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 the
following:
(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 (IC
25-19-1).
(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 (IC
25-35.6-2).
(10) State psychology board (IC 25-33).
(11) Indiana board of veterinary medical examiners (IC
25-38.1-2).
(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 (IC
25-23.6).
(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 individual
who 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, including
a 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 the
sexual desires of either the individual performing the fondling
or 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 practice
in accordance with the standards established by the board regulating
the profession in question and is subject to the exercise of the
disciplinary sanctions under section 9 of this chapter if, after a
hearing, the board finds:
(1) a practitioner has:
(A) engaged in or knowingly cooperated in fraud or material
deception in order to obtain a license to practice, including
cheating on a licensing examination;
(B) engaged in fraud or material deception in the course of
professional services or activities;
(C) advertised services in a false or misleading manner; or
(D) been convicted of a crime or assessed a civil penalty
involving 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 under
IC 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 to
continue to practice competently; or
(B) is harmful to the public;
(3) a practitioner has knowingly violated any state statute or
rule, or federal statute or regulation, regulating the profession
in question;
(4) a practitioner has continued to practice although the
practitioner has become unfit to practice due to:
(A) professional incompetence that:
(i) may include the undertaking of professional activities
that the practitioner is not qualified by training or
experience to undertake; and
(ii) does not include activities performed under
IC 16-21-2-9;
(B) failure to keep abreast of current professional theory or
practice;
(C) physical or mental disability; or
(D) addiction to, abuse of, or severe dependency upon
alcohol or other drugs that endanger the public by impairing
a practitioner's ability to practice safely;
(5) a practitioner has engaged in a course of lewd or immoral
conduct in connection with the delivery of services to the
public;
(6) a practitioner has allowed the practitioner's name or a
license issued under this chapter to be used in connection with
an individual who renders services beyond the scope of that
individual's training, experience, or competence;
(7) a practitioner has had disciplinary action taken against the
practitioner or the practitioner's license to practice in any state
or 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 (as
defined in IC 16-42-19-3) for another person;
(9) a practitioner, except as otherwise provided by law, has
knowingly prescribed, sold, or administered any drug classified
as a narcotic, addicting, or dangerous drug to a habitue or
addict;
(10) a practitioner has failed to comply with an order imposing
a sanction under section 9 of this chapter;
(11) a practitioner has engaged in sexual contact with a patient
under the practitioner's care or has used the practitioner-patient
relationship to solicit sexual contact with a patient under the
practitioner's care;
(12) a practitioner who is a participating provider of a health
maintenance organization has knowingly collected or attempted
to collect from a subscriber or enrollee of the health
maintenance organization any sums that are owed by the health
maintenance organization; or
(13) a practitioner has assisted another person in committing an
act that would be grounds for disciplinary sanctions under this
chapter.
(b) A practitioner who provides health care services to the
practitioner's spouse is not subject to disciplinary action under
subsection (a)(11).
