AB 432 — Revises provisions governing optometry. (BDR 54-929)
Last action — Chapter 230.
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✓Introduced
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✓In Committee
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✓Passed Assembly
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✓Passed Senate
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✓To Executive
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6Enacted
This bill has been enacted into law. Introduced March 27, 2023. Enacted.
Signed by Governor Joe Lombardo (Republican) on June 07, 2023.
Odds of enactment
High chanceBased on the sponsor, cosponsors, and committee posture, this bill has a high chance of becoming law.
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Prognosis
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Enacted
Current position in the legislative process.
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1 sponsor
1 primary, 0 co-sponsors signed on.
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Single-party support
Sponsorship is currently within one party (1 R).
Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.
Bill Text
What changed in the latest version
494 added · 564 removed494 line(s) added, 564 removed.
(ReprintedAssembly withBill amendmentsNo. adopted on April 21, 2023) FIRST REPRINT A.B.
432432–Assemblyman ASSEMBLYKoenig BILLCHAPTER.......... N O.
432–A SSEMBLYMAN K OENIG M ARCH 27, 2023 ____________ Referred to Committee on Commerce and Labor SUMMARY—Revises provisions governing optometry.
(BDR 54-929) FISCAL NOTE:
Effect on Local Government:
No.
Effect on the State:
No.
~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
prohibiting certain persons from owning or controlling an optometry practice under certain circumstances;
Existing law authorizes the Nevada State Board of Optometry to adopt policies and regulations necessary to regulate the practice of optometry in this State and issue licenses to engage in the practice of optometry.
(NRS 636.125, 636.215) andSection Sections20 2-12 of this bill definemakes certaina termsconforming relatingchange to indicate the practiceproper ofplacementtry. optometry.
Section 20 of this bill makes a conforming change to indicate the proper placement of sections 2-12 in the Nevada Revised Statutes.
Section 28 of this bill authorizes -the *AB432_R1*Board –to 2issue –a governingcitation theto practicea ofperson optometry.erson who violates certain provisions of law Existinggoverning law establishes a schedule of fees which the Boardpractice may not exceed when charging for the issuance of aoptometry. license to practice optometry and for certain other purposes.
(NRSExisting 636.143)law Sectionestablishes 21a schedule of thisfees billwhich revisesthe Board may not exceed when charging for the feesissuance associatedof a license to practice optometry and for certain with the initial issuance of a license.
personsExisting wholaw holdauthorizes athe correspondingBoard validto andissue unrestricteda license toby engageendorsement into thencertain practicepersons ofwho optometryhold ina thecorresponding Districtvalid ofand Columbiaunrestricted orlicense anyto stateengage orin territory of the United States and who meet certain other requirements.
(NRS 636.206636.206) ) Section 2424the of this bill requires the:
Existing law requires a licensee to notify the Executive Director of the Board in advance of changing the location where the licensee practices optometry or establishingof anthis additionalbill locationrequires a licensee to practicenotify optometry.the Board not later than 30 days after a change of the personal mailing address or primary telephone number of the licensee or the electronic mail address that the licensee most recently provided to the Board.
(NRS- 636.370)82nd Session (2023) – 2 – Section change16 of thethis personalbill mailingrequires addressa orlicensee primaryto telephonereport numberto ofthe Board within 30 days the licenseeerrevocation, asuspension or thesurrender electronicof, mailor addressany thatdisciplinary theaction licenseetaken mostagainst, recentlya providedlicense, certificate or registration to thepractice Board.any occupation or profession issued by any other jurisdiction.
SectionExisting 16law ofprohibits thisan billoptometrist requiresfrom aowning licenseeall toor reportany topart theof Boardan withinoptometry 30practice daysunder thean revocation,assumed suspension or surrenderfictitious of,name orunless anythe disciplinaryoptometrist actionhas takenthe against,assumed a license, certificate or registrationfictitious toname practiceat anya occupationspecified orlocation. profession issued by any other jurisdiction.
