reglab/statecodes huggingface dataset:
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-2.8. "Ophthalmic Device"

Sec. 2.8. As used in this chapter, "ophthalmic device" means either of the following:
(1) Eye glasses.
(2) Contact lenses.
As added by P.L.52-2020, SEC.2.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-3. "Originating Site"

Sec. 3. As used in this chapter, "originating site" means any site at which a patient is located at the time health care services through telehealth are provided to the individual.
As added by P.L.78-2016, SEC.2. Amended by P.L.85-2021, SEC.12.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-3.5. "Practitioner"

Sec. 3.5. (a) As used in this chapter, "practitioner" means an individual who holds an unlimited license to practice as any of the following in Indiana:
(1) An athletic trainer licensed under IC 25-5.1.
(2) A chiropractor licensed under IC 25-10.
(3) A dental hygienist licensed under IC 25-13.
(4) The following:
(A) A dentist licensed under IC 25-14.
(B) An individual who holds a dental residency permit issued under IC 25-14-1-5.
(C) An individual who holds a dental faculty license under IC 25-14-1-5.5.
(5) A diabetes educator licensed under IC 25-14.3.
(6) A dietitian licensed under IC 25-14.5.
(7) A genetic counselor licensed under IC 25-17.3.
(8) The following:
(A) A physician licensed under IC 25-22.5.
(B) An individual who holds a temporary permit under IC 25-22.5-5-4.
(9) A nurse licensed under IC 25-23.
(10) The following:
(A) An occupational therapist licensed under IC 25-23.5.
(B) An occupational therapy assistant licensed under IC 25-23.5.
(11) Any behavioral health and human services professional licensed under IC 25-23.6.
(12) An optometrist licensed under IC 25-24.
(13) A pharmacist licensed under IC 25-26.
(14) A physical therapist licensed under IC 25-27.
(15) A physician assistant licensed under IC 25-27.5.
(16) A podiatrist licensed under IC 25-29.
(17) A psychologist licensed under IC 25-33.
(18) A respiratory care practitioner licensed under IC 25-34.5.
(19) A speech-language pathologist or audiologist licensed under IC 25-35.6.
(20) A veterinarian licensed under IC 25-38.1.
(21) A behavior analyst licensed under IC 25-8.5.
(22) A school psychologist licensed by the department of education.
(b) The term includes the following:
(1) A developmental therapist enrolled by the bureau of child development services to provide special instruction, as defined in 34 CFR 303.13(b)(14), to infants and toddlers receiving early intervention services.
(2) A peer as defined in IC 12-21-8-5 and certified by the division of mental health and addiction.
(3) A clinical fellow in speech language pathology.
(4) A student who:
(A) is pursuing a course of study in, or is a graduate from, a program in a profession specified in subsection (a)(1) through (a)(22); and
(B) is providing services directed by an individual who holds a license in Indiana for that profession.
(5) The following providers within a community mental health center:
(A) A qualified behavioral health professional.
(B) Other behavioral health professional.
(6) A physical therapist assistant certified under IC 25-27-1-6.3.
(c) The term includes a behavior analyst during the time in which the professional licensing agency is preparing to implement licensure of behavioral analysts under IC 25-8.5. This subsection expires January 1, 2025.
As added by P.L.85-2021, SEC.13. Amended by P.L.207-2021, SEC.25; P.L.109-2022, SEC.4.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-4. "Prescriber"

Sec. 4. As used in this chapter, "prescriber" means any of the following:
(1) A physician licensed under IC 25-22.5.
(2) A physician assistant licensed under IC 25-27.5 and granted the authority to prescribe by the physician assistant's collaborating physician in accordance with IC 25-27.5-5-4.
(3) An advanced practice registered nurse licensed and granted the authority to prescribe drugs under IC 25-23.
(4) An optometrist licensed under IC 25-24.
(5) A podiatrist licensed under IC 25-29.
(6) A dentist licensed under IC 25-14.
(7) A veterinarian licensed under IC 25-38.1.
As added by P.L.78-2016, SEC.2. Amended by P.L.150-2017, SEC.4; P.L.129-2018, SEC.25; P.L.247-2019, SEC.2; P.L.85-2021, SEC.14.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-4.5. "Refraction"

Sec. 4.5. As used in this chapter, "refraction" means a test that is performed to measure an individual's prescription for eye glasses or contact lenses.
As added by P.L.52-2020, SEC.3.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-5. "Store and Forward"

