Introduced Version
SENATE BILL No. 383
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 12-15-5-14; IC 16-41-6-1; IC 25-1-9-6.8;
IC 25-23-1; IC 34-30-2.1-374; IC 35-48-3-11.
Synopsis: Advanced practice registered nurses. Removes the
requirement that an advanced practice registered nurse (APRN) have
a practice agreement with a collaborating physician. Removes a
provision requiring an APRN to operate under a collaborative practice
agreement or the privileges granted by a hospital governing board.
Removes certain provisions concerning the audit of practice
agreements. Allows an APRN with prescriptive authority to prescribe
a schedule II controlled substance for weight reduction or to control
obesity. Makes conforming changes.
Effective: July 1, 2025.
Goode
January 13, 2025, read first time and referred to Committee on Health and Provider
Services.
2025 IN 383—LS 7151/DI 148 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. 383
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 12-15-5-14, AS AMENDED BY P.L.129-2018,
2 SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2025]: Sec. 14. (a) As used in this section, "advanced practice
4 registered nurse" means:
5 (1) a nurse practitioner; or
6 (2) a clinical nurse specialist;
7 who is a registered nurse licensed under IC 25-23 and qualified to
8 practice nursing in a specialty role based upon the additional
9 knowledge and skill gained through a formal organized program of
10 study and clinical experience, or the equivalent as determined by the
11 Indiana state board of nursing.
12 (b) As used in this section, "office" includes the following:
13 (1) The office of the secretary of family and social services.
14 (2) A managed care organization that has contracted with the
15 office of Medicaid policy and planning under this article.
16 (3) A person that has contracted with a managed care organization
17 described in subdivision (2).
2025 IN 383—LS 7151/DI 148 2
1 (c) The office shall reimburse eligible Medicaid claims for the
2 following services provided by an advanced practice registered nurse
3 employed by a community mental health center if the services are part
4 of the advanced practice registered nurse's scope of practice:
5 (1) Mental health services.
6 (2) Behavioral health services.
7 (3) Substance abuse treatment.
8 (4) Primary care services.
9 (5) Evaluation and management services for inpatient or
10 outpatient psychiatric treatment.
11 (6) Prescription drugs.
12 (d) The office shall include an advanced practice registered nurse
13 as an eligible provider for the supervision of a plan of treatment for a
14 patient's outpatient mental health or substance abuse treatment
15 services, if the supervision is in the advanced practice registered
16 nurse's scope of practice, education, and training.
17 (e) This section
18 (1) may not be construed to expand an advanced practice
19 registered nurse's scope of practice. and
20 (2) is subject to IC 25-23-1-19.4(c) and applies only if the service
21 is included in the advanced practice registered nurse's practice
22 agreement with a collaborating physician.
23 SECTION 2. IC 16-41-6-1, AS AMENDED BY P.L.112-2020,
24 SECTION 19, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
25 JULY 1, 2025]: Sec. 1. (a) As used in this section, "physician's
26 authorized representative" means an individual acting under the
27 supervision of a licensed physician and within the individual's
28 scope of employment.
29 (1) an advanced practice registered nurse (as defined by
30 IC 25-23-1-1(b)) who is operating in collaboration with a licensed
31 physician; or
32 (2) an individual acting under the supervision of a licensed
33 physician and within the individual's scope of employment.
34 (b) A physician, an advanced practice registered nurse, or the
35 physician's authorized representative shall not order an HIV test on an
36 individual under the care of a physician unless the physician, the
37 advanced practice registered nurse, or the physician's authorized
38 representative does the following:
39 (1) Informs the patient of the test, orally or in writing.
40 (2) Provides the patient with an explanation of the test orally, in
41 writing, by video, or by a combination of these methods.
42 (3) Informs the patient of the patient's right to ask questions and
2025 IN 383—LS 7151/DI 148 3
1 to refuse the test.
2 Subject to subsection (e), if the patient refuses the test, the physician,
3 the advanced practice registered nurse, or the physician's authorized
4 representative may not perform the test and shall document the patient's
5 refusal in the patient's medical record.
6 (c) Unless it is clearly not feasible, the information delivered to the
7 patient who is to be tested under subsection (b) must be provided in the
8 native language or other communication used by the patient. If the
9 patient is unable to read written materials, the materials must be
10 translated or read to the patient in a language the patient understands.