(NRS 636.350) Section 1326 of this bill prohibits,specifies withthat certaineach exceptions,person who owns any part of such a personpractice whohold isan notactive licensedlicense to practice optometry in this State from:and have been issued such a certificate of registration.
(1)Section owning,14 being an officer or board member of orthis havingbill: control over the management or operations of an an entity that operates such an optometry practice or holding a position in such anf entity that allows the person to have control over the management or operations of an optometry practice.
Section(1) 13authorizes alsoa prohibitssurviving family member of a personlicensed optometrist who ishas employeddied byand awho managementwas servicethe providersole whichowner isof providingan certainoptometry businesspractice services to anown the optometry practice fromwithout performingholding certaina roleslicense forto thepractice optometry practicein orthis theState entityfor thatnot operatesmore than 1 year after the optometrydeath practiceof usingthe thoselicensed services.optometrist;
Existingand law(2) prohibitsclarifies anthat optometristsuch fromownership owningdoes allnot orexempt any part of an optometry practice under an assumed or fictitious name unless the optometrist has been issued a certificateperson offrom registration by the Boardrequirement to practiceobtain optometry under this bill specifies that each person who owns any part of such a practice hold anof active license to practiceengage optometry in thisthe Statepractice and have been issued such a certificate of registration.optometry.
Section 14 ofrequires thissuch bill authorizes a surviving family membermember, ofnot alater licensedthan optometrist1 whoyear hasafter diedthe anddeath whoof was the solelicensee, ownerto transfer ownership of anthat optometry practice to ownanother thelicensed optometryoptometrist practiceor without holding a license to practicedissolve optometry in this State for not more than 1 year after the deathpractice. of the licensed optometrist.
SectionExisting 14 requires such a surviving family member, not later than 1 year after the death of the licensee, to transfer ownership of that optometry practice to another licensed optExisting law prohibits a person from engaging in the practice of optometry in this State unless the person is licensed by the Board.
(NRS 636.145) Section 17 of this bill authorizes students who are participating in certain externship programs pursuant to a course of study in optometry or certain persons engaged in a residency program for optometry to perform certain procedures pursuant to those - *AB432_R1* – 3 – programs which constitute engaging in the practice of optometry.
Existing law authorizes a licensed optometrist to prescribe therapeutic or corrective lenses for the correction or relief of or remedy for an abnormal condition this bill prohibits a licensed optometrist from issuing, offering to issue, duplicating or extendinginefficiency aof prescription for certain lenses if the optometristeye has not performed, or doesvisual notprocess. have access to records relating to, a comprehensive eye examination performed within the immediately preceding 2 years on the intended recipient of the lenses.
Existing(NRS law636.025, defines636.215) theSection term18 “telehealth”of tothis meanbill theprohibits deliverya oflicensed servicesoptometrist from issuing, offering to issue, duplicating or extending a providerprescription offor healthcertain carelenses if the optometrist has not performed, or does not have access to arecords patientrelating atto, a differentcomprehensive locationeye throughexamination performed within the useimmediately preceding 2 years on the intended recipient of electronicthe mail.lenses.
(NRSExisting 629.515)law Section 8 of this bill defines the term “optometric“telehealth” telemedicine” to mean,mean in general, the usedelivery of telehealthservices byfrom a licensedprovider optometristof health care to delivera healthpatient careat servicesa withindifferent location through the scopeuse of theinformation practiceand ofaudio-visual optometrycommunication totechnology, anot patientincluding atfacsimile aor differentelectronic location.mail.
(NRS 629.515) Section 8 of this bill defines the term “optometric telemedicine” to mean, in general, the use of telehealth by a licensed optometrist to patient at a different location.
Section 19 requires, with certain exceptions, a licensed optometrist to have performed a comprehensive examination on a patient within the immediately preceding 2 years to deliver health care services to the patient through optometric telemedicine.
Section 19 additionally authorizes anean licensed optometrist to remotely monitor certain health data of a patient.
