Introduced Version
SENATE BILL No. 246
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 25-22.5-2-7; IC 25-23-1.
Synopsis: Advanced practice registered nurses. Requires the Indiana
medical licensing board to accept and review complaints concerning
physician collaborative practice agreements with advanced practice
registered nurses (APRNs). Provides that an APRN may only: (1)
operate in collaboration with a licensed practitioner who specializes in
the same practice area as the advanced practice registered nurse; and
(2) practice within the scope of the APRN's specialty. Allows a
physician to enter into a collaborative agreement with more than four
APRNs but prohibits the physician from collaborating with more than
four APRNs at the same time.
Effective: July 1, 2025.
Johnson T
January 9, 2025, read first time and referred to Committee on Health and Provider
Services.
2025 IN 246—LS 6671/DI 147 Introduced
First Regular Session of the 124th General Assembly (2025)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2024 Regular Session of the General Assembly.
SENATE BILL No. 246
A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 25-22.5-2-7, AS AMENDED BY P.L.3-2024,
2 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2025]: Sec. 7. (a) The board shall do the following:
4 (1) Adopt rules and forms necessary to implement this article that
5 concern, but are not limited to, the following areas:
6 (A) Qualification by education, residence, citizenship,
7 training, and character for admission to an examination for
8 licensure or by endorsement for licensure.
9 (B) The examination for licensure.
10 (C) The license or permit.
11 (D) Fees for examination, permit, licensure, and registration.
12 (E) Reinstatement of licenses and permits.
13 (F) Payment of costs in disciplinary proceedings conducted by
14 the board.
15 (2) Administer oaths in matters relating to the discharge of the
16 board's official duties.
17 (3) Enforce this article and assign to the personnel of the agency
2025 IN 246—LS 6671/DI 147 2
1 duties as may be necessary in the discharge of the board's duty.
2 (4) Maintain, through the agency, full and complete records of all
3 applicants for licensure or permit and of all licenses and permits
4 issued.
5 (5) Make available, upon request, the complete schedule of
6 minimum requirements for licensure or permit.
7 (6) Issue, at the board's discretion, a temporary permit to an
8 applicant for the interim from the date of application until the
9 next regular meeting of the board.
10 (7) Issue an unlimited license, a limited license, or a temporary
11 medical permit, depending upon the qualifications of the
12 applicant, to any applicant who successfully fulfills all of the
13 requirements of this article.
14 (8) Adopt rules establishing standards for the competent practice
15 of medicine, osteopathic medicine, or any other form of practice
16 regulated by a limited license or permit issued under this article.
17 (9) Adopt rules regarding the appropriate prescribing of Schedule
18 III or Schedule IV controlled substances for the purpose of weight
19 reduction or to control obesity.
20 (10) Adopt rules establishing standards for office based
21 procedures that require moderate sedation, deep sedation, or
22 general anesthesia.
23 (11) Adopt rules or protocol establishing the following:
24 (A) An education program to be used to educate women
25 concerning breast density, including breast density
26 classifications set forth in IC 25-22.5-13.2-1.
27 (B) Standards for providing an annual screening or diagnostic
28 test for a woman who is at least forty (40) years of age whose
29 breast and connective tissue in comparison to fat in the breast
30 is determined to be dense.
31 (12) Adopt rules establishing standards and protocols for the
32 prescribing of controlled substances.
33 (13) Adopt rules as set forth in IC 25-23.4 concerning the
34 certification of certified direct entry midwives.
35 (14) In consultation with the Indiana department of health and the
36 office of the secretary of family and social services, adopt rules
37 under IC 4-22-2 or protocols concerning the following for
38 providers that are providing office based opioid treatment:
39 (A) Requirements of a treatment agreement (as described in
40 IC 12-23-20-2) concerning the proper referral and treatment of
41 mental health and substance use.
42 (B) Parameters around the frequency and types of visits
2025 IN 246—LS 6671/DI 147 3
1 required for the periodic scheduled visits required by
2 IC 12-23-20-2.
3 (C) Conditions on when the following should be ordered or
4 performed:
5 (i) A urine toxicology screening.