Sec. 5. As used in this chapter, "store and forward" means the transmission of a patient's medical information from an originating site to the practitioner at a distant site without the patient being present.
As added by P.L.78-2016, SEC.2. Amended by P.L.150-2017, SEC.5; P.L.85-2021, SEC.15.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-6. "Telehealth"

Sec. 6. (a) As used in this chapter, "telehealth" means the delivery of health care services using interactive electronic communications and information technology, in compliance with the federal Health Insurance Portability and Accountability Act (HIPAA), including:
(1) secure videoconferencing;
(2) store and forward technology; or
(3) remote patient monitoring technology;
between a provider in one (1) location and a patient in another location.
(b) The term does not include the use of the following unless the practitioner has an established relationship with the patient:
(1) Electronic mail.
(2) An instant messaging conversation.
(3) Facsimile.
(4) Internet questionnaire.
(5) Internet consultation.
(c) The term does not include a health care service provided by:
(1) an employee of a practitioner; or
(2) an individual who is employed by the same entity that employs the practitioner;
who is performing a health care service listed in section 2.5(a)(2), 2.5(a)(3), or 2.5(a)(4) of this chapter under the direction and that is customarily within the specific area of practice of the practitioner.
As added by P.L.78-2016, SEC.2. Amended by P.L.85-2021, SEC.16; P.L.207-2021, SEC.26; P.L.109-2022, SEC.5.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-8. Issuance of Prescription; Controlled Substance Conditions

Sec. 8. (a) A prescriber may issue a prescription to a patient who is receiving services through the use of telehealth if the patient has not been examined previously by the prescriber in person if the following conditions are met:
(1) The prescriber has satisfied the applicable standard of care in the treatment of the patient.
(2) The issuance of the prescription by the prescriber is within the prescriber's scope of practice and certification.
(3) The prescription:
(A) meets the requirements of subsection (b); and
(B) is not for an opioid. However, an opioid may be prescribed if the opioid is a partial agonist that is used to treat or manage opioid dependence.
(4) The prescription is not for an abortion inducing drug (as defined in IC 16-18-2-1.6).
(5) If the prescription is for a medical device, including an ophthalmic device, the prescriber must use telehealth technology that is sufficient to allow the provider to make an informed diagnosis and treatment plan that includes the medical device being prescribed. However, a prescription for an ophthalmic device is also subject to the conditions in section 13 of this chapter.
(b) Except as provided in subsection (a), a prescriber may issue a prescription for a controlled substance (as defined in IC 35-48-1-9) to a patient who is receiving services through the use of telehealth, even if the patient has not been examined previously by the prescriber in person, if the following conditions are met:
(1) The prescriber maintains a valid controlled substance registration under IC 35-48-3.
(2) The prescriber meets the conditions set forth in 21 U.S.C. 829 et seq.
(3) A practitioner acting in the usual course of the practitioner's professional practices issues the prescription for a legitimate medical purpose.
(4) The telehealth communication is conducted using an audiovisual, real time, two-way interactive communication system.
(5) The prescriber complies with the requirements of the INSPECT program (IC 25-26-24).
(6) All other applicable federal and state laws are followed.
(c) A prescription for a controlled substance under this section must be prescribed and dispensed in accordance with IC 25-1-9.3 and IC 25-26-24.
As added by P.L.78-2016, SEC.2. Amended by P.L.150-2017, SEC.7; P.L.51-2019, SEC.3; P.L.28-2019, SEC.10; P.L.211-2019, SEC.34; P.L.52-2020, SEC.4; P.L.85-2021, SEC.18.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-9. Physically Located Outside Indiana and Providing Health Care; Certification; Renewal

Sec. 9. (a) A practitioner who is physically located outside Indiana is engaged in the provision of health care services in Indiana when the practitioner:
(1) establishes a provider-patient relationship under this chapter with; or
(2) determines whether to issue a prescription under this chapter for;
an individual who is located in Indiana.
(b) A practitioner described in subsection (a) may not establish a provider-patient relationship under this chapter with or issue a prescription under this chapter for an individual who is located in Indiana unless the practitioner and the practitioner's employer or the practitioner's contractor, for purposes of providing health care services under this chapter, have certified in writing to the Indiana professional licensing agency, in a manner specified by the Indiana professional licensing agency, that the practitioner and the practitioner's employer or practitioner's contractor agree to be subject to:
(1) the jurisdiction of the courts of law of Indiana; and
(2) Indiana substantive and procedural laws;
concerning any claim asserted against the practitioner, the practitioner's employer, or the practitioner's contractor arising from the provision of health care services under this chapter to an individual who is located in Indiana at the time the health care services were provided. The filing of the certification under this subsection shall constitute a voluntary waiver by the practitioner, the practitioner's employer, or the practitioner's contractor of any respective right to avail themselves of the jurisdiction or laws other than those specified in this subsection concerning the claim. However, a practitioner that practices predominately in Indiana is not required to file the certification required by this subsection.
(c) A practitioner shall renew the certification required under subsection (b) at the time the practitioner renews the practitioner's license.
(d) A practitioner's employer or a practitioner's contractor is required to file the certification required by this section only at the time of initial certification.
As added by P.L.78-2016, SEC.2. Amended by P.L.150-2017, SEC.8; P.L.85-2021, SEC.19.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-10. Discipline; Penalties