(NRS 652.130) Section 29 of this bill requires the regulations to include licensed optometrists among the licensed physicians qualified - 82nd Session (2023) – 3 – circumstances.e laboratory director of certain laboratories under certain THEEXPLANATION PEOPLE– OFMatter THEin STATEbolded OFitalics NEVADA,is REPRESENTEDnew; IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
matter between brackets [omitted material] is material to be omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
“Asynchronous optometric telemedicine” means a form of optometric telemedicine in which data that is collected from an examination of a patient that is conducted in person is later transmitted to an optometrist for review.
- *AB432_R1* – 4 – (d) A review of any allergies of the patient;
- 82nd Session (2023) – 4 – (o) Posterior segment examination that includes the examination of the optic nerve, macula, retina and vessels;
Show all 101 changed lines (61 more)
and (p) A review and assessment of all data collected pursuant to paragraphs (a) to (o), inclusive, and the development of a plan to providepro2.deThe necessaryterm treatment.includes an examination in which a test, procedure or action specified in paragraphs (a) to (p), inclusive, of subsection 1 was not performed if the person conducting the examination was unable to perform the test, procedure or action and used an alternative method to obtain comparable data to that which would have been obtained by the proper performance of the test, procedure or action.
2.
The term includes an examination in which a test, procedure or action specified in paragraphs (a) to (p), inclusive, of subsection 1 was not performed if the person conducting the examination was unable to perform the test, procedure or action and used an alternative method to obtain comparable data to that which would have been obtained by the proper performance of the test, procedure or action.
The term includes, without -asynchronous *AB432_R1* – 5 – limitation, synchronous optometric telemedicine.tric telemedicine and asynchronousSec. optometric telemedicine.
Sec.
“Synchronous optometric telemedicine” means a form of optometric telemedicine in which information is exchanged via electronic communication in real time and - 82nd Session (2023) – 5 – includes, without limitation, communication via telephone, video, a mobile application or an online platform on an Internet website.
1.(Deleted by amendment.) Sec.
Except as otherwise provided in section 14 of this act, a person who is not licensed to practice optometry pursuant to this chapter shall not:
(a) Hold an ownership interest in an optometry practice;
(b) Be an officer or board member of an optometry practice or occupy any other position of authority at an optometry practice that allows the person to exert control over the management or operation of the optometry practice;
or (c) Be an officer or board member of an entity that operates one or more optometry practices or occupy any other position of authority at such an entity that allows the person to exert control over the management or operations of an optometry practice that the entity operates.
2.
A person shall not accept compensation to perform any services for a management service provider that is providing services to an optometry practice if the person is:
(a) An officer or board member of the optometry practice or occupies any other position of authority at an optometry practice that allows the person to exert control over the management or operation of the optometry practice receiving those services;
or (b) An officer or board member of an entity that operates the optometry practice or occupies any other position of authority at such an entity that allows the person to exert control over the management or operations of the optometry practice receiving those services.
3.
As used in this section:
- *AB432_R1* – 6 – (a) “Management service provider” means a person that contracts to provide management or administrative support services to an optometry practice.
The term does not include a provider of insurance, a provider of health care as defined in NRS 41A.017 or a person that offers optometric care at an optometry practice or that offers comprehensive examinations.
(b) “Management or administrative support services” includes, without limitation, legal services and services relating to management, billing, credentialing, accounting, marketing, the storage of electronic medical records, the management of human resources, the provision of malpractice insurance, information technology, the financing of equipment, recruitment, transactions involving real estate and technical support for optometric telemedicine.
Sec.
For not more than 1 year after the death of a licensee who is the sole owner of an optometry practice, a surviving member of the licensee’s family may own the optometry practice without being licensed pursuant to this chapter.
The provisions of this section do notnot: abrogate, alter or otherwise affect any obligation to comply with the requirements of chapters 629 and 636 of NRS relating to the custody of health care records.
(a) Exempt a person from the requirement to obtain a license pursuant to this chapter to engage in the practice of optometry;
and (b) Abrogate, alter or otherwise affect any obligation to comply with the requirements of chapters 629 and 636 of NRS relating to the custody of health care records.
