As used in this chapter, unless the
context otherwise requires, words and terms defined in NRS 629.021 and 629.031
have the meanings ascribed to them in those sections.
(Added to NRS by 1977, 1313)
“Health care records”
means any reports, notes, orders, photographs, X rays or other recorded
data or information whether maintained in written, electronic or other
form which is received or produced by a provider of health care, or any
person employed by him, and contains information relating to the medical
history, examination, diagnosis or treatment of the patient.
(Added to NRS by 1977, 1313; A 1993, 916)
Except as
otherwise provided by specific statute:
1. “Provider of health care” means a physician licensed pursuant
to chapter 630 , 630A or 633 of NRS,
dentist, licensed nurse, dispensing optician, optometrist, practitioner
of respiratory care, registered physical therapist, podiatric physician,
licensed psychologist, licensed marriage and family therapist,
chiropractor, athletic trainer, doctor of Oriental medicine in any form,
medical laboratory director or technician, pharmacist or a licensed
hospital as the employer of any such person.
2. For the purposes of NRS 629.051 , 629.061 and
629.065 , the term includes a facility
that maintains the health care records of patients.
(Added to NRS by 1977, 1313; A 1983, 1492; 1987, 2123; 1991, 1126;
1993, 2217; 1995, 1792; 1997, 679; 2003, 904 ; 2005, 69 )
Every provider of health care to whom any person comes
or is brought for treatment of an injury which appears to have been
inflicted by means of a firearm or knife, not under accidental
circumstances, shall promptly report the person’s name, if known, his
location and the character and extent of the injury to an appropriate law
enforcement agency.
(Added to NRS by 1977, 239)
1. Every provider of health care to whom any person comes or is
brought for the treatment of:
(a) Second or third degree burns to 5 percent or more of his body;
(b) Burns to his upper respiratory tract or laryngeal edema
resulting from the inhalation of heated air; or
(c) Burns which may result in death,
Ê shall promptly report that information to the appropriate local fire
department.
2. The report required by subsection 1 must include:
(a) The name and address of the person treated, if known;
(b) The location of the person treated; and
(c) The character and extent of his injuries.
3. A person required to make a report pursuant to subsection 1
shall, within 3 working days after treating the person, submit a written
report to:
(a) The appropriate local fire department in counties whose
population is 40,000 or more; or
(b) The State Fire Marshal in counties whose population is less
than 40,000.
Ê The report must be on a form provided by the State Fire Marshal.
4. A provider of health care, his agents and employees are immune
from any civil action for any disclosures made in good faith in
accordance with the provisions of this section or any consequential
damages.
(Added to NRS by 1991, 1896; A 2001, 1996 )
Except as otherwise
provided in regulations adopted by the State Board of Health pursuant to
NRS 652.135 with regard to the records
of a medical laboratory, each provider of health care shall retain the
health care records of his patients as part of his regularly maintained
records for 5 years after their receipt or production. Health care
records may be retained in written form, or by microfilm or any other
recognized form of size reduction, including, without limitation,
microfiche, computer disc, magnetic tape and optical disc, which does not
adversely affect their use for the purposes of NRS 629.061 . Health care records may be created,
authenticated and stored in a computer system which limits access to
those records.
(Added to NRS by 1977, 1313; A 1993, 916; 1997, 1123)
1. Each provider of health care shall make the health care records
of a patient available for physical inspection by:
(a) The patient or a representative with written authorization from
the patient;
(b) The personal representative of the estate of a deceased patient;
(c) Any trustee of a living trust created by a deceased patient;
(d) The parent or guardian of a deceased patient who died before
reaching the age of majority;
(e) An investigator for the Attorney General or a grand jury
investigating an alleged violation of NRS 200.495 , 200.5091
to 200.50995 , inclusive, or 422.540
to 422.570 , inclusive;
(f) An investigator for the Attorney General investigating an
alleged violation of NRS 616D.200 ,
616D.220 , 616D.240 or 616D.300 to 616D.440 , inclusive, or any fraud in the
administration of chapter 616A , 616B , 616C , 616D or 617 of NRS or in
the provision of benefits for industrial insurance; or
(g) Any authorized representative or investigator of a state
licensing board during the course of any investigation authorized by law.
Ê The records must be made available at a place within the depository
convenient for physical inspection, and inspection must be permitted at
all reasonable office hours and for a reasonable length of time. If the
records are located outside this State, the provider shall make any
records requested pursuant to this section available in this State for
inspection within 10 working days after the request.
