CHAPTER 1. DEFINITIONS AND EXCLUSIONS
IC 25-22.5
ARTICLE 22.5. PHYSICIANS
IC 25-22.5-1
Chapter 1. Definitions and Exclusions
IC 25-22.5-1-1
Repealed
(Repealed by Acts 1978, P.L.8, SEC.14.)
IC 25-22.5-1-1.1
Definitions
Sec. 1.1. As used in this article:
(a) "Practice of medicine or osteopathic medicine" means any one
(1) or a combination of the following:
(1) Holding oneself out to the public as being engaged in:
(A) the diagnosis, treatment, correction, or prevention of any
disease, ailment, defect, injury, infirmity, deformity, pain, or
other condition of human beings;
(B) the suggestion, recommendation, or prescription or
administration of any form of treatment, without limitation;
(C) the performing of any kind of surgical operation upon a
human being, including tattooing, except for tattooing (as
defined in IC 35-42-2-7), in which human tissue is cut,
burned, or vaporized by the use of any mechanical means,
laser, or ionizing radiation, or the penetration of the skin or
body orifice by any means, for the intended palliation, relief,
or cure; or
(D) the prevention of any physical, mental, or functional
ailment or defect of any person.
(2) The maintenance of an office or a place of business for the
reception, examination, or treatment of persons suffering from
disease, ailment, defect, injury, infirmity, deformity, pain, or
other conditions of body or mind.
(3) Attaching the designation "doctor of medicine", "M.D.",
"doctor of osteopathy", "D.O.", "osteopathic medical
physician", "physician", "surgeon", or "physician and surgeon",
either alone or in connection with other words, or any other
words or abbreviations to a name, indicating or inducing others
to believe that the person is engaged in the practice of medicine
or osteopathic medicine (as defined in this section).
(4) Providing diagnostic or treatment services to a person in
Indiana when the diagnostic or treatment services:
(A) are transmitted through electronic communications; and
(B) are on a regular, routine, and nonepisodic basis or under
an oral or written agreement to regularly provide medical
services.
In addition to the exceptions described in section 2 of this
chapter, a nonresident physician who is located outside Indiana
does not practice medicine or osteopathy in Indiana by
providing a second opinion to a licensee or diagnostic or
treatment services to a patient in Indiana following medical care
originally provided to the patient while outside Indiana.
(b) "Board" refers to the medical licensing board of Indiana.
(c) "Diagnose or diagnosis" means to examine a patient, parts of
a patient's body, substances taken or removed from a patient's body,
or materials produced by a patient's body to determine the source or
nature of a disease or other physical or mental condition, or to hold
oneself out or represent that a person is a physician and is so
examining a patient. It is not necessary that the examination be made
in the presence of the patient; it may be made on information
supplied either directly or indirectly by the patient.
(d) "Drug or medicine" means any medicine, compound, or
chemical or biological preparation intended for internal or external
use of humans, and all substances intended to be used for the
diagnosis, cure, mitigation, or prevention of diseases or abnormalities
of humans, which are recognized in the latest editions published of
the United States Pharmacopoeia or National Formulary, or
otherwise established as a drug or medicine.
(e) "Licensee" means any individual holding a valid unlimited
license issued by the board under this article.
(f) "Prescribe or prescription" means to direct, order, or designate
the use of or manner of using a drug, medicine, or treatment, by
spoken or written words or other means.
(g) "Physician" means any person who holds the degree of doctor
of medicine or doctor of osteopathy or its equivalent and who holds
a valid unlimited license to practice medicine or osteopathic
medicine in Indiana.
(h) "Medical school" means a nationally accredited college of
medicine or of osteopathic medicine approved by the board.
(i) "Physician assistant" means an individual who:
(1) is supervised by a physician;
(2) graduated from a physician assistant program accredited by
an accrediting agency (as defined in IC 25-27.5-2-4.5);
(3) passed the examination administered by the National
Commission on Certification of Physician Assistants (NCCPA)
and maintains certification; and
(4) has been licensed by the physician assistant committee
under IC 25-27.5.
(j) "Agency" refers to the Indiana professional licensing agency
under IC 25-1-5.
As added by Acts 1978, P.L.8, SEC.13. Amended by Acts 1981,
P.L.222, SEC.151; P.L.247-1985, SEC.1; P.L.169-1985, SEC.62;
P.L.217-1993, SEC.2; P.L.180-1996, SEC.1; P.L.181-1997, SEC.1;
P.L.1-2006, SEC.444; P.L.90-2007, SEC.3.
IC 25-22.5-1-1.2
Additional definitions
Sec. 1.2. As used in this article:
"Nursing school" includes a hospital nursing school, a nursing
program, and a nursing department of a postsecondary educational
institution. This shall include two (2), three (3), and four (4) year
programs of nursing education.
