SENATOR Wachtmann

To amend sections 109.36, 1751.21, 2305.25, 2305.251,

1

2305.38, 3701.74, 4715.03, 4723.28, 4730.26,

2

4731.22, 4731.36, 4734.45, 4760.14, and 4762.14; to

3

amend, for the purpose of adopting new section

4

numbers as indicated in parentheses, sections

5

2305.25 (2305.251) and 2305.251 (2305.252); and to

6

enact new section 2305.25 and section 2305.253 of

7

the Revised Code to modify the law regarding peer

8

review committees.

9

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 109.36, 1751.21, 2305.25, 2305.251,	10
2305.38, 3701.74, 4715.03, 4723.28, 4730.26, 4731.22, 4731.36,	11
4734.45, 4760.14, and 4762.14 be amended; sections 2305.25	12
(2305.251) and 2305.251 (2305.252) be amended for the purpose of	13
adopting new section numbers as indicated in parentheses; and new	14
section 2305.25 and section 2305.253 of the Revised Code be	15
enacted to read as follows:	16

Sec. 109.36.  As used in this section and sections 109.361 to	17
109.366 of the Revised Code:	18

(A)(1) "Officer or employee" means any of the following:

19

(a) A person who, at the time a cause of action against the	20
person arises, is serving in an elected or appointed office or	21
position with the state or is employed by the state or any.	22

(b) A person that, at the time a cause of action against the	23
person, partnership, or corporation arises, is rendering medical,	24
nursing, dental, podiatric, optometric, physical therapeutic,	25
psychiatric, or psychological services pursuant to a personal	26
services contract or purchased service contract with a department,	27
agency, or institution of the state; or.	28

(c) A person that, at the time a cause of action against the	29
person, partnership, or corporation arises, is rendering peer	30
review, utilization review, or drug utilization review services in	31
relation to medical, nursing, dental, podiatric, optometric,	32
physical therapeutic, psychiatric, or psychological services	33
pursuant to a personal services contract or purchased service	34
contract with a department, agency, or institution of the state.	35

(d) A person who, at the time a cause of action against the	36
person arises, is rendering medical services to patients in a	37
state institution operated by the department of mental health, is	38
a member of the institution's staff, and is performing the	39
services pursuant to an agreement between the state institution	40
and a board of alcohol, drug addiction, and mental health services	41
described in section 340.021 of the Revised Code. "Officer	42

(2) "Officer or employee" does not include any person	43
elected, appointed, or employed by any political subdivision of	44
the state.	45

(B) "State" means the state of Ohio, including but not	46
limited to, the general assembly, the supreme court, the offices	47
of all elected state officers, and all departments, boards,	48
offices, commissions, agencies, institutions, and other	49
instrumentalities of the state of Ohio. "State" does not include	50
political subdivisions.	51

(C) "Political subdivisions" of the state means municipal	52
corporations, townships, counties, school districts, and all other	53
bodies corporate and politic responsible for governmental	54
activities only in geographical areas smaller than that of the	55
state.	56

(D) "Employer" means the general assembly, the supreme	57
court, any office of an elected state officer, or any department,	58
board, office, commission, agency, institution, or other	59
instrumentality of the state of Ohio that employs or contracts	60
with an officer or employee or to which an officer or employee is	61
elected or appointed.	62

Sec. 1751.21.  (A) A peer review committee of a hospital or	63
other health care facility or provider, or of an intermediary	64
organization or health delivery network, with which a health	65
insuring corporation has a contract for health care services may	66
provide to a peer review committee of the health insuring	67
corporation any information, documents, testimony, or other	68
records relating to any matter that is the subject of evaluation	69
or review by the peer review committees, if consent is provided by	70
the health care facility and any physician or other provider whose	71
professional qualifications or activities are the subject of	72
evaluation or review.	73

(B) Any immunity from liability for damages that is provided	74
under section 2305.252305.251 of the Revised Code and that would	75
otherwise apply with respect to the conduct of any peer review	76
committee described in division (A) of this section shall continue	77
to apply, notwithstanding the provision of information as	78
permitted under division (A) of this section.	79

(C) The information, documents, testimony, or other records	80
described in division (A) of this section, if otherwise protected	81
under section 2305.2512305.252 of the Revised Code, shall not be	82
construed as being available for discovery or for use in any civil	83
action solely on the basis that they were provided by the peer	84
review committee as permitted under division (A) of this section.	85

Sec. 2305.25. As used in sections 2305.25 to 2305.253 of the	86
Revised Code:	87

(A) "Health care entity" means a government entity, a	88
for-profit or nonprofit corporation, a limited liability company,	89
a partnership, a professional corporation, a utilization committee	90
of a state or local society composed of doctors of medicine,	91
doctors of osteopathic medicine, or doctors of podiatric medicine,	92
or another health care organization, including, but not limited	93
to, a health care entity described in division (A) of section	94
2305.251 of the Revised Code, whether acting on its own behalf or	95
on behalf of or in affiliation with other health care entities,	96
that conducts as part of its purpose professional credentialing or	97
quality review activities involving the competence or professional	98
conduct of health care practitioners or providers.	99

(B) "Hospital" means either of the following:

100

(1) An institution that has been registered or licensed by	101
the Ohio department of health as a hospital;	102

(2) An entity, other than an insurance company authorized to	103
do business in this state, that owns, controls, or is affiliated	104
with an institution that has been registered or licensed by the	105
Ohio department of health as a hospital.	106

(C) "Incident report or risk management report" means a	107
report of an incident involving injury or potential injury to a	108
patient as a result of patient care by a health care entity that	109
is prepared by or for the use of a review board, committee, risk	110
management personnel, or corporation and is within the scope of	111
the functions of that review board, committee, risk management	112
personnel, or corporation.	113

(D) "Peer review committee" means a utilization review	114
committee, quality assessment committee, performance improvement	115
committee, tissue committee, credentialing committee, or other	116
committee that conducts professional credentialing or quality	117
review activities involving the competence or professional conduct	118
of health care practitioners or health care providers.	119

(E) "Qualified person" means a member of the medical staff of	120
a hospital or a person who has requested or who has clinical	121
privileges at a hospital pursuant to section 3701.351 of the	122
Revised Code.	123

(F) "Review board, committee, risk management personnel, or	124
corporation" means any of the following:	125

(1) A peer review committee of a hospital or long-term care	126
facility, a nonprofit health care corporation or long-term care	127
facility that is a member of the hospital or of which the hospital	128
or facility is a member, or a community mental health center;	129

(2) A board or committee of a hospital, long-term care	130
facility or of a health care entity when reviewing professional	131
qualifications or activities of a qualified person or a provider;	132

(3) A utilization committee of a state or local society	133
composed of doctors of medicine, doctors of osteopathic medicine	134
and surgery, or doctors of podiatric medicine;	135

(4) A peer review committee, professional standards review	136
committee, or arbitration committee of a state or local society	137
composed of doctors of medicine, doctors of osteopathic medicine	138
and surgery, doctors of dentistry, doctors of optometry, doctors	139
of podiatric medicine, psychologists, or registered pharmacists;	140

(5) A peer review committee of a health insuring corporation	141
that has at least a two-thirds majority of member physicians in	142
active practice and that conducts professional credentialing and	143
quality review activities involving the competence or professional	144
conduct of health care providers that adversely affects or could	145
adversely affect the health or welfare of any patient. For	146
purposes of this division, "health insuring corporation" includes	147
wholly owned subsidiaries of a health insuring corporation.	148

(6) A peer review committee of any insurer authorized under	149
Title XXXIX of the Revised Code to do the business of sickness and	150
accident insurance in this state that has at least a two-thirds	151
majority of physicians in active practice and that conducts	152
professional credentialing and quality review activities involving	153
the competence or professional conduct of health care providers	154
that adversely affects or could adversely affect the health or	155
welfare of any patient;	156

(7) A peer review committee of any insurer authorized under	157
Title XXXIX of the Revised Code to do the business of sickness and	158
accident insurance in this state that has at least a two-thirds	159
majority of physicians in active practice and that conducts	160
professional credentialing and quality review activities involving	161
the competence or professional conduct of a health care facility	162
that has contracted with the insurer to provide health care	163
services to insureds, which conduct adversely affects, or could	164
adversely affect, the health or welfare of any patient;	165

(8) A peer review committee of any insurer authorized under	166
Title XXXIX of the Revised Code to do the business of medical	167
professional liability insurance in this state that conducts	168
professional quality review activities involving the competence or	169
professional conduct of health care providers that adversely	170
affects or could affect the health or welfare of any patient;	171

(9) A peer review committee of a health care entity.

