SB 189 — Provides for the licensure and regulation of genetic counselors. (BDR 54-69)

[(bb)]- (cc)83rd AnSession associate(2025) in– social4 work,– a social worker, a master social worker, an independent social worker or a clinical social worker licensed pursuant to chapter 641B of NRS;

For the purposes of NRS 629.400 to 629.490, inclusive, the term includes a person who holds a current license or certificate to practice his or her respective discipline pursuant to the applicable provisionsproSec. of law of another state or territory of the United States.

Sec.

NRSofNRS 629.580 is hereby amended to read as follows:follows:States.

- *SB189_R1* – 5 – (e) Recommends to a client that he or she discontinue or in any manner alter current medical treatment prescribed by a provider of health care licensed, certified or registered in this State;

(f) Makes a diagnosis of a medical disease of any person;

(j) Engages in the practice of medicine or genetic counseling in violation of chapter 630 or 633 of NRS, the practice of homeopathic medicine- in83rd violationSession of(2025) chapter– 630A5 of– NRS, the practice of naprapathy in violation of chapter 634B of NRS or the practice of podiatry in violation of chapter 635 of NRS, unless otherwise expressly authorized by this section;

Any person providing wellness services in this State who is not licensed, certified or registered in this State as a provider of health care and who is advertising or charging a fee for wellness services shall, before providing those services, disclose to each clientcli(a) inThe aperson’s plainlyname, wordedbusiness writtenaddress statement:and telephone number;

(a) The person’s name, business address and telephone number;

It is also - *SB189_R1* – 6 – recommended that you ask your primary care physician or other licensed providers of health care about any potential drug interactions, side effects, risks or conflicts between any medications or treatments prescribed by your primary care physician or other licensed providers of health care and the wellness services you intend to receive.

8  A person who provides wellness services shall obtain from each client a signed copy of the statement required by this subsection, provide the client with a copy of the signed statement at the time of - 83rd Session (2025) – 6 – service and retain a copy of the signed statement for a period of not less than 5 years.

A written copy of the statement required by subsection 2 must be posted in a prominent place in the treatment location of the personReasonable providingaccommodations wellnessmust servicesbe inmade atfor leastclients 12-pointwho: font.

Reasonablefont. accommodations must be made for clients who:

(b) Any health care practice if the practice is exempt from the professional practice laws of this State, or prevent such a health care pra(c) A person who provides health care services if the person is exempt from the professional practice laws of this State, or prevent the person from beingperforming performed.such a health care service.

(c) A person who provides health care services if the person is exempt from the professional practice laws of this State, or prevent the person from performing such a health care service.

- *SB189_R1* – 7 – 7.

- 83rd Session (2025) – 7 – (e) Energetic healing.

(h) Healing practices using food, dietary supplements, nutrients andand(i) theHerbology physicaland forcesherbalism., of heat, cold, water and light.

(i) Herbology and herbalism.

(d) Integrating the results of genetic laboratory tests and other diagnostic studies with the medical histories of patients and their familiesrisk tofactors assessfor andmedical communicateor thegenetic existenceconditions;e and severity of risk(e) factorsExplaining forthe medicalclinical orimplications and results of a genetic conditions;laboratory test;

(e) Explaining the clinical implications and results of a genetic laboratory test;

(g) Identifying and utilizing resources in the community that provide medical, educational, financial and psychosocial support - *SB189_R1* – 8 – and advocacy for persons who have or are at risk of having medical or genetic conditions;

- 83rd Session (2025) – 8 – Sec.

1.

A genetic test performed on a person;

(b) Three members who hold a valid certification issued by the American Board of Genetic Counseling, or its successor organization, and are actively engaged in the practice of genetic counseling;cou(c) One member who is a representative of the public.

and (c) One member who is a representative of the public.

- *SB189_R1* – 9 – 6.

- 83rd Session (2025) – 9 – (a) Elect from its members a Chair and any other officers determined necessary by the members of the Advisory Council at the first meeting of each year;

(b) Meet at least two times each year at the call of the Chair of the(c) Advise the AdvisoryBoard Council;on the adoption of regulations concerning the practice of genetic counseling and other matters related to the practice of genetic counseling.

and (c) Advise the Board on the adoption of regulations concerning the practice of genetic counseling and other matters related to the practice of genetic counseling.

Defining “temporary basis” for the purposes of subsection 3 of section 9 of this act;

3.NRS 630.268;it the fee prescribed by the Board pursuant to 4.

Submit the fee prescribed by the Board pursuant to NRS 630.268;

4.

Pass the examination administered by the American Board of Genetic Counseling, or its successor organization, or the - *SB189_R1* – 10 – examination in clinical genetics and genomics administered by the American Board of Medical Genetics and Genomics, or its successor organization;

and - 83rd Session (2025) – 10 – 6.

(a) Has satisfied all requirements for licensure except the requirements of subsections 5 and 6 of section 7 of this act;

and (b) Submits the fee prescribed by the Board pursuant to NRSNRS4.30.If 630.268.the Board renews a temporary license pursuant to subsection 3, the Board shall prescribe the length of time for which the temporary license remains valid.

4.

If the Board renews a temporary license pursuant to subsection 3, the Board shall prescribe the length of time for which the temporary license remains valid.

Before commencing a supervisory relationship pursuant to subsection 5 and annually thereafter for the duration of the supervisory relationship, a supervisor and a temporarily licensed genetic counselor must enter into a contract that prescribes the - *SB189_R1* – 11 – responsibilities of the supervisor and the temporarily licensed genetic counselor.

- 83rd Session (2025) – 11 – 7.

A student who is enrolled in a program in genetic counseling described in subsection 4 of section 7 of this act and who does not hold a license to practice genetic counseling maymayand assist a genetic counselor in the practice of genetic counseling if such assistance is within the scope of the education and training of the student.

Any other person who is not licensed to practice genetic counseling may assist a physician, osteopathic physician, physician assistant licensed pursuant to this chapter or chapter 633 of NRS, advanced practice registered nurse or genetic counselor in the practice of genetic counseling under the direct supervision of a physician, osteopathic physician, physician assistant, advanced practice registered nurse or genetic counselor who is on the same premises where the assistance is being provided.

A physician or physician assistant who engages in genetic counseling as part of his or her practice of medicine or practice as alicense physicianas assistant,a asgenetic applicable,counselor.cable, is not required to obtain a licenseSec. as a genetic counselor.

Sec.

