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: David Orentlicher (Democratic)
Signed by Governor
BDR 54-791
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Bill Overview
Analyzed Economic Effects
26 provisions identified: 10 benefits, 5 costs, 11 mixed.
Higher fines to reinstate licenses
When the Board lets a suspended license return to active status, it may require a fine up to $10,000. The old cap was $5,000. This raises the possible out‑of‑pocket cost for the license holder.
CRNAs can prescribe in small hospitals
In critical access hospitals or hospitals in cities under 25,000 people, a CRNA supervised by a physician may order, prescribe, possess, and give needed drugs and devices. This applies before surgery or childbirth, during the procedure, and through recovery. Outside those settings, CRNAs may possess and give drugs where a registered nurse may, but cannot prescribe.
More point-of-care testing allowed
Beginning January 1, 2026, many licensed health workers can perform simple “CLIA‑waived” tests without getting a separate lab assistant certificate. Respiratory care practitioners may do these tests if trained and within their scope. The law also lets respiratory care practitioners perform certain authorized lab tests and heart‑lung monitoring as part of care.
Broader discipline grounds for clinicians
The law lists more conduct that can lead to discipline or denied licensure. Examples include malpractice proven by a preponderance of the evidence, sexual contact with patients seen in the last 3 years, disruptive behavior that harms care, and certain crimes. It also covers unsafe practice due to illness or substance use, bad prescribing, injecting liquid silicone (with narrow exception), failing to report arrests within 30 days, poor supervision of medical assistants, and not cooperating with Board investigations. These standards help protect patients and raise professionalism.
Stronger malpractice reporting and fines
Insurers must report malpractice lawsuits, arbitrations, and outcomes within 45 days or face fines up to $10,000 per failure. Clinicians must self‑report the same events and reportable data bank sanctions within 45 days or face Board fines up to $5,000 per violation. Hospitals and clinics must report privilege changes within 30 days, or within 5 days for competency or substance concerns; the state may fine up to $10,000 per missed report. Court clerks must report key findings (like felony convictions or malpractice liability) within 45 days. The Board keeps all complaints at least 10 years and protects good‑faith reporters from civil suits and Board action when they report others’ violations.
Tighter rules for eye lasers and anesthesia
Only physicians who completed an approved ophthalmology residency may perform laser surgery or intense pulsed light on the eye. Doctors, PAs, and anesthesiologist assistants may give or directly supervise general, tumescent, conscious, or deep sedation only in permitted offices, permitted facilities, or medical facilities, or outside Nevada. The Board may allow tumescent anesthesia in other locations by rule.
Faster licenses for physician assistants
The Board must tell you within 15 business days if your endorsement application needs more info. If you qualify, it must issue the license fast: within 45 days, or within 10 days after your fingerprint report or final proof arrives. The Board may grant a provisional PA license so you can start work while your endorsement is pending. Military members, veterans, spouses, and surviving spouses get the same quick timelines if they hold a valid PA license in another state. The Board can now tie PA continuing education to national or recognized certification for renewal.
New physician license paths and rules
You must have your medical school send proof it was accredited when you graduated. Foreign graduates must also provide an ECFMG certificate or proof of passing the exam. The Board can issue administrative‑only licenses, plus locum tenens, temporary, and telemedicine licenses for out‑of‑state doctors who meet set rules. In a declared critical‑need or when a county petitions for an underserved area, the Board may grant restricted licenses; after 3 years of full‑time practice, you can seek an unrestricted license. Retired doctors can get a no‑fee special volunteer license (first term 1 year; renewals 2 years). Residents appointed to ACGME programs get limited licenses with program confirmation; the old rule about being legally entitled to work and remain in the U.S. is removed. All special and restricted licenses issued under prior law end on January 1, 2026.
New rules for medical assistants
A medical assistant is an unlicensed person who does clinical tasks under a registered nurse’s supervision. The Board of Nursing may set supervision rules and limit when a medical assistant can have or give dangerous drugs. The Board can discipline a licensee who fails to adequately supervise a medical assistant.
New rules for perfusionist licenses
To get a perfusionist license, you must hold a current ABCP certification and finish an approved program. The Board may issue a temporary license for 1 year, renewable once, but you must work under a licensed perfusionist. The Board will set rules for qualifications, ethics, continuing education, and reinstatement fees. If your perfusionist license has been expired more than 2 years, you must apply anew under current rules.
Tougher discipline and quicker hearings
If the Board sanctions you, the order takes effect when certified and stays in place unless a court later changes it. Courts cannot pause a summary suspension or restriction. You may petition to remove a suspension or limit, but you may need exams and must prove fitness by clear and convincing evidence; revoked licenses require a new application under current rules. The charging document and records the Board uses to decide discipline are public; complaints and investigation files remain confidential. The Board shares information with other boards, agencies, and employers when feasible and authorized. After charges are filed, an early case conference happens within 20 days to set hearings and deadlines. If you have not practiced for over 24 months, the Board can require testing or other proof of competency.
Updated rules to practice respiratory care
To practice respiratory care, finish an approved program, pass the National Board exam, get that Board’s certification, and obtain a Nevada license with the fee. You may work as an intern for up to 12 months after school under supervision. The law removes the old high school diploma or GED rule.
