CHAPTER 9. HEALTH PROFESSIONS STANDARDS OF PRACTICE
IC 25-1-9
Chapter 9. Health Professions Standards of Practice
IC 25-1-9-1
"Board" defined
Sec. 1. As used in this chapter, "board" means any of thefollowing:
(1) Board of chiropractic examiners (IC 25-10-1).
(2) State board of dentistry (IC 25-14-1).
(3) Indiana state board of health facility administrators (IC25-19-1).
(4) Medical licensing board of Indiana (IC 25-22.5-2).
(5) Indiana state board of nursing (IC 25-23-1).
(6) Indiana optometry board (IC 25-24).
(7) Indiana board of pharmacy (IC 25-26).
(8) Board of podiatric medicine (IC 25-29-2-1).
(9) Speech-language pathology and audiology board (IC25-35.6-2).
(10) State psychology board (IC 25-33).
(11) Indiana board of veterinary medical examiners (IC25-38.1-2).
(12) Indiana physical therapy committee (IC 25-27-1).
(13) Respiratory care committee (IC 25-34.5).
(14) Occupational therapy committee (IC 25-23.5).
(15) Behavioral health and human services licensing board (IC25-23.6).
(16) Physician assistant committee (IC 25-27.5).
(17) Indiana athletic trainers board (IC 25-5.1-2-1).
(18) Indiana dietitians certification board (IC 25-14.5-2-1).
As added by P.L.152-1988, SEC.1. Amended by P.L.242-1989,SEC.7; P.L.238-1989, SEC.7; P.L.186-1990, SEC.7; P.L.48-1991,SEC.20; P.L.227-1993, SEC.7; P.L.33-1993, SEC.14; P.L.213-1993,SEC.4; P.L.1-1994, SEC.122; P.L.124-1994, SEC.6; P.L.175-1997,SEC.6; P.L.147-1997, SEC.10; P.L.84-1998, SEC.5; P.L.24-1999,SEC.6; P.L.2-2008, SEC.59; P.L.122-2009, SEC.8; P.L.84-2010,SEC.16.
IC 25-1-9-2
"Practitioner" defined
Sec. 2. As used in this chapter, "practitioner" means an individualwho holds:
(1) an unlimited license, certificate, or registration;
(2) a limited or probationary license, certificate, or registration;
(3) a temporary license, certificate, registration, or permit;
(4) an intern permit; or
(5) a provisional license;
issued by the board regulating the profession in question, includinga certificate of registration issued under IC 25-20.
As added by P.L.152-1988, SEC.1.
IC 25-1-9-3
"License" defined
Sec. 3. As used in this chapter, "license" includes a license,certificate, registration, or permit.
As added by P.L.152-1988, SEC.1.
IC 25-1-9-3.5
"Sexual contact" defined
Sec. 3.5. As used in this chapter, "sexual contact" means:
(1) sexual intercourse (as defined in IC 35-41-1-26);
(2) deviate sexual conduct (as defined in IC 35-41-1-9); or
(3) any fondling or touching intended to arouse or satisfy thesexual desires of either the individual performing the fondlingor touching or the individual being fondled or touched.
As added by P.L.200-2001, SEC.1.
IC 25-1-9-4
Standards of professional practice; findings required for sanctions;evidence of foreign discipline
Sec. 4. (a) A practitioner shall conduct the practitioner's practicein accordance with the standards established by the board regulatingthe profession in question and is subject to the exercise of thedisciplinary sanctions under section 9 of this chapter if, after ahearing, the board finds:
(1) a practitioner has:
(A) engaged in or knowingly cooperated in fraud or materialdeception in order to obtain a license to practice, includingcheating on a licensing examination;
(B) engaged in fraud or material deception in the course ofprofessional services or activities;
(C) advertised services in a false or misleading manner; or
(D) been convicted of a crime or assessed a civil penaltyinvolving fraudulent billing practices, including fraud under:
(i) Medicaid (42 U.S.C. 1396 et seq.);
(ii) Medicare (42 U.S.C. 1395 et seq.);
(iii) the children's health insurance program underIC 12-17.6; or
(iv) insurance claims;
(2) a practitioner has been convicted of a crime that:
(A) has a direct bearing on the practitioner's ability tocontinue to practice competently; or
(B) is harmful to the public;
(3) a practitioner has knowingly violated any state statute orrule, or federal statute or regulation, regulating the professionin question;
(4) a practitioner has continued to practice although thepractitioner has become unfit to practice due to:
(A) professional incompetence that:
(i) may include the undertaking of professional activitiesthat the practitioner is not qualified by training or
experience to undertake; and
(ii) does not include activities performed underIC 16-21-2-9;
(B) failure to keep abreast of current professional theory orpractice;
