Struck = removed from the bill ·
added = the amendment's new text.
AssemblySession Bill(82nd) A AB432 R1 572 Amendment No.
432–Assemblyman572 KoenigSenate CHAPTER..........Amendment to Assembly Bill No.
432 First Reprint (BDR 54-929) Proposed by:
Senate Committee on Commerce and Labor Amends:
Summary:
No Title:
No Preamble:
No Joint Sponsorship:
No Digest:
Yes ASSEMBLY ACTION Initial and Dat| SENATE ACTION Initial and Date Adopted Lost | Adopted Lost Concurred In Not | Concurred In Not Receded Not | Receded Not EXPLANATION:
Matter in (1) blue bold italics is new language in the original bill;
(2) variations of green bold underlining is language proposed to be added in this amendment;
(3) red strikethrough is deleted language in the original bill;
(4) purple double strikethrough is language proposed to be deleted in this amendment;
(5) orange double underlining is deleted language in the original bill proposed to be retained in this amendment.
JFS/SJQ - Date:
5/21/2023 A.B.
No.
432—Revises provisions governing optometry.
(BDR 54-929) Page 1 of 12 *A_AB432_R1_572* Senate Amendment No.
572 to Assembly Bill No.
432 First Reprint Page 3 A SSEMBLY BILLN O.
432–A SSEMBLYMAN KOENIG 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;
(NRS 636.125, 636.215) SectionSections 202-12 of this bill makesdefine acertain conformingterms changerelating to indicate the properpractice placementtry.of 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 Board to issue a citation to a person who violates certain provisionsprovExisting law establishes a schedule of lawfees governingwhich the practiceBoard may not exceed when charging for the issuance of optometry.a license to practice optometry and for certain other purposes.
Existing(NRS law636.143) establishesSection a21 schedule of feesthis whichbill therevises Board may not exceed when charging for the issuancefees ofassociated a license to practice optometry and for certain with the initial issuance of a license.
Existing law authorizes the Board to issue a license by endorsement to certain persons who hold a corresponding valid and unrestricted license to engage in the practice of optometry in the District of Columbia or any state or territory of the United States and who meet certain otherSenate requirements.Amendment No.
(NRS572 636.206)to SectionAssembly 24theBill ofNo. this bill requires the:
432 First Reprint Page 4 other requirements.
(NRS 636.206) Section 24 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 ofestablishing thisan billadditional requireslocation a licensee to notifypractice theoptometry. 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 82nd636.370) Session (2023) – 2 – Section 1615 of this bill requires a licensee to reportprimary totelephone thenumber Boardof within 30 days the revocation,licensee suspension or surrenderthe of,electronic ormail anyaddress disciplinarythat actionthe takenlicensee against,most arecently license,provided certificate or registration to practicethe anyBoard. occupation or profession issued by any other jurisdiction.
ExistingSection law16 prohibitsof anthis optometristbill fromrequires owninga alllicensee orto anyreport partto ofthe anBoard optometrywithin practice30 underdays anthe assumedrevocation, suspension or fictitioussurrender nameof, unlessor theany optometristdisciplinary hasaction thetaken assumedagainst, a license, certificate or fictitiousregistration nameto atpractice aany specifiedoccupation location.or profession issued by any other jurisdiction.
Section 13 of this bill prohibits, with certain exceptions, a person who is not licensed to practice optometry in this State from:
(1) owning, being an officer or board member of or having control over the management or operations of an optometry practice located in this State;
or (2) being an officer or board member of an entity that operates such an optometry practice or holding a position in such an entity that allows the person to have control over the management or operations of an optometry practice.
Section 13 also prohibits a person who is employed by a management service provider which is providing certain business services to an optometry practice from performing certain roles for the optometry practice or the entity thatExisting law prohibits an optometrist from owning all or any part of an optometry practice under an assumed or fictitious name unless the optometrist has been issued a certificate of registration by the Board to practice optometry under the assumed or fictitious name at a specified location.
Section 14 of this bill:bill :
(1) authorizes a surviving family member of a licensed optometrist who has died and who was the sole owner of an optometry practice to own the optometry practice without holding a license to practice optometry in this State for not more than 1 year after the death of the licensed optometrist;optometrist [.] ;
Section 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 anotheranotExisting licensedlaw optometristprohibits ora toperson dissolvefrom engaging in the practice.practice of optometry in this State unless the person is licensed by the Board.
Existing(NRS law636.145) prohibitsSection a17 personof fromthis engagingbill authorizes students who are participating in thecertain practiceexternship programs pursuant to a course of study in optometry or certain persons engaged in thisa Stateresidency unlessprogram thefor personoptometry isto licensedperform bycertain procedures pursuant to those programs which constitute engaging in the Board.practice of optometry.
(NRS 636.145) Section 17 of this bill authorizes students who are participating in certain externship programs residency program for optometry to perform certain procedures pursuant to those programs which constitute engaging in the practice of optometry.