(b) Proof that the applicant has successfully completed at least 20 hours of continuing education approved by the National Society of Genetic Counselors, or its successor organization, since the license was issued or most recently renewed, as applicable;

- *SB189_R1*83rd –Session 12(2025) – (d)12 Proof– that the applicant has satisfied any other requirements prescribed by the regulations adopted by the Board pursuant to section 6 of this act;

Sec.initiating disciplinary action against a genetic counselor or denying licensure as a genetic counselor:

12.

1.

The following acts constitute grounds for initiating disciplinary action against a genetic counselor or denying licensure as a genetic counselor:

(e) Advertising the practice of genetic counseling in a false, deceptivedec(f) Advertising, practicing or misleadingattempting manner.to practice genetic counseling under a name other than one’s own.

(f) Advertising, practicing or attempting to practice genetic counseling under a name other than one’s own.

- 83rd Session (2025) – 13 – (i) Lack of ability to safely and skillfully practice genetic counseling due to a lack of knowledge or training or the inability to apply professional principles and skills.

- *SB189_R1* – 13 – (j) Violating or attempting to violate, or assisting or abetting chapter or the violationregulations of,adopted pursuant thereto.sion of this (k) Any disciplinary action, including, without limitation, the revocation, suspension, modification or conspiringlimitation of a license to violatepractice genetic counseling, taken by another state, the Federal Government, a foreign country or any provisionother jurisdiction or the surrender of thisthe chapterlicense or discontinuing the regulationspractice adoptedof pursuantgenetic thereto.counseling while under investigation by any licensing authority, a medical facility, a branch of the Armed Forces of the United States, an insurance company, an agency of the Federal Government or an employer.

(k) Any disciplinary action, including, without limitation, the revocation, suspension, modification or limitation of a license to practice genetic counseling, taken by another state, the Federal Government, a foreign country or any other jurisdiction or the surrender of the license or discontinuing the practice of genetic counseling while under investigation by any licensing authority, a medical facility, a branch of the Armed Forces of the United States, an insurance company, an agency of the Federal Government or an employer.

2.hours after the certification of the genetic counselor by the American Board of Genetic Counseling, or its successor organization, lapses or is revoked.

A genetic counselor shall notify the Board not later than 48 hours after the certification of the genetic counselor by the American Board of Genetic Counseling, or its successor organization, lapses or is revoked.

(b) For the protection and benefit of the public, the Legislature delegates to the Board of Medical Examiners the power and duty to determine the initial and continuing competence of physicians, genetic counselors, perfusionists, physician assistants, anesthesiologist- assistants83rd andSession practitioners(2025) – 14 – are subject to the provisions of this chapter;of respiratory care who are(c) subjectThe Board must exercise its regulatory power to ensure that the provisionsinterests of thisthe chapter;medical profession do not outweigh the interests of the public;

(c)(d) The Board must exerciseensure itsthat regulatoryunfit powerphysicians, togenetic ensurecounselors, thatperfusionists, thephysician interestsassistants, anesthesiologist assistants and practitioners of therespiratory care are removed from [the medical professionprofession] dothose notprofessions outweighso thethat intereststhey ofwill not cause harm to the public;

- *SB189_R1* – 14 – (d) The Board must ensure that unfit physicians, genetic counselors, perfusionists, physician assistants, anesthesiologist assistants and practitioners of respiratory care are removed from [the medical profession] those professions so that they will not cause harm to the public;

630.005 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 630.007 to 630.026,630.026,ise inclusive, and sections 4 to 5.6, inclusive, of this act have the meanings ascribed to them in those sections.

(a) A medical officer [or] , genetic counselor, perfusionist or practitioner of respiratory care of the Armed Forces or a medical officer [or] , genetic counselor, perfusionist or practitioner of respiratory care of any division or department of the United States in the discharge of his or her official duties, including, withoutwithoutates in limitation, providing medical care in a hospital in accordance with an agreement entered into pursuant to NRS 449.2455;

(1)- Obtain83rd medicalSession training(2025) approved– by15 the– Board from a physician who is licensed in this State;

or by the Board from a (2) Provide medical instruction or training approved by the Board to physicians licensed in this State;

- *SB189_R1* – 15 – (e) Any person permitted to practice any other healing art under this title who does so within the scope of that authority, or healing by faith or Christian Science;

(1)care Iswhich enrolledhas inbeen aapproved clinicalby programthe Board;am of study in respiratory care(2) whichIs hasemployed beenby approveda bymedical thefacility, Board;as defined in NRS 449.0151;

(2) Is employed by a medical facility, as defined in NRS 449.0151;

(i) A person who is employed by a physician and provides respiratorythat carephysician;e or services as a perfusionist under the supervision of (j) The maintenance of medical equipment for perfusion or respiratory care that physician;is not attached to a patient;

(j) The maintenance of medical equipment for perfusion or respiratory care that is not attached to a patient;

(l)- The83rd performanceSession of(2025) medical– services16 by– a student enrolled in an educational program for a physician assistant which is accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc., or its successor organization, as part of such a program;

and - *SB189_R1* – 16 – (n) Any person permitted to practice any other healing art under this title who engages in the practice of genetic counseling within the scope of that authority, if he or she does not represent himself or herself to be licensed pursuant to this chapter.

(a) Gratuitous services outside of a medical school or medical facility by a person who is not a physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care in cases of emergency.

One or more advisory members may be designated by the Board to assist a committee of its members in an investigation as provided in NRS 630.311 but may not vote on any matter before the committee.

All licenses issued to physicians, genetic counselors, perfusionists, physician assistants, anesthesiologist assistants and - 83rd Session (2025) – 17 – practitioners of respiratory care must bear the seal of the Board and the signatures of its President and Secretary-Treasurer.

Notwithstanding any other provision of law and except as otherwise provided in this section, the Board shall not adopt any regulations that prohibit or have the effect of prohibiting a physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care from collaborating or consulting with another provider of health care.

The provisions of this section do not prevent the Board from adopting regulations that prohibit a physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or - *SB189_R1* – 17 – practitioner of respiratory care from aiding or abetting another person in the unlicensed practice of medicine or the unlicensed practice of genetic counseling, perfusion or respiratory care.

In addition to any other requirements set forth in this chapter, each applicant for a license to practice medicine, including, without limitation, an expedited license pursuant to NRS 630.1606 or 630.1607 or chapter 629A of NRS, and each applicant for a license to practice as a genetic counselor, to practice as a perfusionist, to practice as a physician assistant, to practice as an anesthesiologist assistant or to practice respiratory care shall submit to the Board a complete set of fingerprints and written permission authorizing the Board to forward the fingerprints to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report.

