the license; and

(c) Determine by a preponderance of the evidence that the applicable provisions of this section or NRS 630.30665 were violated.

5. The provisions of this section do not prohibit the Board from initiating disciplinary action for a violation of any other provision of this chapter or chapter 630 of NRS.

(Added to NAC by Bd. of Medical Exam’rs by R152-07, eff. 1-30-2008)

DISCIPLINARY ACTION

NAC 630.240 Voluntary surrender of license. (NRS 630.130, 630.298)

1. If a licensee desires to surrender his or her license to practice medicine, the licensee shall submit to the Board a sworn written statement of surrender of the license accompanied by delivery to the Board of the actual license issued to him or her. The Board will accept or reject the surrender of the license. If the Board accepts the surrender of the license, the surrender is absolute and irrevocable and the Board will notify any agency or person of the surrender and the conditions under which the surrender occurred, as the Board considers advisable.

2. The voluntary surrender of a license or the failure to renew a license does not preclude the Board from hearing a complaint for disciplinary action made against the licensee.

[Bd. of Medical Exam’rs, § 630.240, eff. 12-20-79] — (NAC A 6-23-86)

NAC 630.243 Procedure for dealing with findings of exposure to human immunodeficiency virus. (NRS 630.130, 630.269, 630.275) If a committee conducting an investigation pursuant to NRS 630.311 becomes aware that the physician, physician assistant, practitioner of respiratory care or perfusionist who is subject to the investigation has tested positive for exposure to the human immunodeficiency virus, the committee shall appoint a group of specialists in the fields of public health and infectious diseases who shall:

1. Review all the circumstances of the practice of the physician, physician assistant, practitioner of respiratory care or perfusionist; and

2. Advise the committee, in accordance with the guidelines on “Health Care Workers Infected with HIV” established by the Centers for Disease Control and Prevention, on the action, if any, the committee should take concerning the physician, physician assistant, practitioner of respiratory care or perfusionist.

(Added to NAC by Bd. of Medical Exam’rs by R007-99, eff. 9-27-99; A by R108-01, 11-29-2001; R060-11, 5-30-2012)

NAC 630.251 Grounds: “Gross malpractice” interpreted. (NRS 630.130, 630.301) For the purposes of NRS 630.301, as that section existed before October 1, 1997, a physician shall be deemed to have committed gross malpractice if, before October 1, 1997, the physician has failed to exercise the required degree of care, skill or knowledge and such failure amounts to:

1. A conscious indifference to the consequences which may result from the malpractice; and

2. A disregard for and indifference to the safety and welfare of a patient.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96; A by R149-97, 3-30-98)

NAC 630.255 Exemption from grounds: “Intractable pain” defined. (NRS 630.130, 630.135, 630.3066) For the purposes of NRS 630.3066, “intractable pain” means a condition of discomfort for which the cause cannot be removed or otherwise treated and for which a method of providing relief, or of which a cure for the cause, has not been found after reasonable efforts have been taken in accordance with accepted standards for the practice of medicine, including, but not limited to, evaluation by an attending physician and one or more physicians specializing in the treatment of the area, system, or organ of the body which is believed to be the source of the discomfort.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96)

NAC 630.258 Violation by licensee of certain provisions relating to prescriptions for controlled substances: Additional continuing education required; determination of violation and imposition of disciplinary action by Board. (NRS 630.130, 630.275, 630.323)

1. The disciplinary action imposed by the Board upon finding that a licensee has committed a violation described in subsection 6 of NRS 630.323 must include, without limitation, a requirement that the licensee complete additional continuing education concerning prescribing controlled substances listed in schedules II, III and IV.

2. The Board will consider the degree to which a licensee made a good faith attempt to comply with applicable provisions of law and regulations, including, without limitation, the provisions of NRS 639.2391 to 639.23916, inclusive, or any regulations adopted pursuant thereto, when determining:

(a) Whether a licensee has committed a violation described in subsection 6 of NRS 630.323; and

(b) The disciplinary action to impose for the violation, when applicable.

(Added to NAC by Bd. of Medical Exam’rs by R145-18, eff. 6-26-2019)

NAC 630.260 Notice of technical or scientific facts. (NRS 630.130) Parties to a disciplinary hearing before the Board will be notified, either before or during the hearing, of supposed technical or scientific facts of which the Board may take notice, and the parties will be afforded an opportunity to contest those facts. The Board’s experience, technical competence and specialized knowledge may be utilized in the evaluation of evidence.

[Bd. of Medical Exam’rs, § 630.260, eff. 12-20-79]

NAC 630.270 Disposition of findings and order of Board. (NRS 630.130, 630.269, 630.275) A copy of the disciplinary findings and order of the Board:

1. Will be served by personal service or by certified mail upon the person affected by them at the address of the person on file with the Board and his or her attorney of record;

2. Will be delivered by first-class mail or electronic mail to each hospital in the geographical area in which the physician, physician assistant, perfusionist or practitioner of respiratory care practices; and

3. May be delivered by first-class mail or electronic mail to members of the media.

[Bd. of Medical Exam’rs, § 630.270, eff. 12-20-79] — (NAC A by R149-97, 3-30-98; R007-99, eff. 9-27-99; R062-11, 5-30-2012)

NAC 630.275 Confidentiality of certain information regarding physicians, physician assistants, practitioners of respiratory care and perfusionists. (NRS 630.130, 630.269, 630.275, 630.279, 630.336) The Board will, pursuant to subsection 3 of NRS 630.336, keep confidential all records relating to a program established by the Board to enable a physician, physician assistant, practitioner of respiratory care or perfusionist to correct:

1. A dependence upon alcohol or a controlled substance; or

2. Any other impairment which could result in the revocation of his or her license.

(Added to NAC by Bd. of Medical Exam’rs, eff. 7-18-96; A by R044-09, 11-25-2009, eff. 7-1-2010)

PHYSICIAN ASSISTANTS

NAC 630.280 Qualifications of applicants. (NRS 630.130, 630.275) An applicant for licensure as a physician assistant must have the following qualifications:

1. If the applicant has not practiced as a physician assistant for 12 months or more before applying for licensure in this State, he or she must, at the order of the Board, have taken and passed the same examination to test medical competency as that given to applicants for initial licensure.

2. Be a citizen of the United States or be lawfully entitled to remain and work in the United States.

3. Be able to communicate adequately orally and in writing in the English language.

4. Be of good moral character and reputation.

5. Have attended and completed a course of training in residence as a physician assistant approved by one of the following entities affiliated with the American Medical Association or its successor organization:

(a) The Committee on Allied Health Education and Accreditation or its successor organization;

(b) The Commission on Accreditation of Allied Health Education Programs or its successor organization; or

6. Be certified by the National Commission on Certification of Physician Assistants or its successor organization.

7. Possess a high school diploma, general equivalency diploma or postsecondary degree.

[Bd. of Medical Exam’rs, § 630.280, eff. 12-20-79] — (NAC A 6-23-86; 11-21-88; 9-12-91; R149-97, 3-30-98; R108-01, 11-29-2001; R036-13, 2-26-2014; R022-15, 12-30-2015)

NAC 630.290 Application for license. (NRS 630.130, 630.275)

1. An application for licensure as a physician assistant must be made on a form supplied by the Board. The application must state:

(a) The date and place of the applicant’s birth and his or her sex;

(b) The applicant’s education, including, without limitation, high schools and postsecondary institutions attended, the length of time in attendance at each and whether he or she is a graduate of those schools and institutions;

(c) Whether the applicant has ever applied for a license or certificate as a physician assistant in another state and, if so, when and where and the results of his or her application;

(d) The applicant’s training and experience as a physician assistant;

(e) Whether the applicant has ever been investigated for misconduct as a physician assistant or had a license or certificate as a physician assistant revoked, modified, limited or suspended or whether any disciplinary action or proceedings have ever been instituted against the applicant by a licensing body in any jurisdiction;

(f) Whether the applicant has ever been convicted of a felony or an offense involving moral turpitude;

(g) Whether the applicant has ever been investigated for, charged with or convicted of the use or illegal sale or dispensing of controlled substances; and

(h) The various places of his or her residence from the date of:

(1) Graduation from high school;

(2) Receipt of a high school general equivalency diploma; or

(3) Receipt of a postsecondary degree,

Ê whichever occurred most recently.

2. An applicant must submit to the Board:

(a) Proof of completion of an educational program as a physician assistant:

(1) If the applicant completed the educational program on or before December 31, 2001, which was approved by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs; or

(2) If the applicant completed the educational program on or after January 1, 2002, which is accredited by the Accreditation Review Commission on Education for the Physician Assistant or approved by the Commission on Accreditation of Allied Health Education Programs;

(b) Proof of passage of the examination given by the National Commission on Certification of Physician Assistants; and

3. Each application must be signed by the applicant and sworn to before a notary public or other officer authorized to administer oaths.

4. The application must be accompanied by the applicable fee.

5. An applicant shall pay the reasonable costs of any examination required for licensure.

[Bd. of Medical Exam’rs, § 630.290, eff. 12-20-79] — (NAC A 6-23-86; 9-12-91; 1-13-94; 11-3-95; 7-18-96; R149-97, 3-30-98; R007-99, eff. 9-27-99; R108-01, 11-29-2001; R145-03, 12-16-2003)

NAC 630.310 Rejection of application. (NRS 630.130, 630.275) If it appears that:

1. An applicant for licensure as a physician assistant is not qualified or is not of good moral character or reputation;

2. Any credential submitted is false; or

3. The application is not made in proper form or other deficiencies appear in it,

Ê the application may be rejected.

[Bd. of Medical Exam’rs, § 630.310, eff. 12-20-79] — (NAC A 6-23-86; R149-97, 3-30-98; R108-01, 11-29-2001)

NAC 630.315 Denial of application. (NRS 630.130, 630.275) The Board may deny an application for the issuance or renewal of a license to practice as a physician assistant if the applicant has committed any of the acts described in subsection 1 of NAC 630.380.