11 (d) After ordering an HIV test for a patient, the physician, the
12 advanced practice registered nurse, or the physician's authorized
13 representative shall notify the patient of the test results and the
14 availability of HIV and other bloodborne disease prevention
15 counseling. If a test conducted under this section indicates that a
16 patient is HIV positive, in addition to the requirements set forth in
17 IC 16-41-2, the physician, the advanced practice registered nurse,
18 or the physician's authorized representative shall inform the patient of
19 the availability of counseling and of the treatment and referral options
20 available to the patient.
21 (e) A physician, an advanced practice registered nurse, or a
22 physician's authorized representative may order an HIV test to be
23 performed without informing the patient or the patient's representative
24 (as defined in IC 16-36-1-2) of the test or regardless of the patient's or
25 the patient's representative's refusal of the HIV test if any of the
26 following conditions apply:
27 (1) If ordered by a physician or an advanced practice registered
28 nurse, consent can be implied due to emergency circumstances
29 and the test is medically necessary to diagnose or treat the
30 patient's emergent condition.
31 (2) Under a court order based on clear and convincing evidence
32 of a serious and present health threat to others posed by an
33 individual. A patient shall be notified of the patient's right to:
34 (A) a hearing; and
35 (B) counsel;
36 before a hearing is held under this subdivision. Any hearing
37 conducted under this subdivision shall be held in camera at the
38 request of the individual.
39 (3) If the test is done on blood collected or tested anonymously as
40 part of an epidemiologic survey under IC 16-41-2-3 or
41 IC 16-41-17-10(a)(5).
42 (4) The test is ordered under section 4 of this chapter.
2025 IN 383—LS 7151/DI 148 4
1 (5) The test is required or authorized under IC 11-10-3-2.5.
2 (6) The individual upon whom the test will be performed is
3 described in IC 16-41-8-6 or IC 16-41-10-2.5.
4 (7) A court has ordered the individual to undergo testing for HIV
5 under IC 35-38-1-10.5(a) or IC 35-38-2-2.3(a)(17).
6 (f) The state department shall make HIV testing and treatment
7 information from the federal Centers for Disease Control and
8 Prevention available to health care providers.
9 (g) The state department may adopt rules under IC 4-22-2 necessary
10 to implement this section.
11 SECTION 3. IC 25-1-9-6.8, AS AMENDED BY P.L.129-2018,
12 SECTION 23, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
13 JULY 1, 2025]: Sec. 6.8. (a) This section applies to a practitioner who
14 is:
15 (1) licensed to practice medicine or osteopathic medicine under
16 IC 25-22.5; or
17 (2) an advanced practice registered nurse granted prescriptive
18 authority under IC 25-23. and whose practice agreement with a
19 collaborating physician reflects the conditions specified in
20 subsection (b).
21 (b) Before prescribing a stimulant medication for a child for the
22 treatment of attention deficit disorder or attention deficit hyperactivity
23 disorder, a practitioner described in subsection (a) shall follow the most
24 recent guidelines adopted by the American Academy of Pediatrics or
25 the American Academy of Child and Adolescent Psychiatry for the
26 diagnosis and evaluation of a child with attention deficit disorder or
27 attention deficit hyperactivity disorder.
28 SECTION 4. IC 25-23-1-1, AS AMENDED BY P.L.129-2018,
29 SECTION 28, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
30 JULY 1, 2025]: Sec. 1. As used in this chapter:
31 (a) "Board" means the Indiana state board of nursing.
32 (b) "Advanced practice registered nurse" means:
33 (1) a nurse practitioner;
34 (2) a certified nurse midwife;
35 (3) a clinical nurse specialist; or
36 (4) a certified registered nurse anesthetist;
37 who is a registered nurse qualified to practice nursing in a specialty
38 role based upon the additional knowledge and skill gained through a
39 formal organized program of study and clinical experience, or the
40 equivalent as determined by the board, which does not limit but
41 extends or expands the function of the nurse which may be initiated by
42 the client or provider. in settings that shall include hospital outpatient
2025 IN 383—LS 7151/DI 148 5
1 clinics and health maintenance organizations. Notwithstanding any
2 other law, this subsection does not add to the powers and duties or
3 scope of practice of certified registered nurse anesthetists as described
4 in section 30 of this chapter.
5 (c) "Human response" means those signs, symptoms, behaviors, and
6 processes that denote the individual's interaction with the environment.
7 SECTION 5. IC 25-23-1-7, AS AMENDED BY P.L.69-2022,
8 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
9 JULY 1, 2025]: Sec. 7. (a) The board shall do the following:
10 (1) Adopt under IC 4-22-2 rules necessary to enable it to carry
11 into effect this chapter.
12 (2) Prescribe standards and approve curricula for nursing
13 education programs preparing persons for licensure under this
14 chapter.
