Veterinary telemedicine hearing derails amid confusion and amendments

Lawmaker asking a bill sponsor if she was willing to drop an amendment to save her bill, a lobbyist who mispronounced a client’s last name, and a mysterious foreign company seeking to enforce an interested amendment rings the bell like the start of a very specific Carson City nightmare.

But that same situation happened to MP Shannon Bilbray-Axelrod (D-Las Vegas), who found herself leading a heated hearing on her veterinary telemedicine bill. AB200 before the Senate Trade and Labor Committee hearing on Wednesday.

The intent of the bill is simple: to allow licensed veterinarians to practice telemedicine only after an in-person examination of an animal. Under the proposed bill, veterinarians would not have to examine every member of a herd to see a veterinarian, and a physician with access to medical records could also view a case via remote communication.

Former Nevada State Board of Veterinary Medical Examiners Chairman Jon Pennelle said that if telehealth is vital for expanding access to veterinary care, in-person visits are needed.

“For thousands of years, animals have instinctively hidden disease and pain as a means of survival,” said Pennelle. “And I think there is too much that can be missed if you don’t examine and touch a patient first.”

While many vets praised the measure, two proposed amendments derailed discussions on the bill.

A friendly conceptual modification proposed by the Nevada Board of Veterinary Medical Examiners (SB366) who died in committee. The proposed amendment would make some changes to veterinary medicine outside of simple telemedicine, including:

  • Remove a provision requiring council to post a notice in a newspaper if an applicant for a permit or registration cannot be reached by council
  • Allow council to accept permit applications online by removing a notarization requirement
  • Authorize licensed veterinary technicians to administer vaccines against zoonoses such as rabies

Senator Keith Pickard (R-Henderson) raised concerns about removing the requirement to post notices and asked for more information on the provisions of the amendment.

But when the council’s executive director was not available via Zoom or by phone to answer Pickard’s question, Bilbray-Axelrod said his only goal was to get the bill passed.

Pickard asked Bilbray-Axelrod if what she meant was that she “would be willing to drop the amendment” to save her bill if the amendment was “problematic.”

“I was trying to be nicer,” Bilbray-Axelrod replied. “But I mean, of course.”

In supporting public testimony, the CEO apologized for her technological issues and said she had answered lawmakers’ questions in writing.

Despite the confusion surrounding the proposed council amendment, the committee began to hear testimony on the bill – and that’s when it got into legislative nightmares.

Dutch Pet, Inc., a California-based telemedicine company that the records indicate was incorporated in March in Delaware, testified against the bill. The company has been at the forefront of deregulating veterinary medicine by Florida and submitted a conceptual modification before the hearing requesting that the language requiring a physical examination occur before telemedicine instead becomes optional.

A company lobbyist, John Oceguera, represented the company and called its legal counsel, Virginia Mimmack, to testify on the amendment. Lawmakers were further confused by several mispronounciation of his last name as ‘Mimic’, resulting in further confusion and delays.

Mimmack said requiring a physical exam did not comply with the laws of other states such as New Jersey, Virginia, Idaho and Michigan, and would prevent new entrants to Nevada’s veterinary markets. .

“As currently written, the only vets who can reap the many benefits of telemedicine are vets who already have physical practice in Nevada,” Mimmack said.

This testimony prompted about half an hour of questions from lawmakers, who wanted more clarity on Dutch Pet’s motives for opposing the bill.

“I’m trying to understand why you would want to testify in the Nevada Legislature about Nevada vets, when you don’t have vets here,” said Senator Roberta Lange (D-Las Vegas), noting that Florida and Arizona recently rejected bills pushing for the deregulation of veterinary telemedicine.

Senator Dina Neal (D-Las Vegas) called Mimmack’s comments “confusing” and unrealistic. Senator Melanie Scheible (D-Las Vegas) expressed her thoughts more directly.

“Let’s just be clear that your amendment allows Dutch Pet to enter Nevada,” she said. “If the amendment is not passed, then the Dutch Pet business model would not be allowed in Nevada. And that’s the real deal, right?”

“Our testimony today is really not about Dutch Pet. Dutch Pet is not currently active in Nevada. But our testimony today is about the ban on establishing a vet-client-patient relationship ( VCPR) remotely, ”Mimmack replied. “It does not allow any new entrants into the market and several other states have found ways to do so.”

Pickard said he tends to favor the expansion of competition, but worries vets could misdiagnose or miss warning signs without in-person checks.

“Unless you have Dr. Doolittle on staff, you won’t be able to talk to the patient,” Pickard said.

Committee chair Senator Pat Spearman (D-Las Vegas) joked that five years and six months later she was closing the hearing. The committee made no decision on the bill.

Editor’s Note: This story first appeared in Behind the Bar, The Nevada Independent’s newsletter devoted to comprehensive coverage of the 2021 Legislative Assembly. ‘information here.

About Hector Hedgepeth

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