(Added to NAC by Bd. of Medical Exam’rs by R080-06, eff. 9-18-2006)

NAC 630.320 Temporary license. (NRS 630.130, 630.275)

1. The Board will issue a temporary license to any qualified applicant who:

(a) Meets the educational and training requirements for certification as a physician assistant of the National Commission on Certification of Physician Assistants and is scheduled to and does sit for the first proficiency examination offered by the National Commission on Certification of Physician Assistants following the completion of his or her training;

(b) Has taken the proficiency examination offered by the National Commission on Certification of Physician Assistants but has not yet been notified of the results; or

(c) Is licensed or certified in another state, meets the requirements for licensure pursuant to NAC 630.280 and is scheduled to sit for the next examination offered by the Board.

2. A physician assistant with a temporary license may perform services only under the immediate supervision of a supervising physician.

[Bd. of Medical Exam’rs, § 630.320, eff. 12-20-79] — (NAC A 6-23-86; 3-19-87; 11-21-88; 9-12-91; 1-13-94; R149-97, 3-30-98; R108-01, 11-29-2001)

NAC 630.325 Locum tenens license. (NRS 630.130, 630.275) The Board may issue a locum tenens license, which is effective for not more than 3 months after issuance, to any physician assistant who is licensed or certified as a physician assistant and in good standing in another state and who is of good moral character and reputation. The purpose of this license is to enable an eligible physician assistant to serve as a substitute for another physician assistant who is licensed to practice as a physician assistant in this State and who is absent from his or her practice for reasons deemed sufficient by the Board. A license issued pursuant to this section is not renewable.

(Added to NAC by Bd. of Medical Exam’rs, eff. 1-13-94; A by R149-97, 3-30-98; R108-01, 11-29-2001)

NAC 630.330 Contents of license. (NRS 630.130, 630.275) The license issued by the Board must contain:

1. The name of the physician assistant;

2. The duration of the license; and

3. Any other limitations or requirements which the Board prescribes.

[Bd. of Medical Exam’rs, § 630.330, eff. 12-20-79] — (NAC A 6-23-86; 11-21-88; 9-12-91; 1-13-94; 7-18-96; R149-97, 3-30-98; R108-01, 11-29-2001; R145-03, 12-16-2003)

NAC 630.340 Period of validity of license; notification of practice; termination of supervision; disciplinary action; refusal to license. (NRS 630.130, 630.275)

1. The license of a physician assistant is valid for 2 years.

2. Before providing medical services, a physician assistant, on a form prescribed by the Board, shall notify the Board of the name and location of the practice of the physician assistant, the name of the supervising physician and the portion of the practice of the physician assistant that the supervising physician supervises. The notice must contain the signatures of the physician assistant and the supervising physician of the physician assistant.

3. The physician assistant and the supervising physician shall immediately notify the Board of the termination of the supervision of the physician assistant by the supervising physician. For any portion of the practice of the physician assistant that the supervising physician terminating supervision of the physician assistant supervised, the physician assistant shall not provide medical services until the physician assistant and a supervising physician submit notice to the Board pursuant to subsection 2.

4. A physician assistant who has been licensed by the Board but is not currently licensed, has surrendered his or her license or has failed to renew his or her license will be disciplined by the Board, if the Board deems it necessary, upon hearing a complaint for disciplinary action against the physician assistant.

5. If the Board determines that the conduct of a physician assistant when he or she was on inactive status in another jurisdiction would have resulted in the denial of an application for licensure in this State, the Board will, if appropriate, refuse to license the physician assistant.

[Bd. of Medical Exam’rs, § 630.340, eff. 12-20-79] — (NAC A 6-23-86; 9-12-91; 1-13-94; R149-97, 3-30-98; R108-01, 11-29-2001; R145-03, 12-16-2003)

NAC 630.350 Renewal, expiration and reinstatement of license. (NRS 630.130, 630.253, 630.275)

1. The license of a physician assistant may be renewed biennially. The license will not be renewed unless the physician assistant provides satisfactory proof that the physician assistant has completed the following number of hours of continuing medical education as defined by the American Academy of Physician Assistants or has received a certificate documenting the completion of the following number of hours of Category 1 credits as recognized by the American Medical Association:

(a) If licensed during the first 6 months of the biennial period of registration, 40 hours.

(b) If licensed during the second 6 months of the biennial period of registration, 30 hours.

(d) If licensed during the fourth 6 months of the biennial period of registration, 10 hours.

2. To allow for the renewal of a license to practice as a physician assistant by each person to whom a license was issued or renewed in the preceding renewal period, the Board will make such reasonable attempts as are practicable to:

(a) Mail a renewal notice at least 60 days before the expiration of a license to practice as a physician assistant; and

(b) Send a renewal application to a licensee at the last known address of the licensee on record with the Board.

3. If a licensee fails to pay the fee for biennial registration after it becomes due or fails to submit proof that the licensee completed the number of hours of continuing medical education required by subsection 1, his or her license to practice in this State expires. Within 2 years after the date on which the license expires, the holder may be reinstated to practice as a physician assistant if the holder:

(a) Pays twice the amount of the current fee for biennial registration to the Secretary-Treasurer of the Board;

(b) Submits proof that he or she completed the number of hours of continuing medical education required by subsection 1; and

[Bd. of Medical Exam’rs, § 630.350, eff. 12-20-79] — (NAC A 6-23-86; 1-13-94; R149-97, 3-30-98; R108-01, 11-29-2001; R208-07, 8-26-2008; R038-09, 11-25-2009; R048-10, 10-15-2010; R137-11, 9-14-2012)

NAC 630.353 Continuing education: Course of instruction relating to medical consequences of act of terrorism involving use of weapon of mass destruction. (NRS 630.130, 630.253, 630.275)

1. Pursuant to the provisions of NRS 630.253, a physician assistant shall complete a course of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction:

(a) If the physician assistant was initially licensed by the Board on or after October 1, 2003, within 2 years of initial licensure.

(b) If the physician assistant was initially licensed by the Board before October 1, 2003, on or before September 30, 2005.

(b) Is in addition to the continuing education required pursuant to NAC 630.350.

(a) After January 1, 2002; and

(b) As a part of the training the physician assistant received:

(1) While serving in the military; or

(2) While serving as a public health officer.

(Added to NAC by Bd. of Medical Exam’rs by R145-03, eff. 12-16-2003)

NAC 630.357 Continuing education: Credit for continuing education course on geriatrics and gerontology or Alzheimer’s disease or other forms of dementia. (NRS 630.130, 630.253, 630.275)

1. Except as otherwise provided in subsections 3 and 4, if a physician assistant takes a continuing education course on geriatrics and gerontology, the physician assistant is entitled to receive credit towards the continuing medical education required pursuant to NAC 630.350 equal to twice the number of hours the physician assistant actually spends in the continuing education course on geriatrics and gerontology.

2. Except as otherwise provided in subsections 3 and 4, if a physician assistant takes a continuing education course on the recent developments, research and treatment of Alzheimer’s disease or other forms of dementia, the physician assistant is entitled to receive credit towards the continuing medical education required pursuant to NAC 630.350 equal to twice the number of hours the physician assistant actually spends in the continuing education course on the recent developments, research and treatment of Alzheimer’s disease or other forms of dementia.

3. During any biennial licensing period, a physician assistant may receive a maximum credit pursuant to this section of 8 hours of continuing medical education for 4 hours of time spent in a continuing education course described in subsection 1 or 2, or both.

4. A physician assistant is only entitled to receive the additional credit for a continuing education course pursuant to either subsection 1 or 2, but not both.

(Added to NAC by Bd. of Medical Exam’rs by R145-03, eff. 12-16-2003; A by R103-15, 4-4-2016)

NAC 630.358 Continuing education: Training required for certain physician assistants relating to persons with substance use and other addictive disorders and prescribing of opioids; credit for training. (NRS 630.130, 630.2535)

1. Pursuant to the provisions of NRS 630.2535, a physician assistant who is registered to dispense controlled substances pursuant to NRS 453.231 shall, during each period for biennial registration, complete at least 2 hours of continuing medical education relating specifically to persons with substance use and other addictive disorders and the prescribing of opioids.

2. A program of continuing medical education relating specifically to persons with substance use and other addictive disorders and the prescribing of opioids must:

(a) Be a program of continuing medical education as defined by the American Academy of Physician Assistants; or

(b) Offer, upon successful completion of the program, a certificate of Category 1 credit as recognized by the American Medical Association to the physician assistant.

3. A physician assistant who is registered to dispense controlled substances pursuant to NRS 453.231 is entitled to receive credit towards the continuing medical education required pursuant to subsection 1 of NAC 630.350 for each hour of continuing medical education completed pursuant to subsection 1.

(Added to NAC by Bd. of Medical Exam’rs by R163-16, eff. 8-30-2018)

NAC 630.360 Performance of authorized medical services; identification; misrepresentation; notification of change regarding supervising physician. (NRS 630.130, 630.275)

1. The medical services which a physician assistant is authorized to perform must be:

(a) Commensurate with the education, training, experience and level of competence of the physician assistant; and

(b) Within the scope of the practice of the supervising physician of the physician assistant.

2. The physician assistant shall wear at all times while on duty a placard, plate or insigne which identifies him or her as a physician assistant.

3. No physician assistant may represent himself or herself in any manner which would tend to mislead the general public or the patients of the supervising physician.

4. Except as otherwise provided in subsection 3 of NAC 630.340, a physician assistant shall notify the Board in writing within 72 hours after any change in the supervision of the physician assistant by a supervising physician.