(a)- An83rd applicantSession for(2025) the– issuance18 of– a license to practice medicine, to practice as a genetic counselor, to practice as a perfusionist, to practice as a physician assistant, to practice as an anesthesiologist assistant or to practice as a practitioner of respiratory care shall include the social security number of the applicant in the application submitted to the Board.

- *SB189_R1* – 18 – 2.

(a) The application or any other forms that must be submitted for the issuance or renewal of the license;

or must be submitted (b) A separate form prescribed by the Board.

or (b) Indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order.

If an applicant indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a planplanhe approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order, the Board shall advise the applicant to contact the district attorney or other public agency enforcing the order to determine the actions that the applicant may take to satisfy the arrearage.

- 83rd Session (2025) – 19 – For application for and issuance of a license to practice as a physician, including a license by endorsement ................................................................$600 For application for and issuance of a temporary, locum tenens, limited, restricted, authorized facility, special, special purpose or special event license..................................................................400 For renewal of a limited, restricted, authorized facility or special license...............................................400 For application for and issuance of a license as a physician assistant, including a license by endorsement ..................................................................400 For application for and issuance of a simultaneous license as a physician assistant................200 For biennial registration of a physician assistant................800 - *SB189_R1* – 19 – For biennial simultaneous registration of a physician assistant.......................................................$400assistant.........................................................400 For biennial registration of a physician..............................800 For application for and issuance of a license as a perfusionist or practitioner of respiratory care..............400 For biennial renewal of a license as a perfusionist....................................................................600 For application for and issuance of a license or temporary license to practice as an anesthesiologist assistant...............................................400 For application for and initial issuance of a simultaneous license as an anesthesiologist assistant.........................................................................200 For biennial registration of an anesthesiologistanesthesiologist.....................................200 assistant.......................................................................$800assistant.........................................................................800 For biennial simultaneous registration of an anesthesiologist assistant...............................................400 For biennial registration of a practitioner of respiratory care..............................................................600 For biennial registration for a physician who is on inactive status................................................................400 For application for and issuance of a license or temporary license to practice as a genetic counselor.......................................................................400 For biennial renewal of a license to practice as a genetic counselor or renewal of a temporary license to practice as a genetic counselor.......................................................................600 For- written83rd verificationSession of(2025) licensure.....................................50– 20 – For a duplicate identification card........................................25 For a duplicate license..........................................................50 For computer printouts or labels.........................................500 For verification of a listing of physicians, per hour .................................................................................20 For furnishing a list of new physicians...............................100 2.

Such a special meeting must not be - *SB189_R1* – 20 – called until the person or entity requesting it has paid a cash deposit with the Board sufficient to defray all expenses of the meeting.meeting.deposit 4.

4.

(a) NRS 630.1607, and the applicant is an active member of, or the spouse of an active member of, the Armed Forces of the United States, a veteran or the surviving spouse of a veteran, the Board shall collect not more than one-half of the fee set forth in subsection 1 for the initial issuance of the license.

If an applicant submits an application for a license by endorsement pursuant to NRS 630.1606 or 630.2751, as applicable, the Board shall charge and collect not more than the fee specified in subsectionsubSec. 1 for the application for and initial issuance of a license.

Sec.

license.

(a) Any action for malpractice against the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist not later than 45 days after the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist- 83rd Session (2025) – 21 – action;onist receives service of a summons and complaint for the action;(b) Any claim for malpractice against the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist that is submitted to arbitration or mediation not later than 45 days after the claim is submitted to arbitration or mediation;

(b) Any claim for malpractice against the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist that is submitted to arbitration or mediation not later than 45 days after the claim is submitted to arbitration or mediation;

The Board shall report any failure to comply with subsection 1 by an insurer licensed in this State to the Division of Insurance of the Department of Business and Industry.

If the administrative fine is not paid when due, the fine must be recovered in a civil action brought by the Attorney General on behalf of the Division.Division.ction Sec.

- *SB189_R1* – 21 – Sec.

(c) Any settlement, award, judgment or other disposition of any action or claim described in paragraph (a) or (b) not later than 45 days after the settlement, award, judgment or other disposition, including, without limitation, any amount paid to resolve the claim;

2.- 83rd Session (2025) – 22 – genetic counselor, practitioner of respiratory care or perfusionist has violated any provision of this section, the Board may impose a fine of not more than $5,000 against the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist for each violation, in addition to any other fines or penalties permitted by law.

If the Board finds that a physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist has violated any provision of this section, the Board may impose a fine of not more than $5,000 against the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist for each violation, in addition to any other fines or penalties permitted by law.

630.3069 If the Board receives a report pursuant to the provisions of NRS 630.3067, 630.3068 or 690B.250 indicating that a judgment has been rendered or an award has been made against a physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist regarding an action or claim for malpractice or that such an action or claim against the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist has been resolved by settlement, the Board shall conduct an investigation to determine whether to impose disciplinary action against the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist regarding - *SB189_R1* – 22 – the action or claim, unless the Board has already commenced or completed such an investigation regarding the action or claim before it receives the report.

If a complaint is submitted anonymously, the Board may accept the complaint but may refuse to consider the complaint if the lack of the identity of the complainant makes processing the complaint impossible or unfair to the person who is the subject of the complaint.

3.- 83rd Session (2025) – 23 – clinic or other medical facility licensed in this State, or medical society, shall report to the Board any change in the privileges of a physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care to practice while the physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care is under investigation and the outcome of any disciplinary action taken by that facility or society against the physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care concerning the care of a patient or the competency of the physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care within 30 days after the change in privileges is made or disciplinary action is taken.

Except as otherwise provided in subsection 4, any hospital, clinic or other medical facility licensed in this State, or medical society, shall report to the Board any change in the privileges of a physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care to practice while the physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care is under investigation and the outcome of any disciplinary action taken by that facility or society against the physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care concerning the care of a patient or the competency of the physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care within 30 days after the change in privileges is made or disciplinary action is taken.

A hospital, clinic or other medical facility licensed in this State, or medical society, shall report to the Board within 5 days after a change in the privileges of a physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant ororor, practitioner of respiratory care to practice that is based on:

or - *SB189_R1* – 23 – (b) Suspected or alleged substance abuse in any form by the physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care.

The Board shall report any failure to comply with subsection 3 or 4 by a hospital, clinic or other medical facility licensed in this State to the Division of Public and Behavioral Health of the Department of Health and Human Services.

If, after a hearing, the Division of Public and Behavioral Health determines that any such facility or society failed to comply with the requirements of subsection 3 or 4, the Division may impose an administrative fine of not more than $10,000 against the facility or society for each suchsuchf failure to report.