172

(G) "Tort action" means a civil action for damages for	173
injury, death, or loss to a patient of a health care entity. "Tort	174
action" includes a product liability claim but does not include a	175
civil action for a breach of contract or another agreement between	176
persons.	177

Sec. 2305.25.        Sec. 2305.251. (A) No hospital, no state or local	178
society,health care entity and no individual who is a member of	179
or employeeworks on behalf of any of the following committeesa	180
board or committee of a health care entity or of a corporation	181
shall be liable in damages to any person for any acts, omissions,	182
decisions, or other conduct within the scope of the functions of	183
the board, committee, or corporation:.	184

(A) A utilization review committee, quality assurance, or	185
tissue committee of a hospital or long-term care facility, a	186
nonprofit health care corporation which is a member of the	187
hospital or long-term care facility or of which the hospital or	188
facility is a member, or a community mental health center;	189

(B) A board or committee of a hospital or long-term care	190
facility or of a nonprofit health care corporation which is a	191
member of the hospital or long-term care facility or of which the	192
hospital or long-term care facility is a member reviewing	193
professional qualifications or activities of the medical staff of	194
the hospital or long-term care facility or applicants for	195
admission to the medical staff;	196

(C) A utilization committee of a state or local society	197
composed of doctors of medicine, doctors of osteopathic medicine,	198
or doctors of podiatric medicine;	199

(D) A peer review committee, professional standards review	200
committee, or arbitration committee of a state or local society	201
composed of doctors of medicine, doctors of osteopathic medicine,	202
doctors of dentistry, doctors of optometry, doctors of podiatric	203
medicine, psychologists, or pharmacists;	204

(E) A peer review committee of a health insuring corporation	205
that has at least a two-thirds majority of member physicians in	206
active practice and that conducts professional credentialing and	207
quality review activities involving the competence or professional	208
conduct of health care providers, which conduct adversely affects,	209
or could adversely affect, the health or welfare of any patient.	210
For purposes of this division, "health insuring corporation"	211
includes wholly owned subsidiaries of a health insuring	212
corporation.	213

(F) A peer review committee of any insurer authorized under	214
Title XXXIX of the Revised Code to do the business of sickness and	215
accident insurance in this state that has at least a two-thirds	216
majority of physicians in active practice and that conducts	217
professional credentialing and quality review activities involving	218
the competence or professional conduct of health care providers,	219
which conduct adversely affects, or could adversely affect, the	220
health or welfare of any patient;	221

(G) A peer review committee of any insurer authorized under	222
Title XXXIX of the Revised Code to do the business of sickness and	223
accident insurance in this state that has at least a two-thirds	224
majority of physicians in active practice and that conducts	225
professional credentialing and quality review activities involving	226
the competence or professional conduct of a health care facility	227
that has contracted with the insurer to provide health care	228
services to insureds, which conduct adversely affects, or could	229
adversely affect, the health or welfare of any patient;	230

(B)(1) A hospital shall be presumed to not be negligent in	231
the credentialing of a qualified person if the hospital proves by	232
a preponderance of the evidence that at the time of the alleged	233
negligent credentialing of the qualified person it was accredited	234
by the joint commission on accreditation of health care	235
organizations, the American osteopathic association, or the	236
national committee for quality assurance.	237

(2) The presumption that a hospital is not negligent as	238
provided in division (B)(1) of this section may be rebutted only	239
by proof, by a preponderance of the evidence, of any of the	240
following:	241

(a) The credentialing and review requirements of the	242
accrediting organization did not apply to the hospital, the	243
qualified person, or the type of professional care that is the	244
basis of the claim against the hospital.	245

(b) The hospital failed to comply with all material	246
credentialing and review requirements of the accrediting	247
organization that applied to the qualified person.	248

(c) The hospital, through its medical staff executive	249
committee or its governing body and sufficiently in advance to	250
take appropriate action, knew that a previously competent	251
qualified person with staff privileges at the hospital had	252
developed a pattern of incompetence that indicated that the	253
qualified person's privileges should have been limited prior to	254
treating the plaintiff at the hospital.	255

(d) The hospital, through its medical staff executive	256
committee or its governing body and sufficiently in advance to	257
take appropriate action, knew that a previously competent	258
qualified person with staff privileges at the hospital would	259
provide fraudulent medical treatment but failed to limit the	260
qualified person's privileges prior to treating the plaintiff at	261
the hospital.	262

(3) If the plaintiff fails to rebut the presumption provided	263
in division (B)(1) of this section, upon the motion of the	264
hospital, the court shall enter judgment in favor of the hospital	265
on the claim of negligent credentialing.	266

(C) Nothing in this section otherwise shall relieve any	267
individual or hospitalhealth care entity from liability arising	268
from treatment of a patient or resident. Nothing in this section	269
shall be construed as creating an exception to section 2305.252 of	270
the Revised Code.	271

This section shall also apply to any member or employee of a	272
nonprofit corporation engaged in performing the functions of a	273
peer review committee of nursing home providers or administrators	274
or of a peer review or professional standards review committee.	275

(D) No person who provides information under this section	276
without malice and in the reasonable belief that the information	277
is warranted by the facts known to the person shall be subject to	278
suit for civil damages as a result of providing the information.	279

Sec. 2305.251.        Sec. 2305.252.  Proceedings and records within the	280
scope of the peer review or utilization review functions of alla	281
review committeesboard, committee, or corporation described in	282
section 2305.25 of the Revised Code shall be held in confidence	283
and shall not be subject to discovery or introduction in evidence	284
in any civil action against a health care professional, a	285
hospital, a long-term care facility, a not-for-profit health care	286
corporation that is a member of a hospital or long-term care	287
facility or of which a hospital or long-term care facility is a	288
member, or anotherany other health care institutionentity	289
arising out of matters that are the subject of evaluation and	290
review by the review board, committee, or corporation. No person	291
in attendance at a meeting of a review board, committee, or	292
corporation or serving as a member or employee of a review board,	293
committee, or corporation shall be permitted or required to	294
testify in any civil action as to any evidence or other matters	295
produced or presented during the proceedings of the review board,	296
committee, or corporation or as to any finding, recommendation,	297
evaluation, opinion, or other action of the,review board,	298
committee, or corporation or a member thereofor employee of it.	299
Information, documents, or records otherwise available from	300
original sources are not to be construed as being unavailable for	301
discovery or for use in any civil action merely because they were	302
presented during proceedings of a review board, committee nor	303
should any, or corporation provided that the documents are	304
obtained from the original source. Any person testifying before a	305
review board, committee, or corporation or who is a member or	306
employee of the review board, committee, or corporation shall not	307
be prevented from testifying as to matters within the person's	308
knowledge, but the witness cannot be asked about the witness's	309
testimony before the review board, committee, or corporation or	310
opinion formed by the witness as a result of the review board,	311
committee, or corporation hearing. An order by a court to produce	312
for discovery or for use at trial the proceedings or records	313
described in this section is a final order.	314

Sec. 2305.253. (A) Notwithstanding any contrary provision of	315
section 149.43, 1751.21, 2305.24, 2305.25, 2305.251, 2305.252, or	316
2305.28 of the Revised Code, an incident report or risk management	317
report and the contents of an incident report or risk management	318
report are not subject to discovery in, and are not admissible in	319
evidence in the trial of, a tort action. An individual who	320
prepares or has knowledge of the contents of an incident report or	321
risk management report shall not testify and shall not be required	322
to testify in a tort action as to the contents of the report. This	323
division does not prohibit or limit the discovery or admissibility	324
of testimony or evidence relating to patient care that is within a	325
person's personal knowledge.	326