15 (3) Provide for surveys of such programs at such times as it
16 considers necessary.
17 (4) Accredit such programs as meet the requirements of this
18 chapter and of the board.
19 (5) Deny or withdraw accreditation from nursing education
20 programs for failure to meet prescribed curricula or other
21 standards.
22 (6) Examine, license, and renew the license of qualified
23 applicants.
24 (7) Issue subpoenas, compel the attendance of witnesses, and
25 administer oaths to persons giving testimony at hearings.
26 (8) Cause the prosecution of all persons violating this chapter and
27 have power to incur necessary expenses for these prosecutions.
28 (9) Adopt rules under IC 4-22-2 that do the following:
29 (A) Prescribe standards for the competent practice of
30 registered, practical, and advanced practice registered nursing.
31 (B) Establish with the approval of the medical licensing board
32 created by IC 25-22.5-2-1 requirements that advanced practice
33 registered nurses must meet to be granted authority to
34 prescribe legend drugs and to retain that authority.
35 (C) Establish, with the approval of the medical licensing board
36 created by IC 25-22.5-2-1, requirements for the renewal of a
37 practice agreement under section 19.4 of this chapter, which
38 shall expire on October 31 in each odd-numbered year.
39 (10) Keep a record of all its proceedings.
40 (11) Collect and distribute annually demographic information on
41 the number and type of registered nurses and licensed practical
42 nurses employed in Indiana.
2025 IN 383—LS 7151/DI 148 6
1 (12) Adopt rules and administer the interstate nurse licensure
2 compact under IC 25-42.
3 (13) Adopt or amend rules to implement the nursing licensure by
4 endorsement available for foreign nursing school graduates under
5 sections 11 and 12 of this chapter.
6 (14) Establish an audit procedure, which may include
7 requiring an advanced practice registered nurse to provide
8 the licensing agency with verification of:
9 (A) national certification or its equivalency; or
10 (B) completion of a continuing education course that the
11 advanced practice registered nurse attended during the
12 previous two (2) years.
13 (b) The board may do the following:
14 (1) Create ad hoc subcommittees representing the various nursing
15 specialties and interests of the profession of nursing. Persons
16 appointed to a subcommittee serve for terms as determined by the
17 board.
18 (2) Utilize the appropriate subcommittees so as to assist the board
19 with its responsibilities. The assistance provided by the
20 subcommittees may include the following:
21 (A) Recommendation of rules necessary to carry out the duties
22 of the board.
23 (B) Recommendations concerning educational programs and
24 requirements.
25 (C) Recommendations regarding examinations and licensure
26 of applicants.
27 (3) Appoint nurses to serve on each of the ad hoc subcommittees.
28 (c) Nurses appointed under subsection (b) must:
29 (1) be committed to advancing and safeguarding the nursing
30 profession as a whole; and
31 (2) represent nurses who practice in the field directly affected by
32 a subcommittee's actions.
33 SECTION 6. IC 25-23-1-19.4, AS AMENDED BY P.L.127-2020,
34 SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
35 JULY 1, 2025]: Sec. 19.4. (a) This section does not apply to certified
36 registered nurse anesthetists.
37 (b) As used in this section, "practitioner" has the meaning set forth
38 in IC 16-42-19-5. However, the term does not include the following:
39 (1) A veterinarian.
40 (2) An advanced practice registered nurse.
41 (3) A physician assistant.
42 (c) An advanced practice registered nurse shall operate:
2025 IN 383—LS 7151/DI 148 7
1 (1) in collaboration with a licensed practitioner as evidenced by
2 a practice agreement;
3 (2) by privileges granted by the governing board of a hospital
4 licensed under IC 16-21 with the advice of the medical staff of the
5 hospital that sets forth the manner in which an advanced practice
6 registered nurse and a licensed practitioner will cooperate,
7 coordinate, and consult with each other in the provision of health
8 care to their patients; or
9 (3) by privileges granted by the governing body of a hospital
10 operated under IC 12-24-1 that sets forth the manner in which an
11 advanced practice registered nurse and a licensed practitioner will
12 cooperate, coordinate, and consult with each other in the
13 provision of health care to their patients.
14 (d) (b) This subsection applies for purposes of the Medicaid
15 program to an advanced practice registered nurse who:
16 (1) is licensed pursuant to IC 25-23-1-19.5; section 19.5 of this
17 chapter; and
18 (2) has been educated and trained to work with patients with
19 addiction and mental health needs.