Sec. 10. (a) A practitioner who violates this chapter is subject to disciplinary action under IC 25-1-9.
(b) A practitioner's employer or a practitioner's contractor that violates this section commits a Class B infraction for each act in which a certification is not filed as required by section 9 of this chapter.
As added by P.L.78-2016, SEC.2. Amended by P.L.150-2017, SEC.9; P.L.85-2021, SEC.20.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-11. Pharmacy Filling Prescription

Sec. 11. A pharmacy does not violate this chapter if the pharmacy fills a prescription for an opioid and the pharmacy is unaware that the prescription was written or electronically transmitted by a prescriber providing telehealth services under this chapter.
As added by P.L.78-2016, SEC.2. Amended by P.L.150-2017, SEC.10; P.L.28-2019, SEC.11; P.L.85-2021, SEC.21.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-12. Adoption of Policies or Rules

Sec. 12. The Indiana professional licensing agency may adopt policies or rules under IC 4-22-2 necessary to implement this chapter. Adoption of policies or rules under this section may not delay the implementation and provision of telehealth services under this chapter.
As added by P.L.78-2016, SEC.2. Amended by P.L.85-2021, SEC.22.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-13. Prescription Prerequisites

Sec. 13. (a) As used in this section, "HIPAA" refers to the federal Health Insurance Portability and Accountability Act.
(b) A prescriber may not issue a prescription for an ophthalmic device unless the following conditions are met:
(1) If the prescription is for contact lenses or eyeglasses, the patient must be at least eighteen (18) years of age but not more than fifty-five (55) years of age.
(2) The patient must have completed a medical eye history that includes information concerning the following:
(A) Chronic health conditions.
(B) Current medications.
(C) Eye discomfort.
(D) Blurry vision.
(E) Any prior ocular medical procedures.
(3) The patient must have had a prior prescription from a qualified eye care professional that included a comprehensive in person exam that occurred within two (2) years before the initial use of telehealth for a refraction under subdivision (5)(A).
(4) If the patient desires a contact lens prescription, at the discretion of the eye care professional, that patient must have had a prior contact lens fitting or evaluation by a qualified eye care professional that occurred within two (2) years before the initial use of telehealth for a refraction under subdivision (5)(A).
(5) The patient:
(A) may not use telehealth more than two (2) consecutive times within two (2) years from the date of the examination that occurred under subdivision (3) for a refraction without a subsequent in person comprehensive eye exam; and
(B) must acknowledge that the patient has had a comprehensive eye exam as required under clause (A) before receiving an online prescription.
(6) The patient may allow the prescriber to access the patient's medical records using an appropriate HIPAA compliant process.
(7) The prescriber must ensure that the transfer of all information, including the vision test and prescription, comply with HIPAA requirements.
(8) The prescriber must use technology to allow the patient to have continuing twenty-four (24) hour a day online access to the patient's prescription as soon as the prescription is signed by the prescriber.
As added by P.L.52-2020, SEC.5. Amended by P.L.85-2021, SEC.23.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-14. No Requirement to Provide or Use Telehealth

Sec. 14. Nothing in this chapter requires an individual to provide or use telehealth.
As added by P.L.85-2021, SEC.24.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.5. Telehealth Services and Prescriptions › 25-1-9.5-15. Veterinarian-Client-Patient Relationship

Sec. 15. If a veterinarian is required to establish a veterinarian-client-patient relationship to perform a health care service, the veterinarian shall ensure that a proper veterinarian-client-patient relationship is established, as defined in IC 25-38.1-1-14.5, when providing the service using telehealth.
As added by P.L.85-2021, SEC.25.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.7. Prescribing and Dispensing of Opioids › 25-1-9.7-1. "Prescriber"

