Indiana 2025 Regular Session

Indiana House Bill HB1116 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. 1116
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 12-15-5-14; IC 16-41-6-1; IC 25-1-9-6.8;
7	7	IC 25-23-1; IC 34-30-2.1-374; IC 35-48-3-11.
8	8	Synopsis: Advanced practice registered nurses. Removes the
9	9	requirement that an advanced practice registered nurse (APRN) have
10	10	a practice agreement with a collaborating physician. Removes a
11	11	provision requiring an APRN to operate under a collaborative practice
12	12	agreement or the privileges granted by a hospital governing board.
13	13	Removes certain provisions concerning the audit of practice
14	14	agreements. Allows an APRN with prescriptive authority to prescribe
15	15	a schedule II controlled substance for weight reduction or to control
16	16	obesity. Makes conforming changes.
17	17	Effective: July 1, 2025.
18	18	Ledbetter, Olthoff, Cash
19	19	January 8, 2025, read first time and referred to Committee on Public Health.
20	20	2025 IN 1116—LS 6328/DI 148 Introduced
21	21	First Regular Session of the 124th General Assembly (2025)
22	22	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
23	23	Constitution) is being amended, the text of the existing provision will appear in this style type,
24	24	additions will appear in this style type, and deletions will appear in this style type.
25	25	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
26	26	provision adopted), the text of the new provision will appear in this style type. Also, the
27	27	word NEW will appear in that style type in the introductory clause of each SECTION that adds
28	28	a new provision to the Indiana Code or the Indiana Constitution.
29	29	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
30	30	between statutes enacted by the 2024 Regular Session of the General Assembly.
31	31	HOUSE BILL No. 1116
32	32	A BILL FOR AN ACT to amend the Indiana Code concerning
33	33	professions and occupations.
34	34	Be it enacted by the General Assembly of the State of Indiana:
35	35	1 SECTION 1. IC 12-15-5-14, AS AMENDED BY P.L.129-2018,
36	36	2 SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
37	37	3 JULY 1, 2025]: Sec. 14. (a) As used in this section, "advanced practice
38	38	4 registered nurse" means:
39	39	5 (1) a nurse practitioner; or
40	40	6 (2) a clinical nurse specialist;
41	41	7 who is a registered nurse licensed under IC 25-23 and qualified to
42	42	8 practice nursing in a specialty role based upon the additional
43	43	9 knowledge and skill gained through a formal organized program of
44	44	10 study and clinical experience, or the equivalent as determined by the
45	45	11 Indiana state board of nursing.
46	46	12 (b) As used in this section, "office" includes the following:
47	47	13 (1) The office of the secretary of family and social services.
48	48	14 (2) A managed care organization that has contracted with the
49	49	15 office of Medicaid policy and planning under this article.
50	50	16 (3) A person that has contracted with a managed care organization
51	51	17 described in subdivision (2).
52	52	2025 IN 1116—LS 6328/DI 148 2
53	53	1 (c) The office shall reimburse eligible Medicaid claims for the
54	54	2 following services provided by an advanced practice registered nurse
55	55	3 employed by a community mental health center if the services are part
56	56	4 of the advanced practice registered nurse's scope of practice:
57	57	5 (1) Mental health services.
58	58	6 (2) Behavioral health services.
59	59	7 (3) Substance abuse treatment.
60	60	8 (4) Primary care services.
61	61	9 (5) Evaluation and management services for inpatient or
62	62	10 outpatient psychiatric treatment.
63	63	11 (6) Prescription drugs.
64	64	12 (d) The office shall include an advanced practice registered nurse
65	65	13 as an eligible provider for the supervision of a plan of treatment for a
66	66	14 patient's outpatient mental health or substance abuse treatment
67	67	15 services, if the supervision is in the advanced practice registered
68	68	16 nurse's scope of practice, education, and training.
69	69	17 (e) This section
70	70	18 (1) may not be construed to expand an advanced practice
71	71	19 registered nurse's scope of practice. and
72	72	20 (2) is subject to IC 25-23-1-19.4(c) and applies only if the service
73	73	21 is included in the advanced practice registered nurse's practice
74	74	22 agreement with a collaborating physician.