2. Except as otherwise provided in subsection 3, the provider of
health care shall also furnish a copy of the records to each person
described in subsection 1 who requests it and pays the actual cost of
postage, if any, the costs of making the copy, not to exceed 60 cents per
page for photocopies and a reasonable cost for copies of X-ray
photographs and other health care records produced by similar processes.
No administrative fee or additional service fee of any kind may be
charged for furnishing such a copy.
3. The provider of health care shall also furnish a copy of any
records that are necessary to support a claim or appeal under any
provision of the Social Security Act, 42 U.S.C. §§ 301 et seq., or under
any federal or state financial needs-based benefit program, without
charge, to a patient, or a representative with written authorization from
the patient, who requests it, if the request is accompanied by
documentation of the claim or appeal. A copying fee, not to exceed 60
cents per page for photocopies and a reasonable cost for copies of X-ray
photographs and other health care records produced by similar processes,
may be charged by the provider of health care for furnishing a second
copy of the records to support the same claim or appeal. No
administrative fee or additional service fee of any kind may be charged
for furnishing such a copy. The provider of health care shall furnish the
copy of the records requested pursuant to this subsection within 30 days
after the date of receipt of the request, and the provider of health care
shall not deny the furnishing of a copy of the records pursuant to this
subsection solely because the patient is unable to pay the fees
established in this subsection.
4. Each person who owns or operates an ambulance in this State
shall make his records regarding a sick or injured patient available for
physical inspection by:
(a) The patient or a representative with written authorization from
the patient;
(b) The personal representative of the estate of a deceased patient;
(c) Any trustee of a living trust created by a deceased patient;
(d) The parent or guardian of a deceased patient who died before
reaching the age of majority; or
(e) Any authorized representative or investigator of a state
licensing board during the course of any investigation authorized by law.
Ê The records must be made available at a place within the depository
convenient for physical inspection, and inspection must be permitted at
all reasonable office hours and for a reasonable length of time. The
person who owns or operates an ambulance shall also furnish a copy of the
records to each person described in this subsection who requests it and
pays the actual cost of postage, if any, and the costs of making the
copy, not to exceed 60 cents per page for photocopies. No administrative
fee or additional service fee of any kind may be charged for furnishing a
copy of the records.
5. Records made available to a representative or investigator must
not be used at any public hearing unless:
(a) The patient named in the records has consented in writing to
their use; or
(b) Appropriate procedures are utilized to protect the identity of
the patient from public disclosure.
6. Subsection 5 does not prohibit:
(a) A state licensing board from providing to a provider of health
care or owner or operator of an ambulance against whom a complaint or
written allegation has been filed, or to his attorney, information on the
identity of a patient whose records may be used in a public hearing
relating to the complaint or allegation, but the provider of health care
or owner or operator of an ambulance and his attorney shall keep the
information confidential.
(b) The Attorney General from using health care records in the
course of a civil or criminal action against the patient or provider of
health care.
7. A provider of health care or owner or operator of an ambulance,
his agents and employees are immune from any civil action for any
disclosures made in accordance with the provisions of this section or any
consequential damages.
8. For the purposes of this section:
(a) “Guardian” means a person who has qualified as the guardian of
a minor pursuant to testamentary or judicial appointment, but does not
include a guardian ad litem.
(b) “Living trust” means an inter vivos trust created by a natural
person:
(1) Which was revocable by the person during the lifetime of
the person; and
(2) Who was one of the beneficiaries of the trust during the
lifetime of the person.
(c) “Parent” means a natural or adoptive parent whose parental
rights have not been terminated.
(d) “Personal representative” has the meaning ascribed to it in NRS
132.265 .
(Added to NRS by 1977, 1313; A 1985, 2246; 1987, 728, 1040; 1989,
2049; 1991, 1055, 1947; 1993, 781; 1995, 1879; 1999, 78 ; 2001, 829 ; 2003, 1331 ; 2005, 397 )
1. Each provider of health care shall, upon request, make
available to a law enforcement agent or district attorney the health care
records of a patient which relate to a test of his blood, breath or urine
if:
(a) The patient is suspected of having violated NRS 484.379 , 484.3795 ,
484.37955 , subsection 2 of NRS
488.400 , NRS 488.410 , 488.420 or
488.425 ; and
(b) The records would aid in the related investigation.
Ê To the extent possible, the provider of health care shall limit the
inspection to the portions of the records which pertain to the presence
of alcohol or a controlled substance, chemical, poison, organic solvent
or another prohibited substance in the blood, breath or urine of the
patient.
2. The records must be made available at a place within the
depository convenient for physical inspection. Inspection must be
permitted at all reasonable office hours and for a reasonable length of
time. The provider of health care shall also furnish a copy of the
records to each law enforcement agent or district attorney described in
subsection 1 who requests the copy and pays the costs of reproducing the
copy.