Sec. 1. As used in this chapter, "prescriber" refers to a practitioner who maintains an Indiana controlled substance registration and a federal Drug Enforcement Administration registration.
As added by P.L.182-2017, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.7. Prescribing and Dispensing of Opioids › 25-1-9.7-2. Limitations on Prescribing Opioids; Exemptions; Documentation

Sec. 2. (a) Except as provided in subsection (b), a prescriber may issue a prescription for an opioid only if the following limitations are met:
(1) If the prescription is for an adult who is being prescribed an opioid for the first time by the prescriber, the initial prescription may not exceed a seven (7) day supply.
(2) If the prescription is for a child who is less than eighteen (18) years of age, the prescription may not exceed a seven (7) day supply.
(3) If the prescription is for an animal that is being prescribed an opioid for the first time by the veterinarian, the initial prescription may not exceed a seven (7) day supply.
(b) The limitations set forth in subsection (a) do not apply under any of the following circumstances:
(1) The prescriber is issuing the prescription for the treatment or provision of any of the following:
(A) Cancer.
(B) Palliative care.
(C) Medication-assisted treatment for a substance use disorder.
(D) A condition that is adopted by rule by the medical licensing board under IC 25-22.5-13-8 to be necessary to be exempted from subsection (a).
(2) If, in the professional judgment of a prescriber, a patient requires more than the prescription limitations specified in subsection (a).
(c) If a prescriber:
(1) determines that a drug other than an opioid is not appropriate; and
(2) uses an exemption specified in subsection (b)(1)(B) or (b)(2) and issues a prescription for a patient that exceeds the limitations set forth in subsection (a);
the prescriber shall document in the patient's medical record the indication that a drug other than an opiate was not appropriate and that the patient is receiving palliative care or that the prescriber is using the prescriber's professional judgment for the exemption.
As added by P.L.182-2017, SEC.1. Amended by P.L.12-2019, SEC.1; P.L.156-2020, SEC.98.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.7. Prescribing and Dispensing of Opioids › 25-1-9.7-3. Opioid Prescription for Lesser Amount Upon Request

Sec. 3. A prescriber shall, upon the request of the:
(1) patient;
(2) personal or legal representative of the patient; or
(3) guardian of the patient;
issue the opioid prescription for a lesser amount than the prescriber initially intended to prescribe, issue the opioid prescription for the lesser amount, and indicate the request and who made the request in the patient's medical file.
As added by P.L.182-2017, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.7. Prescribing and Dispensing of Opioids › 25-1-9.7-4. Partial Refill; Pharmacist Responsibilities

Sec. 4. (a) For a partial fill of an opioid prescription, a pharmacist shall dispense, upon request of the:
(1) patient;
(2) personal or legal representative of the patient; or
(3) guardian of the patient;
the lesser amount requested.
(b) If a prescription for an opioid is partially filled under subsection (a), the pharmacist shall do the following:
(1) Comply with the partial refill requirements set forth in 21 U.S.C. 829.
(2) Document that an individual described in subsection (a) for whom the partial prescription was filled (or the individual's personal or legal representative or guardian) requested the partially filled prescription.
As added by P.L.182-2017, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-1. "Covered Individual"

Sec. 1. As used in this chapter, "covered individual" means an individual who is entitled to be provided health care services according to a health carrier's network plan.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-1.5. "Episode of Care"

Sec. 1.5. As used in this chapter, "episode of care" means the medical care ordered to be provided for a specific medical procedure, condition, or illness.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-2. "Good Faith Estimate"

Sec. 2. As used in this chapter, "good faith estimate" means a reasonable estimate of the price each provider anticipates charging for an episode of care for nonemergency health care services that:
(1) is made by a practitioner or provider facility under this chapter upon the request of:
(A) the individual for whom the nonemergency health care service has been ordered; or
(B) the provider facility in which the nonemergency health care service will be provided; and
(2) is not binding upon the provider.
As added by P.L.93-2020, SEC.7. Amended by P.L.202-2021, SEC.2.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-3. "Health Carrier"