75	75	23 SECTION 2. IC 16-41-6-1, AS AMENDED BY P.L.112-2020,
76	76	24 SECTION 19, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
77	77	25 JULY 1, 2025]: Sec. 1. (a) As used in this section, "physician's
78	78	26 authorized representative" means an individual acting under the
79	79	27 supervision of a licensed physician and within the individual's
80	80	28 scope of employment.
81	81	29 (1) an advanced practice registered nurse (as defined by
82	82	30 IC 25-23-1-1(b)) who is operating in collaboration with a licensed
83	83	31 physician; or
84	84	32 (2) an individual acting under the supervision of a licensed
85	85	33 physician and within the individual's scope of employment.
86	86	34 (b) A physician, an advanced practice registered nurse, or the
87	87	35 physician's authorized representative shall not order an HIV test on an
88	88	36 individual under the care of a physician unless the physician, the
89	89	37 advanced practice registered nurse, or the physician's authorized
90	90	38 representative does the following:
91	91	39 (1) Informs the patient of the test, orally or in writing.
92	92	40 (2) Provides the patient with an explanation of the test orally, in
93	93	41 writing, by video, or by a combination of these methods.
94	94	42 (3) Informs the patient of the patient's right to ask questions and
95	95	2025 IN 1116—LS 6328/DI 148 3
96	96	1 to refuse the test.
97	97	2 Subject to subsection (e), if the patient refuses the test, the physician,
98	98	3 the advanced practice registered nurse, or the physician's authorized
99	99	4 representative may not perform the test and shall document the patient's
100	100	5 refusal in the patient's medical record.
101	101	6 (c) Unless it is clearly not feasible, the information delivered to the
102	102	7 patient who is to be tested under subsection (b) must be provided in the
103	103	8 native language or other communication used by the patient. If the
104	104	9 patient is unable to read written materials, the materials must be
105	105	10 translated or read to the patient in a language the patient understands.
106	106	11 (d) After ordering an HIV test for a patient, the physician, the
107	107	12 advanced practice registered nurse, or the physician's authorized
108	108	13 representative shall notify the patient of the test results and the
109	109	14 availability of HIV and other bloodborne disease prevention
110	110	15 counseling. If a test conducted under this section indicates that a
111	111	16 patient is HIV positive, in addition to the requirements set forth in
112	112	17 IC 16-41-2, the physician, the advanced practice registered nurse,
113	113	18 or the physician's authorized representative shall inform the patient of
114	114	19 the availability of counseling and of the treatment and referral options
115	115	20 available to the patient.
116	116	21 (e) A physician, an advanced practice registered nurse, or a
117	117	22 physician's authorized representative may order an HIV test to be
118	118	23 performed without informing the patient or the patient's representative
119	119	24 (as defined in IC 16-36-1-2) of the test or regardless of the patient's or
120	120	25 the patient's representative's refusal of the HIV test if any of the
121	121	26 following conditions apply:
122	122	27 (1) If ordered by a physician or an advanced practice registered
123	123	28 nurse, consent can be implied due to emergency circumstances
124	124	29 and the test is medically necessary to diagnose or treat the
125	125	30 patient's emergent condition.
126	126	31 (2) Under a court order based on clear and convincing evidence
127	127	32 of a serious and present health threat to others posed by an
128	128	33 individual. A patient shall be notified of the patient's right to:
129	129	34 (A) a hearing; and
130	130	35 (B) counsel;
131	131	36 before a hearing is held under this subdivision. Any hearing
132	132	37 conducted under this subdivision shall be held in camera at the
133	133	38 request of the individual.
134	134	39 (3) If the test is done on blood collected or tested anonymously as
135	135	40 part of an epidemiologic survey under IC 16-41-2-3 or
136	136	41 IC 16-41-17-10(a)(5).
137	137	42 (4) The test is ordered under section 4 of this chapter.
