All Roll Calls
Yes: 63 • No: 0
NevadaAB31983rd Regular Session (2025)HouseWALLET
AN ACT relating to health care; making various revisions governing the qualifications and procedure for licensure as a physician, physician assistant, practitioner of respiratory care or perfusionist; requiring screening of youth for certain health conditions when certain physical examinations are conducted; revising the authority of a practitioner of respiratory care to perform certain laboratory tests; requiring certain sharing of information between the Board of Medical Examiners and the State Board of Osteopathic Medicine; authorizing the Board of Medical Examiners to require certain competency demonstrations; eliminating certain special licenses; revising provisions related to fees owed to the Board of Medical Examiners or the State Board of Osteopathic Medicine; eliminating certain fees; revising investigation procedures and grounds for discipline against a licensee of the Board of Medical Examiners; revising requirements governing certain medical procedures; authorizing a medical assistant to perform tasks under the supervision of a registered nurse; authorizing a certified registered nurse anesthetist to perform certain tasks in certain hospitals; authorizing discipline against a registered nurse who fails to adequately supervise a medical assistant; and providing other matters properly relating thereto.
Sponsored By: Sponsor information unavailable
Signed by Governor
BDR 54-791
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Bill Overview
Analyzed Economic Effects
38 provisions identified: 17 benefits, 8 costs, 13 mixed.
Higher fines to regain active license
When the Board lets a license return to active status after finding different information post‑licensure, it may now fine up to $10,000. This cap was $5,000 before. Paying such a fine can be a condition of reinstatement.
Old special licenses end Jan. 2026
Special or restricted licenses issued under NRS 630.261 expire on January 1, 2026. After that date, those licenses are no longer valid. The law also repeals NRS 630.1606, 630.2692, 630.2693 and 630.324. Affected professionals must move to another license type to keep practicing.
Easier doctor licensing in shortage areas
In a declared critical‑need specialty or area, the Board may waive some postgraduate training if the doctor has at least 1 year of residency and 5 years’ experience. A county can also seek a waiver for doctors who will practice in its medically underserved county. Licenses under these waivers are restricted to the named specialty or location.
Faster licensing for military and spouses
Active‑duty members, spouses, veterans, and surviving spouses applying by endorsement get faster decisions. The Board must ask for any missing items within 15 business days. After you submit them, the Board issues the license within 45 days, or within 10 days of receiving your fingerprint report or proof. The Board may issue a provisional license before final approval.
Standard teen screening at checkups
Doctors, physician assistants, and advanced practice nurses must ask standard screening questions at routine checkups for ages 12–18. They use the national Preparticipation Physical Evaluation medical history and exam forms. This makes teen physicals more consistent and thorough.
Medical licensing fees and discounts
The Board sets maximum licensing fees. Examples: $600 for a physician application, $400 for a PA application, $800 for biennial physician registration, $600 for respiratory care registration, and $50 for a duplicate license. The Board may charge for expedited processing. If you qualify for endorsement, your first license fee is no more than half the usual initial fee.
New telehealth rules and licensing
Telehealth now includes live video, store‑and‑forward, and audio‑only visits. A provider outside Nevada who diagnoses, treats, or prescribes for a Nevada patient by telehealth must hold a Nevada license, including a telemedicine license. There is an exception for providers working for an urban Indian organization. Beginning January 1, 2026, any special‑purpose license issued before that date is treated as a telemedicine license. Providers at a site caring for sexual assault or strangulation victims may use telehealth to get real‑time guidance from a trained remote clinician.
Clear limited license for residents
The Board must issue a limited license to physicians appointed to approved residency programs. Graduates of accredited U.S. schools or equivalent foreign schools, or those with an ECFMG certificate, qualify. The license is valid while in the program, for up to 1 year, and is renewable.
Medical assistants under RN supervision
A medical assistant is an unlicensed worker who performs clinical tasks under a registered nurse’s supervision, including APRNs. People who only do administrative work are not medical assistants under this law.
More simple lab tests in clinics
Doctors, nurses, pharmacists, dentists, PAs, respiratory care practitioners, and others may collect specimens and perform CLIA‑waived tests without a lab assistant certificate. Respiratory care practitioners may do these tests if trained and within scope. The scope of respiratory care now clearly includes sample collection, pulmonary function tests, allowed lab tests, and cardiopulmonary monitoring.
Respiratory care schooling rule removed
Applicants no longer need a high school diploma or GED for a respiratory care license. You still must finish a Board‑approved education program, pass the NBRC exam, get NBRC certification, and be licensed by the Board.
Temporary licenses for new perfusionists
Graduates of an approved perfusion program can get a temporary license while awaiting certification. They must work under a licensed perfusionist’s supervision. The temporary license lasts 1 year and may be renewed once with the supervisor’s signature.
Yearly pediatric cancer signs for nurses
Each year, the Board gives nurses who care for children information on signs and symptoms of pediatric cancer. This helps earlier spotting and care.