3. Records made available pursuant to this section may be
presented as evidence during a related administrative or criminal
proceeding against the patient.
4. A provider of health care and his agents and employees are
immune from any civil action for any disclosures made in accordance with
the provisions of this section or any consequential damages.
5. As used in this section, “prohibited substance” has the meaning
ascribed to it in NRS 484.1245 .
(Added to NRS by 1989, 182; A 1997, 334; 1999, 3436 ; 2005, 171 )
1. A provider of health care shall, upon request of the Director
of the Department of Corrections or his designee, provide the Department
of Corrections with a complete copy of the health care records of an
offender confined at the state prison.
2. Records provided to the Department of Corrections must not be
used at any public hearing unless:
(a) The offender named in the records has consented in writing to
their use; or
(b) Appropriate procedures are utilized to protect the identity of
the offender from public disclosure.
3. A provider of health care and an agent or employee of a
provider of health care are immune from civil liability for a disclosure
made in accordance with the provisions of this section.
(Added to NRS by 1997, 3191; A 2001 Special Session, 247 )
1. A provider of health care shall disclose the results of all
tests performed pursuant to NRS 441A.195 to:
(a) The person who was tested;
(b) The law enforcement officer, correctional officer, emergency
medical attendant, firefighter or other person who is employed by an
agency of criminal justice who filed the petition or on whose behalf the
petition was filed pursuant to NRS 441A.195 ;
(c) The designated health care officer for the employer of the
person described in paragraph (b) or, if there is no designated health
care officer, the person designated by the employer to document and
verify possible exposure to contagious diseases; and
(d) If the person who was tested is incarcerated or detained, the
person in charge of the facility in which the person is incarcerated or
detained and the chief medical officer of the facility in which the
person is incarcerated or detained, if any.
2. A provider of health care and an agent or employee of a
provider of health care are immune from civil liability for a disclosure
made in accordance with the provisions of this section.
(Added to NRS by 1999, 1123 ; A 2005, 348 )
Each provider of health care shall, on his bill to a
patient, itemize all charges for services, equipment, supplies and
medicines provided for the patient in terms which the patient is able to
understand. The bill must be timely provided after the charge is incurred
at no additional cost to the patient.
(Added to NRS by 1985, 906)
A
person who is present solely to improve his own personal skill or
knowledge by observing the rendering of care by a practitioner of a
healing art is immune from any civil action for damages arising from the
alleged negligent rendering of that care if he does not participate in
any way in the rendering of that care and is not compensated for that
care.
(Added to NRS by 1985, 1891)
1. Except as otherwise provided in subsection 4, a provider of
health care may authorize a person to act as a personal assistant to
perform specific medical, nursing or home health care services for a
person with a disability without obtaining any license required for a
provider of health care or his assistant to perform the service if:
(a) The services to be performed are services that a person without
a disability usually and customarily would personally perform without the
assistance of a provider of health care;
(b) The provider of health care determines that the personal
assistant has the knowledge, skill and ability to perform the services
competently;
(c) The provider of health care determines that the procedures
involved in providing the services are simple and the performance of such
procedures by the personal assistant does not pose a substantial risk to
the person with a disability;
(d) The provider of health care determines that the condition of
the person with a disability is stable and predictable; and
(e) The personal assistant agrees with the provider of health care
to refer the person with a disability to the provider of health care if:
(1) The condition of the person with a disability changes or
a new medical condition develops;
(2) The progress or condition of the person with a
disability after the provision of the service is different than expected;
(3) An emergency situation develops; or
(4) Any other situation described by the provider of health
care develops.
2. A provider of health care that authorizes a personal assistant
to perform certain services shall note in the medical records of the
person with a disability who receives such services:
(a) The specific services that he has authorized the personal
assistant to perform; and
(b) That the requirements of this section have been satisfied.
3. After a provider of health care has authorized a personal
assistant to perform specific services for a person with a disability, no
further authorization or supervision by the provider is required for the
continued provision of those services.
4. A personal assistant shall not:
(a) Perform services pursuant to this section for a person with a
disability who resides in a medical facility.
(b) Perform any medical, nursing or home health care service for a
person with a disability which is not specifically authorized by a
provider of health care pursuant to subsection 1.
(c) Except if the services are provided in an educational setting,
perform services for a person with a disability in the absence of the
parent or guardian of, or any other person legally responsible for, the
person with a disability, if the person with a disability is not able to
direct his own services.