"Shortage area" is an area in which there is a less than adequate
supply of physicians or nurses relative to the need for nursing or
physician services.
As added by Acts 1981, P.L.227, SEC.1. Amended by P.L.247-1985,
SEC.2; P.L.2-2007, SEC.327.
IC 25-22.5-1-2
Exclusions
Sec. 2. (a) This article, as it relates to the unlawful or
unauthorized practice of medicine or osteopathic medicine, does not
apply to any of the following:
(1) A student in training in a medical school approved by the
board, or while performing duties as an intern or a resident in
a hospital under the supervision of the hospital's staff or in a
program approved by the medical school.
(2) A person who renders service in case of emergency where
no fee or other consideration is contemplated, charged, or
received.
(3) A paramedic (as defined in IC 16-18-2-266), an emergency
medical technician-basic advanced (as defined in
IC 16-18-2-112.5), an emergency medical
technician-intermediate (as defined in IC 16-18-2-112.7), an
emergency medical technician (as defined in IC 16-18-2-112),
or a person with equivalent certification from another state who
renders advanced life support (as defined in IC 16-18-2-7) or
basic life support (as defined in IC 16-18-2-33.5):
(A) during a disaster emergency declared by the governor
under IC 10-14-3-12 in response to an act that the governor
in good faith believes to be an act of terrorism (as defined in
IC 35-41-1-26.5); and
(B) in accordance with the rules adopted by the Indiana
emergency medical services commission or the disaster
emergency declaration of the governor.
(4) Commissioned medical officers or medical service officers
of the armed forces of the United States, the United States
Public Health Service, and medical officers of the United States
Department of Veterans Affairs in the discharge of their official
duties in Indiana.
(5) An individual who is not a licensee who resides in another
state or country and is authorized to practice medicine or
osteopathic medicine there, who is called in for consultation by
an individual licensed to practice medicine or osteopathic
medicine in Indiana.
(6) A person administering a domestic or family remedy to a
member of the person's family.
(7) A member of a church practicing the religious tenets of the
church if the member does not make a medical diagnosis,
prescribe or administer drugs or medicines, perform surgical or
physical operations, or assume the title of or profess to be a
physician.
(8) A school corporation and a school employee who acts under
IC 34-30-14 (or IC 34-4-16.5-3.5 before its repeal).
(9) A chiropractor practicing the chiropractor's profession under
IC 25-10 or to an employee of a chiropractor acting under the
direction and supervision of the chiropractor under
IC 25-10-1-13.
(10) A dental hygienist practicing the dental hygienist's
profession under IC 25-13.
(11) A dentist practicing the dentist's profession under IC 25-14.
(12) A hearing aid dealer practicing the hearing aid dealer's
profession under IC 25-20.
(13) A nurse practicing the nurse's profession under IC 25-23.
However, a certified registered nurse anesthetist (as defined in
IC 25-23-1-1.4) may administer anesthesia if the certified
registered nurse anesthetist acts under the direction of and in
the immediate presence of a physician.
(14) An optometrist practicing the optometrist's profession
under IC 25-24.
(15) A pharmacist practicing the pharmacist's profession under
IC 25-26.
(16) A physical therapist practicing the physical therapist's
profession under IC 25-27.
(17) A podiatrist practicing the podiatrist's profession under
IC 25-29.
(18) A psychologist practicing the psychologist's profession
under IC 25-33.
(19) A speech-language pathologist or audiologist practicing the
pathologist's or audiologist's profession under IC 25-35.6.
(20) An employee of a physician or group of physicians who
performs an act, a duty, or a function that is customarily within
the specific area of practice of the employing physician or
group of physicians, if the act, duty, or function is performed
under the direction and supervision of the employing physician
or a physician of the employing group within whose area of
practice the act, duty, or function falls. An employee may not
make a diagnosis or prescribe a treatment and must report the
results of an examination of a patient conducted by the
employee to the employing physician or the physician of the
employing group under whose supervision the employee is
working. An employee may not administer medication without
the specific order of the employing physician or a physician of
the employing group. Unless an employee is licensed or
registered to independently practice in a profession described
in subdivisions (9) through (18), nothing in this subsection
grants the employee independent practitioner status or the
authority to perform patient services in an independent practice
in a profession.
(21) A hospital licensed under IC 16-21 or IC 12-25.
(22) A health care organization whose members, shareholders,
or partners are individuals, partnerships, corporations, facilities,
or institutions licensed or legally authorized by this state to
provide health care or professional services as:
(A) a physician;
(B) a psychiatric hospital;
(C) a hospital;
(D) a health maintenance organization or limited service
health maintenance organization;
(E) a health facility;
(F) a dentist;
(G) a registered or licensed practical nurse;
(H) a midwife;
(I) an optometrist;
(J) a podiatrist;
(K) a chiropractor;
(L) a physical therapist; or
(M) a psychologist.