[Bd. of Medical Exam’rs, § 630.360, eff. 12-20-79] — (NAC A 6-23-86; 9-12-91; 1-13-94; R149-97, 3-30-98; R108-01, 11-29-2001; R183-12, 4-5-2013)

NAC 630.370 Supervising physician: Duties; qualifications. (NRS 630.130, 630.275)

1. Except as otherwise provided in NAC 630.375, the supervising physician is responsible for all the medical activities of his or her physician assistant and shall ensure that:

(a) The physician assistant is clearly identified to the patients as a physician assistant;

(b) The physician assistant performs only those medical services which have been approved by his or her supervising physician;

(c) The physician assistant does not represent himself or herself in any manner which would tend to mislead the general public, the patients of the supervising physician or any other health professional; and

(d) There is strict compliance with:

(1) The provisions of the certificate of registration issued to his or her physician assistant by the State Board of Pharmacy pursuant to NRS 639.1373; and

(2) The regulations of the State Board of Pharmacy regarding controlled substances, poisons, dangerous drugs or devices.

2. Except as otherwise required in subsection 3 or 4, the supervising physician shall review and initial selected charts of the patients of the physician assistant. Unless the physician assistant is performing medical services pursuant to NAC 630.375, the supervising physician must be available at all times that his or her physician assistant is performing medical services to consult with his or her assistant. Those consultations may be indirect, including, without limitation, by telephone.

3. At least once a month, the supervising physician shall spend part of a day at any location where the physician assistant provides medical services to act as a consultant to the physician assistant and to monitor the quality of care provided by the physician assistant.

4. Except as otherwise provided in this subsection, if the supervising physician is unable to supervise the physician assistant as required by this section, the supervising physician shall designate a qualified substitute physician, who practices medicine in the same specialty as the supervising physician, to supervise the assistant. If the physician assistant is performing medical services pursuant to NAC 630.375, the supervising physician is not required to comply with this subsection.

5. A physician who supervises a physician assistant shall develop and carry out a program to ensure the quality of care provided by a physician assistant. The program must include, without limitation:

(a) An assessment of the medical competency of the physician assistant;

(b) A review and initialing of selected charts;

(c) An assessment of a representative sample of the referrals or consultations made by the physician assistant with other health professionals as required by the condition of the patient;

(d) Direct observation of the ability of the physician assistant to take a medical history from and perform an examination of patients representative of those cared for by the physician assistant; and

(e) Maintenance by the supervising physician of accurate records and documentation regarding the program for each physician assistant supervised.

6. Except as otherwise provided in subsection 7, a physician may supervise a physician assistant if the physician:

(a) Holds an active license in good standing to practice medicine issued by the Board;

(b) Actually practices medicine in this State; and

7. If the Board has disciplined a physician assistant pursuant to NAC 630.410, a physician shall not supervise that physician assistant unless the physician has been specifically approved by the Board to act as the supervising physician of that physician assistant.

[Bd. of Medical Exam’rs, § 630.370, eff. 12-20-79] — (NAC A 6-23-86; 11-21-88; 9-12-91; 1-13-94; R149-97, 3-30-98; R108-01, 11-29-2001; R145-03, 12-16-2003; R005-07, 10-31-2007)

NAC 630.375 Physician assistant deemed to be agent of supervising physician; performance of emergency medical services without supervision. (NRS 630.130, 630.275)

1. Except as otherwise provided in this section, a physician assistant is considered to be and is deemed the agent of his or her supervising physician in the performance of all medical activities.

2. A physician assistant shall not perform medical services without supervision from his or her supervising physician, except in:

(a) Life-threatening emergencies, including, without limitation, at the scene of an accident; or

(b) Emergency situations, including, without limitation, human-caused or natural disaster relief efforts.

3. When a physician assistant performs medical services in a situation described in subsection 2:

(a) The physician assistant is not the agent of his or her supervising physician and the supervising physician is not responsible or liable for any medical services provided by the physician assistant.

(b) The physician assistant shall provide whatever medical services are possible based on the need of the patient and the training, education and experience of the physician assistant.

(d) The physician assistant shall make a reasonable effort to contact his or her supervising physician, as soon as possible, to advise him or her of the incident and the physician assistant’s role in providing medical services.

(Added to NAC by Bd. of Medical Exam’rs by R005-07, eff. 10-31-2007)

NAC 630.380 Disciplinary action: Grounds; institution; exception. (NRS 630.130, 630.138, 630.275)

1. A physician assistant is subject to disciplinary action by the Board if, after notice and hearing in accordance with this chapter, the Board finds that the physician assistant:

(a) Has willfully and intentionally made a false or fraudulent statement or submitted a forged or false document in applying for a license;

(b) Has held himself or herself out as or permitted another to represent the physician assistant to be a licensed physician;

(1) Pursuant to NAC 630.375; or

(2) At the direction or under the supervision of the supervising physician of the physician assistant;

(d) Has performed medical services which have not been approved by the supervising physician of the physician assistant, unless the medical services were performed pursuant to NAC 630.375;

(e) Is guilty of gross or repeated malpractice in the performance of medical services for acts committed before October 1, 1997;

(f) Is guilty of malpractice in the performance of medical services for acts committed on or after October 1, 1997;

(g) Is guilty of disobedience of any order of the Board or an investigative committee of the Board, any provision in the regulations of the State Board of Health or the State Board of Pharmacy or any provision of this chapter;

(h) Is guilty of administering, dispensing or possessing any controlled substance otherwise than in the course of legitimate medical services or as authorized by law and the supervising physician of the physician assistant;

(i) Has been convicted of a violation of any federal or state law regulating the prescribing, possession, distribution or use of a controlled substance;

(j) Is not competent to provide medical services;

(k) Failed to notify the Board of an involuntary loss of certification by the National Commission on Certification of Physician Assistants within 30 days after the involuntary loss of certification;

(l) Is guilty of violating a provision of NAC 630.230, 630.810, 630.820 or 630.830;

(m) Is guilty of violating a provision of NRS 630.301 to 630.3065, inclusive; or

(n) Is guilty of violating a provision of subsection 2 or 3 of NAC 630.340.

2. To institute disciplinary action against a physician assistant, a written complaint, specifying the charges, must be filed with the Board by the investigative committee of the Board.

3. A physician assistant is not subject to disciplinary action solely for prescribing or administering to a patient under the care of the physician assistant a controlled substance which is listed in schedule II, III, IV or V by the State Board of Pharmacy pursuant to NRS 453.146.

[Bd. of Medical Exam’rs, § 630.380, eff. 12-20-79] — (NAC A 6-23-86; 9-12-91; 1-13-94; R149-97, 3-30-98; R007-99, 9-27-99; R089-00, 7-19-2000; R108-01, 11-29-2001; R145-03, 12-16-2003; R005-07, 10-31-2007; R039-09, 11-25-2009; R094-12, 2-20-2013)

NAC 630.390 Disciplinary action: Notice of charges. (NRS 630.130, 630.275) Before the Board takes disciplinary action against a physician assistant, the Board will give to the physician assistant and to his or her supervising physician a written notice specifying the charges made against the physician assistant and stating that the charges will be heard at the time and place indicated in the notice. The notice will be served on the physician assistant and the supervising physician at least 20 days before the date fixed for the hearing. Service of the notice will be made and any investigation and subsequent disciplinary proceedings will be conducted in the same manner as provided by law for disciplinary actions against physicians.

[Bd. of Medical Exam’rs, § 630.390, eff. 12-20-79] — (NAC A 6-23-86; R149-97, 3-30-98; R108-01, 11-29-2001)

NAC 630.400 Examination to determine fitness to practice. (NRS 630.130, 630.275)

1. If the Board or any investigative committee of the Board has reason to believe that the conduct of any physician assistant has raised a reasonable question as to his or her competence to practice as a physician assistant with reasonable skill and safety to patients, it may order that the physician assistant undergo a mental or physical examination or an examination testing his or her competence to practice as a physician assistant by physicians or any other examination designated by the Board to assist the Board or committee in determining the fitness of the physician assistant to practice as a physician assistant.

2. Every physician assistant who applies for or is issued a license and who accepts the privilege of performing medical services in this State shall be deemed to have given his or her consent to submit to such an examination pursuant to subsection 1 when the physician assistant is directed to do so in writing by the Board.

3. For the purpose of this section, the report of testimony or examination by the examining physicians does not constitute a privileged communication.

4. Except in extraordinary circumstances, as determined by the Board, the failure of a licensed physician assistant to submit to an examination when he or she is directed to do so pursuant to this section constitutes an admission of the charges against him or her. A default and final order may be entered without the taking of testimony or presentation of evidence.

5. A physician assistant who is subject to an examination pursuant to this section shall pay the costs of the examination.

[Bd. of Medical Exam’rs, § 630.400, eff. 12-20-79] — (NAC A 6-23-86; 1-13-94; R149-97, 3-30-98; R007-99, 9-27-99; R108-01, 11-29-2001)

NAC 630.410 Determination after notice and hearing: Sanctions or dismissal of charges. (NRS 630.130, 630.275) If the Board finds, by a preponderance of the evidence, after notice and hearing in accordance with this chapter, that:

1. The charges in the complaint against the physician assistant are true, the Board will issue and serve on the physician assistant its written findings and any order of sanctions. The following sanctions may be imposed by order:

(a) Placement on probation for a specified period on any of the conditions specified in the order.

(b) Administration of a public reprimand.

(c) Limitation of his or her practice or exclusion of one or more specified branches of medicine from his or her practice.

(d) Suspension of his or her license, for a specified period or until further order of the Board.

(e) Revocation of his or her license to practice.

(f) A requirement that the physician assistant participate in a program to correct alcohol or drug dependence or any other impairment.

(g) A requirement that there be additional and specified supervision of his or her practice.

(h) A requirement that the physician assistant perform community service without compensation.

(i) A requirement that the physician assistant take a physical or mental examination or an examination testing his or her medical competence.

(j) A requirement that the physician assistant fulfill certain training or educational requirements, or both, as specified by the Board.

(k) A fine not to exceed $5,000.

(l) A requirement that the physician assistant pay all costs incurred by the Board relating to the disciplinary proceedings.