138	138	2025 IN 1116—LS 6328/DI 148 4
139	139	1 (5) The test is required or authorized under IC 11-10-3-2.5.
140	140	2 (6) The individual upon whom the test will be performed is
141	141	3 described in IC 16-41-8-6 or IC 16-41-10-2.5.
142	142	4 (7) A court has ordered the individual to undergo testing for HIV
143	143	5 under IC 35-38-1-10.5(a) or IC 35-38-2-2.3(a)(17).
144	144	6 (f) The state department shall make HIV testing and treatment
145	145	7 information from the federal Centers for Disease Control and
146	146	8 Prevention available to health care providers.
147	147	9 (g) The state department may adopt rules under IC 4-22-2 necessary
148	148	10 to implement this section.
149	149	11 SECTION 3. IC 25-1-9-6.8, AS AMENDED BY P.L.129-2018,
150	150	12 SECTION 23, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
151	151	13 JULY 1, 2025]: Sec. 6.8. (a) This section applies to a practitioner who
152	152	14 is:
153	153	15 (1) licensed to practice medicine or osteopathic medicine under
154	154	16 IC 25-22.5; or
155	155	17 (2) an advanced practice registered nurse granted prescriptive
156	156	18 authority under IC 25-23. and whose practice agreement with a
157	157	19 collaborating physician reflects the conditions specified in
158	158	20 subsection (b).
159	159	21 (b) Before prescribing a stimulant medication for a child for the
160	160	22 treatment of attention deficit disorder or attention deficit hyperactivity
161	161	23 disorder, a practitioner described in subsection (a) shall follow the most
162	162	24 recent guidelines adopted by the American Academy of Pediatrics or
163	163	25 the American Academy of Child and Adolescent Psychiatry for the
164	164	26 diagnosis and evaluation of a child with attention deficit disorder or
165	165	27 attention deficit hyperactivity disorder.
166	166	28 SECTION 4. IC 25-23-1-1, AS AMENDED BY P.L.129-2018,
167	167	29 SECTION 28, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
168	168	30 JULY 1, 2025]: Sec. 1. As used in this chapter:
169	169	31 (a) "Board" means the Indiana state board of nursing.
170	170	32 (b) "Advanced practice registered nurse" means:
171	171	33 (1) a nurse practitioner;
172	172	34 (2) a certified nurse midwife;
173	173	35 (3) a clinical nurse specialist; or
174	174	36 (4) a certified registered nurse anesthetist;
175	175	37 who is a registered nurse qualified to practice nursing in a specialty
176	176	38 role based upon the additional knowledge and skill gained through a
177	177	39 formal organized program of study and clinical experience, or the
178	178	40 equivalent as determined by the board, which does not limit but
179	179	41 extends or expands the function of the nurse which may be initiated by
180	180	42 the client or provider. in settings that shall include hospital outpatient
181	181	2025 IN 1116—LS 6328/DI 148 5
182	182	1 clinics and health maintenance organizations. Notwithstanding any
183	183	2 other law, this subsection does not add to the powers and duties or
184	184	3 scope of practice of certified registered nurse anesthetists as described
185	185	4 in section 30 of this chapter.
186	186	5 (c) "Human response" means those signs, symptoms, behaviors, and
187	187	6 processes that denote the individual's interaction with the environment.
188	188	7 SECTION 5. IC 25-23-1-7, AS AMENDED BY P.L.69-2022,
189	189	8 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
190	190	9 JULY 1, 2025]: Sec. 7. (a) The board shall do the following:
191	191	10 (1) Adopt under IC 4-22-2 rules necessary to enable it to carry
192	192	11 into effect this chapter.
193	193	12 (2) Prescribe standards and approve curricula for nursing
194	194	13 education programs preparing persons for licensure under this
195	195	14 chapter.
196	196	15 (3) Provide for surveys of such programs at such times as it
197	197	16 considers necessary.
198	198	17 (4) Accredit such programs as meet the requirements of this
199	199	18 chapter and of the board.
200	200	19 (5) Deny or withdraw accreditation from nursing education
201	201	20 programs for failure to meet prescribed curricula or other
202	202	21 standards.