Students can practice respiratory or perfusion
Students in approved respiratory care or perfusion programs may practice under a licensed practitioner’s supervision. Employed students may provide care to non‑critical patients under a physician when no practitioner is immediately available. They may also help in emergency critical care until a practitioner arrives.
Boards share info on PAs and AAs
The Board of Medical Examiners and the State Board of Osteopathic Medicine must share information to enforce laws on physician assistants and anesthesiologist assistants. This supports coordinated licensing and discipline.
Clearer steps in discipline cases
Only the Board or its committee can file the charging document, which must list each alleged act in plain language. An early case conference is required within 20 days after an answer is filed or due to set dates and narrow issues. Investigative committees must have at least three Board members, including at least one non‑physician; meetings are confidential, and a summary is posted within 20 days without names. If someone defies a lawful order at a hearing, the Board can send the matter to district court and the case pauses until the court acts. A person may seek to lift limits or suspension but must prove by clear and convincing evidence it is safe; for sex‑with‑patient rules, “currently treating” means within 3 years unless discharged in writing.
Faster action on unsafe prescribing
The Board’s executive director reviews reports of improper Schedule II–IV prescribing and checks the prescription monitoring database. The director can seek more information and open a case if inappropriate prescribing is likely. The Board can order mental, physical, or competence exams when it questions a clinician’s ability to practice. If a clinician poses an imminent risk, the Board can quickly restrict or suspend practice, and courts cannot pause those emergency orders.
Lab techs can collect more samples
Laboratory technical staff may collect blood, remove stomach contents, do certain diagnostic skin or field blood tests, and collect material for smears and cultures. This can speed testing and ease workload on clinicians.
Nurse anesthetists can prescribe in small hospitals
In certified critical access hospitals and hospitals in cities under 25,000 people, a nurse anesthetist supervised by a physician can order, prescribe, have, and give controlled substances and devices. This applies for care before, during, and after surgery or childbirth. Outside those hospitals, nurse anesthetists may handle controlled substances only as registered nurses are allowed and may not otherwise order or prescribe.
Stronger malpractice reporting and Board review
Insurers and practitioners must report malpractice lawsuits, arbitration or mediation, and outcomes within 45 days. Facilities and schools must file complaints within 30 days, or within 5 days for competence or suspected substance abuse; the Board keeps complaints 10 years. Nevada insurers can be fined up to $10,000 per failure; practitioners up to $5,000 per failure. When the Board gets a malpractice judgment or settlement report, it must investigate unless it already started. Good‑faith reporters and the Board acting in good faith have civil immunity.
Tighter oversight of medical assistant supervision
The State Board of Nursing may set supervision rules for medical assistants, including limits on handling dangerous drugs. Nurses can be disciplined for failing to supervise medical assistants properly. Physicians and other licensees can also be disciplined for poor supervision under Board rules.
Extra fees for simultaneous PA/AA licenses
PAs and anesthesiologist assistants who want a simultaneous license with both boards must apply to both and pay all listed fees. If you pay one set of fees but miss the separate fee under NRS 630.268, you have 1 year to pay it. After notice, you must pay the unpaid amount within 30 days.
Fee difference for simultaneous licenses
If you pay one board’s simultaneous license or registration fee but do not pay the other board’s initial fee within 1 year, you must pay the difference within 30 days of notice. This applies to physician assistants and anesthesiologist assistants.
Tighter rules on anesthesia and eye lasers
General anesthesia, tumescent anesthesia, conscious sedation, and deep sedation must be given or directly supervised only in permitted facilities. The Board may allow tumescent anesthesia in other places by rule. Only physicians with approved ophthalmology residency training may perform laser or intense pulsed light surgery on the globe of the eye.
Update your contact info or pay $250
Licensees must keep a permanent mailing and email address on file and report changes within 30 days. If you fail to update, the Board may fine you up to $250 and may start discipline.
Physician and anesthesiologist assistants licensing steps
At renewal, a physician assistant who wants a simultaneous license with the other board must say so, apply, and pay all fees. If the annual simultaneous registration fee is paid at renewal but the application and issuance fee is not paid within 1 year, the State Board of Osteopathic Medicine notifies the PA. The PA then has 30 days to pay the unpaid difference. These simultaneous‑license rules apply to people who told either board of their intent before, on, or after January 1, 2026.
Administrative-only license for physicians
Physicians may apply for an administrative license if they meet Board rules. This license allows only administrative work. It does not allow clinical practice.
Faster checks and new license rules
The Board may use third‑party services to verify credentials and can request primary‑source documents later. Endorsement applicants must hold an active, good‑standing license in another U.S. jurisdiction at filing. All applicants in key license types must submit fingerprints; processing fees are nonrefundable. The Board cannot share FBI criminal‑history details with the Interstate Medical Licensure Compact. If you have not practiced for more than 24 months, the Board can require a competency exam or other proof before you return.
