Statutes and Rules Updates Presented by: Kirk E. Masten, D.O. President, Medical Licensing Board of Indiana

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1 Medical Licensing Board of Indiana Statutes and Rules Updates Presented by: Kirk E. Masten, D.O. President, Medical Licensing Board of Indiana

2 Overview of existing regulations What changed? Overview of 2016 legislation What s going to change? Overview of proposed regulations

3 Ind. Code Ind. Code Indiana Administrative Code Title 844

4 Fraud Criminal convictions Violation of state or federal regulation Incompetence Physical or mental disability Substance abuse Lewd or immoral conduct Unauthorized delegation Discipline in another state Drug diversion Aiding an addict s addiction Failure to follow a Board order Sexual misconduct HMO fraud Accomplice

5 Disciplinary Outcomes Revocation Suspension Censure Probation Reprimand Fine

6 Civil Penalties Ind. Code License renewal fraud Improper termination of patient Expired license Office-based anesthesia without proper accreditation Failure to perform duties related to birth or death certificates Failure to disclose, or negligent omission, of documentation requested for licensure renewal Failure to perform duties related to Terminated Pregnancy Reports

7 Standards of Professional Conduct & Competent Practice 844 IAC 5 -Discontinuance of Practice -Use of Internet & Prescribing to Patients not seen -Opioid prescribing requirements

8 844 IAC Triggers for Imposition of Opioid Prescribing Rule -More than 60 opioid containing pills a month for more than 3 consecutive months -A MED* of more than 15 mg per day for more than 3 consecutive months -A transdermal opioid patch for more than 3 consecutive months -Tramadol dose exceeds 60 mg MED a day for more than 3 consecutive months -Any opioiod extended release medication** not in an abuse deterrent form *- Morphine equivalent dose **- Change from hydrocodone-only

9 2016 LEGISLATIVE CHANGES -Expedited licensure of military spouses -Release of prenatal drug or alcohol screens to law enforcement -INSPECT reports in patient charts -High breast density notifications

10 2016 LEGISLATIVE CHANGES - IC Telehealth, HB Telemedicine means the delivery of health care services using electronic communications and information technology... between a provider in one location and a patient in another location. - Who is a provider subject to this statute? - Physician, Physician Assistant with prescriptive authority, Advanced Practice Nurse with prescriptive authority, or optometrist.

11 2016 LEGISLATIVE CHANGES Telehealth, HB 1263 Telemedicine does not include: - Audio-only communication - Telephone call - Electronic mail - Instant messaging - Fax - Internet questionnaire or consultation

12 2016 LEGISLATIVE CHANGES Telehealth Standards - Held to same standard as in-person setting - Must establish provider-patient relationship Identity and location of patient Informed consent Discussion of diagnosis and treatment Follow-up care instructions Provider s identity disclosed Medical history Creation of medical record Telemedicine summary provided to patient

13 2016 LEGISLATIVE CHANGES Telehealth Prescriptions - May prescribe after telehealth encounter, even if patient not seen in person - Prohibition on prescribing controlled substances, abortifacients; ophthalmic devices - Must meet applicable standard of care

14 2016 LEGISLATIVE CHANGES Telehealth Out-of-state providers - Practice of medicine in Indiana if an out-ofstate provider provides telemedicine services to an Indiana patient - Need Indiana license - Provider telemedicine certification - Employer/contractor telemedicine certification

15 UPCOMING RULE CHANGES High Breast Density Notification Rule -Notification to patients with high breast density -Educational programs -Screening and diagnostic test standards

16 -Licensure requirements & fees -Scope of practice -Standards of practice -Certification requirements UPCOMING RULE CHANGES Anesthesiologist Assistant Rule

17 UPCOMING RULE CHANGES Diabetes Educator Rule -Licensure & education requirements -Standards of practice -Self-management training techniques

18 -Certification requirements -Standards of practice -Collaboration Requirements -Immunity UPCOMING RULE CHANGES Direct Entry Midwife Rule

19 Questions? Kirk E. Masten, D.O. President, Medical Licensing Board of Indiana CONTACT INFO