203	203	22 (6) Examine, license, and renew the license of qualified
204	204	23 applicants.
205	205	24 (7) Issue subpoenas, compel the attendance of witnesses, and
206	206	25 administer oaths to persons giving testimony at hearings.
207	207	26 (8) Cause the prosecution of all persons violating this chapter and
208	208	27 have power to incur necessary expenses for these prosecutions.
209	209	28 (9) Adopt rules under IC 4-22-2 that do the following:
210	210	29 (A) Prescribe standards for the competent practice of
211	211	30 registered, practical, and advanced practice registered nursing.
212	212	31 (B) Establish with the approval of the medical licensing board
213	213	32 created by IC 25-22.5-2-1 requirements that advanced practice
214	214	33 registered nurses must meet to be granted authority to
215	215	34 prescribe legend drugs and to retain that authority.
216	216	35 (C) Establish, with the approval of the medical licensing board
217	217	36 created by IC 25-22.5-2-1, requirements for the renewal of a
218	218	37 practice agreement under section 19.4 of this chapter, which
219	219	38 shall expire on October 31 in each odd-numbered year.
220	220	39 (10) Keep a record of all its proceedings.
221	221	40 (11) Collect and distribute annually demographic information on
222	222	41 the number and type of registered nurses and licensed practical
223	223	42 nurses employed in Indiana.
224	224	2025 IN 1116—LS 6328/DI 148 6
225	225	1 (12) Adopt rules and administer the interstate nurse licensure
226	226	2 compact under IC 25-42.
227	227	3 (13) Adopt or amend rules to implement the nursing licensure by
228	228	4 endorsement available for foreign nursing school graduates under
229	229	5 sections 11 and 12 of this chapter.
230	230	6 (14) Establish an audit procedure, which may include
231	231	7 requiring an advanced practice registered nurse to provide
232	232	8 the licensing agency with verification of:
233	233	9 (A) national certification or its equivalency; or
234	234	10 (B) completion of a continuing education course that the
235	235	11 advanced practice registered nurse attended during the
236	236	12 previous two (2) years.
237	237	13 (b) The board may do the following:
238	238	14 (1) Create ad hoc subcommittees representing the various nursing
239	239	15 specialties and interests of the profession of nursing. Persons
240	240	16 appointed to a subcommittee serve for terms as determined by the
241	241	17 board.
242	242	18 (2) Utilize the appropriate subcommittees so as to assist the board
243	243	19 with its responsibilities. The assistance provided by the
244	244	20 subcommittees may include the following:
245	245	21 (A) Recommendation of rules necessary to carry out the duties
246	246	22 of the board.
247	247	23 (B) Recommendations concerning educational programs and
248	248	24 requirements.
249	249	25 (C) Recommendations regarding examinations and licensure
250	250	26 of applicants.
251	251	27 (3) Appoint nurses to serve on each of the ad hoc subcommittees.
252	252	28 (c) Nurses appointed under subsection (b) must:
253	253	29 (1) be committed to advancing and safeguarding the nursing
254	254	30 profession as a whole; and
255	255	31 (2) represent nurses who practice in the field directly affected by
256	256	32 a subcommittee's actions.
257	257	33 SECTION 6. IC 25-23-1-19.4, AS AMENDED BY P.L.127-2020,
258	258	34 SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
259	259	35 JULY 1, 2025]: Sec. 19.4. (a) This section does not apply to certified
260	260	36 registered nurse anesthetists.
261	261	37 (b) As used in this section, "practitioner" has the meaning set forth
262	262	38 in IC 16-42-19-5. However, the term does not include the following:
263	263	39 (1) A veterinarian.
264	264	40 (2) An advanced practice registered nurse.
265	265	41 (3) A physician assistant.