Faster action on unsafe providers
If patients face imminent or ongoing harm, the Board can immediately limit a provider’s practice or suspend the license. The Board or its committee can order mental, physical, or skills exams; applicants and licensees are treated as having consented to such exams. Refusing an ordered exam leads to immediate suspension and counts as admitting the charges, unless the Board finds extraordinary reasons. When an exam is ordered after a summary action, the exam and results must be done within 30 days. Investigative committees can also order a physician to appear to aid the investigation.
Clearer rules for foreign-trained doctors
Nevada recognizes Canada, the United Kingdom, Australia, and New Zealand as equivalent countries for medical education and licensing. The Board can add more countries by regulation if their standards are similar to U.S. rules. A foreign medical school is any school outside the U.S. and outside those equivalent countries. Postgraduate training counts as continuous if there are no breaks of 12 weeks or more; ACGME‑approved programs qualify, and closely related sequences without long breaks may qualify.
Nevada license required for telehealth
A distant‑site provider who uses telehealth to diagnose, manage care, or write orders or prescriptions for a patient in Nevada must hold a Nevada license. A Nevada telemedicine license counts. This brings out‑of‑state telehealth under Nevada rules to protect patients.
Standard teen screening at checkups
Doctors, osteopathic doctors, physician assistants, and advanced practice nurses must ask standard health questions at every routine physical for ages 12–18. The questions come from the national Preparticipation Physical Evaluation forms. The State Board of Nursing also gives nurses who care for children, every year, information on signs and symptoms of pediatric cancer. These steps help find problems earlier and guide families to care sooner.
Better coordination between medical boards
The osteopathic board must send the medical examiners board a quarterly list of all its licensed anesthesiologist assistants and physician assistants. The two boards must share information to enforce anesthesiologist assistant and physician assistant laws. Rules tied to simultaneous licensure apply to people who told one board they intend to seek a license from the other, whether they said so before, on, or after January 1, 2026. This helps regulators track licensees and enforce rules.
More transparent medical board investigations
Only the Board or its investigation committee can file formal charges. Any complaint review committee must have at least three Board members, and at least one member is not a physician. Committee meetings stay confidential. Within 20 days after each meeting ends, the Board must post a summary that does not name anyone involved.
Tighter checks on risky prescribing
The Board must review tips about improper Schedule II–IV prescribing using the state PDMP. The Executive Director can share findings with other boards or law enforcement and delay notices to avoid harming ongoing cases. The Board must adopt rules to discipline improper prescribers, require added continuing education, and provide clear guidance to physicians and PAs. These steps aim to reduce unsafe or illegal prescribing.
Fingerprint and FBI checks for applicants
Applicants for licenses in medicine, perfusion, physician assisting, anesthesiologist assisting, and respiratory care must submit fingerprints for state and FBI checks. You must sign to allow the Board to send your prints to the state and FBI. Any Board fees for these background checks are not refundable.
New fees from Board of Nursing
The Board of Nursing may set and collect new reasonable fees. Fees may cover investigating applicants and licensees, competence checks, hearings, copying and verifying records, and approving nursing schools. Students, licensees, and schools must pay these charges when they apply for these services.
Pay both boards for dual licenses
If you seek a simultaneous PA or anesthesiologist assistant license with both boards, you must apply to both and pay all fees. If you pay one board but not the other within 1 year, you will be told to pay the difference and must do so within 30 days. Beginning January 1, 2026, the same one‑year rule applies at renewal for PAs who pay the annual simultaneous registration but delay the application or issuance fee.
Mixed changes to physician licensing rules
The Board may accept medical degrees, training, and exams from Board‑recognized equivalent foreign countries. The Board can also require extra exams and set scoring rules for licensure by regulation. For military‑affiliated endorsement, applicants must hold a specialty certification recognized by the American Board of Medical Specialties.
Board fees capped, plus new charges
The law caps many fees. Examples: physician application and issuance $600; PA $400; PA biennial registration $800; perfusionist renewal $600; license verification $50; duplicate license $50; list of new physicians $100. If you apply by endorsement under certain sections, the initial issuance fee is no more than half, or capped at the listed rate. The Board can charge extra for expedited processing or other incidental services. If you request a special Board meeting, you must prepay a cash deposit to cover costs. You must update your mailing address within 30 days or face a fine up to $250.
Hearing rules and court backup
The Board serves hearing papers in person, by certified mail, or by email if you consent; those abroad must consent to email. Board members not involved in the investigation may join to issue a final order after arguments from both sides. The Board may limit argument time and decide by majority vote. If someone blocks a hearing or refuses an oath, the Board can send the matter to district court for an order to show cause.
2026 license transitions and grace periods
Starting January 1, 2026, any special purpose license issued before that date is treated as a telemedicine license. Providers giving or directly supervising tumescent anesthesia in a now‑unauthorized location on January 1, 2026 may keep doing so until July 1, 2026. The law also repeals NRS 630.1606, 630.2692, 630.2693, and 630.324 as of January 1, 2026.
Sponsors & Cosponsors
Sponsor
David Orentlicher
Democratic • House
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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