5. A provider of health care who determines in good faith that a
personal assistant has complied with and meets the requirements of this
section is not liable for civil damages as a result of any act or
omission, not amounting to gross negligence, committed by him in making
such a determination and is not liable for any act or omission of the
personal assistant.
6. As used in this section:
(a) “Guardian” means a person who has qualified as the guardian of
a minor or an adult pursuant to testamentary or judicial appointment, but
does not include a guardian ad litem.
(b) “Parent” means a natural or adoptive parent whose parental
rights have not been terminated.
(c) “Personal assistant” means a person who, for compensation and
under the direction of:
(1) A person with a disability;
(2) A parent or guardian of, or any other person legally
responsible for, a person with a disability who is under the age of 18
years; or
(3) A parent, spouse, guardian or adult child of a person
with a disability who suffers from a cognitive impairment,
Ê performs services for the person with a disability to help him maintain
his independence, personal hygiene and safety.
(d) “Provider of health care” means a physician licensed pursuant
to chapter 630 , 630A or 633 of NRS, a
dentist, a registered nurse, a licensed practical nurse, a physical
therapist or an occupational therapist.
(Added to NRS by 1995, 749; A 2005, 69 )
1. Except as otherwise provided in subsection 2, the Commissioner
of Insurance shall develop, prescribe for use and make available a
single, standardized form for use by insurers, carriers, societies,
corporations, health maintenance organizations and managed care
organizations in obtaining any information related to the credentials of
a provider of health care.
2. The provisions of subsection 1 do not prohibit the Commissioner
of Insurance from developing, prescribing for use and making available:
(a) Appropriate variations of the form described in that subsection
for use in different geographical regions of this State.
(b) Addenda or supplements to the form described in that subsection
to address, until such time as a new form may be developed, prescribed
for use and made available, any requirements newly imposed by the Federal
Government, the State or one of its agencies, or a body that accredits
hospitals, medical facilities or health care plans.
3. With respect to the form described in subsection 1, the
Commissioner of Insurance shall:
(a) Hold public hearings to seek input regarding the development of
the form;
(b) Develop the form in consideration of the input received
pursuant to paragraph (a);
(c) Ensure that the form is developed in such a manner as to
accommodate and reflect the different types of credentials applicable to
different classes of providers of health care;
(d) Ensure that the form is developed in such a manner as to
reflect standards of accreditation adopted by national organizations
which accredit hospitals, medical facilities and health care plans; and
(e) Ensure that the form is developed to be used efficiently and is
developed to be neither unduly long nor unduly voluminous.
4. As used in this section:
(a) “Carrier” has the meaning ascribed to it in NRS 689C.025 .
(b) “Corporation” means a corporation operating pursuant to the
provisions of chapter 695B of NRS.
(c) “Health maintenance organization” has the meaning ascribed to
it in NRS 695C.030 .
(d) “Insurer” means:
(1) An insurer that issues policies of individual health
insurance in accordance with chapter 689A
of NRS; and
(2) An insurer that issues policies of group health
insurance in accordance with chapter 689B
of NRS.
(e) “Managed care organization” has the meaning ascribed to it in
NRS 695G.050 .
(f) “Provider of health care” means a provider of health care who
is licensed pursuant to chapter 630 , 631
, 632 or 633
of NRS.
(g) “Society” has the meaning ascribed to it in NRS 695A.044 .
(Added to NRS by 2003, 3374 )
GENETIC INFORMATION
As used in NRS 629.101 to 629.201 ,
inclusive, unless the context otherwise requires, the words and terms
defined in NRS 629.111 and 629.121
have the meanings ascribed to them in
those sections.
(Added to NRS by 1997, 1463)
“Genetic information”
means any information that is obtained from a genetic test.
(Added to NRS by 1997, 1463)
“Genetic test” means a test,
including a laboratory test that uses deoxyribonucleic acid extracted
from the cells of a person or a diagnostic test, to determine the
presence of abnormalities or deficiencies, including carrier status, that:
1. Are linked to physical or mental disorders or impairments; or
2. Indicate a susceptibility to illness, disease, impairment or
any other disorder, whether physical or mental.
(Added to NRS by 1997, 1463)
1. The provisions of NRS 629.101
to 629.201 , inclusive, do not apply to
any action taken by an insurer or a third-party administrator relating to
a policy that provides coverage for long-term care or disability income.
2. As used in this section, “third-party administrator” has the
meaning ascribed to it in NRS 616A.335 .
(Added to NRS by 1997, 1463)
A person who takes a
genetic test may inspect or obtain any genetic information included in
the records of his test.
