Existing law prescribes certain requirements governing the staffing of hospitals, psychiatric hospitals and certain other health care facilities. (NRS 449.241-449.2428) In 2010, the Attorney General issued an opinion explaining that, while it is the longstanding practice in Nevada that a physician generally works as a contractor for, rather than an employee of, a hospital, there is no provision of law prohibiting a hospital from employing a physician. (Att'y Gen. Op. 2010-04 (March 5, 2010)) Section 1 of this bill expressly prohibits a hospital or psychiatric hospital from employing a physician for the purpose of practicing medicine, homeopathic medicine or osteopathic medicine except where expressly authorized by law. Existing law authorizes a county hospital or hospital district, a private nonprofit medical school, a nonprofit medical research institution or certain mental health facilities operated by divisions of the Department of Health and Human Services to employ a physician under certain circumstances. (NRS 433.264, 433B.150, 450.180, 450.640, 630.365) Section 1 additionally authorizes a hospital or psychiatric hospital to employ a physician: (1) who is participating in certain graduate programs; or (2) if the hospital or psychiatric hospital is owned or operated by the State Government. Existing law exempts a medical facility from certain requirements of existing law relating to the licensing and regulation of medical facilities if the facility: (1) is conducted by and for the adherents of any church or religious denomination for the purpose of providing care and treatment in accordance with the practices of the religion of the church or denomination; or (2) is operated and maintained by the United States Government or an agency thereof. (NRS 449.0301) Section 2 of this bill exempts these facilities from the provisions of section 1. Existing law authorizes certain penalties to be imposed against certain medical facilities that violate certain laws and regulations governing the operation of such medical facilities. (NRS 449.160, 449.163, 449.220, 449.240) Sections 3 and 4 of this bill apply these same penalties to a hospital or psychiatric hospital that violates section 1. Specifically: (1) section 3 of this bill authorizes the Division of Public and Behavioral Health of the Department of Health and Human Services to suspend or revoke the license of a hospital or psychiatric hospital that violates section 1; and (2) section 4 authorizes the Division to impose certain other penalties on a hospital or psychiatric hospital that violates section 1, including, without limitation, the imposition of an administrative penalty of not more than $5,000 per day for each violation, together with interest at a rate not to exceed 10 percent per year. Sections 5-7 and 8 of this bill make conforming changes to indicate the proper placement of section 1 in the Nevada Revised Statutes. Existing law makes it an unlawful employment practice to discriminate against any employee because the employee has inquired about, discussed or voluntarily disclosed his or her wages or the wages of another employee. (NRS 613.330) Section 7.3 of this bill prohibits a hospital from including in a contract with a provider of health care any provision prohibiting the provider from discussing with other persons his or her wages or salary or other information relating to working conditions. Section 7.3 also prohibits a hospital from taking any action to prevent a provider of health care from: (1) discussing such topics; or (2) working for another medical facility or office. Existing law provides that a noncompetition covenant is void unless the covenant: (1) is supported by valuable consideration; (2) does not impose any restraint that is greater than is required for the protection for the employer; (3) does not impose an undue hardship on the employee; and (4) imposes restrictions that are appropriately related to the consideration for the covenant. (NRS 613.195) Section 7.8 of this bill prohibits a hospital from entering into a noncompetition covenant with a provider of health care that prohibits the provider from providing medical services at another medical facility or office during or after the term of the employment or contract, as applicable. Section 7.8 provides that any provision of a noncompetition covenant that violates that prohibition is void. Additionally, the provisions of sections 7.3 and 7.8 would be subject to administrative enforcement by the Labor Commissioner. (NRS 607.160) Section 8.5 of this bill requires the Joint Interim Standing Committee on Health and Human Services to conduct a study on the employment of physicians by corporations. Section 8.5 authorizes the Standing Committee to request the drafting of 1 legislative measure to amend or repeal section 1 or make other changes relating to the study at the 83rd Session of the Legislature. Section 10 of this bill makes this bill effective upon the passage of the bill by the Legislature and approval of the bill by the Governor. Section 9 of this bill provides that section 1 does not apply to any contract existing on the date on which this bill becomes effective.

Statutes affected:
As Introduced: 449.0301, 449.160, 449.163, 449.220, 449.240, 449.241, 654.190
Reprint 1: 449.0301, 449.160, 449.163, 449.220, 449.240, 449.241, 613.195, 654.190
As Enrolled: 449.0301, 449.160, 449.163, 449.220, 449.240, 449.241, 613.195, 654.190
BDR: 449.0301, 449.160, 449.163, 449.220, 449.240, 449.241, 654.190