(B) Except as specified in division (A) of this section, this	327
section does not affect any provision of section 1751.21, 2305.24,	328
2305.25, 2305.251, 2305.252, or 2305.28 of the Revised Code that	329
describes, imposes, or confers an immunity from tort or other	330
civil liability, a forfeiture of an immunity from tort or other	331
civil liability, a requirement of confidentiality, a limitation	332
upon the use of information, data, reports, or records, tort or	333
other civil liability, or a limitation upon discovery of matter,	334
introduction into evidence of matter, or testimony pertaining to	335
matter in a tort or other civil action. This section does not	336
affect a privileged communication between an attorney and the	337
attorney's client as described in section 2317.02 of the Revised	338
Code.	339

Sec. 2305.38.  (A) As used in this section:

340

(1) "Charitable organization" means either of the following:

341

(a) Any charitable nonprofit corporation that is organized	342
and operated pursuant to Chapter 1702. of the Revised Code,	343
including, but not limited to, any such corporation of that nature	344
whose articles of incorporation specify that it is organized and	345
to be operated for an education-related purpose;	346

(b) Any charitable association, group, institution, or	347
society that is not organized and not operated for profit,	348
including, but not limited to, any such association, group,	349
institution, or society of that nature that is organized and	350
operated for any education-related purpose.	351

(2) "Compensation" does not include actual and necessary	352
expenses that are incurred by a volunteer in connection with the	353
services that the volunteer performs for a charitable	354
organization, and that are reimbursed to the volunteer or	355
otherwise paid.	356

(3) "Corporate services" means services that are performed by	357
a volunteer who is associated with a charitable organization as	358
defined in division (A)(1)(a) of this section and that reflect	359
duties or responsibilities arising under Chapter 1702. of the	360
Revised Code.	361

(4) "Supervisory services" means services that are performed	362
by a volunteer who is associated with a charitable organization as	363
defined in division (A)(1)(a) or (b) of this section and that	364
involve duties and responsibilities in connection with the	365
supervision of one or more officers, employees, trustees, or other	366
volunteers of that charitable organization.	367

(5) "Volunteer" means an officer, trustee, or other person	368
who performs services for a charitable organization but does not	369
receive compensation, either directly or indirectly, for those	370
services.	371

(B) A volunteer is not liable in damages in a civil action	372
for injury, death, or loss to person or property that arises from	373
the actions or omissions of any of the officers, employees,	374
trustees, or other volunteers of the charitable organization for	375
which the volunteer performs services, unless either of the	376
following applies:	377

(1) With prior knowledge of an action or omission of a	378
particular officer, employee, trustee, or other volunteer, the	379
volunteer authorizes, approves, or otherwise actively participates	380
in that action or omission.	381

(2) After an action or omission of a particular officer,	382
employee, trustee, or other volunteer, the volunteer, with full	383
knowledge of that action or omission, ratifies it.	384

(C) A volunteer is not liable in damages in a civil action	385
for injury, death, or loss to person or property that arises from	386
the volunteer's actions or omissions in connection with any	387
supervisory or corporate services that the volunteer performs for	388
the charitable organization, unless either of the following	389
applies:	390

(1) An action or omission of the volunteer involves conduct	391
as described in division (B)(1) or (2) of this section;	392

(2) An action or omission of the volunteer constitutes	393
willful or wanton misconduct or intentionally tortious conduct.	394

(D) A volunteer is not liable in damages in a civil action	395
for injury, death, or loss to person or property that arises from	396
the volunteer's actions or omissions in connection with any	397
nonsupervisory or noncorporate services that the volunteer	398
performs for the charitable organization, unless either of the	399
following applies:	400

(1) An action or omission of the volunteer involves conduct	401
as described in division (B)(1) or (2) of this section;	402

(2) An action or omission of the volunteer constitutes	403
negligence, willful or wanton misconduct, or intentionally	404
tortious conduct.	405

(E)(1) This section does not create a new cause of action or	406
substantive legal right against a volunteer.	407

(2) This section does not affect any immunities from civil	408
liability or defenses established by another section of the	409
Revised Code or available at common law, to which a volunteer may	410
be entitled under circumstances not covered by this section. This	411
section does not diminish in any respect the immunities provided	412
in section 2305.252305.251 of the Revised Code. The immunities	413
conferred upon volunteers in this section are not intended to	414
affect the liability of a charitable organization in a civil	415
action for injury, death, or loss to person or property.	416

Sec. 3701.74. (A) As used in this section and section	417
3701.741 of the Revised Code:	418

(1) "Chiropractor" means an individual licensed under Charter	419
Chapter 4734. of the Revised Code to practice chiropractic.	420

(2) "Health care provider" has the same meaning as in	421
section 3729.01 of the Revised Code.	422

(3) "Medical record" means data in any form that pertains	423
to a patient's medical history, diagnosis, prognosis, or medical	424
condition and that is generated and maintained by a health care	425
provider in the process of the patient's health care treatment.	426

(4) "Medical records company" means a person who stores,	427
locates, or copies medical records for a health care provider, or	428
is compensated for doing so by a health care provider, and charges	429
a fee for providing medical records to a patient or patient's	430
representative.	431

(5) "Patient" means either of the following:

432

(a) An individual who received health care treatment from a	433
health care provider or from a practitioner;	434

(b) A guardian, as defined in section 1337.11 of the Revised	435
Code, of an individual described in division (A)(5)(a) of this	436
section.	437

(6) "Patient's representative" means a person to whom a	438
patient has given written authorization to act on the patient's	439
behalf regarding the patient's medical records, except that if the	440
patient is deceased, "patient's representative" means the executor	441
or administrator of the patient's estate or the person responsible	442
for the patient's estate if it is not to be probated. "Patient's	443
representative" does not include an insurer authorized under Title	444
XXXIX of the Revised Code to do the business of sickness and	445
accident insurance in this state or a health insuring corporation	446
holding a certificate of authority under Chapter 1751. of the	447
Revised Code.	448

(7) "Physician" means a person authorized under Chapter	449
4731. of the Revised Code to practice medicine and surgery,	450
osteopathic medicine and surgery, or podiatry.	451

(5) "Practitioner" means an individual authorized under	452
Chapter 4731. of the Revised Code to practice medicine and	453
surgery, osteopathic medicine and surgery, or podiatry or an	454
individual licensed under Chapter 4734. of the Revised Code to	455
practice chiropractic.	456

(B) A patient or patient's representative who wishes to	457
examine or obtain a copy of part or all of a medical record	458
shall submit to the health care provider or practitioner a	459
written request signed by the patient dated not more than sixty	460
days before the date on which it is submitted. The patient or	461
patient's representative who wishes to obtain a copy of the record	462
shall indicate in the request whether the copy is to be sent to	463
the patient's residence, physician or chiropractor, or	464
representative, or held for the patient at the office of the	465
health care provider or by the practitioner. Within a reasonable	466
time after receiving a request that meets the requirements of this	467
division and includes sufficient information to identify the	468
record requested, a health care provider that has the patient's	469
medical records or practitioner shall permit the patient to	470
examine the record during regular business hours without charge	471
or, on request, shall provide a copy of the record in accordance	472
with section 3701.741 of the Revised Code, except that if a	473
physician or chiropractor practitioner who has treated the	474
patient determines for clearly stated treatment reasons that	475
disclosure of the requested record is likely to have an adverse	476
effect on the patient, the health care provider or practitioner	477
shall provide the record to a physician or chiropractor	478
practitioner designated by the patient. The health care provider	479
or practitioner shall take reasonable steps to establish the	480
identity of the person making the request to examine or obtain a	481
copy of the patient's record.	482

(C) If a health care provider or practitioner fails to	483
furnish a medical record as required by division (B) of this	484
section, the patient or patient's representative who requested the	485
record may bring a civil action to enforce the patient's right of	486
access to the record.	487

(D)(1) This section does not apply to medical records whose	488
release is covered by section 173.20 or 3721.13 of the Revised	489
Code, by Chapter 1347. or 5122. of the Revised Code, by 42 C.F.R.	490
part 2, "Confidentiality of Alcohol and Drug Abuse Patient	491
Records," or by 42 C.F.R. 483.10.	492

(2) Nothing in this section is intended to supersede the	493
confidentiality provisions of sections 2305.24 to 2305.251	494
2305.252 of the Revised Code.	495