(C) physical or mental disability; or
(D) addiction to, abuse of, or severe dependency uponalcohol or other drugs that endanger the public by impairinga practitioner's ability to practice safely;
(5) a practitioner has engaged in a course of lewd or immoralconduct in connection with the delivery of services to thepublic;
(6) a practitioner has allowed the practitioner's name or alicense issued under this chapter to be used in connection withan individual who renders services beyond the scope of thatindividual's training, experience, or competence;
(7) a practitioner has had disciplinary action taken against thepractitioner or the practitioner's license to practice in any stateor jurisdiction on grounds similar to those under this chapter;
(8) a practitioner has diverted:
(A) a legend drug (as defined in IC 16-18-2-199); or
(B) any other drug or device issued under a drug order (asdefined in IC 16-42-19-3) for another person;
(9) a practitioner, except as otherwise provided by law, hasknowingly prescribed, sold, or administered any drug classifiedas a narcotic, addicting, or dangerous drug to a habitue oraddict;
(10) a practitioner has failed to comply with an order imposinga sanction under section 9 of this chapter;
(11) a practitioner has engaged in sexual contact with a patientunder the practitioner's care or has used the practitioner-patientrelationship to solicit sexual contact with a patient under thepractitioner's care;
(12) a practitioner who is a participating provider of a healthmaintenance organization has knowingly collected or attemptedto collect from a subscriber or enrollee of the healthmaintenance organization any sums that are owed by the healthmaintenance organization; or
(13) a practitioner has assisted another person in committing anact that would be grounds for disciplinary sanctions under thischapter.
(b) A practitioner who provides health care services to thepractitioner's spouse is not subject to disciplinary action undersubsection (a)(11).
(c) A certified copy of the record of disciplinary action isconclusive evidence of the other jurisdiction's disciplinary actionunder subsection (a)(7).
As added by P.L.152-1988, SEC.1. Amended by P.L.2-1993,SEC.136; P.L.149-1997, SEC.7; P.L.22-1999, SEC.4; P.L.200-2001,SEC.2; P.L.203-2001, SEC.3; P.L.1-2002, SEC.96; P.L.197-2007,
SEC.22.
IC 25-1-9-5
Optometry employment practice
Sec. 5. In addition to section 4 of this chapter, a practitionerlicensed to practice optometry is subject to the exercise ofdisciplinary sanctions under section 9 of this chapter if, after ahearing, the board finds a practitioner has accepted employment topractice optometry from a person other than:
(1) a corporation formed by an optometrist under IC 23-1.5; or
(2) an individual who is licensed as an optometrist under thisarticle and whose legal residence is in Indiana.
As added by P.L.152-1988, SEC.1.
IC 25-1-9-6
Veterinary practitioners; cruelty to animals
Sec. 6. In addition to section 4 of this chapter, a practitionerlicensed to practice veterinary medicine or registered as a veterinarytechnician is subject to the exercise of the disciplinary sanctionsunder section 9 of this chapter if, after a hearing, the board finds apractitioner has engaged in cruelty to animals.
As added by P.L.152-1988, SEC.1.
IC 25-1-9-6.5
Chiropractors; waiver of deductible or copayment
Sec. 6.5. (a) In addition to section 4 of this chapter, a practitionerlicensed to practice chiropractic is subject to the exercise of thedisciplinary sanctions under section 9 of this chapter if, after ahearing, the board regulating the profession finds a practitioner has:
(1) waived a payment of a deductible or a copayment requiredto be made to the practitioner by a patient under the patient'sinsurance or health care plan; and
(2) advertised the waiver of a payment described in subdivision(1).
(b) This section does not apply to the waiver of a deductible or acopayment by a practitioner if:
(1) the practitioner determines chiropractic service is necessaryfor the immediate health and welfare of a patient;
(2) the practitioner determines the payment of a deductible ora copayment would create a substantial financial hardship forthe patient; and
(3) the waiver is based on the evaluation of the individualpatient and is not a regular business practice of the practitioner.
As added by P.L.151-1989, SEC.9.