266	266	42 (c) An advanced practice registered nurse shall operate:
267	267	2025 IN 1116—LS 6328/DI 148 7
268	268	1 (1) in collaboration with a licensed practitioner as evidenced by
269	269	2 a practice agreement;
270	270	3 (2) by privileges granted by the governing board of a hospital
271	271	4 licensed under IC 16-21 with the advice of the medical staff of the
272	272	5 hospital that sets forth the manner in which an advanced practice
273	273	6 registered nurse and a licensed practitioner will cooperate,
274	274	7 coordinate, and consult with each other in the provision of health
275	275	8 care to their patients; or
276	276	9 (3) by privileges granted by the governing body of a hospital
277	277	10 operated under IC 12-24-1 that sets forth the manner in which an
278	278	11 advanced practice registered nurse and a licensed practitioner will
279	279	12 cooperate, coordinate, and consult with each other in the
280	280	13 provision of health care to their patients.
281	281	14 (d) (b) This subsection applies for purposes of the Medicaid
282	282	15 program to an advanced practice registered nurse who:
283	283	16 (1) is licensed pursuant to IC 25-23-1-19.5; section 19.5 of this
284	284	17 chapter; and
285	285	18 (2) has been educated and trained to work with patients with
286	286	19 addiction and mental health needs.
287	287	20 An advanced practice registered nurse who meets the requirements of
288	288	21 this subsection has all of the supervisory rights and responsibilities,
289	289	22 including prior authorization, that are available to a licensed physician
290	290	23 or a health service provider in psychology (HSPP) operating in a
291	291	24 community mental health center certified under IC 12-21-2-3(5)(C).
292	292	25 (e) (c) Before January 1, 2021, the office of the secretary shall apply
293	293	26 to the United States Department of Health and Human Services for any
294	294	27 state plan amendment necessary to implement subsection (d). (b).
295	295	28 SECTION 7. IC 25-23-1-19.6, AS AMENDED BY P.L.28-2019,
296	296	29 SECTION 14, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
297	297	30 JULY 1, 2025]: Sec. 19.6. (a) When the board grants authority to an
298	298	31 advanced practice registered nurse to prescribe legend drugs under this
299	299	32 chapter, the board shall assign an identification number to the
300	300	33 advanced practice registered nurse.
301	301	34 (b) An advanced practice registered nurse who is granted authority
302	302	35 by the board to prescribe legend drugs must do the following:
303	303	36 (1) Enter on each prescription form that the advanced practice
304	304	37 registered nurse uses to prescribe a legend drug:
305	305	38 (A) the signature of the advanced practice registered nurse;
306	306	39 (B) initials indicating the credentials awarded to the advanced
307	307	40 practice registered nurse under this chapter; and
308	308	41 (C) the identification number assigned to the advanced
309	309	42 practice registered nurse under subsection (a).
310	310	2025 IN 1116—LS 6328/DI 148 8
311	311	1 (2) Transmit the prescription in an electronic format for an
312	312	2 electronically transmitted prescription.
313	313	3 (3) Comply with all applicable state and federal laws concerning
314	314	4 prescriptions for legend drugs, including the requirement to issue
315	315	5 electronically transmitted prescriptions under IC 25-1-9.3.
316	316	6 (c) An advanced practice registered nurse may be granted authority
317	317	7 to prescribe legend drugs under this chapter only within the scope of
318	318	8 practice of the advanced practice registered nurse. and the scope of the
319	319	9 licensed collaborating health practitioner.
320	320	10 SECTION 8. IC 25-23-1-19.8 IS REPEALED [EFFECTIVE JULY
321	321	11 1, 2025]. Sec. 19.8. (a) Before December 31 of an even-numbered year,
322	322	12 the Indiana professional licensing agency or the agency's designee shall
323	323	13 randomly audit at least one percent (1%) but not more than ten percent
324	324	14 (10%) of the practice agreements of advanced practice registered
325	325	15 nurses with authority to prescribe legend drugs under section 19.5 of
326	326	16 this chapter to determine whether the practice agreement meets the
327	327	17 requirements of this chapter or rules adopted by the board.
328	328	18 (b) The Indiana professional licensing agency shall establish an
329	329	19 audit procedure, which may include the following:
330	330	20 (1) Requiring the advanced practice registered nurse to provide
331	331	21 the agency with a copy of verification of attendance at or
332	332	22 completion of a continuing education course or program the
333	333	23 advanced practice registered nurse attended during the previous
334	334	24 two (2) years.