2. No violation has occurred, it will issue a written order dismissing the charges and notify the physician assistant that the charges have been dismissed. If the disciplinary proceedings were initiated as a result of a complaint filed against the physician assistant, the Board may provide to the physician assistant a copy of the complaint and the name of the person who filed the complaint.

[Bd. of Medical Exam’rs, § 630.410, eff. 12-20-79] — (NAC A 6-23-86; 1-13-94; R149-97, 3-30-98; R108-01, 11-29-2001)

NAC 630.415 Advisory committee. (NRS 630.130, 630.275)

1. The Board will appoint three licensed physician assistants to an advisory committee. These physician assistants must have lived in and actively and continuously practiced in this State as licensed physician assistants for at least 3 years before their appointment.

2. The Board will give appointees to the advisory committee written notice of their appointment and terms of office and a written summary of any projects pending before the committee.

3. At the request of the Board, the advisory committee shall review and make recommendations to the Board concerning any matters relating to licensed physician assistants.

(Added to NAC by Bd. of Medical Exam’rs, eff. 6-23-86; A 11-21-88; R149-97, 3-30-98; R108-01, 11-29-2001)

PETITIONS, ORDERS, OPINIONS AND RULES OF PRACTICE

NAC 630.420 Petition for amendment or repeal of regulation. (NRS 630.130) A petition requesting the adoption, filing, amendment or repeal of any regulation must be accompanied by a draft of the proposed regulation in a form suitable for filing with the Secretary of State.

[Bd. of Medical Exam’rs, § 630.420, eff. 12-20-79]

NAC 630.430 Filing of petition; copies. (NRS 630.130) A petition described in NAC 630.420 must be filed with the Board. The original and 12 copies of the petition must be filed, together with the original and 12 copies of the proposed regulation.

[Bd. of Medical Exam’rs, § 630.430, eff. 12-20-79] — (NAC A 6-23-86; R149-97, 3-30-98; R002-14, 6-26-2015)

NAC 630.440 Submission, consideration and disposition of petitions. (NRS 630.130)

1. Any petition described in NAC 630.420 filed more than 30 days before the next regularly scheduled meeting of the Board will be considered by the Board at that meeting. Any petition filed 30 days or less before the next regularly scheduled meeting of the Board will be considered at the first regular meeting scheduled more than 30 days after the petition is filed.

2. The Board will, within 30 days after consideration of a petition, deny the petition in writing stating the reasons for the denial or initiate proceedings under NRS 233B.060 for adoption of the proposed regulation.

[Bd. of Medical Exam’rs, § 630.440, eff. 12-20-79] — (NAC A by R002-14, 6-26-2015)

NAC 630.450 Declaratory orders and advisory opinions. (NRS 630.130)

1. A petition for a declaratory order or advisory opinion may be filed only by a holder of or applicant for a license.

2. The original and 12 copies of the petition must be filed with the Board not less than 31 days before its next regularly scheduled meeting. The petition must be submitted to the Board at that meeting. Within 30 days thereafter, the Board will issue its declaratory order or advisory opinion.

[Bd. of Medical Exam’rs, § 630.450, eff. 12-20-79] — (NAC A 6-23-86; R149-97, 3-30-98; R002-14, 6-26-2015)

NAC 630.455 Time limit for request to Board for consideration or action upon matter at meeting. (NRS 630.130) A request for the Board to consider or take action upon a matter at a meeting other than a petition described in NAC 630.420 or 630.450 must be received by the Board at least 31 days before the date of the meeting.

(Added to NAC by Bd. of Medical Exam’rs by R007-99, eff. 9-27-99; A by R002-14, 6-26-2015)

NAC 630.460 Hearings: Appearance; pleadings; motions; documents. (NRS 630.130)

1. Each party shall enter his or her appearance at the beginning of a hearing or at a time designated by the presiding officer by giving the party’s name and address and stating his or her position or interest to the presiding officer. The information will be entered in the record of the hearing.

2. Following the entry of an appearance by an attorney for a party, all notices, pleadings and orders to be served on that party must be served upon the attorney, and that service is valid for all purposes upon the party represented.

3. All pleadings must be verified.

4. A party may respond to a complaint by filing an answer within 20 working days after receiving the complaint. If a party fails to file an answer within the time prescribed, he or she shall be deemed to have denied generally the allegations of the complaint.

5. All motions, unless they are made during a hearing, must be in writing. All written motions must set forth the nature of relief sought, the grounds therefor and the points and authorities relied upon in support of the motion. A party desiring to oppose a motion may serve and file a written response to the motion within 10 working days after service of the motion. The moving party may serve and file a written reply within 5 working days after service of the opposition to the motion. All motions made during a hearing must be based upon matters arising during the hearing. A decision on the motion will be rendered without oral argument unless oral argument is ordered by the Board, a panel of members of the Board or the hearing officer in which event the Board, panel or hearing officer will set a date and time for hearing.

6. The original and two copies of each pleading, motion or other paper must be filed with the Board. A copy of each pleading or motion must be made available by the party filing it to any other person whom the Board determines may be affected by the proceeding and who desires the copy.

7. Any document required to be served by a party, other than a notice of hearing, complaint, adverse decision, or order of the Board, may be served by mail, and the service shall be deemed complete when a true copy of the document, properly addressed and stamped, is deposited in the United States mail.

8. There must appear on, or be attached to, each document required to be served:

(a) Proof of service by a certificate of an attorney or his or her employee;

(b) Proof of personal service;

(d) An affidavit of mailing.

[Bd. of Medical Exam’rs, § 630.460, eff. 12-20-79] — (NAC A 6-23-86; 1-13-94; R149-97, 3-30-98)

NAC 630.465 Hearings: Prehearing conference. (NRS 630.130, 630.275)

1. At least 30 days before a hearing but not earlier than 30 days after the date of service upon the physician or physician assistant of a formal complaint that has been filed with the Board pursuant to NRS 630.311, unless a different time is agreed to by the parties, the presiding member of the Board or panel of members of the Board or the hearing officer shall conduct a prehearing conference with the parties and their attorneys. All documents presented at the prehearing conference are not evidence, are not part of the record and may not be filed with the Board.

2. Each party shall provide to every other party a copy of the list of proposed witnesses and their qualifications and a summary of the testimony of each proposed witness. A witness whose name does not appear on the list of proposed witnesses may not testify at the hearing unless good cause is shown.

3. All evidence, except rebuttal evidence, which is not provided to each party at the prehearing conference may not be introduced or admitted at the hearing unless good cause is shown.

4. Each party shall submit to the presiding member of the Board or panel or to the hearing officer conducting the conference each issue which has been resolved by negotiation or stipulation and an estimate, to the nearest hour, of the time required for presentation of its oral argument.

(Added to NAC by Bd. of Medical Exam’rs, eff. 1-13-94; A by R149-97, 3-30-98; R167-99, 1-19-2000; R108-01, 11-29-2001)

NAC 630.470 Hearings: Procedure. (NRS 630.130, 630.275)

1. The President of the Board shall determine whether a hearing will be held before the Board, a hearing officer or a panel of members of the Board. Any hearing before the Board must be held before a majority of the members of the Board.

2. If a licensee fails to appear at a scheduled hearing and no continuance has been requested and granted, the evidence may be heard and the matter may be considered and disposed of on the basis of the evidence before the Board, panel or hearing officer in the manner required by this section.

3. The presiding member of the Board or panel, or the hearing officer will call the hearing to order and proceed to take the appearances on behalf of the Board, panel or hearing officer and the licensee, any other party and their counsel. The Board, panel or hearing officer will act upon any pending motions, stipulations and preliminary matters. The notice of hearing, complaint, petition, answer, response or written stipulation becomes a part of the record without being read unless a party requests that the document be read verbatim into the record. The Board will present its evidence first and then the licensee will submit his or her evidence. Closing statements by the parties may be allowed by the Board, panel or hearing officer.

4. Prehearing depositions of witnesses and parties may not be taken and no formal discovery of evidence, except as otherwise provided in NAC 630.465, will be allowed.

5. The Board, panel or hearing officer will hear the evidence presented, make appropriate rulings on the admissibility of evidence, and maintain procedure and order during the hearing. The Board, panel or hearing officer may not dismiss the complaint.

6. The presiding member of the Board or panel or the hearing officer may, upon his or her motion or the motion of a party, order a witness, other than the licensee, to be excluded from the hearing to prevent that witness from hearing the testimony of another witness at the hearing.

7. Briefs must be filed upon the order of the Board, panel or hearing officer. The time for filing briefs will be set by the Board, panel or hearing officer.

8. The hearing officer or panel of members of the Board conducting a hearing shall:

(a) Submit to the Board a synopsis of the testimony taken at the hearing; and

(b) Make a recommendation to the Board on the veracity of witnesses if there is conflicting evidence or the credibility of witnesses is a determining factor.

9. A case shall be deemed submitted for decision by the Board after the taking of evidence, the filing of briefs or the presentation of such oral arguments as may have been permitted, the filing of the transcript of the hearing and the filing of the synopsis of the testimony taken at the hearing. The Board will issue its order or render its decision within 90 days after the hearing or the submission of the case, whichever is later.

(Added to NAC by Bd. of Medical Exam’rs, eff. 6-23-86; A 1-13-94; R149-97, 3-30-98; R108-01, 11-29-2001)

NAC 630.475 Subpoenas. (NRS 630.130, 630.140)

1. A subpoena issued pursuant to NRS 630.140 must specify the name of the witness and specifically identify the books, X-rays, medical records or other papers which are required to be produced.

2. The Board or a person acting on its behalf will not issue a subpoena to compel the attendance of a member of the Board or a licensee at a hearing or require a member of the Board or a licensee to produce books, X-rays, medical records or any other papers during a hearing.

3. The Board or a person acting on its behalf will not petition the district court for an order compelling compliance with a subpoena unless:

(a) At the time the subpoena is served, the witness is tendered:

(1) A fee of $25 for the first day of attendance at the hearing;

(2) An allowance for travel which is equal to the allowance for travel by private conveyance provided for state officers and employees generally; and

(3) A per diem allowance equal to the per diem allowance provided for state officers and employees generally.