(c) A certified copy of the record of disciplinary action is
conclusive evidence of the other jurisdiction's disciplinary action
under 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 practitioner
licensed to practice optometry is subject to the exercise of
disciplinary sanctions under section 9 of this chapter if, after a
hearing, the board finds a practitioner has accepted employment to
practice 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 this
article 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 practitioner
licensed to practice veterinary medicine or registered as a veterinary
technician is subject to the exercise of the disciplinary sanctions
under section 9 of this chapter if, after a hearing, the board finds a
practitioner 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 practitioner
licensed to practice chiropractic is subject to the exercise of the
disciplinary sanctions under section 9 of this chapter if, after a
hearing, the board regulating the profession finds a practitioner has:
(1) waived a payment of a deductible or a copayment required
to be made to the practitioner by a patient under the patient's
insurance 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 a
copayment by a practitioner if:
(1) the practitioner determines chiropractic service is necessary
for the immediate health and welfare of a patient;
(2) the practitioner determines the payment of a deductible or
a copayment would create a substantial financial hardship for
the patient; and
(3) the waiver is based on the evaluation of the individual
patient 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 this
chapter that subject a practitioner to the exercise of disciplinary
sanctions, a practitioner who is licensed under IC 25-23.6 is subject
to the exercise of disciplinary sanctions under section 9 of this
chapter if, after a hearing, the board regulating the profession finds
that the practitioner has:
(1) performed any therapy that, by the prevailing standards of
the mental health professions in the community where the
services were provided, would constitute experimentation on
human subjects, without first obtaining full, informed, and
written consent;
(2) failed to meet the minimum standards of performance in
professional activities when measured against generally
prevailing peer performance in professional activities, including
the undertaking of activities that the practitioner is not qualified
by training or experience to undertake;
(3) performed services, including any duties required of the
individual under IC 31, in reckless disregard of the best
interests of a patient, a client, or the public;
(4) without the consent of the child's parent, guardian, or
custodian, knowingly participated in the child's removal or
precipitated others to remove a child from the child's home
unless:
(A) the child's physical health was endangered due to injury
as 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 of
an 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 result
of the inability, refusal, or neglect of the child's parent,
guardian, or custodian to supply the child with necessary
food, shelter, or medical care, and a court order was first
obtained;
(5) willfully made or filed a false report or record, failed to file
a report or record required by law, willfully impeded or
obstructed the filing of a report or record, or induced another
individual 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 judicial
proceeding that had insufficient factual basis for the
conclusions rendered by the practitioner;
(8) willfully planted in the mind of the patient suggestions that
are not based in facts known to the practitioner; or
(9) performed services outside of the scope of practice of the
license 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 under
IC 25-22.5; or
(2) an advanced practice nurse granted prescriptive authority
under IC 25-23, and whose practice agreement with a
collaborating physician reflects the conditions specified in
subsection (b).
(b) Before prescribing a stimulant medication for a child for the
treatment of attention deficit disorder or attention deficit
hyperactivity disorder, a practitioner described in subsection (a) shall
follow the most recent guidelines adopted by the American Academy
of Pediatrics or the American Academy of Child and Adolescent
Psychiatry for the diagnosis and evaluation of a child with attention
deficit 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 this
chapter that subject a practitioner to disciplinary sanctions, a
practitioner is subject to the exercise of disciplinary sanctions under
section 9 of this chapter if, after a hearing, the board finds that the
practitioner has:
(1) failed to provide information requested by the Indiana
professional licensing agency; or
(2) knowingly provided false information to the Indiana
professional 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 a
reasonable physical or mental examination, at the practitioner's own
expense, if the practitioner's physical or mental capacity to practice
safely 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 a
physical or mental examination makes a practitioner liable to
summary 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 to
disciplinary sanctions under section 4, 5, 6, 6.7, or 6.9 of this chapter
or 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 the
practitioner to:
(A) report regularly to the board upon the matters that are
the basis of probation;
(B) limit practice to those areas prescribed by the board;
(C) continue or renew professional education under a
preceptor, or as otherwise directed or approved by the board,
until a satisfactory degree of skill has been attained in those
areas that are the basis of the probation; or
(D) perform or refrain from performing any acts, including
community restitution or service without compensation, that
the board considers appropriate to the public interest or to
the rehabilitation or treatment of the practitioner.
(6) Assess a fine against the practitioner in an amount not to
exceed one thousand dollars ($1,000) for each violation listed
in section 4 of this chapter, except for a finding of
incompetency due to a physical or mental disability. When
imposing a fine, the board shall consider a practitioner's ability
to pay the amount assessed. If the practitioner fails to pay the
fine within the time specified by the board, the board may
suspend the practitioner's license without additional
proceedings. However, a suspension may not be imposed if the
sole basis for the suspension is the practitioner's inability to pay
a fine.