(23) A physician assistant practicing the physician assistant
profession under IC 25-27.5.
(24) A physician providing medical treatment under
IC 25-22.5-1-2.1.
(25) An attendant who provides attendant care services (as
defined in IC 16-18-2-28.5).
(26) A personal services attendant providing authorized
attendant care services under IC 12-10-17.1.
(b) A person described in subsection (a)(9) through (a)(18) is not
excluded from the application of this article if:
(1) the person performs an act that an Indiana statute does not
authorize the person to perform; and
(2) the act qualifies in whole or in part as the practice of
medicine or osteopathic medicine.
(c) An employment or other contractual relationship between an
entity described in subsection (a)(21) through (a)(22) and a licensed
physician does not constitute the unlawful practice of medicine under
this article if the entity does not direct or control independent
medical acts, decisions, or judgment of the licensed physician.
However, if the direction or control is done by the entity under
IC 34-30-15 (or IC 34-4-12.6 before its repeal), the entity is excluded
from the application of this article as it relates to the unlawful
practice of medicine or osteopathic medicine.
(d) This subsection does not apply to a prescription or drug order
for a legend drug that is filled or refilled in a pharmacy owned or
operated by a hospital licensed under IC 16-21. A physician licensed
in Indiana who permits or authorizes a person to fill or refill a
prescription or drug order for a legend drug except as authorized in
IC 16-42-19-11 through IC 16-42-19-19 is subject to disciplinary
action under IC 25-1-9. A person who violates this subsection
commits the unlawful practice of medicine under this chapter.
(e) A person described in subsection (a)(8) shall not be authorized
to dispense contraceptives or birth control devices.
(Formerly: Acts 1975, P.L.271, SEC.1.) As amended by Acts 1977,
P.L.273, SEC.2; P.L.244-1985, SEC.2; P.L.149-1987, SEC.50;
P.L.156-1988, SEC.1; P.L.237-1989, SEC.1; P.L.1-1990, SEC.253;
P.L.2-1992, SEC.776; P.L.2-1993, SEC.141; P.L.227-1993, SEC.10;
P.L.227-1995, SEC.1; P.L.1-1998, SEC.132; P.L.44-1998, SEC.1;
P.L.156-2001, SEC.6; P.L.255-2001, SEC.17; P.L.2-2003, SEC.65;
P.L.205-2003, SEC.37; P.L.97-2004, SEC.93; P.L.212-2005,
SEC.20; P.L.141-2006, SEC.106; P.L.90-2007, SEC.4;
P.L.177-2009, SEC.40.
IC 25-22.5-1-2.1
Experimental or nonconventional treatment; protocols for
treatment
Sec. 2.1. (a) An individual who consents under IC 34-18-12 may
receive any experimental or nonconventional medical treatment if:
(1) a licensed physician has personally examined the individual
and agrees to treat the individual;
(2) there is no reasonable basis to conclude that the medical
treatment, when administered as directed, poses an
unreasonable and significant risk of danger to the individual
receiving the medical treatment; and
(3) the physician has provided the individual with a written
statement and an oral explanation of the medical treatment that
the individual has acknowledged by the individual's signature
or the signature of the individual's legal representative and that
discloses the following:
(A) That the medical treatment is experimental or
nonconventional.
(B) That the drug or medical device has not been approved
by the United States Food and Drug Administration for any
indication.
(C) The material risks generally recognized by a reasonably
prudent physician of the medical treatment's side effects.
(b) If the medical treatment is to be provided on an inpatient or
outpatient basis at a hospital licensed under IC 16-21, then that type
of treatment must have been approved by the governing board of the
hospital or by a commitee of the hospital authorized by the governing
board to approve the types of experimental or nonconventional
medical treatments that may be provided at the hospital on an
inpatient or outpatient basis.
(c) The medical licensing board shall develop protocols for
medical treatments that are provided in a setting other than the
inpatient or outpatient hospital setting specified in subsection (b). A
physician who fails to comply with a protocol developed under this
subsection shall be subject to discipline by the medical licensing
board.
(d) This section does not require any person or organization to
provide an individual with access to a medical treatment not
otherwise commercially available to that individual.
(e) This section does not require:
(1) an insurer;
(2) a fraternal benefit society;
(3) a nonprofit corporation;
(4) a health maintenance organization (as defined in
IC 27-13-1-19);
(5) a preferred provider arrangement under IC 27-8-11; or
(6) a limited service health maintenance organization (as
defined in IC 27-13-34-4);
to provide coverage or make payment beyond the terms and
conditions of the contract for medical treatment authorized under this
section.
As added by P.L.44-1998, SEC.2. Amended by P.L.49-1999, SEC.1.