6 (ii) HIV, hepatitis B, and hepatitis C testing.
7 (D) Required documentation in a patient's medical record
8 when buprenorphine is prescribed over a specified dosage.
9 (15) Adopt rules as set forth in IC 25-14.5 concerning the
10 certification of certified dietitians.
11 (16) Adopt rules and establish fees as set forth in IC 25-8.5-2-6
12 concerning the licensure of behavior analysts.
13 (17) Administer the interstate medical licensure compact under
14 IC 25-22.5-16, including appointing members to the interstate
15 medical licensure compact commission and adopting any rules
16 necessary to administer the compact.
17 (18) Accept and review complaints concerning a collaborating
18 physician's practice agreement with an advanced practice
19 registered nurse under IC 25-23-1-25.5.
20 (b) The board may adopt rules that establish:
21 (1) certification requirements for child death pathologists;
22 (2) an annual training program for child death pathologists under
23 IC 16-35-7-3(b)(2); and
24 (3) a process to certify a qualified child death pathologist.
25 (c) The board may adopt rules under IC 4-22-2 establishing
26 guidelines for the practice of telehealth in Indiana. Adoption of rules
27 under this subsection may not delay the implementation and provision
28 of telehealth services by a provider under IC 25-1-9.5.
29 SECTION 2. IC 25-23-1-19.4, AS AMENDED BY P.L.127-2020,
30 SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
31 JULY 1, 2025]: Sec. 19.4. (a) This section does not apply to certified
32 registered nurse anesthetists.
33 (b) As used in this section, "practitioner" has the meaning set forth
34 in IC 16-42-19-5. However, the term does not include the following:
35 (1) A veterinarian.
36 (2) An advanced practice registered nurse.
37 (3) A physician assistant.
38 (c) Subject to section 25.5 of this chapter, an advanced practice
39 registered nurse shall operate:
40 (1) in collaboration with a licensed practitioner as evidenced by
41 a practice agreement;
42 (2) by privileges granted by the governing board of a hospital
2025 IN 246—LS 6671/DI 147 4
1 licensed under IC 16-21 with the advice of the medical staff of the
2 hospital that sets forth the manner in which an advanced practice
3 registered nurse and a licensed practitioner will cooperate,
4 coordinate, and consult with each other in the provision of health
5 care to their patients; or
6 (3) by privileges granted by the governing body of a hospital
7 operated under IC 12-24-1 that sets forth the manner in which an
8 advanced practice registered nurse and a licensed practitioner will
9 cooperate, coordinate, and consult with each other in the
10 provision of health care to their patients.
11 (d) This subsection applies for purposes of the Medicaid program
12 to an advanced practice registered nurse who:
13 (1) is licensed pursuant to IC 25-23-1-19.5; section 19.5 of this
14 chapter; and
15 (2) has been educated and trained to work with patients with
16 addiction and mental health needs.
17 An advanced practice registered nurse who meets the requirements of
18 this subsection has all of the supervisory rights and responsibilities,
19 including prior authorization, that are available to a licensed physician
20 or a health service provider in psychology (HSPP) operating in a
21 community mental health center certified under IC 12-21-2-3(5)(C).
22 (e) Before January 1, 2021, the office of the secretary shall apply to
23 the United States Department of Health and Human Services for any
24 state plan amendment necessary to implement subsection (d).
25 SECTION 3. IC 25-23-1-25.5 IS ADDED TO THE INDIANA
26 CODE AS A NEW SECTION TO READ AS FOLLOWS
27 [EFFECTIVE JULY 1, 2025]: Sec. 25.5. (a) An advanced practice
28 registered nurse may only operate in collaboration with a licensed
29 practitioner (as defined in section 19.4 of this chapter) who
30 specializes in the same practice area as the advanced practice
31 registered nurse.
32 (b) An advanced practice registered nurse may only practice
33 within the scope of the advanced practice registered nurse's
34 specialty.
35 (c) A physician may enter into a collaborative agreement with
36 more than four (4) advanced practice registered nurses but may
37 not collaborate with more than four (4) advanced practice
38 registered nurses at the same time.
2025 IN 246—LS 6671/DI 147