(b) The board may withdraw or modify the probation under
subsection (a)(5) if it finds, after a hearing, that the deficiency that
required disciplinary action has been remedied, or that changed
circumstances 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's
license for ninety (90) days before a final adjudication or during the
appeals process if the board finds that a practitioner represents a
clear and immediate danger to the public health and safety if the
practitioner is allowed to continue to practice. The summary
suspension may be renewed upon a hearing before the board, and
each renewal may be for ninety (90) days or less.
(b) Before the board may summarily suspend a license that has
been issued under IC 25-22.5, IC 25-38.1, or IC 25-14, the consumer
protection division of the attorney general's office shall make a
reasonable attempt to notify a practitioner of a hearing by the board
to suspend a practitioner's license and of information regarding the
allegation against the practitioner. The consumer protection division
of the attorney general's office shall also notify the practitioner that
the practitioner may provide a written or an oral statement to the
board on the practitioner's behalf before the board issues an order for
summary suspension. A reasonable attempt to reach the practitioner
is made if the consumer protection division of the attorney general's
office attempts to reach the practitioner by telephone or facsimile at
the last telephone number of the practitioner on file with the board.
(c) After a reasonable attempt is made to notify a practitioner
under subsection (b):
(1) a court may not stay or vacate a summary suspension of a
practitioner's license for the sole reason that the practitioner was
not notified; and
(2) the practitioner may not petition the board for a delay of the
summary 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 on
suspension
Sec. 10.1. The attorney general may retain the services of a
clinical consultant or an expert to provide the attorney general with
advice concerning the acts that are the subject of a suspension under
this 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 been
suspended under this chapter if, after a hearing, the board is satisfied
that the applicant is able to practice with reasonable skill and safety
to the public. As a condition of reinstatement, the board may impose
disciplinary 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 been
revoked under this chapter. An individual whose license has been
revoked under this chapter may not apply for a new license until
seven (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 the
application of the sanctions authorized in this section. Significant
departures from prior decisions involving similar conduct must be
explained 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 the
surrender of the practitioner's license instead of a hearing before the
board. The practitioner may not surrender the practitioner's license
without the written approval of the board, and the board may impose
any conditions appropriate to the surrender or reinstatement of a
surrendered 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 disciplinary
sanctions may be required by a board to pay for the costs of the
proceeding. The practitioner's ability to pay shall be considered when
costs are assessed. If the practitioner fails to pay the costs, a
suspension may not be imposed solely upon the practitioner's
inability to pay the amount assessed. These costs are limited to costs
for 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 issue
a probationary license to an applicant for licensure if:
(1) the applicant has been disciplined by a licensing entity of
any state or jurisdiction, or has committed an act that would
have subjected the applicant to the disciplinary process had the
applicant been licensed in Indiana when the act occurred; and
(2) the violation for which the applicant was, or could have
been, disciplined has a direct bearing on the applicant's ability
to 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 a
license in violation of the law.
(c) Whenever the board issues a probationary license, the board
may impose one (1) or more of the following conditions:
(1) Report regularly to the board upon the matters that are the
basis 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 without
compensation for a number of hours specified by the board.
(5) Perform or refrain from performing an act that the board
considers appropriate to the public interest or to the
rehabilitation or treatment of the applicant.
(d) The board shall remove any limitations placed on a
probationary license under this section if the board finds after a
hearing that the deficiency that required disciplinary action has been
remedied.
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 to
appear 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 board
the 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 section
4 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 under
subsection (a), the board must report to the consumer protection
division 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 attorney
general prosecute the matter before the board under
IC 25-1-7-7; or
(3) on the board's agenda for a vote on summary suspension of
the practitioner's license pending prosecution of the matter
before the board under IC 25-1-7-7.
(c) A board may designate a board member or staff member to act
on 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 concerning
a third party billing for a health care service provided to the patient
shall 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, including
emergency rules under IC 4-22-2-37.1, to establish procedures to
expedite 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 in
IC 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 establish
requirements 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.