IC 25-1-9-6.7
Marriage and family therapists; disciplinary sanctions
Sec. 6.7. In addition to the actions listed under section 4 of thischapter that subject a practitioner to the exercise of disciplinarysanctions, a practitioner who is licensed under IC 25-23.6 is subject
to the exercise of disciplinary sanctions under section 9 of thischapter if, after a hearing, the board regulating the profession findsthat the practitioner has:
(1) performed any therapy that, by the prevailing standards ofthe mental health professions in the community where theservices were provided, would constitute experimentation onhuman subjects, without first obtaining full, informed, andwritten consent;
(2) failed to meet the minimum standards of performance inprofessional activities when measured against generallyprevailing peer performance in professional activities, includingthe undertaking of activities that the practitioner is not qualifiedby training or experience to undertake;
(3) performed services, including any duties required of theindividual under IC 31, in reckless disregard of the bestinterests of a patient, a client, or the public;
(4) without the consent of the child's parent, guardian, orcustodian, knowingly participated in the child's removal orprecipitated others to remove a child from the child's homeunless:
(A) the child's physical health was endangered due to injuryas a result of the act or omission of the child's parent,guardian, or custodian;
(B) the child had been or was in danger of being a victim ofan offense under IC 35-42-4, IC 35-45-4-1, IC 35-45-4-2,IC 35-46-1-3, IC 35-49-2-2, or IC 35-49-3-2; or
(C) the child was in danger of serious bodily harm as a resultof the inability, refusal, or neglect of the child's parent,guardian, or custodian to supply the child with necessaryfood, shelter, or medical care, and a court order was firstobtained;
(5) willfully made or filed a false report or record, failed to filea report or record required by law, willfully impeded orobstructed the filing of a report or record, or induced anotherindividual to:
(A) make or file a false report or record; or
(B) impede or obstruct the filing of a report or record; or
(6) performed a diagnosis (as defined in IC 25-22.5-1-1.1(c));
(7) provided evidence in an administrative or judicialproceeding that had insufficient factual basis for theconclusions rendered by the practitioner;
(8) willfully planted in the mind of the patient suggestions thatare not based in facts known to the practitioner; or
(9) performed services outside of the scope of practice of thelicense issued under IC 25-23.6.
As added by P.L.147-1997, SEC.11. Amended by P.L.2-1998,SEC.65.
IC 25-1-9-6.8
Practitioner guidelines before prescribing stimulant medication for
a child for treatment of certain disorders
Sec. 6.8. (a) This section applies to a practitioner who is:
(1) licensed to practice medicine or osteopathic medicine underIC 25-22.5; or
(2) an advanced practice nurse granted prescriptive authorityunder IC 25-23, and whose practice agreement with acollaborating physician reflects the conditions specified insubsection (b).
(b) Before prescribing a stimulant medication for a child for thetreatment of attention deficit disorder or attention deficithyperactivity disorder, a practitioner described in subsection (a) shallfollow the most recent guidelines adopted by the American Academyof Pediatrics or the American Academy of Child and AdolescentPsychiatry for the diagnosis and evaluation of a child with attentiondeficit disorder or attention deficit hyperactivity disorder.
As added by P.L.107-2002, SEC.28.
IC 25-1-9-6.9
Failing to provide or providing false information to agency
Sec. 6.9. In addition to the actions listed under section 4 of thischapter that subject a practitioner to disciplinary sanctions, apractitioner is subject to the exercise of disciplinary sanctions undersection 9 of this chapter if, after a hearing, the board finds that thepractitioner has:
(1) failed to provide information requested by the Indianaprofessional licensing agency; or
(2) knowingly provided false information to the Indianaprofessional licensing agency;
for a provider profile required under IC 25-1-5-10.
As added by P.L.211-2001, SEC.2. Amended by P.L.206-2005,SEC.14.
IC 25-1-9-7
Physical or mental examination; power to require
Sec. 7. The board may order a practitioner to submit to areasonable physical or mental examination, at the practitioner's ownexpense, if the practitioner's physical or mental capacity to practicesafely is at issue in a disciplinary proceeding.
As added by P.L.152-1988, SEC.1. Amended by P.L.158-2003,SEC.2.
IC 25-1-9-8
Failure to submit to physical or mental examination; sanctions
Sec. 8. Failure to comply with a board order to submit to aphysical or mental examination makes a practitioner liable tosummary suspension under section 10 of this chapter.
As added by P.L.152-1988, SEC.1.
IC 25-1-9-9
Disciplinary sanctions Sec. 9. (a) The board may impose any of the following sanctions,singly or in combination, if it finds that a practitioner is subject todisciplinary sanctions under section 4, 5, 6, 6.7, or 6.9 of this chapteror IC 25-1-5-4:
(1) Permanently revoke a practitioner's license.
(2) Suspend a practitioner's license.
(3) Censure a practitioner.
(4) Issue a letter of reprimand.