A licensee shall report to the Board within 30 days the revocation, suspension or surrender of, or any other disciplinary action taken against, a license, certificate or registration to practice any occupation or profession issued to the licensee by another state or territory of the United States, the District of Columbia or a foreign country.
A student who is enrolled in a graduate course of study in optometry at an accredited school or college of optometry and who is participating in an externship authorized by the school or college, as applicable, as part of that course of study may perform procedures within the scope of a license to practice - *AB432_R1* – 7 – optometry issued pursuant to this chapter if an optometrist or ophthalmologist licensed in this State:
- 82nd Session (2023) – 6 – 2.
Except as otherwise provided in subsection 3, a person who has received a degree of doctor of optometry and who is engaged in a residency program for optometry in this State may, without a license, engage in the practice of optometry within the scope of a license to practice optometry issued pursuant to this chapter and examine and manage patients without supervision if an chapter and optometrist or ophthalmologist licensed in this State is physically present at the clinic at all times when the person is practicing optometry.
Except as otherwise provided in subsection 5, a person shall not engage in optometric telemedicine to provide health care services to a patient located at an originating site in thispursuant Stateto unlessthis thechapter.son person is licensed to practice optometry pursuant2. to this chapter.
2.
A licensee may engage in synchronous optometric telemedicine to perform a non-comprehensive examination of a new patient if the licensee has access to all the information obtained from a comprehensive examination of the patient that - *AB432_R1* – 8 – was conducted by an optometrist or ophthalmologist within the immediately preceding 2 years.
A licensee may engage in asynchronous optometric telemedicine to conduct a consultation regarding a patient on - 82nd Session (2023) – 7 – whom the licensee has not completed a comprehensive examination within the immediately preceding 2 years if:
(a) An optometrist, ophthalmologist or primary care physician providing care to the patient requests that the licensee conduct the consultation and provides the licensee with all the information about the patient that is necessary to determine whether thetheion patient requires a comprehensive examination;
7.provide health care services to a patient who is located at an originating site outside this State if the licensee has completed a comprehensive examination of the patient within the immediately preceding 2 years and such action is permitted by the laws of the state in which the patient is located.
A licensee may engage in optometric telemedicine to provide health care services to a patient who is located at an originating site outside this State if the licensee has completed a comprehensive examination of the patient within the immediately preceding 2 years and such action is permitted by the laws of the state in which the patient is located.
(a) Conduct himself or herself in a manner that violates the standard of care required of an optometrist who is treating a patient in person, including, without limitation, by issuing a - *AB432_R1* – 9 – prescription for ophthalmic lenses based solely upon one or more of the following:
- 82nd Session (2023) – 8 – (1) Answers provided by a patient in an online questionnaire;
or (b) Condition the provision of optometric telemedicine or remote patient monitoring on the patient consenting to receiving a standard of care below that which is required by paragraph (a).
Renewal] Initial issuance or renewal of a license...............................................................................$1,200 [4.] (c) Granting certification or issuing certificates................................................................................$1,000 [5.] (d) Licensing of extended clinical facilities and other practice locations..........................................$500 [6.] (e) Individually verifying licensure or disciplinary status .......................................................................$100 [7.] (f) Late fee..................................................................$1,000 [8.] (g) Initial issuance of a license to an applicant who is a veteran .........................................................$600 (h) Any other service provided by the Board pursuant to this chapter .................................................$1,000 2.
- *AB432_R1*82nd Session (2023) – 109 – (a) The person has obtained a license pursuant to the provisions of this chapter;
2.subsection 3 if the Board receives a complaint which sets forth any reason to believe that a person has engaged in the practice of optometry in this State without a license issued pursuant to this chapter.
The Board shall conduct an investigation pursuant to subsection 3 if the Board receives a complaint which sets forth any reason to believe that a person has engaged in the practice of optometry in this State without a license issued pursuant to this chapter.
(Deleted by amendment.) Sec.636.206 1.