(Added to NRS by 1997, 1463)
It is unlawful to obtain any genetic
information of a person without first obtaining the informed consent of
the person or the person’s legal guardian pursuant to NRS 629.181 , unless the information is obtained:
1. By a federal, state, county or city law enforcement agency to
establish the identity of a person or dead human body;
2. To determine the parentage or identity of a person pursuant to
NRS 56.020 ;
3. To determine the paternity of a person pursuant to NRS 126.121
or 425.384 ;
4. For use in a study where the identities of the persons from
whom the genetic information is obtained are not disclosed to the person
conducting the study;
5. To determine the presence of certain preventable or inheritable
disorders in an infant pursuant to NRS 442.008 or a provision of federal law; or
6. Pursuant to an order of a court of competent jurisdiction.
(Added to NRS by 1997, 1463; A 1999, 1062 )
1. It is unlawful to retain genetic information that identifies a
person, without first obtaining the informed consent of the person or the
person’s legal guardian pursuant to NRS 629.181 , unless retention of the genetic information
is:
(a) Necessary to conduct a criminal investigation, an investigation
concerning the death of a person or a criminal or juvenile proceeding;
(b) Authorized pursuant to an order of a court of competent
jurisdiction; or
(c) Necessary for a medical facility as defined in NRS 449.0151
to maintain a medical record of the
person.
2. A person who has authorized another person to retain his
genetic information may request that person to destroy the genetic
information. If so requested, the person who retains that genetic
information shall destroy the information, unless retention of that
information is:
(a) Necessary to conduct a criminal investigation, an investigation
concerning the death of a person or a criminal or juvenile proceeding;
(b) Authorized by an order of a court of competent jurisdiction;
(c) Necessary for a medical facility as defined in NRS 449.0151
to maintain a medical record of the
person; or
(d) Authorized or required by state or federal law or regulation.
3. Except as otherwise provided in subsection 4 or by federal law
or regulation, a person who obtains the genetic information of a person
for use in a study shall destroy that information upon:
(a) The completion of the study;
(b) The withdrawal of the person from the study,
Ê whichever occurs first.
4. A person whose genetic information is used in a study may
authorize the person who conducts the study to retain that genetic
information after the study is completed or upon his withdrawal from the
study.
(Added to NRS by 1997, 1464)
It is unlawful to disclose or to compel a
person to disclose the identity of a person who was the subject of a
genetic test or to disclose genetic information of that person in a
manner that allows identification of the person, without first obtaining
the informed consent of that person or his legal guardian pursuant to NRS
629.181 , unless the information is
disclosed:
1. To conduct a criminal investigation, an investigation
concerning the death of a person or a criminal or juvenile proceeding;
2. To determine the parentage or identity of a person pursuant to
NRS 56.020 ;
3. To determine the paternity of a person pursuant to NRS 126.121
or 425.384 ;
4. Pursuant to an order of a court of competent jurisdiction;
5. By a physician and is the genetic information of a deceased
person that will assist in the medical diagnosis of persons related to
the deceased person by blood;
6. To a federal, state, county or city law enforcement agency to
establish the identity of a person or dead human body;
7. To determine the presence of certain preventable or inheritable
preventable disorders in an infant pursuant to NRS 442.008 or a provision of federal law; or
8. To carry out the provisions of NRS 442.300 to 442.330 ,
inclusive;
9. By an agency of criminal justice pursuant to NRS 179A.075
.
(Added to NRS by 1997, 1464; A 1999, 1063 , 3515 )
1. Except as otherwise provided in subsection 2, the State Board
of Health shall by regulation:
(a) Establish a procedure for obtaining the informed consent of a
person pursuant to NRS 629.101 to
629.201 , inclusive, and
(b) Prescribe a form for use in obtaining the informed consent of a
person. The form must include:
(1) Information relating to the use and confidentiality of
the genetic information of the person set forth in NRS 629.101 to 629.201 ,
inclusive, and
(2) Any other information the State Board of Health may
prescribe.
2. The State Board of Health is not required to adopt regulations
establishing a procedure for obtaining the informed consent of a person
pursuant to NRS 629.101 to 629.201
, inclusive, if the procedure for
obtaining that consent is required by federal law or regulation.
(Added to NRS by 1997, 1465)
A person who violates any of the provisions
of NRS 629.151 , 629.161 or 629.171
is guilty of a misdemeanor.
(Added to NRS by 1997, 1465)
Any person who suffers
an injury as a result of the disclosure of his genetic information by
another person in violation of NRS 629.171 may bring a civil action for the recovery of
his actual damages, including costs and attorney’s fees.
(Added to NRS by 1997, 1465)
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