Indiana 2025 Regular Session

Indiana House Bill HB1040 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. 1040
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 25-22.5; IC 25-23-1-30; IC 34-30-2.1-374.5.
7	7	Synopsis: Certified registered nurse anesthetists. Allows a certified
8	8	registered nurse anesthetist (CRNA) to administer anesthesia under the
9	9	direction of and in the immediate presence of a physician, podiatrist,
10	10	or dentist. (Under current law, a CRNA may administer anesthesia
11	11	under the direction of and in the immediate presence of a physician.)
12	12	Provides that a physician, podiatrist, or dentist is not liable for any act
13	13	or omission of a CRNA who administers anesthesia. Makes
14	14	corresponding changes.
15	15	Effective: July 1, 2025.
16	16	King
17	17	January 8, 2025, read first time and referred to Committee on Public Health.
18	18	2025 IN 1040—LS 6303/DI 153 Introduced
19	19	First Regular Session of the 124th General Assembly (2025)
20	20	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
21	21	Constitution) is being amended, the text of the existing provision will appear in this style type,
22	22	additions will appear in this style type, and deletions will appear in this style type.
23	23	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
24	24	provision adopted), the text of the new provision will appear in this style type. Also, the
25	25	word NEW will appear in that style type in the introductory clause of each SECTION that adds
26	26	a new provision to the Indiana Code or the Indiana Constitution.
27	27	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
28	28	between statutes enacted by the 2024 Regular Session of the General Assembly.
29	29	HOUSE BILL No. 1040
30	30	A BILL FOR AN ACT to amend the Indiana Code concerning
31	31	professions and occupations.
32	32	Be it enacted by the General Assembly of the State of Indiana:
33	33	1 SECTION 1. IC 25-22.5-1-2, AS AMENDED BY P.L.128-2022,
34	34	2 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
35	35	3 JULY 1, 2025]: Sec. 2. (a) This article, as it relates to the unlawful or
36	36	4 unauthorized practice of medicine or osteopathic medicine, does not
37	37	5 apply to any of the following:
38	38	6 (1) A student in training in a medical school approved by the
39	39	7 board, or while performing duties as an intern or a resident in a
40	40	8 hospital under the supervision of the hospital's staff or in a
41	41	9 program approved by the medical school.
42	42	10 (2) A person who renders service in case of emergency where no
43	43	11 fee or other consideration is contemplated, charged, or received.
44	44	12 (3) A paramedic (as defined in IC 16-18-2-266), an advanced
45	45	13 emergency medical technician (as defined in IC 16-18-2-6.5), an
46	46	14 emergency medical technician (as defined in IC 16-18-2-112), or
47	47	15 a person with equivalent certification from another state who
48	48	16 renders advanced life support (as defined in IC 16-18-2-7), or
49	49	17 basic life support (as defined in IC 16-18-2-33.5):
50	50	2025 IN 1040—LS 6303/DI 153 2
51	51	1 (A) during a disaster emergency declared by the governor
52	52	2 under IC 10-14-3-12 in response to an act that the governor in
53	53	3 good faith believes to be an act of terrorism (as defined in
54	54	4 IC 35-31.5-2-329); and
55	55	5 (B) in accordance with the rules adopted by the Indiana
56	56	6 emergency medical services commission or the disaster
57	57	7 emergency declaration of the governor.
58	58	8 (4) Commissioned medical officers or medical service officers of
59	59	9 the armed forces of the United States, the United States Public
60	60	10 Health Service, and medical officers of the United States
61	61	11 Department of Veterans Affairs in the discharge of their official
62	62	12 duties in Indiana.
63	63	13 (5) An individual who is not a licensee who resides in another
64	64	14 state or country and is authorized to practice medicine or
65	65	15 osteopathic medicine there, who is called in for consultation by an
66	66	16 individual licensed to practice medicine or osteopathic medicine
67	67	17 in Indiana.
68	68	18 (6) A person administering a domestic or family remedy to a
69	69	19 member of the person's family.
70	70	20 (7) A member of a church practicing the religious tenets of the
71	71	21 church if the member does not make a medical diagnosis,
72	72	22 prescribe or administer drugs or medicines, perform surgical or
73	73	23 physical operations, or assume the title of or profess to be a
74	74	24 physician.
75	75	25 (8) A school corporation and a school employee who acts under
76	76	26 IC 34-30-14 (or IC 34-4-16.5-3.5 before its repeal).
77	77	27 (9) A chiropractor practicing the chiropractor's profession under
78	78	28 IC 25-10 or to an employee of a chiropractor acting under the
79	79	29 direction and supervision of the chiropractor under IC 25-10-1-13.
80	80	30 (10) A dental hygienist practicing the dental hygienist's profession
81	81	31 under IC 25-13.