Sec. 4715.03.  (A) The state dental board shall organize by	496
the election from its members of a president and a secretary. It	497
shall hold meetings monthly at least eight months a year at such	498
times and places as the board designates. A majority of the	499
members of the board shall constitute a quorum. The board shall	500
make such reasonable rules as it determines necessary pursuant to	501
Chapter 119. of the Revised Code.	502

(B) A concurrence of a majority of the members of the board	503
shall be required to grant, refuse, suspend, place on probationary	504
status, revoke, refuse to renew, or refuse to reinstate a license	505
or censure a license holder.	506

(C) The board shall adopt rules establishing standards for	507
the safe practice of dentistry and dental hygiene by qualified	508
practitioners and shall, through its policies and activities,	509
promote such practice.	510

The board shall adopt rules in accordance with Chapter 119.	511
of the Revised Code establishing universal blood and body fluid	512
precautions that shall be used by each person licensed under this	513
chapter who performs exposure prone invasive procedures. The	514
rules shall define and establish requirements for universal blood	515
and body fluid precautions that include the following:	516

(1) Appropriate use of hand washing;

517

(2) Disinfection and sterilization of equipment;

518

(3) Handling and disposal of needles and other sharp	519
instruments;	520

(4) Wearing and disposal of gloves and other protective	521
garments and devices.	522

(D) The board shall administer and enforce the provisions of	523
this chapter. The board shall investigate evidence which appears	524
to show that any person has violated any provision of this	525
chapter. Any person may report to the board under oath any	526
information such person may have appearing to show a violation of	527
any provision of this chapter. In the absence of bad faith, any	528
person who reports such information or who testifies before the	529
board in any disciplinary proceeding conducted pursuant to Chapter	530
119. of the Revised Code is not liable for civil damages as a	531
result of making the report or providing testimony. If after	532
investigation the board determines that there are reasonable	533
grounds to believe that a violation of this chapter has occurred,	534
the board shall conduct disciplinary proceedings pursuant to	535
Chapter 119. of the Revised Code or provide for a license holder	536
to participate in the quality intervention program established	537
under section 4715.031 of the Revised Code. The board shall not	538
dismiss any complaint or terminate any investigation except by a	539
majority vote of its members. For the purpose of any disciplinary	540
proceeding or any investigation conducted under this division,	541
the board may administer oaths, order the taking of depositions,	542
issue subpoenas, compel the attendance and testimony of persons at	543
depositions and compel the production of books, accounts, papers,	544
documents, or other tangible things. The hearings and	545
investigations of the board shall be considered civil actions for	546
the purposes of section 2305.2512305.252 of the Revised Code.	547
Notwithstanding section 121.22 of the Revised Code, proceedings of	548
the board relative to the investigation of a complaint or the	549
determination whether there are reasonable grounds to believe that	550
a violation of this chapter has occurred are confidential and are	551
not subject to discovery in any civil action.	552

(E) The board shall examine or cause to be examined eligible	553
applicants to practice dentistry and dental hygiene. The board may	554
distinguish by rule different classes of qualified personnel	555
according to skill levels and require all or only certain of these	556
classes of qualified personnel to be examined and certified by the	557
board.	558

(F) In accordance with Chapter 119. of the Revised Code, the	559
board shall adopt, and may amend or rescind, rules establishing	560
the eligibility criteria, the application and permit renewal	561
procedures, and safety standards applicable to a dentist licensed	562
under this chapter who applies for a permit to employ or use	563
conscious intravenous sedation. These rules shall include all of	564
the following:	565

(1) The eligibility requirements and application procedures	566
for an eligible dentist to obtain a conscious intravenous sedation	567
permit;	568

(2) The minimum educational and clinical training standards	569
required of applicants, which shall include satisfactory	570
completion of an advanced cardiac life support course;	571

(3) The facility equipment and inspection requirements;

572

(4) Safety standards;

573

(5) Requirements for reporting adverse occurrences.

574

Sec. 4723.28.  (A) The board of nursing, by a vote of a	575
quorum, may revoke or may refuse to grant a nursing license,	576
certificate of authority, or dialysis technician certificate to a	577
person found by the board to have committed fraud in passing an	578
examination required to obtain the license, certificate of	579
authority, or dialysis technician certificate or to have committed	580
fraud, misrepresentation, or deception in applying for or securing	581
any nursing license, certificate of authority, or dialysis	582
technician certificate issued by the board.	583

(B) The board of nursing, and by a vote of a quorum, may	584
impose one or more of the following sanctions: deny, revoke,	585
suspend, or place restrictions on any nursing license, certificate	586
of authority, or dialysis technician certificate issued by the	587
board; reprimand or otherwise discipline a holder of a nursing	588
license, certificate of authority, or dialysis technician	589
certificate; or impose a fine of not more than five hundred	590
dollars per violation. The sanctions may be imposed for any of	591
the following:	592

(1) Denial, revocation, suspension, or restriction of	593
authority to practice a health care occupation, including nursing	594
or practice as a dialysis technician, for any reason other than a	595
failure to renew, in Ohio or another state or jurisdiction;	596

(2) Engaging in the practice of nursing or engaging in	597
practice as a dialysis technician, having failed to renew a	598
nursing license or dialysis technician certificate issued under	599
this chapter, or while a nursing license or dialysis technician	600
certificate is under suspension;	601

(3) Conviction of, a plea of guilty to, a judicial finding	602
of guilt of, a judicial finding of guilt resulting from a plea of	603
no contest to, or a judicial finding of eligibility for	604
intervention in lieu of conviction for, a misdemeanor committed in	605
the course of practice;	606

(4) Conviction of, a plea of guilty to, a judicial finding	607
of guilt of, a judicial finding of guilt resulting from a plea of	608
no contest to, or a judicial finding of eligibility for	609
intervention in lieu of conviction for, any felony or of any crime	610
involving gross immorality or moral turpitude;	611

(5) Selling, giving away, or administering drugs or	612
therapeutic devices for other than legal and legitimate	613
therapeutic purposes; or conviction of, a plea of guilty to, a	614
judicial finding of guilt of, a judicial finding of guilt	615
resulting from a plea of no contest to, or a judicial finding of	616
eligibility for intervention in lieu of conviction for, violating	617
any municipal, state, county, or federal drug law;	618

(6) Conviction of, a plea of guilty to, a judicial finding	619
of guilt of, a judicial finding of guilt resulting from a plea of	620
no contest to, or a judicial finding of eligibility for	621
intervention in lieu of conviction for, an act in another	622
jurisdiction that would constitute a felony or a crime of moral	623
turpitude in Ohio;	624

(7) Conviction of, a plea of guilty to, a judicial finding	625
of guilt of, a judicial finding of guilt resulting from a plea of	626
no contest to, or a judicial finding of eligibility for	627
intervention in lieu of conviction for, an act in the course of	628
practice in another jurisdiction that would constitute a	629
misdemeanor in Ohio;	630

(8) Self-administering or otherwise taking into the body any	631
dangerous drug, as defined in section 4729.01 of the Revised Code,	632
in any way not in accordance with a legal, valid presription	633
prescription issued for that individual;	634

(9) Habitual indulgence in the use of controlled substances,	635
other habit-forming drugs, or alcohol or other chemical substances	636
to an extent that impairs ability to practice;	637

(10) Impairment of the ability to practice according to	638
acceptable and prevailing standards of safe nursing care because	639
of habitual or excessive use of drugs, alcohol, or other chemical	640
substances that impair the ability to practice;	641

(11) Impairment of the ability to practice according to	642
acceptable and prevailing standards of safe nursing care because	643
of a physical or mental disability;	644

(12) Assaulting or causing harm to a patient or depriving a	645
patient of the means to summon assistance;	646

(13) Obtaining or attempting to obtain money or anything of	647
value by intentional misrepresentation or material deception in	648
the course of practice;	649

(14) Adjudication by a probate court of being mentally ill	650
or mentally incompetent. The board may restore the person's	651
nursing license or dialysis technician certificate upon	652
adjudication by a probate court of the person's restoration to	653
competency or upon submission to the board of other proof of	654
competency.	655

(15) The suspension or termination of employment by the	656
department of defense or the veterans administration of the United	657
States for any act that violates or would violate this chapter;	658

