Existing law defines the term “provider of health care” as a person who practices certain professions related to the provision of health care. (NRS 629.031) Existing law imposes certain requirements upon providers of health care, including requirements for billing, standards for advertisements and criminal penalties for acquiring certain debts. (NRS 629.071, 629.076, 629.078) Section 1 of this bill includes dental hygienists and dental therapists in the definition of “provider of health care,” thereby subjecting dental hygienists and dental therapists to those requirements. Existing law defines the term “telehealth” to mean the delivery of services from a provider of health care to a patient at a different location through the use of information and audio-visual communication technology, not including facsimile or electronic mail. (NRS 629.515) Section 5 of this bill defines the term “teledentistry” to mean the use of telehealth by a dentist, dental hygienist or dental therapist to facilitate the diagnosis, treatment, education, care management and self-management of or consultation with a patient. Sections 3, 4 and 6 of this bill define certain other terms related to teledentistry. Section 20 of this bill makes a conforming change to indicate the proper placement of sections 3-6 in the Nevada Revised Statutes. Section 7 of this bill requires a person who provides services through teledentistry to a patient located in this State to be licensed in this State as a dentist, dental hygienist or dental therapist, to have completed certain training and to adhere to the applicable laws, regulations and standards of care to the same extent as when providing services in person. Section 8 of this bill requires a dentist, dental hygienist or dental therapist who provides services through teledentistry to patients in this State to be insured against liabilities arising from dental services provided through teledentistry. Section 9 of this bill authorizes the use of teledentistry for certain purposes relating to the provision of a diagnosis. Section 10 of this bill requires a dentist, dental hygienist or dental therapist to establish a bona fide relationship with a patient, confirm certain facts about a patient and obtain informed consent before providing services through teledentistry. Section 10 also requires a dentist, dental hygienist or dental therapist to provide certain information to a patient receiving services through teledentistry concerning the license and practice of the dentist, dental hygienist or dental therapist before providing the services and upon request of a patient. Section 11 of this bill requires a dentist, dental hygienist or dental therapist to: (1) use communications technology that complies with certain federal requirements relating to the privacy of information relating to patients when providing services through teledentistry; and (2) create a complete record of each encounter with a patient through teledentistry. Section 12 of this bill imposes certain requirements to ensure that adequate, in-person care is available to a patient who receives services through teledentistry, if needed. Section 13 of this bill requires the Board of Dental Examiners of Nevada to adopt regulations governing teledentistry. Section 40.5 of this bill requires the Board to report to the Joint Interim Standing Committee on Commerce and Labor on or before January 1, 2024, concerning the adoption of those regulations. Sections 21 and 40 of this bill require an applicant for a license to practice dentistry, dental therapy or dental hygiene or the holder of such a license who intends to provide services through teledentistry to complete certain training on teledentistry. Section 22 of this bill makes a conforming change to revise a reference to the section of existing law amended by section 21. Section 24 of this bill requires the Board to adopt regulations prescribing specific criteria for the accreditation of a course in teledentistry. Section 14 of this bill prescribes certain requirements for the secure storage of electronic information concerning patients. Section 25 of this bill provides that it is unprofessional conduct for which the Board is authorized to impose disciplinary action if a dentist, dental hygienist or dental therapist: (1) fails to actively involve a patient in decisions relating to his or her treatment; (2) requires a patient to enter into an agreement that restricts the ability of the patient to submit a complaint to the Board; (3) fails to review certain radiographs before an initial diagnosis and correction of malpositions of teeth or the initial use of orthodontic appliances; or (4) fails to provide the information required by section 10. Sections 30, 38 and 39 of this bill require hospitals and issuers of plans that provide coverage to recipients of Medicaid, including managed care plans, to take certain measures to improve the access of recipients of Medicaid to teledentistry. Sections 31-37 of this bill make conforming changes to indicate the proper placement of section 30 in the Nevada Revised Statutes and provide for the enforcement of the requirements of section 30. Section 19.5 of this bill requires a dentist, dental therapist or dental hygienist performing an initial dental examination, screening or assessment on a minor to refer the minor or his or her parent or guardian to a dental home if appropriate. Existing law authorizes, in general, a dental hygienist or dental therapist to perform only the tasks authorized by a licensed dentist. (NRS 631.310, 631.3122) Section 15 of this bill requires the Board to issue to a licensed dentist, dental hygienist or dental therapist a special endorsement to administer immunizations only if the licensed dentist, dental hygienist or dental therapist completes a course of training in the administration of immunizations that is approved by the Board. Section 24 prescribes the continuing education required to maintain such an endorsement. Section 17 of this bill requires a dentist who holds a special endorsement to administer immunizations issued pursuant to section 15 and who administers immunizations, or under whose authorization a dental hygienist or dental therapist administers immunizations, to: (1) issue or obtain from certain persons a standing order for the administration of the immunizations; (2) establish certain policies and procedures relating to the administration of immunizations; and (3) comply with the instructions of the manufacturer of an immunization and certain federal guidelines for administering immunizations. Section 18 of this bill requires a dentist, dental hygienist or dental therapist to: (1) provide certain information to the patient, obtain the informed written consent of the patient and review the medical history of the patient before administering an immunization; and (2) thereafter, act in conformance with the conclusions of a physician, physician assistant or advanced practice registered nurse regarding the advisability of administering an immunization to a patient. Section 19 of this bill requires a dentist, dental hygienist or dental therapist who holds a special endorsement to administer immunizations to maintain certain records of the administration of immunizations. Section 25 provides that it is unprofessional conduct, for which the Board is authorized to impose disciplinary action, for a dentist, dental hygienist or dental therapist to: (1) administer an immunization without the proper special endorsement; or (2) fail to comply with existing requirements to report certain information relating to immunizations. The Board would also be authorized under existing law to impose disciplinary action against a dentist, dental hygienist or dental therapist who willfully or repeatedly violates other provisions of this bill governing the administration of immunizations. (NRS 631.3485)

Statutes affected:
As Introduced: 629.031, 631.005, 631.220, 631.260, 631.287, 631.342, 631.3475, 394.610, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 695C.1708, 695G.162
Reprint 1: 629.031, 631.005, 631.220, 631.260, 631.342, 631.3475, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 695C.1708, 695G.162
Reprint 2: 629.031, 631.005, 631.220, 631.260, 631.342, 631.3475, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 695C.1708, 695G.162
As Enrolled: 629.031, 631.005, 631.220, 631.260, 631.342, 631.3475, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 695C.1708, 695G.162
BDR: 629.031, 631.005, 631.220, 631.260, 631.287, 631.342, 631.3475, 394.610, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 695C.1708, 695G.162