Existing law provides for the licensing of physicians and physician assistants by the Board of Medical Examiners and for the licensing of osteopathic physicians and physician assistants by the State Board of Osteopathic Medicine. (NRS 630.160-630.1607, 630.258-630.2665, 630.271-630.2755, 633.305-633.420, 633.432-633.4336) Sections 2-9 and 14-21 of this bill create limited licenses that authorize certain medical school graduates to engage in the supervised practice of medicine as an associate physician or associate osteopathic physician. Sections 2 and 14 authorize the Board of Medical Examiners and State Board of Osteopathic Medicine, respectively, to issue a limited license as an associate physician or associate osteopathic physician to an applicant who: (1) has graduated from certain medical schools; (2) has completed at least 1 year of postgraduate medical education as a resident or intern as a part of certain programs; and (3) possesses certain other qualifications. Sections 3 and 15 limit an associate physician or associate osteopathic physician to practicing medicine under the supervision and control of a supervising physician or supervising osteopathic physician. Sections 5 and 17 prescribe the required qualifications of a supervising physician or supervising osteopathic physician. Sections 3 and 15 require an associate physician or associate osteopathic physician to enter into a collaborative practice agreement with his or her supervising physician or supervising osteopathic physician. Sections 6 and 18 prescribe the provisions that are required to be included in the collaborative practice agreement. Sections 3 and 15 require a supervising physician or supervising osteopathic physician to be on the same premises and available to assist an associate physician or associate osteopathic physician for the first 30 days of supervision. Sections 3 and 15 require a supervising physician or supervising osteopathic physician, or designee thereof, to be on the same premises and available to assist at all times an associate physician or associate osteopathic physician, as applicable, who is practicing in a county whose population is less than 100,000 (currently all counties other than Clark and Washoe Counties). Sections 3 and 15 also require the employer of an associate physician or associate osteopathic physician to credential and bill for services rendered by an associate physician or associate osteopathic physician in the same manner as a physician assistant. Sections 4 and 16 require a supervising physician and associate physician or supervising osteopathic physician and associate osteopathic physician to take certain measures to notify the public of their respective statuses and their relationship. Sections 5 and 17: (1) provide that a supervising physician or supervising osteopathic physician is responsible for the practice of medicine or osteopathic medicine by the associate physician or associate osteopathic physician, as applicable, that he or she is supervising; and (2) require a supervising physician or supervising osteopathic physician to maintain insurance that covers malpractice by an associate physician or associate osteopathic physician, as applicable. Sections 5 and 17 prohibit a supervising physician or supervising osteopathic physician from entering into a collaborative practice agreement with more than three associate physicians or associate osteopathic physicians, as applicable. Sections 5 and 17 additionally prohibit the Board of Medical Examiners and the State Board of Osteopathic Medicine, respectively, from disciplining a supervising physician or supervising osteopathic physician for legal activity of an associate physician or associate osteopathic physician that is within the scope of the relevant collaborative practice agreement. Sections 7 and 19 authorize an associate physician or associate osteopathic physician, respectively, to prescribe or dispense certain controlled substances and establish the conditions under which an associate physician or associate osteopathic physician may prescribe or dispense such controlled substances. Existing law: (1) authorizes the State Board of Pharmacy to issue a registration certificate to authorize a physician assistant to possess, administer, prescribe or dispense controlled substances, poisons, dangerous drugs or devices in or out of the presence of his or her supervising physician; and (2) requires the Board to adopt regulations governing the storage, security, recordkeeping and transportation of controlled substances, poisons, dangerous drugs or devices by a physician assistant. (NRS 639.1373) Section 26 of this bill authorizes the State Board of Pharmacy to additionally issue such a registration certificate to associate physicians and associate osteopathic physicians and to regulate associate physicians and associate osteopathic physicians who hold such a certificate in the same manner as physician assistants. Sections 8 and 20 provide for the expiration and renewal of the limited licenses issued to associate physicians and associate osteopathic physicians, respectively. Sections 11 and 25 of this bill require a physician or osteopathic physician to biennially submit to the Board of Medical Examiners or the State Board of Osteopathic Medicine, as applicable, a list of the names of each associate physician or associate osteopathic physician who is supervised by the physician or osteopathic physician. Sections 9 and 21 of this bill require those Boards to adopt regulations to implement sections 2-9 and 19-21. Sections 10, 22 and 27 of this bill make conforming changes to clarify the meaning of the terms “supervising physician,” “associate physician,” “supervising osteopathic physician” and “associate osteopathic physician.” Sections 11 and 23 of this bill make conforming changes to clarify that an applicant for a license as an associate physician or an associate osteopathic physician does not hold the same qualifications for licensure as an applicant for a standard license as a physician or an osteopathic physician. Section 24 of this bill makes a conforming change to clarify the applicability of a provision relating to the supervising osteopathic physician of a physician assistant.

Statutes affected:
As Introduced: 630.025, 630.160, 630.267, 633.123, 633.311, 633.467, 633.471, 639.1373, 0.040