335	335	25 (2) Requiring the advanced practice registered nurse and the
336	336	26 licensed practitioner who have entered into a practice agreement
337	337	27 to submit information on a form prescribed by the agency that
338	338	28 must include a sworn statement signed by the advanced practice
339	339	29 registered nurse and the licensed practitioner that the parties are
340	340	30 operating within the terms of the practice agreement and the
341	341	31 requirements under this chapter or rules adopted by the board.
342	342	32 (3) Reviewing patient health records and other patient information
343	343	33 at the practice location or by requiring the submission of accurate
344	344	34 copies to determine if the parties are operating within the terms
345	345	35 of the practice agreement and the requirements under this chapter
346	346	36 or rules adopted by the board.
347	347	37 (4) After a reasonable determination that the advanced practice
348	348	38 registered nurse and the licensed practitioner who have entered
349	349	39 into a practice agreement are not operating within the terms of the
350	350	40 practice agreement, requiring the parties to appear before the
351	351	41 agency or the agency's designee to provide evidence of
352	352	42 compliance with the practice agreement.
353	353	2025 IN 1116—LS 6328/DI 148 9
354	354	1 (c) Not more than sixty (60) days after the completion of the audit
355	355	2 required in subsection (a), the Indiana professional licensing agency
356	356	3 shall provide the board with the following:
357	357	4 (1) A summary of the information obtained in the audit.
358	358	5 (2) A statement regarding whether an advanced practice
359	359	6 registered nurse and a licensed practitioner who have entered into
360	360	7 a practice agreement that is audited under subsection (a) are
361	361	8 operating within the terms of the practice agreement.
362	362	9 The agency shall also provide a copy of the information described in
363	363	10 this subsection to the board that regulates the licensed practitioner.
364	364	11 (d) The Indiana professional licensing agency may cause to be
365	365	12 served upon the advanced practice registered nurse an order to show
366	366	13 cause to the board as to why the board should not impose disciplinary
367	367	14 sanctions under IC 25-1-9-9 on the advanced practice registered nurse
368	368	15 for the advanced practice registered nurse's failure to comply with:
369	369	16 (1) an audit conducted under this section; or
370	370	17 (2) the requirements of a practice agreement under this chapter.
371	371	18 (e) Except for a violation concerning continuing education
372	372	19 requirements under IC 25-1-4, the board shall hold a hearing in
373	373	20 accordance with IC 4-21.5 and state the date, time, and location of the
374	374	21 hearing in the order served under subsection (d).
375	375	22 (f) The board that regulates the licensed practitioner may cause to
376	376	23 be served upon the licensed practitioner an order to show cause to the
377	377	24 board as to why the board should not impose disciplinary sanctions
378	378	25 under IC 25-1-9-9 on the licensed practitioner for the licensed
379	379	26 practitioner's failure to comply with:
380	380	27 (1) an audit conducted under this section; or
381	381	28 (2) the requirements of a practice agreement under this chapter.
382	382	29 (g) The board that regulates the licensed practitioner shall hold a
383	383	30 hearing in accordance with IC 4-21.5 and state the date, time, and
384	384	31 location of the hearing in the order served under subsection (f).
385	385	32 (h) An order to show cause issued under this section must comply
386	386	33 with the notice requirements of IC 4-21.5.
387	387	34 (i) The licensed practitioner may divulge health records and other
388	388	35 patient information to the Indiana professional licensing agency or the
389	389	36 agency's designee. The licensed practitioner is immune from civil
390	390	37 liability for any action based upon release of the patient information
391	391	38 under this section.
392	392	39 SECTION 9. IC 34-30-2.1-374 IS REPEALED [EFFECTIVE JULY
393	393	40 1, 2025]. Sec. 374. IC 25-23-1-19.8(i) (Concerning licensed
394	394	41 practitioners who release health records and patient information to the
395	395	42 Indiana professional licensing agency).
