Indiana 2022 Regular Session

Indiana House Bill HB1346 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2	Introduced Version
3	3	HOUSE BILL No. 1346
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 16-42-27-1; IC 25-1; IC 25-27.5.
7	7	Synopsis: Physician assistants. Amends current requirements for a
8	8	collaborative agreement between a physician and a physician assistant
9	9	with the following: (1) the collaborative agreement must include
10	10	limitations; (2) the collaborative agreement must set forth the method
11	11	of collaboration between the physician and physician assistant; and (3)
12	12	the collaborative agreement must be signed, updated annually, and
13	13	made available to the medical licensing board of Indiana upon request.
14	14	Provides that a written collaborative agreement between a physician
15	15	assistant, who is employed by a certain health care facility or center,
16	16	and a particular collaborating physician is not required. Requires a
17	17	physician assistant employed by a certain health care facility or center
18	18	to enter into a practice agreement with the health care facility or center
19	19	that employs the physician assistant. Eliminates: (1) a prohibition
20	20	against a physician collaborating with more than four physician
21	21	assistants at the same time; (2) a requirement that a physician submit
22	22	a collaborative agreement to the medical licensing board; and (3) a
23	23	requirement that a collaborating physician and physician assistant
24	24	submit a list of locations the physician and physician assistant will
25	25	practice to the medical licensing board.
26	26	Effective: July 1, 2022.
27	27	Vermilion
28	28	January 11, 2022, read first time and referred to Committee on Public Health.
29	29	2022 IN 1346—LS 6881/DI 147 Introduced
30	30	Second Regular Session of the 122nd General Assembly (2022)
31	31	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
32	32	Constitution) is being amended, the text of the existing provision will appear in this style type,
33	33	additions will appear in this style type, and deletions will appear in this style type.
34	34	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
35	35	provision adopted), the text of the new provision will appear in this style type. Also, the
36	36	word NEW will appear in that style type in the introductory clause of each SECTION that adds
37	37	a new provision to the Indiana Code or the Indiana Constitution.
38	38	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
39	39	between statutes enacted by the 2021 Regular Session of the General Assembly.
40	40	HOUSE BILL No. 1346
41	41	A BILL FOR AN ACT to amend the Indiana Code concerning
42	42	professions and occupations.
43	43	Be it enacted by the General Assembly of the State of Indiana:
44	44	1 SECTION 1. IC 16-42-27-1, AS AMENDED BY P.L.247-2019,
45	45	2 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
46	46	3 JULY 1, 2022]: Sec. 1. As used in this chapter, "prescriber" means any
47	47	4 of the following:
48	48	5 (1) A physician licensed under IC 25-22.5.
49	49	6 (2) A physician assistant licensed under IC 25-27.5. and granted
50	50	7 the authority to prescribe by the physician assistant's collaborating
51	51	8 physician and in accordance with IC 25-27.5-5-4.
52	52	9 (3) An advanced practice registered nurse licensed and granted
53	53	10 the authority to prescribe drugs under IC 25-23.
54	54	11 (4) The state health commissioner, if the state health
55	55	12 commissioner holds an active license under IC 25-22.5.
56	56	13 (5) A public health authority.
57	57	14 SECTION 2. IC 25-1-9.3-5, AS ADDED BY P.L.28-2019,
58	58	15 SECTION 9, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
59	59	16 JULY 1, 2022]: Sec. 5. As used in this chapter, "prescriber" means any
60	60	17 of the following:
61	61	2022 IN 1346—LS 6881/DI 147 2
62	62	1 (1) A dentist licensed under IC 25-14.
63	63	2 (2) A physician licensed under IC 25-22.5.
64	64	3 (3) An advanced practice registered nurse licensed and granted
65	65	4 the authority to prescribe under IC 25-23.
66	66	5 (4) An optometrist licensed under IC 25-24.
67	67	6 (5) A physician assistant licensed under IC 25-27.5. and granted
68	68	7 the authority to prescribe by the physician assistant's supervisory
69	69	8 physician in accordance with IC 25-27.5-5-4.
70	70	9 (6) A podiatrist licensed under IC 25-29.