- 83rd Session (2025) – 24 – (b) Is mentally incompetent;

(d) Is guilty of abuse or fraud under any state or federal program providingpro(e) medicalIs assistance;liable for damages for malpractice or negligence,  within 45 days after such a finding, judgment or determination is made.

or (e) Is liable for damages for malpractice or negligence,  within 45 days after such a finding, judgment or determination is made.

If the Board or any investigative committee of the Board has reason to believe that the conduct of any physician, physician assistant, genetic counselor, practitioner of respiratory - *SB189_R1* – 24 – care or perfusionist has raised a reasonable question as to his or her competence to practice medicine, genetic counseling, respiratory care or perfusion or practice as a physician assistant, as applicable, with reasonable skill and safety to patients, or if the Board has received a report pursuant to the provisions of NRS 630.3067, 630.3068 or 690B.250 indicating that a judgment has been rendered or an award has been made against a physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist regarding an action or claim for malpractice or that such an action or claim against the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist has been resolved by settlement, the Board or committee may order that the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist undergo a mental or physical examination, an examination testing his or her competence to practice medicine, genetic counseling, respiratory care or perfusion or practice as a physician assistant, as applicable, or any other examination - 83rd Session (2025) – 25 – designated by the Board to assist the Board or committee in determining the fitness of the physician, physician assistant, genetic counselor, practitioner of respiratory care or perfusionist to practice medicine, genetic counseling, respiratory care or perfusion or practicepra2.iceFor asthe apurposes physicianof assistant,this assection:licable. applicable.

2.

For the purposes of this section:

- *SB189_R1* – 25 – Sec.

630.326physician, 1.genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care reasonably determines that the health, safety or welfare of the public or any patient served by the licensee is at risk of imminent or continued harm, the Board may summarily suspend the license of the licensee pending the conclusion of a hearing to consider a formal complaint against the licensee.

If an investigation by the Board regarding a physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care reasonably determines that the health, safety or welfare of the public or any patient served by the licensee is at risk of imminent or continued harm, the Board may summarily suspend the license of the licensee pending the conclusion of a hearing to consider a formal complaint against the licensee.

If the Board or an investigative committee of the Board issues an order summarily suspending the license of a physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care pursuant to subsection 1, the Board shall hold a hearing not later than 60 days after the date on which the order is issued, unless the Board and the licensee - 83rd Session (2025) – 26 – mutually agree to a longer period, to determine whether a reasonable basis exists to continue the suspension of the license pending the conclusion of a hearing to consider a formal complaint against the licensee.

If no formal complaint against the licensee is pending before the Board on the date on which a hearing is held pursuant to this section, the Board shall reinstate the license of the licensee.

Any deliberations conducted or vote taken by the Board or any investigative committee of the Board regarding its ordering of a physician, genetic counselor, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care to undergo a physical or mental examination or any other examination designated to assist the Board or committee in determining the fitness of a physician, genetic counselor, - *SB189_R1* – 26 – perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care are not subject to the requirements of NRS 241.020.

- 83rd Session (2025) – 27 – (b) Any report concerning the fitness of any person to receive or hold a license to practice medicine, genetic counseling, perfusion or respiratory care;

(1)(2) The Board andor anyits ofstaff, itsinvestigators, committeesexperts, committees, panels, hearing officers, advisory members or panels;consultants and counsel for the Board.

and (2) The Board or its staff, investigators, experts, committees, panels, hearing officers, advisory members or consultants and counsel for the Board.

1.hearing officer are not bound by formal rules of evidence, except that evidence must be taken and considered in the hearing pursuant to NRS 233B.123, and a witness must not be barred from testifying solely because the witness was or is incompetent.

The Board, a panel of the members of the Board and a hearing officer are not bound by formal rules of evidence, except that evidence must be taken and considered in the hearing pursuant - *SB189_R1* – 27 – to NRS 233B.123, and a witness must not be barred from testifying solely because the witness was or is incompetent.

(a)- Whose83rd practiceSession of(2025) medicine,– genetic28 counseling,– perfusion or respiratory care has been limited;

ororic counseling, perfusion (b) Whose license to practice medicine, genetic counseling, perfusion or respiratory care has been:

(b) Shall determine whether under all the circumstances the time of (c) May deny the application isor reasonable;modify or rescind its order as it deems the evidence and the public safety warrants.

and (c) May deny the application or modify or rescind its order as it deems the evidence and the public safety warrants.

- *SB189_R1* – 28 – Sec.

If the Board receives a copy of a court order issued pursuant to NRS 425.540 that provides for the suspension of all professional, occupational and recreational licenses, certificates and permits issued to a person who is the holder of a license to practice medicine, to practice as a genetic counselor, to practice as a perfusionist, to practice as a physician assistant, to practice as an anesthesiologist assistant or to practice as a practitioner of respiratory care, the Board shall deem the license issued to that person to be suspended at the end of the 30th day after the date on which the court order was issued unless the Board receives a letter issued to the holder of the license by the district attorney or other public- agency83rd pursuantSession to(2025) NRS– 425.55029 stating– that the holder of the license has complied with the subpoena or warrant or has satisfiedsatisfiedhe the arrearage pursuant to NRS 425.560.

(a) To enjoin any prohibited act or other conduct of a licensee which is harmful to the public;

act or other conduct of a licensee (b) To enjoin any person who is not licensed under this chapter from practicing medicine, genetic counseling, perfusion or respiratory care;

[or] - *SB189_R1* – 29 – (e) To enjoin the use of the title “L.P.,” “T.L.P.,” “licensed perfusionist,” “temporarily licensed perfusionist” or any other word, combination of letters or other designation intended to imply ororword, designate a person as a perfusionist, when not licensed by the Board pursuant to this chapter, unless the use is otherwise authorized by a specific statute [.] ;

or (f) To enjoin the use of the title “G.A.,” “G.C.,” “L.G.C.,” “R.G.C.,” “genetic associate,” “genetic counselor,” “licensed genetic counselor,” “registered genetic counselor” or any other word, combination of letters or other designation intended to imply or designate a person as a genetic counselor, when not licensed by - 83rd Session (2025) – 30 – the Board pursuant to this chapter, unless the use is otherwise authorized by a specific statute.