Sec. 3. (a) As used in this chapter, "health carrier" means an entity:
(1) that is subject to IC 27 and the administrative rules adopted under IC 27; and
(2) that enters into a contract to:
(A) provide health care services;
(B) deliver health care services;
(C) arrange for health care services; or
(D) pay for or reimburse any of the costs of health care services.
(b) The term includes the following:
(1) An insurer, as defined in IC 27-1-2-3(x), that issues a policy of accident and sickness insurance, as defined in IC 27-8-5-1(a).
(2) A health maintenance organization, as defined in IC 27-13-1-19.
(3) An administrator (as defined in IC 27-1-25-1(a)) that is licensed under IC 27-1-25.
(4) A state employee health plan offered under IC 5-10-8.
(5) A short term insurance plan (as defined by IC 27-8-5.9-3).
(6) Any other entity that provides a plan of health insurance, health benefits, or health care services.
(c) The term does not include:
(1) an insurer that issues a policy of accident and sickness insurance;
(2) a limited service health maintenance organization (as defined in IC 27-13-34-4); or
(3) an administrator;
that only provides coverage for, or processes claims for, dental or vision care services.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-4. "In Network"

Sec. 4. As used in this chapter, "in network", when used in reference to a practitioner, means that the health care services provided by the practitioner are subject to a health carrier's network plan.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-5. "Network"

Sec. 5. (a) As used in this chapter, "network" means a group of provider facilities and practitioners that:
(1) provide health care services to covered individuals; and
(2) have agreed to, or are otherwise subject to, maximum limits on the prices for the health care services to be provided to the covered individuals.
(b) The term includes the following:
(1) A network described in subsection (a) that is established pursuant to a contract between an insurer providing coverage under a group health policy and:
(A) individual provider facilities and practitioners;
(B) a preferred provider organization; or
(C) an entity that employs or represents providers, including:
(i) an independent practice association; and
(ii) a physician-hospital organization.
(2) A health maintenance organization, as defined in IC 27-13-1-19.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-6. "Network Plan"

Sec. 6. As used in this chapter, "network plan" means a plan of a health carrier that:
(1) requires a covered individual to receive; or
(2) creates incentives, including financial incentives, for a covered individual to receive;
health care services from one (1) or more providers that are under contract with, managed by, or owned by the health carrier.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-7. "Nonemergency Health Care Service"

Sec. 7. As used in this chapter, "nonemergency health care service" means a discrete service or series of services ordered by a practitioner for an episode of care for the:
(1) diagnosis;
(2) prevention;
(3) treatment;
(4) cure; or
(5) relief;
of a physical, mental, or behavioral health condition, illness, injury, or disease that is not provided on an emergency or urgent care basis.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-8. "Practitioner"

Sec. 8. (a) As used in this chapter, "practitioner" means the following:
(1) An individual who holds:
(A) an unlimited license, certificate, or registration;
(B) a limited or probationary license, certificate, or registration;
(C) a temporary license, certificate, registration, or permit;
(D) an intern permit; or
(E) a provisional license;
issued by the board (as defined in IC 25-0.5-11-1) regulating the profession in question.
(2) An entity that:
(A) is owned by, or employs; or
(B) performs billing for professional health care services rendered by;
an individual described in subdivision (1).
(b) The term does not include the following:
(1) A dentist licensed under IC 25-14.
(2) An optometrist licensed under IC 25-24.
(3) A provider facility.
As added by P.L.93-2020, SEC.7. Amended by P.L.202-2021, SEC.3.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-8.5. "Price"

Sec. 8.5. As used in this chapter, "price" means the negotiated rate between the:
(1) provider facility and practitioner; and
(2) covered individual's primary health carrier.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-9. "Provider"

Sec. 9. As used in this chapter, "provider" means:
(1) a provider facility; or
(2) a practitioner.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-10. "Provider Facility"

Sec. 10. (a) As used in this chapter, "provider facility" means any of the following:
(1) A hospital licensed under IC 16-21-2.
(2) An ambulatory outpatient surgical center licensed under IC 16-21-2.
(3) A birthing center licensed under IC 16-21-2.
(4) Except for an urgent care facility (as defined by IC 27-1-46-10.5), a facility that provides diagnostic services to the medical profession or the general public.
(5) A laboratory where clinical pathology tests are carried out on specimens to obtain information about the health of a patient.
(6) A facility where radiologic and electromagnetic images are made to obtain information about the health of a patient.
(7) An infusion center that administers intravenous medications.
(b) The term does not include the following:
(1) A private mental health institution licensed under IC 12-25.
(2) A Medicare certified, freestanding rehabilitation hospital.
As added by P.L.93-2020, SEC.7. Amended by P.L.9-2022, SEC.46; P.L.179-2022(ss), SEC.40.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-11. Applicability; Request for Good Faith Estimate; Requirements