71	71	10 SECTION 3. IC 25-1-9.5-4, AS AMENDED BY P.L.85-2021,
72	72	11 SECTION 14, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
73	73	12 JULY 1, 2022]: Sec. 4. As used in this chapter, "prescriber" means any
74	74	13 of the following:
75	75	14 (1) A physician licensed under IC 25-22.5.
76	76	15 (2) A physician assistant licensed under IC 25-27.5. and granted
77	77	16 the authority to prescribe by the physician assistant's collaborating
78	78	17 physician in accordance with IC 25-27.5-5-4.
79	79	18 (3) An advanced practice registered nurse licensed and granted
80	80	19 the authority to prescribe drugs under IC 25-23.
81	81	20 (4) An optometrist licensed under IC 25-24.
82	82	21 (5) A podiatrist licensed under IC 25-29.
83	83	22 (6) A dentist licensed under IC 25-14.
84	84	23 (7) A veterinarian licensed under IC 25-38.1.
85	85	24 SECTION 4. IC 25-27.5-5-2, AS AMENDED BY P.L.247-2019,
86	86	25 SECTION 13, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
87	87	26 JULY 1, 2022]: Sec. 2. (a) Except as provided in section 2.1 of this
88	88	27 chapter, a physician assistant:
89	89	28 (1) must engage in a dependent practice with a collaborating
90	90	29 physician; and
91	91	30 (2) may not be independent from the collaborating physician,
92	92	31 including any of even in conducting the activities of other health
93	93	32 care providers set forth under in IC 25-22.5-1-2(a)(1) through
94	94	33 IC 25-22.5-1-2(a)(19).
95	95	34 A physician assistant may perform, under a collaborative agreement,
96	96	35 the duties and responsibilities that are delegated by the collaborating
97	97	36 physician and that are within the collaborating physician's scope of
98	98	37 practice, including prescribing and dispensing drugs and medical
99	99	38 devices. A patient may elect to be seen, examined, and treated by the
100	100	39 collaborating physician.
101	101	40 (b) If a physician assistant determines that a patient needs to be
102	102	41 examined by a physician, the physician assistant shall immediately
103	103	42 notify the collaborating physician or physician designee.
104	104	2022 IN 1346—LS 6881/DI 147 3
105	105	1 (c) If a physician assistant notifies the collaborating physician
106	106	2 under subsection (b) that the physician should examine a patient, a
107	107	3 patient needs to be examined by the collaborating physician, the
108	108	4 collaborating physician shall:
109	109	5 (1) schedule an examination of the patient, unless the patient
110	110	6 declines; or
111	111	7 (2) arrange for another physician to examine the patient.
112	112	8 (d) A collaborating physician or physician assistant who does not
113	113	9 comply with subsections subsection (b) and or a collaborating
114	114	10 physician who does not comply with subsection (c) is subject to
115	115	11 discipline under IC 25-1-9.
116	116	12 (e) A physician assistant's collaborative agreement with between a
117	117	13 collaborating physician and a physician assistant must:
118	118	14 (1) be in writing;
119	119	15 (2) include all the tasks delegated to the physician assistant by the
120	120	16 collaborating physician; any limitations;
121	121	17 (3) set forth the collaborative agreement for the physician
122	122	18 assistant, including the emergency procedures that the physician
123	123	19 assistant must follow; method by which the physician assistant
124	124	20 and the health care medical team of which the physician
125	125	21 assistant is a member may collaborate with the collaborating
126	126	22 physician to deliver patient care; and
127	127	23 (4) specify the protocol the physician assistant shall follow in
128	128	24 prescribing a drug.
129	129	25 (4) be signed by the collaborating physician and the physician
130	130	26 assistant;
131	131	27 (5) be updated annually; and
132	132	28 (6) be made available to the board upon request.
133	133	29 (f) The physician shall submit the collaborative agreement to the
134	134	30 board. The physician assistant may prescribe a drug under the
135	135	31 collaborative agreement unless the board denies the collaborative
136	136	32 agreement. Any amendment to the collaborative agreement must be
137	137	33 resubmitted to the board, and the physician assistant may operate under
138	138	34 any new prescriptive authority under the amended collaborative
139	139	35 agreement unless the agreement has been denied by the board.
140	140	36 (g) A physician or a physician assistant who violates the
141	141	37 collaborative agreement described in this section may be disciplined
142	142	38 under IC 25-1-9.