New standards for perfusionist licenses
To get licensed, perfusionists must complete a Board‑approved education program and hold current certification from the American Board of Cardiovascular Perfusion. The Board sets continuing education and discipline rules.
No-fee volunteer doctor license
Retired physicians may receive a special volunteer license with no fees to review, issue, or renew. The first license lasts 1 year; renewals last 2 years. The Board issues it at its discretion and only for unpaid, volunteer practice.
Quicker PA endorsement with safeguards
The Board sets PA licensing rules, including use of telehealth. For endorsement, the Board must ask for missing items within 15 business days and issue a decision by 45 days, or 10 days after fingerprint or other required proofs. The law removes a blanket bar based on past malpractice liability. Endorsement applicants must show they have not been disciplined and are not under investigation by their home regulator.
Rules for foreign-trained doctor licensing
Canada, the United Kingdom, Australia, and New Zealand count as “equivalent foreign countries.” The Board may add more by regulation if standards match U.S. levels. A “foreign medical school” is any school outside the U.S. or an equivalent foreign country. These rules guide how foreign‑trained applicants are reviewed.
Short grace period for tumescent anesthesia
If a clinician is giving or supervising tumescent anesthesia on January 1, 2026 in a location the new law does not allow, they may keep doing so only until July 1, 2026. After that date, the new location rules apply.
Simpler licensing for foreign doctors
Foreign‑trained doctors can meet exam rules by passing the most common licensure exam in an equivalent foreign country. The Board can accept 36 months of progressive training in the U.S. or an approved equivalent foreign program. Your medical school must send proof it was accredited at your graduation. You must also have an ECFMG certificate or a written ECFMG statement that you passed its exam.
Stronger Board discipline and transparency
Charging papers and discipline materials are public; applications and investigation files stay confidential. The Board must serve papers in person or by certified mail; email needs written consent. If violations are found, the Board can fine up to $10,000 per violation and must issue a final order within 30 days. Final orders take effect when certified and remain in force during court review.
Licensing tests and training now clarified
The Board must investigate each applicant’s character and may issue licenses to qualified people. The Board no longer has a fixed duty to run its own exams but can still require one or more exams by regulation. The law defines “progressive” training as continuous years without breaks of 12 weeks or more. ACGME‑approved programs, including research years, count. The Executive Director may also count related back‑to‑back programs with no long breaks.
Most changes start January 1, 2026
Agencies may start adopting rules now. Most other parts take effect January 1, 2026. Some sections depend on whether a separate bill on anesthesiologist assistant renewal fees passed this session.
Out-of-state telehealth follows Nevada law
Providers outside Nevada who use telehealth to direct care, diagnose, or issue treatment orders for Nevada patients must follow Nevada law. Nevada licensing boards have jurisdiction over those services. Providers must comply with state and federal rules as if working in Nevada.
Sponsors & Cosponsors
Sponsors
There is no primary sponsor on record.
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 5/22/2025
Final Passage - Senate (2nd Reprint)
Yes: 21 • No: 0
House vote • 4/22/2025
Final Passage - Assembly (1st Reprint)
Yes: 42 • No: 0
Actions Timeline
Chapter 246.
6/3/2025legislatureApproved by the Governor.
6/3/2025legislatureEnrolled and delivered to Governor.
5/29/2025legislatureSenate Amendment No. 682 concurred in. To enrollment.
5/27/2025HouseIn Assembly.
5/26/2025HouseFrom printer. To re-engrossment. Re-engrossed. Second reprint. To Assembly.
5/23/2025SenateRead third time. Passed, as amended. Title approved, as amended. (Yeas: 21, Nays: None.) To printer.
5/22/2025SenateReprinting dispensed with.
5/21/2025SenateRead second time. Amended. (Amend. No. 682.)
5/21/2025SenatePlaced on Second Reading File.
5/20/2025SenateFrom committee: Amend, and do pass as amended.
5/20/2025SenateRead first time. Referred to Committee on Commerce and Labor. To committee.
4/29/2025SenateIn Senate.
4/28/2025SenateTo Senate.
4/25/2025HouseFrom printer. To engrossment. Engrossed. First reprint.
4/25/2025HouseTo printer.
4/22/2025HouseRead third time. Passed, as amended. Title approved. (Yeas: 42, Nays: None.)
4/22/2025HouseDispensed with reprinting.
4/21/2025HouseRead second time. Amended. (Amend. No. 248.)
4/21/2025HousePlaced on Second Reading File.
4/21/2025HouseFrom committee: Amend, and do pass as amended.
4/21/2025HouseFrom printer. To committee.
2/28/2025HouseRead first time. Referred to Committee on Commerce and Labor. To printer.
2/27/2025House
Bill Text
As Enrolled
As Introduced
Reprint 1
Reprint 2
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