(16) Violation of this chapter or any rules adopted under	659
it;	660

(17) Violation of any restrictions placed on a nursing	661
license or dialysis technician certificate by the board;	662

(18) Failure to use universal blood and body fluid	663
precautions established by rules adopted under section 4723.07 of	664
the Revised Code;	665

(19) Failure to practice in accordance with acceptable and	666
prevailing standards of safe nursing care or safe dialysis care;	667

(20) In the case of a registered nurse, engaging in	668
activities that exceed the practice of nursing as a registered	669
nurse;	670

(21) In the case of a licensed practical nurse, engaging in	671
activities that exceed the practice of nursing as a licensed	672
practical nurse;	673

(22) In the case of a dialysis technician, engaging in	674
activities that exceed those permitted under section 4723.72 of	675
the Revised Code;	676

(23) Aiding and abetting a person in that person's practice	677
of nursing without a license or practice as a dialysis technician	678
without a certificate issued under this chapter;	679

(24) In the case of a certified registered nurse	680
anesthetist, clinical nurse specialist, certified nurse-midwife,	681
certified nurse practitioner, or advanced practice nurse, except	682
as provided in division (M) of this section, either of the	683
following:	684

(a) Waiving the payment of all or any part of a deductible	685
or copayment that a patient, pursuant to a health insurance or	686
health care policy, contract, or plan that covers such nursing	687
services, would otherwise be required to pay if the waiver is used	688
as an enticement to a patient or group of patients to receive	689
health care services from that provider;	690

(b) Advertising that the nurse will waive the payment of all	691
or any part of a deductible or copayment that a patient, pursuant	692
to a health insurance or health care policy, contract, or plan	693
that covers such nursing services, would otherwise be required to	694
pay.	695

(25) Failure to comply with the terms and conditions of	696
participation in the chemical dependency monitoring program	697
established under section 4723.35 of the Revised Code;	698

(26) Failure to comply with the terms and conditions	699
required under the practice intervention and improvement program	700
established under section 4723.282 of the Revised Code;	701

(27) In the case of a certified registered nurse	702
anesthetist, clinical nurse specialist, certified nurse-midwife,	703
or certified nurse practitioner:	704

(a) Engaging in activities that exceed those permitted for	705
the nurse's nursing specialty under section 4723.43 of the Revised	706
Code;	707

(b) Failure to meet the quality assurance standards	708
established under section 4723.07 of the Revised Code.	709

(28) In the case of a clinical nurse specialist, certified	710
nurse-midwife, or certified nurse practitioner, failure to	711
maintain a standard care arrangement in accordance with section	712
4723.431 of the Revised Code or to practice in accordance with the	713
standard care arrangement;	714

(29) In the case of a clinical nurse specialist, certified	715
nurse-midwife, or certified nurse practitioner who holds a	716
certificate to prescribe issued under section 4723.48 of the	717
Revised Code, failure to prescribe drugs and therapeutic devices	718
in accordance with section 4723.481 of the Revised Code;	719

(30) Prescribing any drug or device to perform or induce an	720
abortion, or otherwise performing or inducing an abortion;	721

(31) Failure to establish and maintain professional	723
boundaries with a patient, as specified in rules adopted under	724
section 4723.07 of the Revised Code;	725

(32) Regardless of whether the contact or verbal behavior is	726
consensual, engaging with a patient other than the spouse of the	727
registered nurse, licensed practical nurse, or dialysis technician	728
in any of the following:	729

(a) Sexual contact, as defined in section 2907.01 of the	730
Revised Code;	731

(b) Verbal behavior that is sexually demeaning to the	732
patient or may be reasonably interpreted by the patient as	733
sexually demeaning.	734

(C) Disciplinary actions taken by the board under divisions	735
(A) and (B) of this section shall be taken pursuant to an	736
adjudication conducted under Chapter 119. of the Revised Code,	737
except that in lieu of a hearing, the board may enter into a	738
consent agreement with an individual to resolve an allegation of a	739
violation of this chapter or any rule adopted under it. A consent	740
agreement, when ratified by a vote of a quorum, shall constitute	741
the findings and order of the board with respect to the matter	742
addressed in the agreement. If the board refuses to ratify a	743
consent agreement, the admissions and findings contained in the	744
agreement shall be of no effect.	745

(D) The hearings of the board shall be conducted in	746
accordance with Chapter 119. of the Revised Code, the board may	747
appoint a hearing examiner, as provided in section 119.09 of the	748
Revised Code, to conduct any hearing the board is authorized to	749
hold under Chapter 119. of the Revised Code.	750

In any instance in which the board is required under Chapter	751
119. of the Revised Code to give notice of an opportunity for a	752
hearing and the applicant or license holder does not make a timely	753
request for a hearing in accordance with section 119.07 of the	754
Revised Code, the board is not required to hold a hearing, but may	755
adopt, by a vote of a quorum, a final order that contains the	756
board's findings. In the final order, the board may order any of	757
the sanctions listed in division (A) or (B) of this section.	758

(E) If a criminal action is brought against a registered	759
nurse, licensed practical nurse, or dialysis technician for an act	760
or crime described in divisions (B)(3) to (7) of this section and	761
the action is dismissed by the trial court other than on the	762
merits, the board shall conduct an adjudication to determine	763
whether the registered nurse, licensed practical nurse, or	764
dialysis technician committed the act on which the action was	765
based. If the board determines on the basis of the adjudication	766
that the registered nurse, licensed practical nurse, or dialysis	767
technician committed the act, or if the registered nurse, licensed	768
practical nurse, or dialysis technician fails to participate in	769
the adjudication, the board may take action as though the	770
registered nurse, licensed practical nurse, or dialysis technician	771
had been convicted of the act.	772

If the board takes action on the basis of a conviction, plea,	773
or a judicial finding as described in divisions (B)(3) to (7) of	774
this section that is overturned on appeal, the registered nurse,	775
licensed practical nurse, or dialysis technician may, on	776
exhaustion of the appeal process, petition the board for	777
reconsideration of its action. On receipt of the petition and	778
supporting court documents, the board shall temporarily rescind	779
its action. If the board determines that the decision on appeal	780
was a decision on the merits, it shall permanently rescind its	781
action. If the board determines that the decision on appeal was	782
not a decision on the merits, it shall conduct an adjudication	783
to determine whether the registered nurse, licensed practical	784
nurse, or dialysis technician committed the act on which the	785
original conviction, plea, or judicial finding was based. If the	786
board determines on the basis of the adjudication that the	787
registered nurse, licensed practical nurse, or dialysis technician	788
committed such act, or if the registered nurse, licensed practical	789
nurse, or dialysis technician does not request an adjudication,	790
the board shall reinstate its action; otherwise, the board shall	791
permanently rescind its action.	792

Notwithstanding the provision of division (C)(2) of section	793
2953.32 of the Revised Code specifying that if records pertaining	794
to a criminal case are sealed under that section the proceedings	795
in the case shall be deemed not to have occurred, sealing of the	796
records of a conviction on which the board has based an action	797
under this section shall have no effect on the board's action or	798
any sanction imposed by the board under this section.	799

The board shall not be required to seal, destroy, redact, or	800
otherwise modify its records to reflect the court's sealing of	801
conviction records.	802

(F) The board may investigate an individual's criminal	803
background in performing its duties under this section.	804

(G) During the course of an investigation conducted under	805
this section, the board may compel any registered nurse, licensed	806
practical nurse, or dialysis technician or applicant under this	807
chapter to submit to a mental or physical examination, or both, as	808
required by the board and at the expense of the individual, if the	809
board finds reason to believe that the individual under	810
investigation may have a physical or mental impairment that may	811
affect the individual's ability to provide safe nursing care.	812
Failure of any individual to submit to a mental or physical	813
examination when directed constitutes an admission of the	814
allegations, unless the failure is due to circumstances beyond the	815
individual's control, and a default and final order may be entered	816
without the taking of testimony or presentation of evidence.	817

If the board finds that an individual is impaired, the board	818
shall require the individual to submit to care, counseling, or	819
treatment approved or designated by the board, as a condition for	820
initial, continued, reinstated, or renewed authority to practice.	821
The individual shall be afforded an opportunity to demonstrate to	822
the board that the individual can begin or resume the individual's	823
occupation in compliance with acceptable and prevailing standards	824
of care under the provisions of the individual's authority to	825
practice.	826