(5) Place a practitioner on probation status and require thepractitioner to:
(A) report regularly to the board upon the matters that arethe basis of probation;
(B) limit practice to those areas prescribed by the board;
(C) continue or renew professional education under apreceptor, or as otherwise directed or approved by the board,until a satisfactory degree of skill has been attained in thoseareas that are the basis of the probation; or
(D) perform or refrain from performing any acts, includingcommunity restitution or service without compensation, thatthe board considers appropriate to the public interest or tothe rehabilitation or treatment of the practitioner.
(6) Assess a fine against the practitioner in an amount not toexceed one thousand dollars ($1,000) for each violation listedin section 4 of this chapter, except for a finding ofincompetency due to a physical or mental disability. Whenimposing a fine, the board shall consider a practitioner's abilityto pay the amount assessed. If the practitioner fails to pay thefine within the time specified by the board, the board maysuspend the practitioner's license without additionalproceedings. However, a suspension may not be imposed if thesole basis for the suspension is the practitioner's inability to paya fine.
(b) The board may withdraw or modify the probation undersubsection (a)(5) if it finds, after a hearing, that the deficiency thatrequired disciplinary action has been remedied, or that changedcircumstances warrant a modification of the order.
As added by P.L.152-1988, SEC.1. Amended by P.L.48-1991,SEC.21; P.L.22-1999, SEC.5; P.L.32-2000, SEC.10; P.L.211-2001,SEC.3.
IC 25-1-9-10
Summary license suspension pending final adjudication; notice;opportunity to be heard
Sec. 10. (a) The board may summarily suspend a practitioner'slicense for ninety (90) days before a final adjudication or during theappeals process if the board finds that a practitioner represents aclear and immediate danger to the public health and safety if thepractitioner is allowed to continue to practice. The summarysuspension may be renewed upon a hearing before the board, andeach renewal may be for ninety (90) days or less. (b) Before the board may summarily suspend a license that hasbeen issued under IC 25-22.5, IC 25-38.1, or IC 25-14, the consumerprotection division of the attorney general's office shall make areasonable attempt to notify a practitioner of a hearing by the boardto suspend a practitioner's license and of information regarding theallegation against the practitioner. The consumer protection divisionof the attorney general's office shall also notify the practitioner thatthe practitioner may provide a written or an oral statement to theboard on the practitioner's behalf before the board issues an order forsummary suspension. A reasonable attempt to reach the practitioneris made if the consumer protection division of the attorney general'soffice attempts to reach the practitioner by telephone or facsimile atthe last telephone number of the practitioner on file with the board.
(c) After a reasonable attempt is made to notify a practitionerunder subsection (b):
(1) a court may not stay or vacate a summary suspension of apractitioner's license for the sole reason that the practitioner wasnot notified; and
(2) the practitioner may not petition the board for a delay of thesummary suspension proceedings.
As added by P.L.152-1988, SEC.1. Amended by P.L.43-1995, SEC.2;P.L.71-2000, SEC.18; P.L.2-2008, SEC.60.
IC 25-1-9-10.1
Retention of clinical consultants and experts to advise onsuspension
Sec. 10.1. The attorney general may retain the services of aclinical consultant or an expert to provide the attorney general withadvice concerning the acts that are the subject of a suspension underthis chapter.
As added by P.L.43-1995, SEC.3.
IC 25-1-9-11
Reinstatement of suspended licenses
Sec. 11. The board may reinstate a license which has beensuspended under this chapter if, after a hearing, the board is satisfiedthat the applicant is able to practice with reasonable skill and safetyto the public. As a condition of reinstatement, the board may imposedisciplinary or corrective measures authorized under this chapter.
As added by P.L.152-1988, SEC.1.
IC 25-1-9-12
Reinstatement of revoked license
Sec. 12. The board may not reinstate a license that has beenrevoked under this chapter. An individual whose license has beenrevoked under this chapter may not apply for a new license untilseven (7) years after the date of revocation.
As added by P.L.152-1988, SEC.1.
IC 25-1-9-13 Consistency of sanctions prescribed
Sec. 13. The board shall seek to achieve consistency in theapplication of the sanctions authorized in this section. Significantdepartures from prior decisions involving similar conduct must beexplained in the board's findings or orders.
As added by P.L.152-1988, SEC.1.
IC 25-1-9-14
Surrender of practitioners license instead of hearing; approval
Sec. 14. A practitioner may petition the board to accept thesurrender of the practitioner's license instead of a hearing before theboard. The practitioner may not surrender the practitioner's licensewithout the written approval of the board, and the board may imposeany conditions appropriate to the surrender or reinstatement of asurrendered license.
As added by P.L.152-1988, SEC.1.