20 An advanced practice registered nurse who meets the requirements of
21 this subsection has all of the supervisory rights and responsibilities,
22 including prior authorization, that are available to a licensed physician
23 or a health service provider in psychology (HSPP) operating in a
24 community mental health center certified under IC 12-21-2-3(5)(C).
25 (e) (c) Before January 1, 2021, the office of the secretary shall apply
26 to the United States Department of Health and Human Services for any
27 state plan amendment necessary to implement subsection (d). (b).
28 SECTION 7. IC 25-23-1-19.6, AS AMENDED BY P.L.28-2019,
29 SECTION 14, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
30 JULY 1, 2025]: Sec. 19.6. (a) When the board grants authority to an
31 advanced practice registered nurse to prescribe legend drugs under this
32 chapter, the board shall assign an identification number to the
33 advanced practice registered nurse.
34 (b) An advanced practice registered nurse who is granted authority
35 by the board to prescribe legend drugs must do the following:
36 (1) Enter on each prescription form that the advanced practice
37 registered nurse uses to prescribe a legend drug:
38 (A) the signature of the advanced practice registered nurse;
39 (B) initials indicating the credentials awarded to the advanced
40 practice registered nurse under this chapter; and
41 (C) the identification number assigned to the advanced
42 practice registered nurse under subsection (a).
2025 IN 383—LS 7151/DI 148 8
1 (2) Transmit the prescription in an electronic format for an
2 electronically transmitted prescription.
3 (3) Comply with all applicable state and federal laws concerning
4 prescriptions for legend drugs, including the requirement to issue
5 electronically transmitted prescriptions under IC 25-1-9.3.
6 (c) An advanced practice registered nurse may be granted authority
7 to prescribe legend drugs under this chapter only within the scope of
8 practice of the advanced practice registered nurse. and the scope of the
9 licensed collaborating health practitioner.
10 SECTION 8. IC 25-23-1-19.8 IS REPEALED [EFFECTIVE JULY
11 1, 2025]. Sec. 19.8. (a) Before December 31 of an even-numbered year,
12 the Indiana professional licensing agency or the agency's designee shall
13 randomly audit at least one percent (1%) but not more than ten percent
14 (10%) of the practice agreements of advanced practice registered
15 nurses with authority to prescribe legend drugs under section 19.5 of
16 this chapter to determine whether the practice agreement meets the
17 requirements of this chapter or rules adopted by the board.
18 (b) The Indiana professional licensing agency shall establish an
19 audit procedure, which may include the following:
20 (1) Requiring the advanced practice registered nurse to provide
21 the agency with a copy of verification of attendance at or
22 completion of a continuing education course or program the
23 advanced practice registered nurse attended during the previous
24 two (2) years.
25 (2) Requiring the advanced practice registered nurse and the
26 licensed practitioner who have entered into a practice agreement
27 to submit information on a form prescribed by the agency that
28 must include a sworn statement signed by the advanced practice
29 registered nurse and the licensed practitioner that the parties are
30 operating within the terms of the practice agreement and the
31 requirements under this chapter or rules adopted by the board.
32 (3) Reviewing patient health records and other patient information
33 at the practice location or by requiring the submission of accurate
34 copies to determine if the parties are operating within the terms
35 of the practice agreement and the requirements under this chapter
36 or rules adopted by the board.
37 (4) After a reasonable determination that the advanced practice
38 registered nurse and the licensed practitioner who have entered
39 into a practice agreement are not operating within the terms of the
40 practice agreement, requiring the parties to appear before the
41 agency or the agency's designee to provide evidence of
42 compliance with the practice agreement.
2025 IN 383—LS 7151/DI 148 9
1 (c) Not more than sixty (60) days after the completion of the audit
2 required in subsection (a), the Indiana professional licensing agency
3 shall provide the board with the following:
4 (1) A summary of the information obtained in the audit.
5 (2) A statement regarding whether an advanced practice
6 registered nurse and a licensed practitioner who have entered into
7 a practice agreement that is audited under subsection (a) are
8 operating within the terms of the practice agreement.
9 The agency shall also provide a copy of the information described in
10 this subsection to the board that regulates the licensed practitioner.
11 (d) The Indiana professional licensing agency may cause to be
12 served upon the advanced practice registered nurse an order to show
13 cause to the board as to why the board should not impose disciplinary
14 sanctions under IC 25-1-9-9 on the advanced practice registered nurse
15 for the advanced practice registered nurse's failure to comply with:
16 (1) an audit conducted under this section; or
17 (2) the requirements of a practice agreement under this chapter.