(NRS 636.025, 636.215) Section 18 of this bill prohibits a licensed optometrist from issuing, offering to issue, duplicating or extending a prescription for certain lenses if the optometrist has not performed, or does not have access to records relating to, a comprehensive eye examination performed within the immediately preceding 2 years on the intended recipientreciExisting 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 lenses.use of information and audio-visual communication technology, not including facsimile or electronic mail.
Existing(NRS law629.515) Section 8 of this bill defines the term “telehealth”“optometric telemedicine” to meanmean, in general, the deliveryuse of servicestelehealth fromby a providerlicensed ofoptometrist health care to adeliver patienthealth atcare aservices differentwithin location through the usescope of informationthe andpractice audio-visualof communicationoptometry technology,to nota includingpatient facsimileat ora electronicdifferent mail.location.
(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.Senate Amendment No.
Section572 19 additionally authorizes an licensed optometrist to remotelyAssembly monitorBill certainNo. health data of a patient.
432 First Reprint Page 5 certain health data of a patient.ally authorizes an licensed optometrist to remotely monitor Existing law authorizes the State Board of Health to prescribe regulations relating to the operation of medical laboratories and the qualifications of the directors of those laboratories.
(NRS 652.130) Section 29 of this bill requires the regulations to include licensed optometrists among the licensed physicians qualified -to 82ndserve Sessionas (2023)the – 3 – circumstances.e laboratory director of certain laboratories under certain EXPLANATIONcircumstances. – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
“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.
- 82nd Session (2023) – 4 – (o) Posterior segment examination that includes the examination of the optic nerve, macula, retina and vessels;
and (p) A review and assessment of all data collected pursuant to paragraphs (a) to (o), inclusive, and the development of a plan to pro2.deTheprovide termnecessary includestreatment. 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.
Sec.Senate Amendment No.
572 to Assembly Bill No.
432 First Reprint Page 6 Sec.
The term includes, without asynchronouslimitation, synchronous optometric telemedicine.tric telemedicine and Sec.asynchronous 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.
(Deleted1. 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:
(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.
Senate Amendment No.
572 to Assembly Bill No.
432 First Reprint Page 7 (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 not:not [abrogate,] :
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.
- 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.
4.Senate Amendment No.
572 to Assembly Bill No.
432 First Reprint Page 8 4.
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 pursuantthis toState thisunless chapter.sonthe person is licensed to practice optometry 2.pursuant to this chapter.
2.
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 theionthe patient requires a comprehensive examination;
provide7. 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.
9.Senate Amendment No.
572 to Assembly Bill No.
432 First Reprint Page 9 9.
- 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).
Not more than [1.] (a) Examinations...........................................................$250Examinations..................................................................................$250 [2.] (b) [Applications for the issuance of a 1-year license..............................................................................$600license.................................................................................................................$600 3.
Renewal] Initial issuance or renewal of a license...............................................................................$1,200license.............................$1,200 [4.] (c) Granting certification or issuing certificates................................................................................$1,000certificates................................$1,000 [5.] (d) Licensing of extended clinical facilities and other practice locations..........................................$500locations.......................................................................................$500 [6.] (e) Individually verifying licensure or disciplinary statusstatus...............................................................................................$100 .......................................................................$100 [7.] (f) Late fee..................................................................$1,000fee........................................................................................$1,000 [8.] (g) Initial issuance of a license to an applicant who is a veteranveteran.................................................................................................$600 .........................................................$600 (h) Any other service provided by the Board pursuant to this chapterchapter....................................................................................$1,000 .................................................$1,000 2.
- 82nd Session (2023) – 9 – (a) The person has obtained a license pursuant to the provisions of this chapter;
subsection2. 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.
In addition to any other penalty prescribed by law, if the Board, after conducting an investigation and hearing in accordance with chapters 233B, 622 and 622ASenate ofAmendment NRS,No. determines that a person has committed any act described in subsection 1, the Board may:
572 to Assembly Bill No.
432 First Reprint Page 10 622A of NRS, determines that a person has committed any act described in subsection 1, the Board may:
(Deleted by amendment.) 636.206Sec. 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;
(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 ofantof optometry;
(Deleted by amendment.) Sec.Senate Amendment No.
572 to Assembly Bill No.
432 First Reprint Page 11 Sec.
any636.350 portion1. 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.
(a) Comply with the provisions of chapter 602 of NRS;
[In addition to any other penalty prescribed by law, if] If the Board determines that a person has violated any provision of this chapter, the Board may issue a citation to the administrativeperson. 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 citation may contain an order to pay an 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.
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:
(a)Senate TheAmendment education,No. training and experience qualifications of laboratory directors and technical personnel.
572 to Assembly Bill No.
432 First Reprint Page 12 (a) The education, training and experience qualifications of laboratory directors and technical personnel.
(c) Sanitary conditions within the laboratory and its surroundings, including the water supply, sewage, the handling of specimens and matters of general hygiene, to ensure the protection of (d) The equipment essential to the properpublic conducthealth. and operation of a laboratory.
(d) The equipment essential to the proper conduct and operation of a laboratory.
(Deleted by amendment.) ~~~~~ 23 - 82nd Session (2023)