Sec. 11. (a) This section does not apply to an individual who is a Medicaid recipient.
(b) An individual for whom a nonemergency health care service has been ordered, scheduled, or referred may request from the practitioner who may provide the nonemergency health care service a good faith estimate of the total price the practitioner will charge for providing the nonemergency health care service.
(c) A practitioner who receives a request from a patient under subsection (b) shall, not more than five (5) business days after receiving relevant information from the individual, provide to the individual a good faith estimate of the price that the practitioner will charge for providing the nonemergency health care service.
(d) A practitioner must ensure that a good faith estimate provided to an individual under this section is accompanied by a notice stating that:
(1) an estimate provided under this section is not binding on the practitioner;
(2) the price the practitioner charges the individual may vary from the estimate based on the individual's medical needs; and
(3) the estimate provided under this section is only valid for thirty (30) days.
(e) A practitioner may not charge an individual for information provided under this section.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-12. In Network Good Faith Estimates; Out of Network Good Faith Estimates

Sec. 12. (a) If:
(1) the individual who requests a good faith estimate from a practitioner under this chapter is a covered individual with respect to a network plan; and
(2) the practitioner from which the individual requests the good faith estimate is in network with respect to the same network plan;
the good faith estimate that the practitioner provides to the individual under this chapter must be based on the negotiated price to which the practitioner has agreed as an in network provider.
(b) If the individual who requests a good faith estimate from a practitioner under this chapter:
(1) is not a covered individual with respect to any network plan; or
(2) is not a covered individual with respect to a network plan with respect to which the practitioner is in network;
the good faith estimate that the practitioner provides to the individual under this chapter must be based on the price that the practitioner charges for the nonemergency health care service in the absence of any network plan.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-13. Provision of Good Faith Estimate

Sec. 13. A practitioner may provide a good faith estimate to an individual under this chapter:
(1) in a writing delivered to the individual;
(2) by electronic mail; or
(3) through a mobile application or other Internet web based method, if available;
according to the preference expressed by the individual.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-14. Good Faith Estimate Requirements; Information Health Carrier and Provider Must Provide to Practitioner; When Practitioner Not Subject to Penalties

Sec. 14. (a) A good faith estimate provided by a practitioner to an individual under this chapter must meet the following requirements:
(1) Provide a summary of the services and material items that the good faith estimate is based on.
(2) Include:
(A) the price charged for the services and material items that the practitioner will provide and charge the individual; and
(B) the price that the provider facility in which the health care service will be performed charged for:
(i) the use of the provider facility to care for the individual for the nonemergency health care service;
(ii) the services rendered by the employed or contracted staff of the provider facility in connection with the nonemergency health care service; and
(iii) medication, supplies, equipment, and material items to be provided to or used by the individual while the individual is present in the provider facility in connection with the nonemergency health care service;
for imaging, laboratory services, diagnostic services, therapy, observation services, and other services expected to be provided to the individual for the episode of care.
(3) Include a total figure that is a sum of the estimated prices referred to in subdivisions (1) and (2).
(b) Subsection (a) does not prohibit a practitioner from providing to an individual a good faith estimate that indicates how much of the total figure stated under subsection (a)(2) will be the individual's out-of-pocket expense after the health carrier's payment of charges.
(c) A health carrier and a provider facility must provide a practitioner with the information needed by the practitioner to comply with the requirements under this chapter not more than two (2) business days after receiving the request. The provider facility shall provide the practitioner with all relevant information for services and costs for the good faith estimate that are to be provided by the provider facility for inclusion in a good faith estimate by the practitioner.
(d) A practitioner is not subject to the penalties under section 19 of this chapter if:
(1) a health carrier or provider facility fails to provide the practitioner with the information as required under subsection (c);
(2) the practitioner provides the individual with a good faith estimate based on any information that the practitioner has; and
(3) the practitioner provides the individual with an updated good faith estimate after the health carrier or provider facility has provided the information required under subsection (c).
As added by P.L.93-2020, SEC.7. Amended by P.L.202-2021, SEC.4.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-15. Provision of Information by Practitioner to Provider Facility

Sec. 15. If:
(1) a practitioner is expected to provide a nonemergency health care service to an individual in a provider facility; and
(2) the provider facility receives a request from an individual for a good faith estimate under IC 27-1-46;
the practitioner, upon request from the provider facility, shall provide to the provider facility a good faith estimate of the practitioner's price for providing the nonemergency health care service to enable the provider facility to comply with IC 27-1-46-11.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-16. Practitioner Duty to Give Written Notice of Individual's Right to an Estimate; Rules