18 (e) Except for a violation concerning continuing education
19 requirements under IC 25-1-4, the board shall hold a hearing in
20 accordance with IC 4-21.5 and state the date, time, and location of the
21 hearing in the order served under subsection (d).
22 (f) The board that regulates the licensed practitioner may cause to
23 be served upon the licensed practitioner an order to show cause to the
24 board as to why the board should not impose disciplinary sanctions
25 under IC 25-1-9-9 on the licensed practitioner for the licensed
26 practitioner's failure to comply with:
27 (1) an audit conducted under this section; or
28 (2) the requirements of a practice agreement under this chapter.
29 (g) The board that regulates the licensed practitioner shall hold a
30 hearing in accordance with IC 4-21.5 and state the date, time, and
31 location of the hearing in the order served under subsection (f).
32 (h) An order to show cause issued under this section must comply
33 with the notice requirements of IC 4-21.5.
34 (i) The licensed practitioner may divulge health records and other
35 patient information to the Indiana professional licensing agency or the
36 agency's designee. The licensed practitioner is immune from civil
37 liability for any action based upon release of the patient information
38 under this section.
39 SECTION 9. IC 34-30-2.1-374 IS REPEALED [EFFECTIVE JULY
40 1, 2025]. Sec. 374. IC 25-23-1-19.8(i) (Concerning licensed
41 practitioners who release health records and patient information to the
42 Indiana professional licensing agency).
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1 SECTION 10. IC 35-48-3-11, AS AMENDED BY P.L.129-2018,
2 SECTION 45, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2025]: Sec. 11. (a) Only a physician licensed under
4 IC 25-22.5, a physician assistant licensed under IC 25-27.5, or an
5 advanced practice registered nurse licensed under IC 25-23 with
6 prescriptive authority may treat a patient with a Schedule III or
7 Schedule IV controlled substance for the purpose of weight reduction
8 or to control obesity.
9 (b) A physician licensed under IC 25-22.5, a physician assistant
10 licensed under IC 25-27.5, or an advanced practice registered nurse
11 licensed under IC 25-23 with prescriptive authority may not prescribe,
12 dispense, administer, supply, sell, or give any amphetamine,
13 sympathomimetic amine drug, or compound designated as a Schedule
14 III or Schedule IV controlled substance under IC 35-48-2-8 and
15 IC 35-48-2-10 for a patient for purposes of weight reduction or to
16 control obesity, unless the physician, physician assistant, or advanced
17 practice registered nurse does the following:
18 (1) Determines:
19 (A) through review of:
20 (i) the physician's records of prior treatment of the patient;
21 or
22 (ii) the records of prior treatment of the patient provided by
23 a previous treating physician practitioner or weight loss
24 program;
25 that the physician's patient has made a reasonable effort to lose
26 weight in a treatment program using a regimen of weight
27 reduction based on caloric restriction, nutritional counseling,
28 behavior modification, and exercise without using controlled
29 substances; and
30 (B) that the treatment described in clause (A) has been
31 ineffective for the physician's patient.
32 (2) Obtains a thorough history and performs a thorough physical
33 examination of the physician's patient before initiating a treatment
34 plan using a Schedule III or Schedule IV controlled substance for
35 purposes of weight reduction or to control obesity.
36 (c) A physician licensed under IC 25-22.5, a physician assistant
37 licensed under IC 25-27.5, or an advanced practice registered nurse
38 licensed under IC 25-23 with prescriptive authority may not begin and
39 shall discontinue using a Schedule III or Schedule IV controlled
40 substance for purposes of weight reduction or to control obesity after
41 the physician, physician assistant, or advanced practice registered nurse
42 determines in the physician's, physician assistant's, or advanced
2025 IN 383—LS 7151/DI 148 11
1 practice registered nurse's professional judgment that:
2 (1) the physician's patient has failed to lose weight using a
3 treatment plan involving the controlled substance;
4 (2) the controlled substance has provided a decreasing
5 contribution toward further weight loss for the patient unless
6 continuing to take the controlled substance is medically necessary
7 or appropriate for maintenance therapy;
8 (3) the physician's patient:
9 (A) has a history of; or
10 (B) shows a propensity for;
11 alcohol or drug abuse; or
12 (4) the physician's patient has consumed or disposed of a
13 controlled substance in a manner that does not strictly comply
14 with a treating physician's, physician assistant's, or advanced
15 practice registered nurse's direction.
16 (d) A physician assistant licensed under IC 25-27.5 or an advanced
17 practice registered nurse licensed under IC 25-23 with prescriptive
18 authority may not prescribe a schedule II controlled substance for the
19 purpose of weight reduction or to control obesity.
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