396	396	2025 IN 1116—LS 6328/DI 148 10
397	397	1 SECTION 10. IC 35-48-3-11, AS AMENDED BY P.L.129-2018,
398	398	2 SECTION 45, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
399	399	3 JULY 1, 2025]: Sec. 11. (a) Only a physician licensed under
400	400	4 IC 25-22.5, a physician assistant licensed under IC 25-27.5, or an
401	401	5 advanced practice registered nurse licensed under IC 25-23 with
402	402	6 prescriptive authority may treat a patient with a Schedule III or
403	403	7 Schedule IV controlled substance for the purpose of weight reduction
404	404	8 or to control obesity.
405	405	9 (b) A physician licensed under IC 25-22.5, a physician assistant
406	406	10 licensed under IC 25-27.5, or an advanced practice registered nurse
407	407	11 licensed under IC 25-23 with prescriptive authority may not prescribe,
408	408	12 dispense, administer, supply, sell, or give any amphetamine,
409	409	13 sympathomimetic amine drug, or compound designated as a Schedule
410	410	14 III or Schedule IV controlled substance under IC 35-48-2-8 and
411	411	15 IC 35-48-2-10 for a patient for purposes of weight reduction or to
412	412	16 control obesity, unless the physician, physician assistant, or advanced
413	413	17 practice registered nurse does the following:
414	414	18 (1) Determines:
415	415	19 (A) through review of:
416	416	20 (i) the physician's records of prior treatment of the patient;
417	417	21 or
418	418	22 (ii) the records of prior treatment of the patient provided by
419	419	23 a previous treating physician practitioner or weight loss
420	420	24 program;
421	421	25 that the physician's patient has made a reasonable effort to lose
422	422	26 weight in a treatment program using a regimen of weight
423	423	27 reduction based on caloric restriction, nutritional counseling,
424	424	28 behavior modification, and exercise without using controlled
425	425	29 substances; and
426	426	30 (B) that the treatment described in clause (A) has been
427	427	31 ineffective for the physician's patient.
428	428	32 (2) Obtains a thorough history and performs a thorough physical
429	429	33 examination of the physician's patient before initiating a treatment
430	430	34 plan using a Schedule III or Schedule IV controlled substance for
431	431	35 purposes of weight reduction or to control obesity.
432	432	36 (c) A physician licensed under IC 25-22.5, a physician assistant
433	433	37 licensed under IC 25-27.5, or an advanced practice registered nurse
434	434	38 licensed under IC 25-23 with prescriptive authority may not begin and
435	435	39 shall discontinue using a Schedule III or Schedule IV controlled
436	436	40 substance for purposes of weight reduction or to control obesity after
437	437	41 the physician, physician assistant, or advanced practice registered nurse
438	438	42 determines in the physician's, physician assistant's, or advanced
439	439	2025 IN 1116—LS 6328/DI 148 11
440	440	1 practice registered nurse's professional judgment that:
441	441	2 (1) the physician's patient has failed to lose weight using a
442	442	3 treatment plan involving the controlled substance;
443	443	4 (2) the controlled substance has provided a decreasing
444	444	5 contribution toward further weight loss for the patient unless
445	445	6 continuing to take the controlled substance is medically necessary
446	446	7 or appropriate for maintenance therapy;
447	447	8 (3) the physician's patient:
448	448	9 (A) has a history of; or
449	449	10 (B) shows a propensity for;
450	450	11 alcohol or drug abuse; or
451	451	12 (4) the physician's patient has consumed or disposed of a
452	452	13 controlled substance in a manner that does not strictly comply
453	453	14 with a treating physician's, physician assistant's, or advanced
454	454	15 practice registered nurse's direction.
455	455	16 (d) A physician assistant licensed under IC 25-27.5 or an advanced
456	456	17 practice registered nurse licensed under IC 25-23 with prescriptive
457	457	18 authority may not prescribe a schedule II controlled substance for the
458	458	19 purpose of weight reduction or to control obesity.
459	459	2025 IN 1116—LS 6328/DI 148