The court in a proper case may issue a temporary restraining order or a preliminary injunction for the purposes set forth in subsectionsub(a) 1:Without proof of actual damage sustained by any person;

(a) Without proof of actual damage sustained by any person;

An inspection to determine whether any person at the premises is practicing medicine, genetic counseling, perfusion or respiratory care without the appropriate license issued pursuant to the provisions of this chapter;

An inspection to determine whether any physician is allowing a person to perform or participate in any activity under the supervision of the physician for the purpose of receiving credit - *SB189_R1* – 30 – toward a degree of doctor of medicine, osteopathy or osteopathic medicine in violation of the provisions of NRS 630.3745.

- 83rd Session (2025) – 31 – Sec.

(b) Give either false or forged evidence of any kind to the Board;

Give either false or forged evidence of any kind to the (c) Practice medicine, genetic counseling, perfusion or respiratory care under a false or assumed name or falsely personate another licensee;

or (i) Hold himself or herself out as a genetic counselor or use any other term indicating or implying that he or she is a genetic counselorcou2.eloUnless withouta beinggreater licensedpenalty byis theprovided Board.pursuant to NRS 200.830 or 200.840, a person who violates any provision of subsection 1:

2.

Unless a greater penalty is provided pursuant to NRS 200.830 or 200.840, a person who violates any provision of subsection 1:

or - *SB189_R1* – 31 – (b) If substantial bodily harm results, is guilty of a category C felony,  and shall be punished as provided in NRS 193.130.

(a) Issue and serve on the person an order to cease and desist until the person obtains from the Board the proper license or otherwise demonstrates that he or she is no longer in violation of subsection- 1.83rd Session (2025) – 32 – number with which the person may contact the Board.lude a telephone (b) Issue a citation to the person.

An order to cease and desist must include a telephone number with which the person may contact the Board.

(b) Issue a citation to the person.

(a) The practice of genetic counseling, dentistry, chiropractic, naprapathy, Oriental medicine, podiatry, optometry, perfusion, respiratory care, faith or Christian Science healing, nursing, veterinary medicine or fitting hearing aids.

3.

This chapter does not prohibit:

- *SB189_R1* – 32 – 4.

The following persons shall report in writing to the Executive Director of the Board any conduct of a licensee or holder- 83rd Session (2025) – 33 – of athis certificatechapter:ificate which constitutes a violation of the provisions (a) Any physician, dentist, dental hygienist, expanded function dental assistant, naprapath, chiropractic physician, optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, nursing assistant, medication aide - certified, genetic counselor, perfusionist, physician assistant licensed pursuant to chapter 630 or 633 of NRS, anesthesiologist assistant, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, alcohol or drug counselor, peer recovery support specialist, peer recovery support specialist supervisor, music therapist, holder of a license or limited license issued pursuant to chapter 653 of NRS, driver of an ambulance, paramedic or other person providing medical services licensed or certified to practice in this chapter:State.

(a)(b) Any physician,personnel dentist,of dentala hygienist, expanded function dental assistant, naprapath, chiropractic physician, optometrist, podiatric physician, medical examiner,facility resident, intern, professional or practicalfacility nurse,for nursingthe assistant,dependent medicationengaged aidein -the certified,admission, geneticexamination, counselor,care perfusionist, physician assistant licensed pursuant to chapter 630 or 633treatment ofa NRS,medical anesthesiologistfacility assistant, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, alcohol or drugfacility counselor,for peerthe recoverydependent supportupon specialist,notification peerby recovery support specialist supervisor, music therapist, holder of a licensemember or limited license issued pursuant to chapter 653 of NRS,the driverstaff of anthe ambulance,facility. paramedic or other person providing medical services licensed or certified to practice in this State.

(b) Any personnel of a medical facility or facility for the dependent engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a medical facility or facility for the dependent upon notification by a member of the staff of the facility.

(i) Any person who maintains or is employed by a facility or establishment that provides care for older persons.

facility or (j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding the abuse, neglect or exploitation of an older person and refers them to persons and agencies where their requests and needs can be met.

- *SB189_R1* – 33 – (k) Any social worker.

(l) Any person who operates or is employed by a community health worker pool or with whom a community health worker pool contracts- to83rd provideSession the(2025) services– of34 a– community health worker, as defined in NRS 449.0027.

services of a community health worker, as 2.

(a) “Agency to provide personal care services in the home” has the(b) “Community health worker pool” has the meaning ascribed to it in NRS 449.0021.449.0028.

(b) “Community health worker pool” has the meaning ascribed to it in NRS 449.0028.

(b) A medical officer of the Armed Forces or a medical officer of any division or department of the United States in the discharge of his or her official duties, including, without limitation, providing medicalinto carepursuant into aNRS hospital449.2455.accordance in accordance with an agreement entered (c) Osteopathic physicians who are called into pursuantthis State, other than on a regular basis, for consultation or assistance to NRSa 449.2455.physician licensed in this State, and who are legally qualified to practice in the state where they reside.

(c) Osteopathic physicians who are called into this State, other than on a regular basis, for consultation or assistance to a physician licensed in this State, and who are legally qualified to practice in the state where they reside.

- *SB189_R1*83rd Session (2025) – 3435 – (e) The performance of medical services by a student enrolled in an educational program for a physician assistant which is accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc., or its successor organization, as part of suchsuc(f) A physician assistant of any division or department of the United States in the discharge of his or her official duties unless licensure by a program.state is required by the division or department of the United States.

(f) A physician assistant of any division or department of the United States in the discharge of his or her official duties unless licensure by a state is required by the division or department of the United States.

(1) Practices within the scope of that license or registration;

(d)- A83rd personSession who(2025) furnishes– nutrition36 information,– provides recommendations or advice concerning nutrition, or markets food, food materials or dietary supplements and provides nutrition - *SB189_R1* – 35 – information, recommendations or advice related to that marketing, if the person does not represent that he or she is a licensed dietitian or registered dietitian.

As used in this section, “nutrition information” means information relating to the principles of nutrition and the effect of nutritionnut(a) onFood thepreparation;ody, human body, including, without limitation:

(a) Food preparation;

An attorney shall not contract for or collect a fee contingent on the amount of recovery for representing a person seeking damages in connection with an action for injury or death against a provider of health care based upon professional negligence in excess2. of 35 percent of the amount recovered.

2.

4.- 83rd Session (2025) – 37 – (a) “Professional negligence” means a negligent act or omission to act by a provider of health care in the rendering of professional services, which act or omission is the proximate cause of a personal injury or wrongful death.

AsThe usedterm indoes thisnot section:include services that are outside the scope of services for which the provider of health care is licensed or services for which any restriction has been imposed by the applicable regulatory board or health care facility.

(a) “Professional negligence” means a negligent act or omission to act by a provider of health care in the rendering of professional services, which act or omission is the proximate cause of a personal injury or wrongful death.