For purposes of this division, any registered nurse,	827
licensed practical nurse, or dialysis technician or applicant	828
under this chapter shall be deemed to have given consent to submit	829
to a mental or physical examination when directed to do so in	830
writing by the board, and to have waived all objections to the	831
admissibility of testimony or examination reports that constitute	832
a privileged communication.	833

(H) The board shall investigate evidence that appears to	834
show that any person has violated any provision of this chapter or	835
any rule of the board. Any person may report to the board any	836
information the person may have that appears to show a violation	837
of any provision of this chapter or rule of the board. In the	838
absence of bad faith, any person who reports such information or	839
who testifies before the board in any adjudication conducted under	840
Chapter 119. of the Revised Code shall not be liable for civil	841
damages as a result of the report or testimony.	842

(I) All of the following apply under this chapter with	843
respect to the confidentiality of information:	844

(1) Information received by the board pursuant to an	845
investigation is confidential and not subject to discovery in any	846
civil action, except that the board may disclose information to	847
law enforcement officers and government entities investigating a	848
registered nurse, licensed practical nurse, or dialysis technician	849
or a person who may have engaged in the unauthorized practice of	850
nursing. No law enforcement officer or government entity with	851
knowledge of any information disclosed by the board pursuant to	852
this division shall divulge the information to any other person or	853
government entity except for the purpose of an adjudication by a	854
court or licensing or registration board or officer to which the	855
person to whom the information relates is a party.	856

(2) If an investigation requires a review of patient	857
records, the investigation and proceeding shall be conducted in	858
such a manner as to protect patient confidentiality.	859

(3) All adjudications and investigations of the board shall	860
be considered civil actions for the purposes of section 2305.251	861
2305.252 of the Revised Code.	862

(4) Any board activity that involves continued monitoring of	863
an individual as part of or following any disciplinary action	864
taken under this section shall be conducted in a manner that	865
maintains the individual's confidentiality. Information received	866
or maintained by the board with respect to the board's monitoring	867
activities is confidential and not subject to discovery in any	868
civil action.	869

(J) Any action taken by the board under this section	870
resulting in a suspension from practice shall be accompanied by a	871
written statement of the conditions under which the person may be	872
reinstated to practice.	873

(K) When the board refuses to grant a license or certificate	874
to an applicant, revokes a license or certificate, or refuses to	875
reinstate a license or certificate, the board may specify that its	876
action is permanent. An individual subject to permanent action	877
taken by the board is forever ineligible to hold a license or	878
certificate of the type that was refused or revoked and the board	879
shall not accept from the individual an application for	880
reinstatement of the license or certificate or for a new license	881
or certificate.	882

(L) No unilateral surrender of a nursing license,	883
certificate of authority, or dialysis technician certificate	884
issued under this chapter shall be effective unless accepted by	885
majority vote of the board. No application for a nursing license,	886
certificate of authority, or dialysis technician certificate	887
issued under this chapter may be withdrawn without a majority vote	888
of the board. The board's jurisdiction to take disciplinary	889
action under this section is not removed or limited when an	890
individual has a license or certificate classified as inactive or	891
fails to renew a license or certificate.	892

(M) Sanctions shall not be imposed under division (B)(24) of	893
this section against any licensee who waives deductibles and	894
copayments as follows:	895

(1) In compliance with the health benefit plan that	896
expressly allows such a practice. Waiver of the deductibles or	897
copayments shall be made only with the full knowledge and consent	898
of the plan purchaser, payer, and third-party administrator.	899
Documentation of the consent shall be made available to the board	900
upon request.	901

(2) For professional services rendered to any other person	902
licensed pursuant to this chapter to the extent allowed by this	903
chapter and the rules of the board.	904

Sec. 4730.26.  (A) The state medical board shall investigate	905
evidence that appears to show that any person has violated this	906
chapter or a rule adopted under it. Any person may report to the	907
board in a signed writing any information the person has that	908
appears to show a violation of any provision of this chapter or	909
rule adopted under it. In the absence of bad faith, a person who	910
reports such information or testifies before the board in an	911
adjudication conducted under Chapter 119. of the Revised Code	912
shall not be liable for civil damages as a result of reporting the	913
information or providing testimony. Each complaint or allegation	914
of a violation received by the board shall be assigned a case	915
number and be recorded by the board.	916

(B) Investigations of alleged violations of this chapter or	917
rules adopted under it shall be supervised by the supervising	918
member elected by the board in accordance with section 4731.02 of	919
the Revised Code and by the secretary as provided in section	920
4730.33 of the Revised Code. The president may designate another	921
member of the board to supervise the investigation in place of the	922
supervising member. A member of the board who supervises the	923
investigation of a case shall not participate in further	924
adjudication of the case.	925

(C) In investigating a possible violation of this chapter or	926
a rule adopted under it, the board may administer oaths, order the	927
taking of depositions, issue subpoenas, and compel the attendance	928
of witnesses and production of books, accounts, papers, records,	929
documents, and testimony, except that a subpoena for patient	930
record information shall not be issued without consultation with	931
the attorney general's office and approval of the secretary and	932
supervising member of the board. Before issuance of a subpoena	933
for patient record information, the secretary and supervising	934
member shall determine whether there is probable cause to believe	935
that the complaint filed alleges a violation of this chapter or a	936
rule adopted under it and that the records sought are relevant to	937
the alleged violation and material to the investigation. The	938
subpoena may apply only to records that cover a reasonable period	939
of time surrounding the alleged violation.	940

On failure to comply with any subpoena issued by the board	941
and after reasonable notice to the person being subpoenaed, the	942
board may move for an order compelling the production of persons	943
or records pursuant to the Rules of Civil Procedure.	944

A subpoena issued by the board may be served by a sheriff,	945
the sheriff's deputy, or a board employee designated by the board.	946
Service of a subpoena issued by the board may be made by	947
delivering a copy of the subpoena to the person named therein,	948
reading it to the person, or leaving it at the person's usual	949
place of residence. When the person being served is a physician	950
assistant, service of the subpoena may be made by certified mail,	951
restricted delivery, return receipt requested, and the subpoena	952
shall be deemed served on the date delivery is made or the date	953
the person refuses to accept delivery.	954

A sheriff's deputy who serves a subpoena shall receive the	955
same fees as a sheriff. Each witness who appears before the board	956
in obedience to a subpoena shall receive the fees and mileage	957
provided for witnesses in civil cases in the courts of common	958
pleas.	959

(D) All hearings and investigations of the board shall be	960
considered civil actions for the purposes of section 2305.251	961
2305.252 of the Revised Code.	962

(E) Information received by the board pursuant to an	963
investigation is confidential and not subject to discovery in any	964
civil action.	965

The board shall conduct all investigations and proceedings in	966
a manner that protects the confidentiality of patients and persons	967
who file complaints with the board. The board shall not make	968
public the names or any other identifying information about	969
patients or complainants unless proper consent is given or, in the	970
case of a patient, a waiver of the patient privilege exists under	971
division (B) of section 2317.02 of the Revised Code, except that	972
consent or a waiver is not required if the board possesses	973
reliable and substantial evidence that no bona fide	974
physician-patient relationship exists.	975

The board may share any information it receives pursuant to	976
an investigation, including patient records and patient record	977
information, with law enforcement agencies, other licensing	978
boards, and other governmental agencies that are prosecuting,	979
adjudicating, or investigating alleged violations of statutes or	980
administrative rules. An agency or board that receives the	981
information shall comply with the same requirements regarding	982
confidentiality as those with which the state medical board must	983
comply, notwithstanding any conflicting provision of the Revised	984
Code or procedure of the agency or board that applies when it is	985
dealing with other information in its possession. In a judicial	986
proceeding, the information may be admitted into evidence only in	987
accordance with the Rules of Evidence, but the court shall require	988
that appropriate measures are taken to ensure that confidentiality	989
is maintained with respect to any part of the information that	990
contains names or other identifying information about patients or	991
complainants whose confidentiality was protected by the state	992
medical board when the information was in the board's possession.	993
Measures to ensure confidentiality that may be taken by the court	994
include sealing its records or deleting specific information from	995
its records.	996

(F) The state medical board shall develop requirements for	997
and provide appropriate initial and continuing training for	998
investigators employed by the board to carry out its duties under	999
this chapter. The training and continuing education may include	1000
enrollment in courses operated or approved by the Ohio peace	1001
officer training council that the board considers appropriate	1002
under conditions set forth in section 109.79 of the Revised Code.	1003

(G) On a quarterly basis, the board shall prepare a report	1004
that documents the disposition of all cases during the preceding	1005
three months. The report shall contain the following information	1006
for each case with which the board has completed its activities:	1007

(1) The case number assigned to the complaint or alleged	1008
violation;	1009

(2) The type of certificate to practice, if any, held by the	1010
individual against whom the complaint is directed;	1011

(3) A description of the allegations contained in the	1012
complaint;	1013

(4) The disposition of the case.