Sec. 16. (a) A practitioner that has scheduled or ordered for an individual a nonemergency health care service shall provide to the individual an electronic or paper copy of a written notice that states the following, or words to the same effect: "A patient may ask a health care provider for an estimate of the price the health care providers and health facility will charge for providing a nonemergency health care service. The law requires that the estimate be provided within 5 business days of scheduling the nonemergency health care service unless the nonemergency health care service is scheduled to be performed by the practitioner within 5 business days of the date of the patient's request.".
(b) The appropriate board (as defined in IC 25-1-9-1) may adopt rules under IC 4-22-2 to establish requirements for practitioners to provide additional charging information under this section.
As added by P.L.93-2020, SEC.7. Amended by P.L.32-2021, SEC.69; P.L.202-2021, SEC.5.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-17. Medicare Good Faith Estimates

Sec. 17. If:
(1) a practitioner receives a request for a good faith estimate under this chapter; and
(2) the patient is eligible for Medicare coverage;
the practitioner shall provide a good faith estimate to the patient within five (5) business days based on available Medicare rates.
As added by P.L.93-2020, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-18. Practitioner or Provider Facility Communication About Right to Good Faith Estimate by at Least Three Means; Required Contents

Sec. 18. (a) Each provider must make diligent attempts to ensure that the patient is aware of the patient's right to request a good faith estimate under this chapter. The communication by each provider of information to the patient concerning the right to a good faith estimate must be conspicuous and must be provided by at least three (3) of the following means:
(1) Notice on the provider's Internet web site.
(2) On hold messaging.
(3) Waiting room notification.
(4) Preappointment reminders, including through electronic mail (email) or text messaging.
(5) During appointment or services check in.
(6) During appointment or services check out.
(7) During patient financial services or billing department inquiries.
(8) Through an electronic medical and patient communication portal.
(b) The communication required under subsection (a) must state the following, or words to the same effect: "A patient may ask for an estimate of the amount the patient will be charged for a nonemergency medical service provided in our office. The law requires that an estimate be provided within 5 business days of scheduling the nonemergency health care service unless the nonemergency health care service is scheduled to be performed by the practitioner within 5 business days of the date of the patient's request.".
As added by P.L.93-2020, SEC.7. Amended by P.L.202-2021, SEC.6.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-19. Action by Appropriate Board Concerning Good Faith Estimate or Communication About Right to Estimate

Sec. 19. The appropriate board (as defined in IC 25-1-9-1) may take action against a practitioner:
(1) under IC 25-1-9-9(a)(3) or IC 25-1-9-9(a)(4) for an initial violation or isolated violations of this chapter; or
(2) under IC 25-1-9-9(a)(6) for repeated or persistent violations of this chapter;
concerning the providing of a good faith estimate to an individual for whom a nonemergency health care service has been ordered or the communication to a patient under section 18 of this chapter of information concerning the patient's right to a good faith estimate of the price that the patient will be charged for a medical service.
As added by P.L.93-2020, SEC.7. Amended by P.L.202-2021, SEC.7.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 9.8. Practitioner Good Faith Estimates › 25-1-9.8-20. Compliance With Federal Requirements

Sec. 20. The requirements of this chapter do not apply to a practitioner who:
(1) is required to comply with; and
(2) is in compliance with;
45 CFR Part 149, Subparts E and G, as may be enforced and amended by the federal Department of Health and Human Services.
As added by P.L.165-2022, SEC.2. Amended by P.L.190-2023, SEC.9.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10. Direct Primary Care Agreements › 25-1-10-1. "Direct Primary Care Agreement"

Sec. 1. As used in this chapter, "direct primary care agreement" means a contract entered into between a primary care provider or an employer of a primary care provider and an individual patient or the patient's legal representative in which the primary care provider or the employer of the primary care provider:
(1) agrees to provide primary care health services to the individual patient for an agreed upon fee and time;
(2) does not bill a third party that provides coverage to the patient for the primary care health services; and
(3) charges a periodic fee for the primary care health services.
As added by P.L.108-2017, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10. Direct Primary Care Agreements › 25-1-10-2. "Primary Care Provider"

Sec. 2. As used in this chapter, "primary care provider" means a person that is licensed, certified, or registered under IC 12, IC 16, or this title to provide primary care health services in Indiana.
As added by P.L.108-2017, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10. Direct Primary Care Agreements › 25-1-10-3. "Primary Care Health Services"

Sec. 3. As used in this chapter, "primary care health services" includes any of the following services that are provided within the primary care provider's scope of practice and for the purpose of promotion of health or the detection and management of disease or injury:
(1) Screening.
(2) Assessment.
(3) Diagnosis.
(4) Treatment.
(5) Referrals.
(6) Coordination of care.
As added by P.L.108-2017, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10. Direct Primary Care Agreements › 25-1-10-4. Direct Primary Care Agreement Not Insurance; Not Subject to Ic 27