The term does not include services that are - *SB189_R1* – 36 – outside the scope of services for which the provider of health care is licensed or services for which any restriction has been imposed by the applicable regulatory board or health care facility.

41A.017 “Provider of health care” means a physician licensed pursuant to chapter 630 or 633 of NRS, physician assistant, genetic counselor, anesthesiologist assistant, dentist, licensed nurse, dispensing optician, optometrist, registered physical therapist, podiatric physician, licensed psychologist, chiropractic physician, naprapath, doctor of Oriental medicine, holder of a license or a limited license issued under the provisions of chapter 653 of NRS, medical laboratory director or technician, licensed dietitian or a licensed hospital, clinic, surgery center, physicians’ professional corporation or group practice that employs any such person and its employees.

In an action for injury or death against a provider of health care based upon professional negligence, if the defendant so elects, the defendant may introduce evidence of any amount payable as a benefit to the plaintiff as a result of the injury or death pursuant to the United States Social Security Act, any state or federal income disability or worker’s compensation act, any health, sickness or income-disability insurance, accident insurance that provides health benefits or income-disability coverage, and any contract or agreement of any group, organization, partnership or corporation to provide, pay for or reimburse the cost of medical, hospital, dental or other health care services.

If the defendant elects to introduce such evidence, the plaintiff may introduce evidence of any amount that the plaintiff has paid or contributed to secure the - 83rd Session (2025) – 38 – plaintiff’s right to any insurance benefits concerning which the defendant has introduced evidence.

(a)(b) RecoverBe anysubrogated amountto againstthe rights of the plaintiff;plaintiff against a defendant.

or3. (b) Be subrogated to the rights of the plaintiff against a defendant.

- *SB189_R1* – 37 – 3.

A judgment ordering the payment of future damages by periodic payments entered pursuant to subsection 3 must specify the recipient or recipients of the payments, the dollar amount of the payments, the interval between payments, and the number of payments or the period of time over which payments will be made.

If the court finds that the judgment debtor has exhibited a continuing pattern of failing to make the periodic payments as specified pursuant to subsection 5, the court shall find the judgment debtor in contempt of court and, in addition to the required periodic - 83rd Session (2025) – 39 – payments, shall order the judgment debtor to pay the judgment creditor all damages caused by the failure to make such periodic payments, including, but not limited to, court costs and attorney’s fees.

7.specified in the periodic payment judgment, any obligation of the judgment debtor to make further payments ceases and any security given pursuant to subsection 4 reverts to the judgment debtor.

Following the occurrence or expiration of all obligations specified in the periodic payment judgment, any obligation of the judgment debtor to make further payments ceases and any security given pursuant to subsection 4 reverts to the judgment debtor.

- *SB189_R1* – 38 – (a) “Future damages” includes damages for future medical treatment, care or custody, loss of future earnings, loss of bodily function, or future pain and suffering of the judgment creditor.

(d) “Provider of health care” means a physician licensed under chapter 630 or 633 of NRS, genetic counselor, dentist, licensed nurse, dispensing optician, optometrist, registered physical therapist, podiatric physician, naprapath, licensed psychologist, chiropractic physician, doctor of Oriental medicine, holder of a license or a limited license issued under the provisions of chapter 653 of NRS, medical laboratory director or technician, licensed dietitian or a licensed hospital and its employees.

“Doctor” means a person licensed to practice medicine, genetic counseling, dentistry or osteopathic medicine, chiropractic - 83rd Session (2025) – 40 – or naprapathy in any state or nation, or a person who is reasonably believed by the patient to be so licensed, and in addition includes a person employed by a public or private agency as a psychiatric social worker, or someone under his or her guidance, direction or control,a whilepatient engagedfor ina themental examination,condition.mination, diagnosis or treatment of a3. patient for a mental condition.

3.

- *SB189_R1* – 39 – 1.

Except as otherwise provided in subsection 2, a professional entity may be organized only for the purpose of rendering one specific type of professional service and may not engage in any business other than rendering the professional service for which it was organized and services reasonably related thereto, except that a professional entity may own real and personal property appropriate to its business and may invest its money in any form ofofy real property, securities or any other type of investment.

and (5)- Engaged83rd Session (2025) – 41 – provided in thechapter practice625 of NRS.ce of professional engineering as provided(b) inMedicine, chaptergenetic 625counseling, homeopathy, osteopathy, naprapathy, chiropractic and psychology, or any combination thereof, and may be composed of NRS.persons engaged in the practice of:

(b)(1) Medicine,Medicine genetic counseling, homeopathy, osteopathy, naprapathy, chiropractic and psychology, or anygenetic combinationcounseling thereof,as andprovided mayin bechapter composed of personsNRS; engaged in the practice of:

(1) Medicine or genetic counseling as provided in chapter 630 of NRS;

and - *SB189_R1* – 40 – (6) Psychology and licensed to provide services pursuant to chapter 641 of NRS.

 Such a professional entity may market and manage additional professional entities which are organized to render a professional service relating to medicine, genetic counseling, homeopathy, osteopathy,ost(c) naprapathy,Mental chiropractichealth services, and psychology.may be composed of the following persons, in any number and in any combination:

(c) Mental health services, and may be composed of the following persons, in any number and in any combination:

3.through its officers, managers and employees who are licensed oronly otherwise authorized by law to render the professional service.

A professional entity may render a professional service only through its officers, managers and employees who are licensed or otherwise authorized by law to render the professional service.

(b)- “Fire-fighting83rd Session (2025) – 42 – NRS 239B.020.fighting agency” has the meaning ascribed to it in (c) “Health care facility” means a facility licensed pursuant to chapter 449 of NRS, an office of a person listed in NRS 239B.020.629.031, a clinic or any other location, other than a residence, where health care is provided.

(c) “Health care facility” means a facility licensed pursuant to chapter 449 of NRS, an office of a person listed in NRS 629.031, a clinic or any other location, other than a residence, where health care is provided.

- *SB189_R1* – 41 – (5) A prosecuting attorney of an agency or political subdivision of the United States or of this State;

(6) A justice of the Supreme Court, judge of the Court of Appeals, district judge, justice of the peace, municipal judge, magistrate, court commissioner, master or referee, including aa, person acting pro tempore in a capacity listed in this subparagraph;

(II) Perform tasks related to fire fighting or fire prevention;

andandPerform tasks related to fire fighting or fire (III) Wear identification, clothing or a uniform that identifies the employee or volunteer as working or volunteering for the fire-fighting agency;

and (III)- Wear83rd identification,Session clothing(2025) or– a43 uniform– that identifies the employee or volunteer as working or volunteering for this State or a political subdivision of this State.