82	82	32 (11) A dentist practicing the dentist's profession under IC 25-14.
83	83	33 (12) A hearing aid dealer practicing the hearing aid dealer's
84	84	34 profession under IC 25-20.
85	85	35 (13) A nurse practicing the nurse's profession under IC 25-23.
86	86	36 However, a certified registered nurse anesthetist (as defined in
87	87	37 IC 25-23-1-1.4) may administer anesthesia if the certified
88	88	38 registered nurse anesthetist acts under the direction of and in the
89	89	39 immediate presence of a physician, podiatrist, or dentist.
90	90	40 (14) An optometrist practicing the optometrist's profession under
91	91	41 IC 25-24.
92	92	42 (15) A pharmacist practicing the pharmacist's profession under
93	93	2025 IN 1040—LS 6303/DI 153 3
94	94	1 IC 25-26.
95	95	2 (16) A physical therapist practicing the physical therapist's
96	96	3 profession under IC 25-27.
97	97	4 (17) A podiatrist practicing the podiatrist's profession under
98	98	5 IC 25-29.
99	99	6 (18) A psychologist practicing the psychologist's profession under
100	100	7 IC 25-33.
101	101	8 (19) A speech-language pathologist or audiologist practicing the
102	102	9 pathologist's or audiologist's profession under IC 25-35.6.
103	103	10 (20) An employee of a physician or group of physicians who
104	104	11 performs an act, a duty, or a function that is customarily within
105	105	12 the specific area of practice of the employing physician or group
106	106	13 of physicians, if the act, duty, or function is performed under the
107	107	14 direction and supervision of the employing physician or a
108	108	15 physician of the employing group within whose area of practice
109	109	16 the act, duty, or function falls. An employee may not make a
110	110	17 diagnosis or prescribe a treatment and must report the results of
111	111	18 an examination of a patient conducted by the employee to the
112	112	19 employing physician or the physician of the employing group
113	113	20 under whose supervision the employee is working. An employee
114	114	21 may not administer medication without the specific order of the
115	115	22 employing physician or a physician of the employing group.
116	116	23 Unless an employee is licensed or registered to independently
117	117	24 practice in a profession described in subdivisions (9) through
118	118	25 (18), nothing in this subsection grants the employee independent
119	119	26 practitioner status or the authority to perform patient services in
120	120	27 an independent practice in a profession.
121	121	28 (21) A hospital licensed under IC 16-21 or IC 12-25.
122	122	29 (22) A health care organization whose members, shareholders, or
123	123	30 partners are individuals, partnerships, corporations, facilities, or
124	124	31 institutions licensed or legally authorized by this state to provide
125	125	32 health care or professional services as:
126	126	33 (A) a physician;
127	127	34 (B) a psychiatric hospital;
128	128	35 (C) a hospital;
129	129	36 (D) a health maintenance organization or limited service
130	130	37 health maintenance organization;
131	131	38 (E) a health facility;
132	132	39 (F) a dentist;
133	133	40 (G) a registered or licensed practical nurse;
134	134	41 (H) a certified nurse midwife or a certified direct entry
135	135	42 midwife;
136	136	2025 IN 1040—LS 6303/DI 153 4
137	137	1 (I) an optometrist;
138	138	2 (J) a podiatrist;
139	139	3 (K) a chiropractor;
140	140	4 (L) a physical therapist; or
141	141	5 (M) a psychologist.
142	142	6 (23) A physician assistant practicing the physician assistant
143	143	7 profession under IC 25-27.5.
144	144	8 (24) A physician providing medical treatment under section 2.1
145	145	9 of this chapter.
146	146	10 (25) An attendant who provides attendant care services (as
147	147	11 defined in IC 16-18-2-28.5).
148	148	12 (26) A personal services attendant providing authorized attendant
149	149	13 care services under IC 12-10-17.1.
150	150	14 (27) A respiratory care practitioner practicing the practitioner's
151	151	15 profession under IC 25-34.5.
152	152	16 (b) A person described in subsection (a)(9) through (a)(18) is not
153	153	17 excluded from the application of this article if:
154	154	18 (1) the person performs an act that an Indiana statute does not
155	155	19 authorize the person to perform; and
156	156	20 (2) the act qualifies in whole or in part as the practice of medicine
157	157	21 or osteopathic medicine.
158	158	22 (c) An employment or other contractual relationship between an
159	159	23 entity described in subsection (a)(21) through (a)(22) and a licensed
160	160	24 physician does not constitute the unlawful practice of medicine or
161	161	25 osteopathic medicine under this article if the entity does not direct or
162	162	26 control independent medical acts, decisions, or judgment of the
163	163	27 licensed physician. However, if the direction or control is done by the
164	164	28 entity under IC 34-30-15 (or IC 34-4-12.6 before its repeal), the entity
165	165	29 is excluded from the application of this article as it relates to the
166	166	30 unlawful practice of medicine or osteopathic medicine.