IC 25-1-9-15
Costs in disciplinary proceedings
Sec. 15. Practitioners who have been subjected to disciplinarysanctions may be required by a board to pay for the costs of theproceeding. The practitioner's ability to pay shall be considered whencosts are assessed. If the practitioner fails to pay the costs, asuspension may not be imposed solely upon the practitioner'sinability to pay the amount assessed. These costs are limited to costsfor the following:
(1) Court reporters.
(2) Transcripts.
(3) Certification of documents.
(4) Photoduplication.
(5) Witness attendance and mileage fees.
(6) Postage.
(7) Expert witnesses.
(8) Depositions.
(9) Notarizations.
(10) Administrative law judges.
As added by P.L.152-1988, SEC.1. Amended by P.L.158-2003,SEC.3.
IC 25-1-9-16
Refusal of licensure or grant of probationary license
Sec. 16. (a) The board may refuse to issue a license or may issuea probationary license to an applicant for licensure if:
(1) the applicant has been disciplined by a licensing entity ofany state or jurisdiction, or has committed an act that wouldhave subjected the applicant to the disciplinary process had theapplicant been licensed in Indiana when the act occurred; and
(2) the violation for which the applicant was, or could havebeen, disciplined has a direct bearing on the applicant's abilityto competently practice in Indiana. (b) The board may:
(1) refuse to issue a license; or
(2) issue a probationary license;
to an applicant for licensure if the applicant practiced without alicense in violation of the law.
(c) Whenever the board issues a probationary license, the boardmay impose one (1) or more of the following conditions:
(1) Report regularly to the board upon the matters that are thebasis of the discipline of the other state or jurisdiction.
(2) Limit practice to those areas prescribed by the board.
(3) Continue or renew professional education.
(4) Engage in community restitution or service withoutcompensation for a number of hours specified by the board.
(5) Perform or refrain from performing an act that the boardconsiders appropriate to the public interest or to therehabilitation or treatment of the applicant.
(d) The board shall remove any limitations placed on aprobationary license under this section if the board finds after ahearing that the deficiency that required disciplinary action has beenremedied.
As added by P.L.33-1993, SEC.15. Amended by P.L.32-2000,SEC.11; P.L.197-2007, SEC.23.
IC 25-1-9-17
Applicant appearance before board
Sec. 17. The board may require an applicant for licensure toappear before the board before issuing a license.
As added by P.L.33-1993, SEC.16. Amended by P.L.84-2010,SEC.17.
IC 25-1-9-18
Fitness determination of health care provider; filing complaint
Sec. 18. (a) If the insurance commissioner forwards to the boardthe name of a practitioner under IC 34-18-9-4(a) (or IC 27-12-9-4(a)before its repeal), the board shall consider whether:
(1) the practitioner has become unfit to practice under section4 of this chapter; and
(2) a complaint should be filed under IC 25-1-7-4.
(b) If the board determines that a complaint should be filed undersubsection (a), the board must report to the consumer protectiondivision whether the board will schedule the matter:
(1) for informal negotiation under IC 25-1-7-6;
(2) on the board's agenda for a vote requesting that the attorneygeneral prosecute the matter before the board underIC 25-1-7-7; or
(3) on the board's agenda for a vote on summary suspension ofthe practitioner's license pending prosecution of the matterbefore the board under IC 25-1-7-7.
(c) A board may designate a board member or staff member to acton behalf of the board under this section.As added by P.L.43-1995, SEC.4. Amended by P.L.1-1998, SEC.131.
IC 25-1-9-19
Third party billing notice
Sec. 19. A practitioner that provides to a patient notice concerninga third party billing for a health care service provided to the patientshall ensure that the notice:
(1) conspicuously states that the notice is not a bill;
(2) does not include a tear-off portion; and
(3) is not accompanied by a return mailing envelope.
As added by P.L.178-2003, SEC.12.
IC 25-1-9-20
Authority to adopt rules
Sec. 20. The board may adopt rules under IC 4-22-2, includingemergency rules under IC 4-22-2-37.1, to establish procedures toexpedite the issuance or renewal of a:
(1) license;
(2) certificate;
(3) registration; or
(4) permit;
of a person whose spouse serves on active duty (as defined inIC 25-1-12-2) and is assigned to a duty station in Indiana.
As added by P.L.144-2007, SEC.25.
IC 25-1-9-21
Rules; management and disposition of health records
Sec. 21. The board may adopt rules under IC 4-22-2 to establishrequirements for the management and disposition of health records(as defined in IC 16-18-2-168) on the discontinuation of practice by:
(1) sale;
(2) transfer;
(3) closure;
(4) disciplinary action;
(5) retirement; or
(6) death;
of the practitioner.
As added by P.L.177-2009, SEC.16.