(1) A physician, a medical student, a genetic counselor, a perfusionist, an anesthesiologist assistant or a physician assistant licensed pursuant to chapter 630 of NRS, a practitioner of respiratory care, a homeopathic physician, an advanced practitioner of homeopathy, a homeopathic assistant, an osteopathic physician, a physician assistant or anesthesiologist assistant licensed pursuant to chapter 633 of NRS, a podiatric physician, a podiatry hygienist, a physical therapist, a medical laboratory technician, an optometrist, a chiropractic physician, a chiropractic assistant, a naprapath, a doctor of Oriental medicine, a nurse, a student nurse, a certified nursing assistant, a nursing assistant trainee, a medication aide - certified, a person who provides health care services in the home for - *SB189_R1* – 42 – compensation, a dentist, a dental student, a dental hygienist, a dental hygienist student, an expanded function dental assistant, an expanded function dental assistant student, a pharmacist, aan pharmacy student, an intern pharmacist, an attendant on an ambulance or air ambulance, a psychologist, a social worker, a marriage and family therapist, a marriage and family therapist intern, a clinical professional counselor, a clinical professional counselor intern, a behavior analyst, an assistant behavior analyst, a registered behavior technician, a mental health technician, a licensed dietitian, the holder of a license or a limited license issued under the provisions of chapter 653 of NRS, a public safety officer at a health care facility, an emergency medical technician, an advanced emergency medical technician, a paramedic or a participant in a program of training to provide emergency medical services;

(II)(III) PerformsWears tasksidentification, relatedclothing toor providinga uniform thatand identifies the person as an employee or volunteer of the health care;care facility.

and (III) Wears identification, clothing or a uniform that identifies the person as an employee or volunteer of the health care facility.

(h)- “Sports83rd Session (2025) – 44 – NRS 41.630.rts official” has the meaning ascribed to it in (i) “Taxicab” has the meaning ascribed to it in NRS 41.630.706.8816.

(i) “Taxicab” has the meaning ascribed to it in NRS 706.8816.

(a) If paragraph (c) or (d) does not apply to the circumstances of the crime and the assault is not made with the use of a deadly misdemeanor.e present ability to use a deadly weapon, for a (b) If the assault is made with the use of a deadly weapon or the present ability to use a deadly weapon, for a misdemeanor.category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.

- *SB189_R1* – 43 – (b) If the assault is made with the use of a deadly weapon or the present ability to use a deadly weapon, for a category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.

or (III) A sports official based on the performance of his or her duties at a sporting event;

andandased on the performance of his or (2) The person charged knew or should have known that the victim was an officer, a provider of health care, a school employee, a taxicab driver, a transit operator, a utility worker or a sports official,  for a gross misdemeanor, unless the assault is made with the use of a deadly weapon or the present ability to use a deadly weapon, then for a category B felony by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more- than83rd 6Session years,(2025) or– by45 – fine and imprisonment.by a fine of not more than $5,000, or by both fine(d) andIf imprisonment.the assault:

(d) If the assault:

and (2) The probationer, prisoner or parolee charged knew or should have known that the victim was an officer, a provider of health care, a school employee, a taxicab driver, a transit operator, a utility worker or a sports official,  for a category D felony as provided in NRS 193.130, unless the assault is made with the use of a deadly weapon or the presentpresenthe ability to use a deadly weapon, then for a category B felony by imprisonment in the state prison for a minimum term of not less - *SB189_R1* – 44 – than 1 year and a maximum term of not more than 6 years, or by a fine of not more than $5,000, or by both fine and imprisonment.

(1) The local office of the Aging and Disability Services DivisionDivisio(2) ofA thepolice Departmentdepartment ofor Healthsheriff’s andoffice; Human Services;

(2)ors; A police department or sheriff’s office;

or (3) A toll-free telephone service designated by the Aging and Disability Services Division of the Department of Health and Human Services;

2.- 83rd Session (2025) – 46 – subsection 1 knows or has reasonable cause to believe that theto abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person involves an act or omission of the Aging and Disability Services Division, another division of the Department of Health and Human Services or a law enforcement agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission.

If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that the abuse, neglect, exploitation, isolation or abandonment of the older person or vulnerable person involves an act or omission of the Aging and Disability Services Division, another division of the Department of Health and Human Services or a law enforcement agency, the person shall make the report to an agency other than the one alleged to have committed the act or omission.

(a) Every physician, dentist, dental hygienist, expanded function dental assistant, chiropractic physician, naprapath, optometrist, podiatric physician, medical examiner, resident, intern, professional or practical nurse, physician assistant licensed pursuant to chapter 630 or 633 of NRS, genetic counselor, anesthesiologist assistant,assistant,ter perfusionist, psychiatrist, psychologist, marriage and family therapist, clinical professional counselor, clinical alcohol and drug counselor, alcohol and drug counselor, music therapist, athletic trainer, driver of an ambulance, paramedic, licensed dietitian, holder of a license or a limited license issued under the provisions of - *SB189_R1* – 45 – chapter 653 of NRS, behavior analyst, assistant behavior analyst, registered behavior technician, peer recovery support specialist, as defined in NRS 433.627, peer recovery support specialist supervisor, as defined in NRS 433.629, or other person providing medical services licensed or certified to practice in this State, who examines, attends or treats an older person or vulnerable person who appears to have been abused, neglected, exploited, isolated or abandoned.

(b) Any personnel of a hospital or similar institution engaged in the admission, examination, care or treatment of persons or an administrator, manager or other person in charge of a hospital or similar institution upon notification of the suspected abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person by a member of the staff of the hospital.

(f)- Every83rd personSession who(2025) operates,– who47 is– employed by or who contracts to provide services for an intermediary serviceserviceho organization as defined in NRS 449.4304.

(g) Any employee of the Department of Health and Human Services, except the State Long-Term Care Ombudsman appointed pursuant to NRS 427A.125 and any of his or her advocates or volunteers where prohibited from making such a report pursuant to 45 C.F.R.

(j) Any person who maintains, is employed by or serves as a volunteer for an agency or service which advises persons regarding the abuse, neglect, exploitation, isolation or abandonment of an older person or vulnerable person and refers them to persons and agencies where their requests and needs can be met.met.o persons and (k) Every social worker.

(k) Every social worker.

- *SB189_R1* – 46 – (n) Every person who is enrolled with the Division of Health Care Financing and Policy of the Department of Health and Human Services to provide doula services to recipients of Medicaid pursuant to NRS 422.27177.