167	167	31 (d) This subsection does not apply to a prescription or drug order for
168	168	32 a legend drug that is filled or refilled in a pharmacy owned or operated
169	169	33 by a hospital licensed under IC 16-21. A physician licensed in Indiana
170	170	34 who permits or authorizes a person to fill or refill a prescription or drug
171	171	35 order for a legend drug except as authorized in IC 16-42-19-11 through
172	172	36 IC 16-42-19-19 is subject to disciplinary action under IC 25-1-9. A
173	173	37 person who violates this subsection commits the unlawful practice of
174	174	38 medicine or osteopathic medicine under this chapter.
175	175	39 (e) A person described in subsection (a)(8) shall not be authorized
176	176	40 to dispense contraceptives or birth control devices.
177	177	41 (f) Nothing in this section allows a person to use words or
178	178	42 abbreviations that indicate or induce an individual to believe that the
179	179	2025 IN 1040—LS 6303/DI 153 5
180	180	1 person is engaged in the practice of medicine or osteopathic medicine.
181	181	2 SECTION 2. IC 25-22.5-2-9, AS ADDED BY P.L.106-2023,
182	182	3 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
183	183	4 JULY 1, 2025]: Sec. 9. (a) Any rule adopted under section 7(a)(10) of
184	184	5 this chapter that requires an office based setting to be accredited by an
185	185	6 accreditation agency approved by the board shall not apply to an
186	186	7 individual described in subsection (b) providing anesthesia in a dental
187	187	8 office.
188	188	9 (b) The following may administer moderate sedation, deep sedation,
189	189	10 or general anesthesia to a patient in a dental office if the standards
190	190	11 described in subsection (c) are met:
191	191	12 (1) An anesthesiologist licensed under this article.
192	192	13 (2) A certified registered nurse anesthetist (as defined in
193	193	14 IC 25-23-1-1.4) under the direction of and in the immediate
194	194	15 presence of a physician, podiatrist, or dentist.
195	195	16 (3) An anesthesiologist assistant practicing in compliance with
196	196	17 IC 25-3.7-2-4.
197	197	18 (c) An anesthesiologist administering anesthesia or a physician,
198	198	19 podiatrist, or dentist directing or supervising the administration of
199	199	20 anesthesia, as required by subsection (b)(2) and or (b)(3), in a dental
200	200	21 office shall do the following:
201	201	22 (1) Ensure that the standards required by rules adopted under
202	202	23 section 7(a)(10) of this chapter concerning:
203	203	24 (A) procedures performed in office based settings;
204	204	25 (B) the operation of office based settings; and
205	205	26 (C) requirements for practitioners administering anesthesia in
206	206	27 office based settings;
207	207	28 are met.
208	208	29 (2) Once every two (2) years, submit the following to the board in
209	209	30 writing:
210	210	31 (A) The address of the dental office.
211	211	32 (B) An attestation that the standards required under this
212	212	33 section have been met.
213	213	34 (d) A physician group practice, on behalf of the physicians in the
214	214	35 group practice, may submit the attestation required by subsection
215	215	36 (c)(2).
216	216	37 SECTION 3. IC 25-23-1-30, AS AMENDED BY P.L.177-2009,
217	217	38 SECTION 44, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
218	218	39 JULY 1, 2025]: Sec. 30. (a) A certified registered nurse anesthetist may
219	219	40 administer anesthesia if the certified registered nurse anesthetist acts
220	220	41 under the direction of and in the immediate presence of a physician,
221	221	42 podiatrist, or dentist.
222	222	2025 IN 1040—LS 6303/DI 153 6
223	223	1 (b) Nothing in this chapter shall be construed as requiring a certified
224	224	2 registered nurse anesthetist to obtain prescriptive authority to
225	225	3 administer anesthesia under subsection (a).
226	226	4 (c) A physician, podiatrist, or dentist is not liable for any act or
227	227	5 omission of a certified registered nurse anesthetist who administers
228	228	6 anesthesia under this section.
229	229	7 SECTION 4. IC 34-30-2.1-374.5 IS ADDED TO THE INDIANA
230	230	8 CODE AS A NEW SECTION TO READ AS FOLLOWS
231	231	9 [EFFECTIVE JULY 1, 2025]: Sec. 374.5. IC 25-23-1-30 (Concerning
232	232	10 a physician, podiatrist, or dentist for actions of a certified
233	233	11 registered nurse anesthetist who administers anesthesia).
234	234	2025 IN 1040—LS 6303/DI 153