(b) It is served upon the witness at least 120 hours before he or she is required to appear at the hearing.

(Added to NAC by Bd. of Medical Exam’rs, eff. 1-13-94; A by R149-97, 3-30-98)

COLLABORATING OR SUPERVISING PHYSICIANS

NAC 630.490 Collaboration with advanced practice registered nurse. (NRS 630.130)

1. Except as otherwise provided in this section, a physician may collaborate with an advanced practice registered nurse if the physician:

(a) Holds an active license in good standing to practice medicine;

(b) Actually practices medicine in this State; and

2. No physician may collaborate with an advanced practice registered nurse whose scope of practice or medical competence is other than the scope of practice or medical competence of the physician.

3. Before collaborating with an advanced practice registered nurse, a physician, on a form prescribed by the Board, shall notify the Board of the name and location of the practice of the advanced practice registered nurse and the portion of the practice of the advanced practice registered nurse that the physician will collaborate on with the advanced practice registered nurse. The notice must contain the signatures of the advanced practice registered nurse and the collaborating physician.

4. In addition to any other requirements, if the State Board of Nursing pursuant to NRS 632.349 has disciplined an advanced practice registered nurse, a physician shall not collaborate with that advanced practice registered nurse unless the physician has been specifically approved by the Board to act as the collaborating physician of that advanced practice registered nurse.

5. A collaborating physician shall immediately notify the Board of the termination of collaboration between the collaborating physician and an advanced practice registered nurse. For any portion of the practice of the advanced practice registered nurse that the collaborating physician terminating collaboration with the advanced practice registered nurse collaborated, no physician shall collaborate with the advanced practice registered nurse until the physician submits notice to the Board pursuant to subsection 3.

6. The collaborating physician or his or her substitute shall be available at all times that the advanced practice registered nurse is providing medical services to consult with the advanced practice registered nurse. Those consultations may be indirect, including, without limitation, by telephone.

7. The collaborating physician shall, at least once a month, spend part of a day at any location where the advanced practice registered nurse provides medical services to act as consultant to the advanced practice registered nurse and to monitor the quality of care provided by an advanced practice registered nurse.

8. The collaborating physician shall develop and carry out a program to ensure the quality of care provided by an advanced practice registered nurse. The program must include, without limitation:

(a) An assessment of the medical competency of the advanced practice registered nurse;

(b) A review and initialing of selected charts;

(c) An assessment of a representative sample of referrals or consultations made by the advanced practice registered nurse with another health professional as required by the condition of the patient;

(d) Direct observation of the ability of the advanced practice registered nurse to take a medical history from and perform an examination of patients representative of those cared for by the advanced practice registered nurse; and

(e) Maintenance of accurate records and documentation of the program for each advanced practice registered nurse with whom the physician collaborated.

9. The collaborating physician shall ensure that the advanced practice registered nurse:

(a) Does not use presigned prescriptions; and

(b) Practices in strict compliance with the regulations of the State Board of Pharmacy regarding prescriptions, controlled substances, dangerous drugs and devices.

10. The medical director of a practice that is specific to a site, including, without limitation, a facility for skilled nursing or a hospital, may act as a collaborating physician to an advanced practice registered nurse who works at the practice. A medical director acting as a collaborating physician may allow the advanced practice registered nurse to evaluate and care for patients under the direction of an attending physician who is not the collaborating physician of the advanced practice registered nurse.

11. A collaborating physician shall ensure that the medical services that an advanced practice registered nurse performs while collaborating with the physician are:

(a) Commensurate with the education, training, experience and level of competence of the advanced practice registered nurse; and

(b) Within the scope of practice of the:

(1) Advanced practice registered nurse;

(2) Certification of the advanced practice registered nurse; and

(3) Collaborating physician.

12. If the collaborating physician is unable to act as the collaborating physician for an advanced practice registered nurse, he or she shall designate a qualified substitute physician to act as a temporary collaborating physician. The scope of practice or medical competence of the temporary collaborating physician must be the same as the scope of practice or medical competence of the original collaborating physician.

13. The collaborating physician is responsible for all the medical services performed by the advanced practice registered nurse.

(Added to NAC by Bd. of Medical Exam’rs, eff. 6-23-86; A by R149-97, 3-30-98; R145-03, 12-16-2003)

NAC 630.495 Restrictions on simultaneous supervision of physician assistants and collaboration with advanced practice registered nurses. (NRS 630.130)

1. Except as otherwise provided in subsection 2, a physician shall not simultaneously:

(a) Supervise more than three physician assistants;

(b) Collaborate with more than three advanced practice registered nurses; or

(c) Supervise or collaborate with a combination of more than three physician assistants and advanced practice registered nurses.

2. A physician may petition the Board for approval to supervise or collaborate with more physician assistants and advanced practice registered nurses than he or she would otherwise be allowed pursuant to subsection 1. The Board will not approve the petition unless the physician provides satisfactory proof to the Board that:

(a) Special circumstances regarding his or her practice exist that necessitate his or her supervision or collaboration with more physician assistants and advanced practice registered nurses than would otherwise be allowed pursuant to subsection 1; and

(b) The physician will be able to supervise or collaborate with the number of physician assistants and advanced practice registered nurses for which he or she is requesting approval in a satisfactory manner.

(Added to NAC by Bd. of Medical Exam’rs by R149-97, eff. 3-30-98; A by R108-01, 11-29-2001)

PRACTITIONERS OF RESPIRATORY CARE

NAC 630.500 Qualifications of applicants. (NRS 630.130, 630.279) An applicant for licensure as a practitioner of respiratory care must have the following qualifications:

1. If he or she has not practiced as a practitioner of respiratory care for 12 months or more immediately preceding his or her application for licensure in this State, the applicant must, except as otherwise provided in subsections 2 and 3, at the order of the Board, take and pass any examination that the Board deems appropriate to test the professional competency of the practitioner.

2. If he or she has not practiced as a practitioner of respiratory care for 12 months or more but less than 5 years immediately preceding his or her application for licensure in this State, the applicant may provide proof that he or she has successfully completed 10 units of continuing education for each year or portion thereof he or she has not practiced respiratory care. If he or she provides proof of successfully completing at least 10 units of continuing education for each year or portion thereof he or she has not practiced respiratory care, the applicant is exempt from the examination required pursuant to subsection 1.

3. If he or she has not practiced as a practitioner of respiratory care for 5 years or more immediately preceding his or her application for licensure in this State, the applicant must retake and pass the examination required to be certified as a practitioner of respiratory care administered by the National Board for Respiratory Care or its successor organization.

4. Be a citizen of the United States or be lawfully entitled to remain and work in the United States.

5. Be able to communicate adequately orally and in writing in the English language.

6. Be of good moral character and reputation.

7. Be in compliance with the provisions of NRS 630.277.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001; A by R176-08, 2-11-2009; R036-13, 2-26-2014)

NAC 630.505 Application for license. (NRS 630.130, 630.279)

1. An application for licensure as a practitioner of respiratory care must be made on a form supplied by the Board. The application must include:

(a) The date of birth and the birthplace of the applicant, his or her sex and the various places of his or her residence after reaching 18 years of age;

(b) The education of the applicant, including, without limitation, all high schools, postsecondary institutions and professional institutions attended, the length of time in attendance at each high school or institution and whether he or she is a graduate of those schools and institutions;

(c) Whether the applicant has ever applied for a license or certificate as a practitioner of respiratory care in another state and, if so, when and where and the results of his or her application;

(d) The professional training and experience of the applicant;

(e) Whether the applicant has ever been investigated for misconduct as a practitioner of respiratory care or had a license or certificate as a practitioner of respiratory care revoked, modified, limited or suspended or whether any disciplinary action or proceedings have ever been instituted against him or her by a licensing body in any jurisdiction;

(f) Whether the applicant has ever been convicted of a felony or an offense involving moral turpitude;

(g) Whether the applicant has ever been investigated for, charged with or convicted of the use, illegal sale or distribution of controlled substances; and

(h) A public address where the applicant may be contacted by the Board.

2. An applicant must submit to the Board:

(a) Proof of completion of an educational program as a practitioner of respiratory care that is approved by the Commission on Accreditation of Allied Health Education Programs or its successor organization or the Commission on Accreditation for Respiratory Care or its successor organization;

(b) Proof of passage of the examinations required by NRS 630.277 and NAC 630.500 and 630.515; and

3. Each application must be signed by the applicant and sworn to before a notary public or other officer authorized to administer oaths.

4. The application must be accompanied by the applicable fees for the application for licensure and biennial registration.

5. An applicant shall pay the reasonable costs of any examination required for licensure.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001; A by R043-11, 5-30-2012; R023-15, 12-30-2015)

NAC 630.510 Grounds for rejection of application. (NRS 630.130, 630.279) If it appears that:

1. An applicant for licensure as a practitioner of respiratory care is not qualified or is not of good moral character or reputation;

2. Any credential submitted is false; or

3. The application is not made in proper form or other deficiencies appear in it,

Ê the application may be rejected.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.515 Temporary license to practice as intern. (NRS 630.130, 630.279)

1. Upon payment of a fee, the Board may issue a temporary license to practice respiratory care as an intern for a period of 12 months to an applicant for licensure providing the applicant shows:

(a) Written evidence, verified by oath, that the applicant is a graduate of a respiratory education program; and

(b) That he or she is scheduled to sit for the national exam administered by the National Board for Respiratory Care or its successor organization.

2. During the 12-month period, the applicant shall wear a name badge that prominently displays the phrase “Graduate Therapist” while on the job.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.520 Contents of license. (NRS 630.130, 630.279) The license as a practitioner of respiratory care issued by the Board must contain:

1. The name of the practitioner of respiratory care;

2. The duration of the license; and

3. Any other limitations or requirements that the Board prescribes.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.525 Fee for biennial registration; cause for disciplinary action or refusal to issue license. (NRS 630.130, 630.279)

1. Each holder of a license to practice respiratory care must, on or before June 30 or, if June 30 is a Saturday, Sunday or legal holiday, the next business day after June 30, of each odd-numbered year, pay the applicable fee for biennial registration to the Secretary-Treasurer of the Board.