If a person who is required to make a report pursuant to subsection 1 knows or has reasonable cause to believe that an older person or vulnerable person has died as a result of abuse, neglect, isolation or abandonment, the person shall, as soon as reasonablyreasonablyt, practicable, report this belief to the appropriate medical examiner or coroner, who shall investigate the cause of death of the older person or vulnerable person and submit to the appropriate local law enforcement agencies, the appropriate prosecuting attorney, the Aging and Disability Services Division of the Department of Health and Human Services and the Unit for the Investigation and Prosecution of Crimes his or her written findings.

The written findings- must83rd includeSession the(2025) information– required48 pursuant– to the provisions of NRS 200.5094, when possible.possible.ired pursuant to the 7.

7.

If the investigation of a report results in the belief that an older person or vulnerable person is abused, neglected, exploited, isolated or abandoned, the Aging and Disability Services Division of the Department of Health and Human Services or the county’s office for protective services may provide protective services to the older person or vulnerable person if the older person or vulnerable person is able and willing to accept them.

- *SB189_R1* – 47 – Sec.

(b) Public building.

(f)- Child83rd careSession facility.(2025) – 49 – (g) Bus used by the general public, other than a chartered bus, or in any maintenance facility or office associated with a bus system operated by any regional transportation commission.

(g) Bus used by the general public, other than a chartered bus, or in any maintenance facility or office associated with a bus system operated by any regional transportation commission.

and (2) Does not otherwise qualify for an exemption set forth in NRSNRS3. 202.24915.

3.

- *SB189_R1* – 48 – 5.

A business which derives more than 50 percent of its gross receipts from the sale of alcoholic beverages or 50 percent of its gross receipts from gaming operations may be designated as a smokingsmo6. area in its entirety by the operator of the business.

6.The smoking of tobacco is not prohibited in:e business.

The smoking of tobacco is not prohibited in:

(a) “Child care facility” means an establishment operated and maintained to furnish care on a temporary or permanent basis, - 83rd Session (2025) – 50 – during the day or overnight, to five or more children under 18 years of age, if compensation is received for the care of any of those children.

(b)to “Licensedit gamingin NRS 463.0169.g establishment” has the meaning ascribed to(c) it“Public inbuilding” NRSmeans 463.0169.any building or office space owned or occupied by:

(c) “Public building” means any building or office space owned or occupied by:

A physician assistant licensed pursuant to chapter 630 or 6336333.f ofNA NRS;dentist;

3.

A dentist;

- *SB189_R1* – 49 – 5.

- 83rd Session (2025) – 51 – [14.] 15.

or [16.]Division 17.of Health Care Financing and Policy of the Department ofthe Health and Human Services to receive reimbursement through Medicaid pursuant to NRS 422.27177.

A provider of doula services who is enrolled with the Division of Health Care Financing and Policy of the Department of Health and Human Services to receive reimbursement through Medicaid pursuant to NRS 422.27177.

4.which is organized pursuant to chapter 280 of NRS may be ament member of an employee organization only if such employee organization is composed exclusively of civilian employees of a metropolitan police department which is organized pursuant to chapter 280 of NRS.

A5. civilian employee of a metropolitan police department which is organized pursuant to chapter 280 of NRS may be a member of an employee organization only if such employee organization is composed exclusively of civilian employees of a metropolitan police department which is organized pursuant to chapter 280 of NRS.

- *SB189_R1* – 50 – 5.

(c) Except as otherwise provided in this paragraph, an attorney who is employed by a local government employer and who is - 83rd Session (2025) – 52 – assigned to a civil law division, department or agency.

6.doctor, physician, genetic counselor, homeopathic physician, a osteopathic physician, naprapath, chiropractic physician, practitioner of Oriental medicine, podiatric physician or practitioner of optometry, as those terms are defined or used, respectively, in NRS 630.014, 630A.050, 633.091, chapter 634 of NRS, chapter 634A of NRS, NRS 634B.050, chapter 635 of NRS or chapter 636 of NRS.

As used in this section, “doctor or physician” means a doctor, physician, genetic counselor, homeopathic physician, osteopathic physician, naprapath, chiropractic physician, practitioner of Oriental medicine, podiatric physician or practitioner of optometry, as those terms are defined or used, respectively, in NRS 630.014, 630A.050, 633.091, chapter 634 of NRS, chapter 634A of NRS, NRS 634B.050, chapter 635 of NRS or chapter 636 of NRS.

Sec.685B.120 NRS 1.

58.

NRS 685B.120 is hereby amended to read as follows:

685B.120 1.

- *SB189_R1* – 51 – (f) Audiology;

or [(l)] (m) Ambulance services, - 83rd Session (2025) – 53 –  whether the coverage provides for direct payment, reimbursement or any other method of payment, is subject to regulation by the Division and to the provisions of this Code unless the person shows that while providing such coverage the person is subject to reg2.atiA nonprofit corporation that provides prepaid ambulance services is not subject to regulation by the FederalDivision Government.or to the provisions of this Code if the corporation presents evidence satisfactory to the Commissioner that the corporation is subject to regulation by a political subdivision of this State pursuant to an exclusive franchise which limits the number of times any such prepaid services may be used to a defined number that are medically necessary.

2.

A nonprofit corporation that provides prepaid ambulance services is not subject to regulation by the Division or to the provisions of this Code if the corporation presents evidence satisfactory to the Commissioner that the corporation is subject to regulation by a political subdivision of this State pursuant to an exclusive franchise which limits the number of times any such prepaid services may be used to a defined number that are medically necessary.

Sec.this act, any person who is engaged in the practice of geneticf counseling on or before January 1, 2026, may continue to engage in the practice of genetic counseling without obtaining a license pursuant to section 7 of this act until July 1, 2026.

60.

1.

Notwithstanding the amendatory provisions of this act, any person who is engaged in the practice of genetic counseling on or before January 1, 2026, may continue to engage in the practice of genetic counseling without obtaining a license pursuant to section 7 of this act until July 1, 2026.

As soon as practicable after the effective date of this section, the Board of Medical Examiners shall appoint to the - *SB189_R1* – 52 – Genetic Counseling Advisory Council created by section 5.9 of this act:

and - 83rd Session (2025) – 54 – 2.

The provisions of subsection 1 of NRS 218D.380 do not apply to any provision of this act which adds or revises a requirement to submit a report to the Legislature.Legislature.or revises a Sec.

become62. effective upon passage and approval.9 and 60.5 of this act 2.

1.

This section and sections 5.9 and 60.5 of this act become effective upon passage and approval.

2.

H~~~~~ 25 - *SB189_R1*83rd Session (2025)