1014

The report shall state how many cases are still pending, and	1015
shall be prepared in a manner that protects the identity of each	1016
person involved in each case. The report shall be submitted to	1017
the physician assistant policy committee of the board and is a	1018
public record for purposes of section 149.43 of the Revised Code.	1019

Sec. 4731.22.  (A) The state medical board, by an	1020
affirmative vote of not fewer than six of its members, may revoke	1021
or may refuse to grant a certificate to a person found by the	1022
board to have committed fraud during the administration of the	1023
examination for a certificate to practice or to have committed	1024
fraud, misrepresentation, or deception in applying for or securing	1025
any certificate to practice or certificate of registration issued	1026
by the board.	1027

(B) The board, by an affirmative vote of not fewer than six	1028
members, shall, to the extent permitted by law, limit, revoke, or	1029
suspend an individual's certificate to practice, refuse to	1030
register an individual, refuse to reinstate a certificate, or	1031
reprimand or place on probation the holder of a certificate for	1032
one or more of the following reasons:	1033

(1) Permitting one's name or one's certificate to practice	1034
or certificate of registration to be used by a person, group, or	1035
corporation when the individual concerned is not actually	1036
directing the treatment given;	1037

(2) Failure to maintain minimal standards applicable to the	1038
selection or administration of drugs, or failure to employ	1039
acceptable scientific methods in the selection of drugs or other	1040
modalities for treatment of disease;	1041

(3) Selling, giving away, personally furnishing,	1042
prescribing, or administering drugs for other than legal and	1043
legitimate therapeutic purposes or a plea of guilty to, a judicial	1044
finding of guilt of, or a judicial finding of eligibility for	1045
intervention in lieu of conviction of, a violation of any federal	1046
or state law regulating the possession, distribution, or use of	1047
any drug;	1048

(4) Willfully betraying a professional confidence.

1049

For purposes of this division, "willfully betraying a	1050
professional confidence" does not include providing any	1051
information, documents, or reports to a child fatality review	1052
board under sections 307.621 to 307.629 of the Revised Code and	1053
does not include the making of a report of an employee's use of a	1054
drug of abuse, or a report of a condition of an employee other	1055
than one involving the use of a drug of abuse, to the employer of	1056
the employee as described in division (B) of section 2305.33 of	1057
the Revised Code. Nothing in this division affects the immunity	1058
from civil liability conferred by that section upon a physician	1059
who makes either type of report in accordance with division (B) of	1060
that section. As used in this division, "employee," "employer,"	1061
and "physician" have the same meanings as in section 2305.33 of	1062
the Revised Code.	1063

(5) Making a false, fraudulent, deceptive, or misleading	1064
statement in the solicitation of or advertising for patients; in	1065
relation to the practice of medicine and surgery, osteopathic	1066
medicine and surgery, podiatric medicine and surgery, or a	1067
limited branch of medicine; or in securing or attempting to secure	1068
any certificate to practice or certificate of registration issued	1069
by the board.	1070

As used in this division, "false, fraudulent, deceptive, or	1071
misleading statement" means a statement that includes a	1072
misrepresentation of fact, is likely to mislead or deceive because	1073
of a failure to disclose material facts, is intended or is likely	1074
to create false or unjustified expectations of favorable results,	1075
or includes representations or implications that in reasonable	1076
probability will cause an ordinarily prudent person to	1077
misunderstand or be deceived.	1078

(6) A departure from, or the failure to conform to, minimal	1079
standards of care of similar practitioners under the same or	1080
similar circumstances, whether or not actual injury to a patient	1081
is established;	1082

(7) Representing, with the purpose of obtaining compensation	1083
or other advantage as personal gain or for any other person, that	1084
an incurable disease or injury, or other incurable condition, can	1085
be permanently cured;	1086

(8) The obtaining of, or attempting to obtain, money or	1087
anything of value by fraudulent misrepresentations in the course	1088
of practice;	1089

(9) A plea of guilty to, a judicial finding of guilt of, or	1090
a judicial finding of eligibility for intervention in lieu of	1091
conviction for, a felony;	1092

(10) Commission of an act that constitutes a felony in this	1093
state, regardless of the jurisdiction in which the act was	1094
committed;	1095

(11) A plea of guilty to, a judicial finding of guilt of, or	1096
a judicial finding of eligibility for intervention in lieu of	1097
conviction for, a misdemeanor committed in the course of practice;	1098

(12) Commission of an act in the course of practice that	1099
constitutes a misdemeanor in this state, regardless of the	1100
jurisdiction in which the act was committed;	1101

(13) A plea of guilty to, a judicial finding of guilt of, or	1102
a judicial finding of eligibility for intervention in lieu of	1103
conviction for, a misdemeanor involving moral turpitude;	1104

(14) Commission of an act involving moral turpitude that	1105
constitutes a misdemeanor in this state, regardless of the	1106
jurisdiction in which the act was committed;	1107

(15) Violation of the conditions of limitation placed by the	1108
board upon a certificate to practice;	1109

(16) Failure to pay license renewal fees specified in this	1110
chapter;	1111

(17) Except as authorized in section 4731.31 of the Revised	1112
Code, engaging in the division of fees for referral of patients,	1113
or the receiving of a thing of value in return for a specific	1114
referral of a patient to utilize a particular service or business;	1115

(18) Subject to section 4731.226 of the Revised Code,	1116
violation of any provision of a code of ethics of the American	1117
medical association, the American osteopathic association, the	1118
American podiatric medical association, or any other national	1119
professional organizations that the board specifies by rule. The	1120
state medical board shall obtain and keep on file current copies	1121
of the codes of ethics of the various national professional	1122
organizations. The individual whose certificate is being	1123
suspended or revoked shall not be found to have violated any	1124
provision of a code of ethics of an organization not appropriate	1125
to the individual's profession.	1126

For purposes of this division, a "provision of a code of	1127
ethics of a national professional organization" does not include	1128
any provision that would preclude the making of a report by a	1129
physician of an employee's use of a drug of abuse, or of a	1130
condition of an employee other than one involving the use of a	1131
drug of abuse, to the employer of the employee as described in	1132
division (B) of section 2305.33 of the Revised Code. Nothing in	1133
this division affects the immunity from civil liability conferred	1134
by that section upon a physician who makes either type of report	1135
in accordance with division (B) of that section. As used in this	1136
division, "employee," "employer," and "physician" have the same	1137
meanings as in section 2305.33 of the Revised Code.	1138

(19) Inability to practice according to acceptable and	1139
prevailing standards of care by reason of mental illness or	1140
physical illness, including, but not limited to, physical	1141
deterioration that adversely affects cognitive, motor, or	1142
perceptive skills.	1143