Sec. 4. (a) A direct primary care agreement is not insurance and is not subject to IC 27.
(b) Entering into a direct primary care agreement is not the business of insurance and is not subject to IC 27.
(c) A primary care provider or an employer of a primary care provider that enters into a direct primary care agreement is not required to obtain a certificate of authority under IC 27-1-3-20.
As added by P.L.108-2017, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10. Direct Primary Care Agreements › 25-1-10-5. Requirements for Direct Primary Care Agreement

Sec. 5. A direct primary care agreement must meet all of the following requirements:
(1) Be in writing.
(2) Be signed by the:
(A) primary care provider, the employer of the primary care provider, or an agent of the primary care provider or employer of the primary care provider; and
(B) the patient or the patient's legal representative.
(3) Allow either party to terminate the agreement upon written notice to the other party.
(4) Describe the scope of primary care health services that are covered by the periodic fee.
(5) Specify the periodic fee and any additional fees for ongoing care under the agreement.
(6) Specify the duration of the agreement and any automatic renewal periods.
(7) Require not more than twelve (12) months of a periodic fee to be paid in advance.
(8) Prominently state in writing that the agreement is not health insurance.
As added by P.L.108-2017, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10.3. Health Care Provider Advertising › 25-1-10.3-1. Application of Chapter

Sec. 1. This chapter does not apply to an advertisement communicated or disseminated before January 1, 2023. However, an advertisement that was prepared or created before January 1, 2023, may not be disseminated after December 31, 2022, unless the advertisement complies with the requirements set forth in section 7 of this chapter.
As added by P.L.128-2022, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10.3. Health Care Provider Advertising › 25-1-10.3-2. "Advertisement"

Sec. 2. (a) As used in this chapter, "advertisement" means any printed, electronic, or oral statement:
(1) that is communicated or disseminated to the general public;
(2) that:
(A) is intended to encourage a person to use a practitioner's professional services; or
(B) for commercial purposes, names a practitioner in connection with the practice, profession, or institution in which the practitioner is employed, volunteers, or provides health care services; and
(3) that the practitioner or the practitioner's group practice has control over the preparation, communication, or dissemination of the statement.
(b) The term includes the communication or dissemination as described in subsection (a) of any other communication or statement used in the course of business for the purpose of promoting a practitioner's services offered to the public.
(c) The term does not include the following:
(1) Office building placards.
(2) Exterior building signage that was in place before January 1, 2023.
As added by P.L.128-2022, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10.3. Health Care Provider Advertising › 25-1-10.3-3. "Deceptive or Misleading Information"

Sec. 3. As used in this chapter, "deceptive or misleading information" means any information that misrepresents or falsely describes a practitioner's:
(1) profession;
(2) skills;
(3) training;
(4) expertise;
(5) educational degree;
(6) board certification; or
(7) license.
As added by P.L.128-2022, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10.3. Health Care Provider Advertising › 25-1-10.3-3.5. "Educational Degree"

Sec. 3.5. As used in this chapter, "educational degree" means the degree awarded to the practitioner by a college or university in the practitioner's profession, which may be used under the scope of the practitioner's license, including use of its acronym.
As added by P.L.128-2022, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10.3. Health Care Provider Advertising › 25-1-10.3-4. "License"

Sec. 4. As used in this chapter, "license" has the meaning set forth in IC 25-1-2-6.
As added by P.L.128-2022, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10.3. Health Care Provider Advertising › 25-1-10.3-5. "Practitioner"

Sec. 5. (a) As used in this chapter, except as provided in subsection (b), "practitioner" means an individual who holds a license issued by a board described in IC 25-0.5-11, including a certificate of registration issued under IC 25-20.
(b) The term does not include a veterinarian licensed under IC 25-38.1.
As added by P.L.128-2022, SEC.1.
2023 Indiana Code › Title 25. Professions and Occupations › Article 1. General Provisions › Chapter 10.3. Health Care Provider Advertising › 25-1-10.3-6. "Profession"

Sec. 6. As used in this chapter, "profession" means the name or title of the profession of which a practitioner is a member, as specifically allowed for use by individuals who hold a license, license by endorsement, certificate, or registration from a board described in IC 25-0.5-11 under the board's governing statute or rules. The term does not include the license or educational degree of a practitioner.
As added by P.L.128-2022, SEC.1.