2. A practitioner of respiratory care who has been licensed by the Board but is not currently licensed, has surrendered his or her license or has failed to renew his or her license may be disciplined by the Board, if the Board deems necessary, upon hearing a complaint for disciplinary action against him or her.

3. If the Board determines that the conduct of a practitioner of respiratory care when he or she was on inactive status in another jurisdiction would have resulted in the denial of an application for licensure in this State, the Board will, if appropriate, refuse to license the practitioner of respiratory care.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001; A by R124-10, 12-16-2010; R024-15, 12-30-2015)

NAC 630.530 Renewal of license; notification of withdrawal of certification; expiration and reinstatement of license. (NRS 630.130, 630.279)

1. The license of a practitioner of respiratory care may be renewed biennially upon dates set by the Board. The license will not be renewed unless the practitioner of respiratory care provides satisfactory proof:

(a) Of current certification by the National Board for Respiratory Care or its successor organization; and

(b) That he or she has completed the number of contact hours of continuing professional education required by subsections 2 and 3.

2. To renew a license for the practice of respiratory care, a licensee must complete the number of contact hours of continuing education required by subsection 3, of which:

(a) Sixty percent must be from an approved educational source directly related to the practice of respiratory care. Two hours of this 60 percent must be in medical ethics.

(b) Forty percent must be in any program approved by the American Association for Respiratory Care for Continuing Respiratory Care Education or any program of another organization approved by the Board.

3. The following contact hours for continuing education are required for a licensee to renew a license for the practice of respiratory care:

(a) If licensed during the first 6 months of the biennial period of registration, 20 hours.

(b) If licensed during the second 6 months of the biennial period of registration, 15 hours.

(d) If licensed during the fourth 6 months of the biennial period of registration, 5 hours.

4. A practitioner of respiratory care shall notify the Board within 10 days if his or her certification by the National Board for Respiratory Care or its successor organization is withdrawn.

5. To allow for the renewal of a license to practice respiratory care by each person to whom a license was issued or renewed in the preceding renewal period, the Board will make such reasonable attempts as are practicable to:

(a) Mail a renewal notice at least 60 days before the expiration of a license to practice respiratory care; and

(b) Send a renewal application to a licensee at the last known address of the licensee on record with the Board.

6. If a licensee fails to pay the fee for biennial registration on or before the date required by NAC 630.525 or fails to submit proof that the licensee completed the number of contact hours of continuing education required by subsections 2 and 3, his or her license to practice respiratory therapy in this State expires. Within 2 years after the date on which the license expires, the holder may be reinstated to practice respiratory care if he or she:

(a) Pays twice the amount of the current fee for biennial registration to the Secretary-Treasurer of the Board;

(b) Submits proof that he or she completed the number of contact hours of continuing education required by subsections 2 and 3; and

7. The Board may issue not more than 10 contact hours of continuing education during a biennial licensing period to a licensee if the licensee performs a medical review for the Board. The hours issued by the Board:

(a) May be credited against the hours required for a biennial licensing period pursuant to subsections 2 and 3; and

(b) Must be equal to the actual time involved in performing the medical review, not to exceed 10 hours.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001; A by R049-10, 10-15-2010; R124-10, 12-16-2010; R140-11, 9-14-2012; R035-13, 2-26-2014; R024-15, 12-30-2015)

NAC 630.535 Suspension upon loss of certification. (NRS 630.130, 630.279) If a licensee loses certification by the National Board for Respiratory Care or its successor organization, his or her license to practice respiratory care is automatically suspended until further order of the Board.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.540 Grounds for discipline or denial of licensure. (NRS 630.130, 630.279) A practitioner of respiratory care is subject to discipline or denial of licensure by the Board if, after notice and hearing in accordance with this chapter, the Board finds that the practitioner of respiratory care:

1. Willfully and intentionally made a false or fraudulent statement or submitted a forged or false document in applying for a license or renewing a license.

2. Performed respiratory care services other than as permitted by law.

3. Committed malpractice in the performance of respiratory care services, which may be evidenced by claims settled against a practitioner of respiratory care.

4. Disobeyed any order of the Board or an investigative committee of the Board or violated a provision of this chapter.

5. Is not competent to provide respiratory care services.

6. Lost his or her certification by the National Board for Respiratory Care or its successor organization.

7. Failed to notify the Board of loss of certification by the National Board for Respiratory Care or its successor organization.

8. Falsified records of health care.

9. Rendered respiratory care to a patient while under the influence of alcohol or any controlled substance or in any impaired mental or physical condition.

10. Practiced respiratory care after his or her license has expired or been suspended.

11. Has been convicted of a felony, any offense involving moral turpitude or any offense relating to the practice of respiratory care or the ability to practice respiratory care.

12. Has had a license to practice respiratory care revoked, suspended, modified or limited by any other jurisdiction or has surrendered such license or discontinued the practice of respiratory care while under investigation by any licensing authority, a medical facility, a branch of the Armed Forces of the United States, an insurance company, an agency of the Federal Government or any employer.

13. Engaged in any sexual activity with a patient who is currently being treated by the practitioner of respiratory care.

14. Engaged in disruptive behavior with physicians, hospital personnel, patients, members of the family of a patient or any other person if the behavior interferes with patient care or has an adverse impact on the quality of care rendered to a patient.

15. Engaged in conduct that violates the trust of a patient and exploits the relationship between the practitioner of respiratory care and the patient for financial or other personal gain.

16. Engaged in conduct which brings the respiratory care profession into disrepute, including, without limitation, conduct which violates any provision of a national code of ethics adopted by the Board by regulation.

17. Engaged in sexual contact with a surrogate of a patient or other key person related to a patient, including, without limitation, a spouse, parent or legal guardian, that exploits the relationship between the practitioner of respiratory care and the patient in a sexual manner.

18. Made or filed a report that the practitioner of respiratory care knows to be false, failed to file a record or report as required by law or willfully obstructed or induced another to obstruct such filing.

19. Altered the medical records of a patient.

20. Failed to report any person that the practitioner of respiratory care knows, or has reason to know, is in violation of the provisions of chapter 630 of NRS or NAC 630.500 to 630.560, inclusive, relating to the practice of respiratory care.

21. Has been convicted of a violation of any federal or state law regulating the prescription, possession, distribution or use of a controlled substance.

22. Held himself or herself out or permitted another to represent him or her as a licensed physician.

23. Violated any provision that would subject a practitioner of medicine to discipline pursuant to NRS 630.301 to 630.3065, inclusive, or NAC 630.230.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.545 Disciplinary action: Notice of charges. (NRS 630.130, 630.279) Before the Board takes disciplinary action against a practitioner of respiratory care, the Board will give to the practitioner of respiratory care a written notice specifying the charges made against the practitioner of respiratory care and stating that the charges will be heard at the time and place indicated in the notice. The notice will be served on the practitioner of respiratory care at least 20 days before the date fixed for the hearing. Service of the notice will be made, and any investigation and subsequent proceedings will be conducted in the same manner as provided by law for disciplinary actions against physicians.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.550 Examination to determine fitness to practice. (NRS 630.130, 630.279)

1. If the Board or any investigative committee of the Board has reason to believe that the conduct of any practitioner of respiratory care has raised a reasonable question as to his or her competence to practice as a practitioner of respiratory care with reasonable skill and safety to patients, the Board may order that the practitioner of respiratory care undergo a mental or physical examination or an examination testing his or her competence to practice as a practitioner of respiratory care administered by physicians or practitioners of respiratory care or any other examination designated by the Board to assist the Board or committee in determining the fitness of the practitioner of respiratory care to practice as a practitioner of respiratory care.

2. Every practitioner of respiratory care who applies for or is issued a license and who accepts the privilege of performing respiratory care in this State shall be deemed to have given his or her consent to submit to such an examination pursuant to subsection 1 if he or she is directed to do so in writing by the Board.

3. For the purpose of this section, a report of the testimony or an examination by an examining physician or practitioner of respiratory care does not constitute a privileged communication.

4. Except in extraordinary circumstances, as determined by the Board, the failure of a licensed practitioner of respiratory care to submit to an examination if he or she is directed to do so pursuant to this section constitutes an admission of the charges against him or her. A default and final order may be entered without the taking of testimony or presentation of evidence.

5. A practitioner of respiratory care who is subject to an examination pursuant to this section shall pay the costs of the examination.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.555 Determination after notice and hearing: Sanctions or dismissal of charges. (NRS 630.130, 630.279) If the Board finds, by a preponderance of the evidence, after notice and hearing in accordance with this chapter, that:

1. The charges in a complaint against a practitioner of respiratory care are true, the Board will issue and serve on the practitioner of respiratory care its written findings and any order of sanctions. The following sanctions may be imposed on a practitioner of respiratory care by order of the Board:

(a) Placement on probation for a specified period on any of the conditions specified in the order.

(b) Administration of a public reprimand.

(d) Revocation of his or her license to practice.

(e) A requirement that he or she participate in a program to correct alcohol or drug dependence or any other impairment.

(f) A requirement that there be specified supervision of his or her practice.

(g) A requirement that he or she perform public service without compensation.

(h) A requirement that he or she take a physical or mental examination or an examination testing his or her medical competence.

(i) A requirement that he or she fulfill certain training or educational requirements, or both, as specified by the Board.

(j) A fine not to exceed $1,500.

(k) A requirement that the practitioner of respiratory care pay all costs incurred by the Board relating to the disciplinary proceedings.