24.
NRS 636.206 is hereby amended to read as follows:
636.206 1.
- 82nd Session (2023) – 10 – (4) Has not held a license to practice optometry in this State in the immediately preceding year;
- *AB432_R1* – 11 – (5) Has not been disciplined and is not currently under investigation by the corresponding regulatory authority of the District of Columbia or any state or territory in which the applicant currently holds or has held a license to engage in the practice ofofant optometry;
636.350any 1.portion of an optometry practice under an assumed or fictitious name unless the [optometrist has] person:
[An optometrist] A person shall not own all or any portion of an optometry practice under an assumed or fictitious name unless the [optometrist has] person:
The application must be accompanied by proof satisfactory to the Board that the assumed or fictitious name has been registered or otherwise approved by any appropriate governmental entity, including, without limitation, any incorporated city or unincorporated town in which the optometrist - 82nd Session (2023) – 11 – practices, if the registration or other approval is required by the governmental entity.
- *AB432_R1* – 12 – (a) Comply with the provisions of chapter 602 of NRS;
InIf addition to any other penalty prescribed by law, if the Board determines that a person has violated any provision of this chapter, the Board may issue a citation to the person.administrative fine of not more than $1,000 for each violation or, for a violation described in subsection 1, $5,000 for each such violation.
The Board shall provide notice of and conduct a hearing requested pursuant to this subsection in accordance with the provisions of chapter 622A of NRS.
Except as otherwise provided in NRS 652.127, the Board, with the advice of the Medical Laboratory Advisory - 82nd Session (2023) – 12 – Committee, may prescribe and publish rules and regulations relating to:
(c) Sanitary conditions within the laboratory and its surroundings, including the water supply, sewage, the handling of - *AB432_R1* – 13 – specimens and matters of general hygiene, to ensure the protection of (d) The equipment essential to the publicproper health.conduct and operation of a laboratory.
(d) The equipment essential to the proper conduct and operation of a laboratory.
Any regulations adopted by the Board pursuant to this section must not require that the laboratory director of a laboratory in which the only test performed is a test for the detection of the human immunodeficiency virus that is classified as a waived test Regulations:Subpartpursuant to Subpart A of Part 493 of Title 42 of the Code of Federal (a)Regulations: Be a licensed physician;
(a) Be a licensed physician;
(Deleted by amendment.) H~~~~~ 23 - *AB432_R1*82nd Session (2023)
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- Introduced As Introduced pdf
Amendments
3 amendmentsClick Show changes on an amendment above to see how it modifies the bill.
Action History
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Chapter 230.
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Approved by the Governor.
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Enrolled and delivered to Governor.
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Senate Amendment Nos. 572 and 779 concurred in. To enrollment.
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In Assembly.
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Read third time. Amended. (Amend. No. 779.) Reprinting dispensed with. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 20, Nays: None, Excused: 1.) To printer. From printer. To re-engrossment. Re-engrossed. Third reprint. To Assembly.
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Taken from General File. Placed on General File for next legislative day.
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From printer. To re-engrossment. Re-engrossed. Second reprint. Taken from General File. Placed on General File for next legislative day.
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From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time. Amended. (Amend. No. 572.) To printer.
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In Senate. Read first time. Referred to Committee on Commerce and Labor. To committee.
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From printer. To engrossment. Engrossed. First reprint. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 42, Nays: None.) To Senate.
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From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time. Amended. (Amend. No. 434.) To printer.
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From printer. To committee.
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Read first time. Referred to Committee on Commerce and Labor. To printer.
Sponsors
- Gregory S. Koenig · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 66 not signed on
Sponsors (1)
- Koenig, Gregory S. Republican
Co-sponsors (0)
None.
Not signed on (66)
66 members have not signed on to this bill.
Show all 66 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- Who sponsors AB 432?
- AB 432 is sponsored by Koenig, Gregory S. (Republican).
- What is the current status of AB 432?
- This bill has been enacted into law. Introduced March 27, 2023. Enacted.
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