Bill seeks to exempt dual‑degree oral surgeons from duplicate medical permitting

Assemblymember Rebecca Edgeworth presented Assembly Bill 221 to the Health and Human Services Committee, saying the bill would exempt oral and maxillofacial surgeons who hold both medical (MD) and dental (DMD/DDS) degrees from duplicative medical permitting requirements when they practise oral surgery under their dental license.

Edgeworth said the change would apply only to practitioners who are licensed dentists in Nevada and hold the dental board’s permit to administer general anesthesia; the bill would remove the additional medical‑board permitting requirement that was added after a 2009 law (AB 123) targeting office‑based anesthesia following a hepatitis C outbreak. “We are only seeking an exemption for physicians who are doing dental work… If a physician wanted to also do tummy tucks or something like that, that is not what we're talking about,” Edgeworth said.

Oral and maxillofacial surgeons and dental educators told the committee that the current dual‑permit regime imposes duplicate inspections, paperwork and fees without improving patient safety. Dr. Mark Deegan, a dual‑degree oral and maxillofacial surgeon, described multiple inspections, national accreditation costs and permit fees, and said the added regulatory burden has financial and workforce consequences. “Compliance with regulations from both dental and medical boards is redundant and onerous to oral and maxillofacial surgeons on numerous levels,” Deegan said. He estimated extra annual costs could be “greater than $5,000” for affected practices and cited accreditation surveys that can cost $8,000–$12,000 every three years plus state permit fees and renewals.

Supporters included the UNLV School of Dental Medicine, the Nevada State Society of Oral and Maxillofacial Surgeons, private practitioners and the Nevada State Medical Association. Dr. James Mah, dean of the UNLV School of Dental Medicine, said reducing duplicative administrative burden could reduce overhead and help make care more affordable for underinsured patients. “If we can reduce the administrative burden and the costs associated with it, I think it'll translate into reduced overhead and reduced care costs for our patients,” Mah said.

The Division of Public and Behavioral Health testified neutral and provided a fiscal note estimating approximately $9,000 per year in lost permit revenue if current state permits were no longer required for the handful of dual‑degree practitioners they currently regulate. Division administrator Cody Finney said the revenue loss would not change staffing levels and that inspectors could be reassigned to other permitting work.

Committee members asked how many practitioners would be affected and whether patient safety standards would change. Edgeworth and Dr. Deegan said the population affected is small — roughly seven practitioners by their estimate — and that affected clinicians already hold dental permits, maintain anesthesia certifications and are subject to dental board site visits and continuing education. Deegan and other speakers emphasized that the bill would not remove dental board oversight; it would exempt dual‑degree oral surgeons from the additional medical permitting that applies to non‑dental physician offices providing anesthesia.

No formal committee vote appears in the transcript. Edgeworth closed by asking the committee to support AB 221 and offered to answer follow‑up questions offline.

Why this matters: Proponents described this as a narrow fix to prevent duplication of facility permits and inspections for clinicians who already meet dental board anesthesia requirements. Supporters said the change could reduce costs, administrative burden and potential disincentives for dual‑trained oral surgeons to practice in Nevada.

Looking ahead: If advanced, the bill would require rule coordination between the state’s dental board and medical permitting bodies to define the exemption’s scope and ensure continued site inspections and accreditation where appropriate.