2. No violation has occurred, the Board will issue a written order dismissing the charges and notify the practitioner of respiratory care that the charges have been dismissed. If the disciplinary proceedings were initiated as a result of a complaint filed against the practitioner of respiratory care, the Board may provide to the practitioner of respiratory care a copy of the complaint and the name of the person who filed the complaint.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.560 Advisory committee. (NRS 630.130, 630.279)

1. The Board will appoint five licensed practitioners of respiratory care to an advisory committee. These practitioners of respiratory care must have lived in and actively and continuously practiced in this State as practitioners of respiratory care for at least 3 years before their appointment.

2. The Board will give appointees to the advisory committee written notice of their appointment and terms of office and a written summary of any projects pending before the committee.

3. At the request of the Board, the advisory committee shall review and make recommendations to the Board concerning any matters relating to licensed practitioners of respiratory care.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001; A by R081-05, 10-31-2005)

USE OF MEANS OR INSTRUMENTALITIES OF TREATMENT OTHER THAN CONVENTIONAL TREATMENT

NAC 630.600 “Conventional treatment” defined. (NRS 630.130) As used in NAC 630.600 to 630.630, inclusive, unless the context otherwise requires, “conventional treatment” means the health care methods of diagnoses, treatments or interventions that are:

1. Generally accepted methods of routine practice offered by most licensed physicians;

2. Based upon medical training, experience and peer-reviewed scientific literature; and

3. Ordinarily utilized by physicians in good standing practicing in the same specialty or field.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.605 Provisional approval; disciplinary action for violation. (NRS 630.130) Except as otherwise provided in NAC 630.610 to 630.630, inclusive, a licensee may practice medicine by utilizing any means or instrumentality. A licensee is subject to disciplinary action by the Board if the Board finds that the licensee has violated any of the provisions of NAC 630.610 to 630.630, inclusive.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.610 Use of certain means or instrumentalities prohibited. (NRS 630.130) A licensee shall not practice medicine by utilizing any means or instrumentality that:

1. Has a risk for a patient which is unreasonably greater than the means or instrumentality ordinarily utilized by physicians in good standing practicing in the same specialty or field; or

2. Is provided as a substitute for any conventional treatment which has proven to be of substantial benefit to the patient.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.615 Assessment of patient; contents of assessment. (NRS 630.130) Before offering advice about the means or instrumentality of treatment, the licensee shall undertake an assessment of the patient. The assessment must be documented in the medical chart of the patient and should include, without limitation, the conventional methods of diagnosis ordinarily utilized by physicians in good standing practicing in the same specialty or field. The assessment may include nonconventional methods of diagnosis. The assessment must include the following:

1. An adequate medical record.

2. Documentation as to whether conventional treatment options, including, without limitation, referral options for conventional treatment, ordinarily utilized by physicians in good standing practicing in the same specialty or field have been:

(a) Discussed with the patient;

(b) Offered to the patient;

(d) Undertaken with the patient and, if so, the outcome of the treatment.

3. If a treatment is offered which is not considered to be conventional, documentation of written informed consent by the patient for each treatment plan, including, without limitation, documentation that the risks and benefits of the use of both the conventional and the other means or instrumentality of treatment were discussed with the patient or guardian.

4. A review of the current diagnosis and conventional treatment.

5. Documentation as to whether the other means or instrumentality of treatment could interfere with any other ongoing conventional treatment.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.620 Documented treatment plan. (NRS 630.130) The licensee may offer the patient any means or instrumentality of treatment other than conventional treatment if it is offered pursuant to a documented treatment plan tailored for the individual needs of the patient. The documented treatment plan must:

1. Evaluate treatment progress or success with stated objectives, including, without limitation, pain relief and improved physical or psychosocial function.

2. Consider pertinent medical history, previous medical records and physical examinations, and the need for further testing, consultations, referrals or the use of other treatment modalities.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.625 Periodic reviews of care of patient. (NRS 630.130) To utilize means or instrumentalities of treatment other than conventional treatment, the licensee must document and conduct periodic reviews of the care of the patient. The periodic reviews must:

1. Consider the individual circumstances of the patient;

2. Be conducted at reasonable intervals in consideration of the individual circumstances of the patient;

3. Report the progress in reaching treatment objectives; and

4. Take into consideration the treatment prescribed, ordered or administered, as well as any new information about the etiology of the complaint.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

NAC 630.630 Records of care provided to patient. (NRS 630.130) The licensee shall maintain complete and accurate records of the care provided to the patient, including, without limitation, the requirements of NAC 630.610 to 630.625, inclusive.

(Added to NAC by Bd. of Medical Exam’rs by R108-01, eff. 11-29-2001)

PERFUSIONISTS

NAC 630.700 Application for license. (NRS 630.130, 630.269, 630.2691)

1. An application for licensure as a perfusionist must be made on a form provided by the Board. The application must set forth:

(a) The date and place of birth of the applicant;

(b) The gender of the applicant;

(c) The education of the applicant, including, without limitation, each high school and postsecondary institution attended by the applicant, the dates of attendance and whether the applicant is a graduate of those schools and institutions;

(d) If the applicant has ever applied for a license or certificate to practice perfusion in another state or jurisdiction, the date and disposition of the application;

(e) The training and experience of the applicant in the practice of perfusion;

(f) If the applicant has ever been investigated for misconduct in the practice of perfusion, had a license or certificate to practice perfusion revoked, modified, limited or suspended or had any disciplinary action or proceeding instituted against the applicant by a licensing body in another state or jurisdiction, the dates, circumstances and disposition of each such occurrence;

(g) If the applicant has ever been convicted of a felony or any offense involving moral turpitude, the dates, circumstances and disposition of each such occurrence;

(h) If the applicant has ever been investigated for, charged with or convicted of the use or illegal sale or dispensing of a controlled substance, the dates, circumstances and disposition of each such occurrence; and

(i) Each place of residence of the applicant after the date of graduation of the applicant from high school or the receipt by the applicant of a high school general equivalency diploma, whichever occurred most recently.

2. An applicant must submit to the Board:

(a) Proof that the applicant is a citizen of the United States or that the applicant is lawfully entitled to remain and work in the United States.

(b) Proof of completion of a perfusion education program that satisfies the requirements of NRS 630.2691. For the purpose of that section, the following perfusion education programs shall be deemed approved by the Board:

(1) Any perfusion education program completed by the applicant on or before June 1, 1994, which was approved by the Committee on Allied Health Education and Accreditation of the American Medical Association;

(2) Any perfusion education program completed by the applicant after June 1, 1994, which was accredited by the Accreditation Committee-Perfusion Education and approved by the Commission on Accreditation of Allied Health Education Programs of the American Medical Association, or its successor; or

(3) Any other perfusion education program completed by the applicant, the educational standards of which the Board determines are at least as stringent as those established by the Accreditation Committee-Perfusion Education and approved by the Commission on Accreditation of Allied Health Education Programs of the American Medical Association, or its successor.

(c) Except as otherwise provided in NRS 630.2693, proof of passage of the certification examination given by the American Board of Cardiovascular Perfusion or its successor, as required by NRS 630.2692.

(d) Such further evidence and other documents or proof of qualifications as are required by the Board.

3. Each application must be signed by the applicant and sworn to before a notary public or other officer authorized to administer oaths.

4. The application must be accompanied by the applicable fee.

5. An applicant shall pay the reasonable costs of any examination required for licensure.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010; A by R093-12, 2-20-2013; R036-13, 2-26-2014)

NAC 630.710 Grounds for rejection of application. (NRS 630.130, 630.269) The Board may reject an application for licensure as a perfusionist if the Board determines that:

1. The applicant is not qualified or is not of good moral character or reputation;

2. Any credential submitted by the applicant is false; or

3. The application is not made in proper form or is otherwise deficient.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010)

NAC 630.720 Contents of license. (NRS 630.130, 630.269) A license to practice perfusion issued by the Board must contain:

1. The name of the perfusionist;

2. The duration of the license, as determined pursuant to NRS 630.2695; and

3. Any limitation or requirement applicable to the license that is prescribed by the Board.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010)

NAC 630.730 Primary location of practice. (NRS 630.130, 630.269) Before providing perfusion services, a perfusionist must notify the Board, on a form prescribed by the Board, of the name and location of the primary location of practice of the perfusionist. The form must be signed by the perfusionist.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010)

NAC 630.740 Renewal of license; continuing education; notice of renewal. (NRS 630.130, 630.269)

1. The license of a perfusionist may be renewed biennially. Except as otherwise provided in subsection 2, each person licensed as a perfusionist shall, at the time of the renewal of his or her license, provide satisfactory proof to the Board that he or she has completed during the biennial licensing period at least 30 hours of continuing education units that have been approved for credit by the American Board of Cardiovascular Perfusion. The continuing education units must be completed in the various categories of continuing education recognized by the American Board of Cardiovascular Perfusion, as follows:

(a) At least 15 hours, not less than 2 hours of which must be related to medical ethics, must be completed in Category I approved continuing education, which may include, without limitation, such activities as:

(1) Attendance at an international, national, regional or state meeting relating to perfusion.

(2) Publication of a book, chapter or article relating to perfusion.

(3) Presenting or addressing at an international, national, regional or state meeting relating to perfusion.

(4) Completion of a self-directed continuing education course relating to perfusion.

(b) Not more than 15 hours may be completed in Category II or Category III approved continuing education, which may include, without limitation, such activities as:

(1) Attendance at an international, national, regional, state or local meeting relating to perfusion that has not been approved for Category I credit.

(2) Attendance at a manufacturer-specific or company-sponsored educational activity that was not equally accessible to all perfusionists.

(3) Attendance at a medically-related international, national, regional, state or local meeting that has not been approved for Category I credit.

(4) Attendance at advanced cardiac life-support training that has not been approved for Category I credit.

(5) Individual education and other self-study activities that have not been approved for Category I credit.

2. If the perfusionist was licensed only during the second year of a biennial licensing period, he or she must attain and prove upon his or her renewal application the completion during the biennial licensing period of at least 16 hours of continuing education units that have been approved for credit by the American Board of Cardiovascular Perfusion, as follows:

(a) At least 8 hours, not less than 2 hours of which must be related to medical ethics, must be completed in Category I approved continuing education activities; and

(b) Not more than 8 hours must be completed in Category II and Category III approved continuing education activities.