143	143	39 SECTION 5. IC 25-27.5-5-2.1 IS ADDED TO THE INDIANA
144	144	40 CODE AS A NEW SECTION TO READ AS FOLLOWS
145	145	41 [EFFECTIVE JULY 1, 2022]: Sec. 2.1. (a) This section applies to a
146	146	42 physician assistant who is employed by a:
147	147	2022 IN 1346—LS 6881/DI 147 4
148	148	1 (1) health care facility or an affiliate of a health care facility;
149	149	2 (2) physician-owned or private medical facility or practice; or
150	150	3 (3) federally qualified health center or rural health care clinic
151	151	4 (both as defined in 42 U.S.C. 1396(d)(l)).
152	152	5 (b) The following apply to a physician assistant described in
153	153	6 subsection (a):
154	154	7 (1) A written collaborative agreement between the physician
155	155	8 assistant and a particular collaborating physician is not
156	156	9 required.
157	157	10 (2) The physician assistant shall enter into a practice
158	158	11 agreement with the entity described in subsection (a)(1),
159	159	12 (a)(2), or (a)(3) that employs the physician assistant.
160	160	13 (3) The practice agreement described in subdivision (2) must
161	161	14 set forth the manner in which the physician assistant is
162	162	15 required to cooperate, coordinate, and consult with the other
163	163	16 health care workers in providing health care to patients of the
164	164	17 entity.
165	165	18 SECTION 6. IC 25-27.5-6-2 IS REPEALED [EFFECTIVE JULY
166	166	19 1, 2022]. Sec. 2. A physician may enter into a collaborative agreement
167	167	20 with more than four (4) physician assistants but may not collaborate
168	168	21 with more than four (4) physician assistants at the same time.
169	169	22 SECTION 7. IC 25-27.5-6-4, AS AMENDED BY P.L.247-2019,
170	170	23 SECTION 19, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
171	171	24 JULY 1, 2022]: Sec. 4. (a) A physician collaborating with a physician
172	172	25 assistant must do the following: under IC 25-27.5-5-2 must:
173	173	26 (1) be licensed under IC 25-22.5;
174	174	27 (2) Register with the board the physician's intent to enter into a
175	175	28 collaborative agreement with a physician assistant.
176	176	29 (3) (2) not have a disciplinary action restriction that limits the
177	177	30 physician's ability to collaborate with a physician assistant; and
178	178	31 (4) (3) maintain a written collaborative agreement with the
179	179	32 physician assistant that states the physician will: as specified in
180	180	33 IC 25-27.5-5-2.
181	181	34 (A) work in collaboration with the physician assistant in
182	182	35 accordance with any rules adopted by the board; and
183	183	36 (B) retain responsibility for the care rendered by the physician
184	184	37 assistant.
185	185	38 The collaborative agreement must be signed by the physician and
186	186	39 physician assistant, updated annually, and made available to the
187	187	40 board upon request.
188	188	41 (5) Submit to the board a list of locations that the collaborating
189	189	42 physician and the physician assistant may practice. The board
190	190	2022 IN 1346—LS 6881/DI 147 5
191	191	1 may request additional information concerning the practice
192	192	2 locations to assist the board with considering the written
193	193	3 agreement described in subdivision (4).
194	194	4 (b) Except as provided in this section, this chapter may not be
195	195	5 construed to limit the employment arrangement of a physician
196	196	6 assistant with a collaborating physician under this chapter.
197	197	7 SECTION 8. IC 25-27.5-6-5 IS REPEALED [EFFECTIVE JULY
198	198	8 1, 2022]. Sec. 5. (a) Before initiating practice the collaborating
199	199	9 physician and the physician assistant must submit, on forms approved
200	200	10 by the board, the following information:
201	201	11 (1) The name, the business address, and the telephone number of
202	202	12 the collaborating physician.
203	203	13 (2) The name, the business address, and the telephone number of
204	204	14 the physician assistant.
205	205	15 (3) A brief description of the setting in which the physician
206	206	16 assistant will practice.
207	207	17 (4) Any other information required by the board.
208	208	18 (b) A physician assistant must notify the committee of any changes
209	209	19 or additions in practice sites or collaborating physicians not more than
210	210	20 thirty (30) days after the change or addition.
211	211	2022 IN 1346—LS 6881/DI 147