3. The notice of renewal that the Board is required to send to a licensed perfusionist pursuant to NRS 630.2695 will be sent to the last known address of the perfusionist on record with the Board.

4. The Board may issue not more than 15 hours of continuing education units during a biennial licensing period to a licensed perfusionist if the perfusionist performs a medical review for the Board. The hours issued by the Board:

(a) May be credited against the hours required for a biennial licensing period pursuant to subsection 1 or 2; and

(b) Must be equal to the actual time involved in performing the medical review, not to exceed 15 hours.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010; A by R035-13, 2-26-2014)

NAC 630.750 Fee for reinstatement of expired license. (NRS 630.130, 630.269) The fee for the reinstatement of an expired license pursuant to NRS 630.2695 is an amount equal to twice the current amount of the fee for the biennial renewal of the license.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010)

NAC 630.760 Performance of authorized services; identification; misrepresentation. (NRS 630.130, 630.269)

1. The services that a perfusionist may be authorized to perform under the order and supervision of a physician must be commensurate with the education, training, experience and level of competence of the perfusionist.

2. A perfusionist shall at all times while on duty wear a placard, plate or insigne which identifies himself or herself as a perfusionist.

3. A perfusionist shall not represent himself or herself in any manner that would tend to mislead a patient or the general public.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010)

NAC 630.770 Grounds for discipline or denial of licensure. (NRS 630.130, 630.269)

1. A perfusionist is subject to discipline pursuant to chapter 630 of NRS or denial of licensure by the Board if, after notice and hearing, the Board finds that the perfusionist:

(a) Willfully and intentionally made a false or fraudulent statement or submitted a forged or false document in applying for or renewing a license.

(b) Performed perfusion services other than as permitted by law.

(c) Committed malpractice in the performance of perfusion services, which may be evidenced by claims settled against the perfusionist.

(d) Disobeyed any order of the Board or an investigative committee of the Board or violated any provision of this chapter or chapter 630 of NRS.

(e) Is not competent to provide perfusion services.

(f) Lost his or her certification by the American Board of Cardiovascular Perfusion or its successor organization.

(g) Failed to notify the Board of loss of certification by the American Board of Cardiovascular Perfusion or its successor organization within 30 days after the loss of certification.

(h) Falsified or altered records of health care.

(i) Rendered perfusion services to a patient while under the influence of alcohol or any controlled substance or in any impaired mental or physical condition.

(j) Practiced perfusion after his or her license as a perfusionist had expired or been revoked or suspended.

(k) Has been convicted of a felony, any offense involving moral turpitude or any offense relating to the practice of perfusion or the ability to practice perfusion.

(l) Has had a license to practice perfusion revoked, suspended, modified or limited by another state or jurisdiction or has surrendered such a license or discontinued the practice of perfusion while under investigation by any licensing authority, a medical facility, a branch of the Armed Forces of the United States, an insurance company, an agency of the Federal Government or any employer.

(m) Engaged in any sexual activity with a patient who was being treated by the perfusionist.

(n) Engaged in disruptive behavior with physicians, hospital personnel, patients, members of the family of a patient or any other person if the behavior interferes with the care of a patient or has an adverse impact on the quality of care rendered to a patient.

(o) Engaged in conduct which brings the profession of perfusion into disrepute, including, without limitation, conduct that violates any of the following ethical guidelines:

(1) A perfusionist shall at all times hold the well-being of his or her patients paramount and shall not act in such a way as to bring the interests of the perfusionist into conflict with the interests of his or her patients.

(2) A perfusionist shall not engage in conduct that violates the trust of a patient and exploits the relationship between the perfusionist and the patient for financial or other personal gain.

(3) A perfusionist shall not delegate licensed responsibilities to a person who is not qualified to perform those responsibilities.

(p) Engaged in sexual contact with a surrogate of a patient or with any person related to a patient, including, without limitation, a spouse, parent or legal guardian of a patient, that exploits the relationship between the perfusionist and the patient in a sexual manner.

(q) Made or filed a report that the perfusionist knew to be false, failed to file a record or report as required by law or willfully obstructed or induced another person to obstruct any such filing.

(r) Failed to report to the Board any person that the perfusionist knew, or had reason to know, was in violation of any provision of this chapter or chapter 630 of NRS relating to the practice of perfusion.

(s) Has been convicted of a violation of any federal or state law regulating the prescription, possession, distribution or use of a controlled substance.

(t) Held himself or herself out or permitted another person to represent the perfusionist as a licensed physician.

(u) Violated any provision that would subject a person to discipline pursuant to NRS 630.301 to 630.3065, inclusive, or NAC 630.230.

2. A person who has been licensed as a perfusionist by the Board but is not currently licensed, has surrendered his or her license or has failed to renew his or her license may be disciplined by the Board upon hearing a complaint for disciplinary action against the person.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010)

NAC 630.780 Examination to determine fitness to practice. (NRS 630.130, 630.269)

1. If the Board or any investigative committee of the Board has reason to believe that the conduct of any perfusionist has raised a reasonable question as to his or her competence to practice as a perfusionist with reasonable skill and safety to patients, the Board or investigative committee may order that the perfusionist undergo a mental or physical examination or an examination testing his or her competence to practice as a perfusionist by physicians or any other examination designated by the Board or investigative committee to assist the Board or investigative committee in determining the fitness of the perfusionist to practice perfusion.

2. Every perfusionist who applies for or is issued a license and who accepts the privilege of performing perfusion services in this State shall be deemed to have given consent to submit to an examination pursuant to subsection 1 if directed to do so in writing by the Board or investigative committee.

3. For the purpose of this section, the report of testimony or examination by the examining physicians does not constitute a privileged communication.

4. Except in extraordinary circumstances, as determined by the Board, the failure of a perfusionist to submit to an examination if directed to do so pursuant to this section constitutes an admission of the charges against the perfusionist. A default and final order may be entered without the taking of testimony or presentation of evidence.

5. A perfusionist who is subject to an examination pursuant to this section shall pay the costs of the examination.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010)

NAC 630.790 Advisory committee. (NRS 630.130, 630.269)

1. The Board will appoint three perfusionists to an advisory committee. To the extent practicable, each appointee must have lived in and actively and continuously practiced perfusion in this State for at least 3 years before his or her appointment.

2. The Board will give each appointee written notice of his or her appointment and term of office and a written summary of any projects pending before the advisory committee.

3. At the request of the Board, the advisory committee shall review and make recommendations to the Board concerning any matter relating to perfusionists.

(Added to NAC by Bd. of Medical Exam’rs by R079-10, eff. 12-16-2010)

SUPERVISION OF MEDICAL ASSISTANTS

NAC 630.800 “Delegating practitioner” defined. (NRS 630.130, 630.138) As used in NAC 630.800 to 630.830, inclusive, unless the context otherwise requires, “delegating practitioner” means a person who is licensed as a physician or physician assistant and who delegates to a medical assistant the performance of a task pursuant to the provisions of NAC 630.810 or 630.820.

(Added to NAC by Bd. of Medical Exam’rs by R094-12, eff. 2-20-2013)

NAC 630.810 Delegation of tasks to medical assistant. (NRS 630.130, 630.138)

1. Except as otherwise provided in this section, a delegating practitioner may delegate to a medical assistant the performance of a task if:

(a) The delegating practitioner knows that the medical assistant possesses the knowledge, skill and training to perform the task safely and properly;

(b) The medical assistant is not required to be certified or licensed to perform that task;

(c) The medical assistant is employed by the delegating practitioner or the medical assistant and the delegating practitioner are employed by the same employer; and

(d) The employer of the medical assistant has complied with the requirements of subsection 2 as they relate to the task.

2. The employer of a medical assistant shall document in the employment record of the medical assistant that he or she has been appropriately trained and is competent to perform any task or procedure assigned to him or her.

3. Except as otherwise provided in NAC 630.820, if a medical assistant is delegated a task which involves an invasive procedure, the delegating practitioner must be immediately available to exercise oversight in person while the medical assistant performs the task.

4. A medical assistant shall not make a diagnosis, initiate any treatment or prescribe any drug.

(Added to NAC by Bd. of Medical Exam’rs by R094-12, eff. 2-20-2013; A by R096-16, 12-21-2016)

NAC 630.820 Remote supervision of medical assistant. (NRS 630.130, 630.138)

1. A delegating practitioner may supervise remotely a medical assistant to whom the practitioner has delegated the performance of a task if:

(a) The patient is located in a rural area;

(b) The delegating practitioner is physically located a significant distance from the location where the task is to be performed;

(d) The patient and the delegating practitioner previously established a practitioner-patient relationship; and

(e) The delegating practitioner is immediately available by telephone or other means of instant communication during the performance of the task by the medical assistant.

2. As used in this section, “rural area” means any area in this State other than Carson City or the City of Elko, Henderson, Reno, Sparks, Las Vegas or North Las Vegas.

(Added to NAC by Bd. of Medical Exam’rs by R094-12, eff. 2-20-2013)

NAC 630.830 Prohibited activities by delegating practitioner. (NRS 630.130, 630.138) A delegating practitioner retains responsibility for the safety and performance of each task which is delegated to a medical assistant. A delegating practitioner shall not:

1. Delegate a task that is not within the authority, training, expertise or normal scope of practice of the delegating practitioner;

2. Transfer to another physician or physician assistant the responsibility of supervising a medical assistant during the performance of a task unless the physician or physician assistant knowingly accepts that responsibility;

3. Authorize or allow a medical assistant to delegate the performance of a task delegated to the medical assistant to any other person; or

4. Delegate or otherwise allow a medical assistant to administer an anesthetic agent which renders a patient unconscious or semiconscious.

(Added to NAC by Bd. of Medical Exam’rs by R094-12, eff. 2-20-2013)