In enforcing this division, the board, upon a showing of a	1144
possible violation, may compel any individual authorized to	1145
practice by this chapter or who has submitted an application	1146
pursuant to this chapter to submit to a mental examination,	1147
physical examination, including an HIV test, or both a mental and	1148
a physical examination. The expense of the examination is the	1149
responsibility of the individual compelled to be examined. Failure	1150
to submit to a mental or physical examination or consent to an HIV	1151
test ordered by the board constitutes an admission of the	1152
allegations against the individual unless the failure is due to	1153
circumstances beyond the individual's control, and a default and	1154
final order may be entered without the taking of testimony or	1155
presentation of evidence. If the board finds an individual unable	1156
to practice because of the reasons set forth in this division, the	1157
board shall require the individual to submit to care, counseling,	1158
or treatment by physicians approved or designated by the board, as	1159
a condition for initial, continued, reinstated, or renewed	1160
authority to practice. An individual affected under this division	1161
shall be afforded an opportunity to demonstrate to the board the	1162
ability to resume practice in compliance with acceptable and	1163
prevailing standards under the provisions of the individual's	1164
certificate. For the purpose of this division, any individual who	1165
applies for or receives a certificate to practice under this	1166
chapter accepts the privilege of practicing in this state and, by	1167
so doing, shall be deemed to have given consent to submit to a	1168
mental or physical examination when directed to do so in writing	1169
by the board, and to have waived all objections to the	1170
admissibility of testimony or examination reports that constitute	1171
a privileged communication.	1172

(20) Except when civil penalties are imposed under section	1173
4731.225 or 4731.281 of the Revised Code, and subject to section	1174
4731.226 of the Revised Code, violating or attempting to violate,	1175
directly or indirectly, or assisting in or abetting the violation	1176
of, or conspiring to violate, any provisions of this chapter or	1177
any rule promulgated by the board.	1178

This division does not apply to a violation or attempted	1179
violation of, assisting in or abetting the violation of, or a	1180
conspiracy to violate, any provision of this chapter or any rule	1181
adopted by the board that would preclude the making of a report by	1182
a physician of an employee's use of a drug of abuse, or of a	1183
condition of an employee other than one involving the use of a	1184
drug of abuse, to the employer of the employee as described in	1185
division (B) of section 2305.33 of the Revised Code. Nothing in	1186
this division affects the immunity from civil liability conferred	1187
by that section upon a physician who makes either type of report	1188
in accordance with division (B) of that section. As used in this	1189
division, "employee," "employer," and "physician" have the same	1190
meanings as in section 2305.33 of the Revised Code.	1191

(21) The violation of any abortion rule adopted by the	1192
public health council pursuant to section 3701.341 of the Revised	1193
Code;	1194

(22) Any of the following actions taken by the agency	1195
responsible for regulating the practice of medicine and surgery,	1196
osteopathic medicine and surgery, podiatric medicine and surgery,	1197
or the limited branches of medicine in another jurisdiction, for	1198
any reason other than the nonpayment of fees: the limitation,	1199
revocation, or suspension of an individual's license to practice;	1200
acceptance of an individual's license surrender; denial of a	1201
license; refusal to renew or reinstate a license; imposition of	1202
probation; or issuance of an order of censure or other reprimand;	1203

(23) The violation of section 2919.12 of the Revised Code or	1204
the performance or inducement of an abortion upon a pregnant woman	1205
with actual knowledge that the conditions specified in division	1206
(B) of section 2317.56 of the Revised Code have not been satisfied	1207
or with a heedless indifference as to whether those conditions	1208
have been satisfied, unless an affirmative defense as specified in	1209
division (H)(2) of that section would apply in a civil action	1210
authorized by division (H)(1) of that section;	1211

(24) The revocation, suspension, restriction, reduction, or	1212
termination of clinical privileges by the United States department	1213
of defense or department of veterans affairs or the termination or	1214
suspension of a certificate of registration to prescribe drugs by	1215
the drug enforcement administration of the United States	1216
department of justice;	1217

(25) Termination or suspension from participation in the	1218
medicare or medicaid programs by the department of health and	1219
human services or other responsible agency for any act or acts	1220
that also would constitute a violation of division (B)(2), (3),	1221
(6), (8), or (19) of this section;	1222

(26) Impairment of ability to practice according to	1223
acceptable and prevailing standards of care because of habitual or	1224
excessive use or abuse of drugs, alcohol, or other substances that	1225
impair ability to practice.	1226

For the purposes of this division, any individual authorized	1227
to practice by this chapter accepts the privilege of practicing in	1228
this state subject to supervision by the board. By filing an	1229
application for or holding a certificate to practice under this	1230
chapter, an individual shall be deemed to have given consent to	1231
submit to a mental or physical examination when ordered to do so	1232
by the board in writing, and to have waived all objections to the	1233
admissibility of testimony or examination reports that constitute	1234
privileged communications.	1235

If it has reason to believe that any individual authorized to	1236
practice by this chapter or any applicant for certification to	1237
practice suffers such impairment, the board may compel the	1238
individual to submit to a mental or physical examination, or both.	1239
The expense of the examination is the responsibility of the	1240
individual compelled to be examined. Any mental or physical	1241
examination required under this division shall be undertaken by a	1242
treatment provider or physician who is qualified to conduct the	1243
examination and who is chosen by the board.	1244

Failure to submit to a mental or physical examination ordered	1245
by the board constitutes an admission of the allegations against	1246
the individual unless the failure is due to circumstances beyond	1247
the individual's control, and a default and final order may be	1248
entered without the taking of testimony or presentation of	1249
evidence. If the board determines that the individual's ability	1250
to practice is impaired, the board shall suspend the individual's	1251
certificate or deny the individual's application and shall require	1252
the individual, as a condition for initial, continued, reinstated,	1253
or renewed certification to practice, to submit to treatment.	1254

Before being eligible to apply for reinstatement of a	1255
certificate suspended under this division, the impaired	1256
practitioner shall demonstrate to the board the ability to resume	1257
practice in compliance with acceptable and prevailing standards of	1258
care under the provisions of the practitioner's certificate. The	1259
demonstration shall include, but shall not be limited to, the	1260
following:	1261

(a) Certification from a treatment provider approved under	1262
section 4731.25 of the Revised Code that the individual has	1263
successfully completed any required inpatient treatment;	1264

(b) Evidence of continuing full compliance with an aftercare	1265
contract or consent agreement;	1266

(c) Two written reports indicating that the individual's	1267
ability to practice has been assessed and that the individual has	1268
been found capable of practicing according to acceptable and	1269
prevailing standards of care. The reports shall be made by	1270
individuals or providers approved by the board for making the	1271
assessments and shall describe the basis for their determination.	1272

The board may reinstate a certificate suspended under this	1273
division after that demonstration and after the individual has	1274
entered into a written consent agreement.	1275

When the impaired practitioner resumes practice, the board	1276
shall require continued monitoring of the individual. The	1277
monitoring shall include, but not be limited to, compliance with	1278
the written consent agreement entered into before reinstatement or	1279
with conditions imposed by board order after a hearing, and, upon	1280
termination of the consent agreement, submission to the board for	1281
at least two years of annual written progress reports made under	1282
penalty of perjury stating whether the individual has maintained	1283
sobriety.	1284

(27) A second or subsequent violation of section 4731.66 or	1285
4731.69 of the Revised Code;	1286

(28) Except as provided in division (N) of this section:

1287

(a) Waiving the payment of all or any part of a deductible	1288
or copayment that a patient, pursuant to a health insurance or	1289
health care policy, contract, or plan that covers the individual's	1290
services, otherwise would be required to pay if the waiver is used	1291
as an enticement to a patient or group of patients to receive	1292
health care services from that individual;	1293

(b) Advertising that the individual will waive the payment	1294
of all or any part of a deductible or copayment that a patient,	1295
pursuant to a health insurance or health care policy, contract, or	1296
plan that covers the individual's services, otherwise would be	1297
required to pay.	1298

(29) Failure to use universal blood and body fluid	1299
precautions established by rules adopted under section 4731.051 of	1300
the Revised Code;	1301

(30) Failure of a collaborating physician to fulfill the	1302
responsibilities agreed to by the physician and an advanced	1303
practice nurse participating in a pilot program under section	1304
4723.52 of the Revised Code;	1305

(31) Failure to provide notice to, and receive	1306
acknowledgment of the notice from, a patient when required by	1307
section 4731.143 of the Revised Code prior to providing	1308
nonemergency professional services, or failure to maintain that	1309
notice in the patient's file;	1310

(32) Failure of a physician supervising a physician	1311
assistant to maintain supervision in accordance with the	1312
requirements of Chapter 4730. of the Revised Code and the rules	1313
adopted under that chapter;	1314

(33) Failure of a physician or podiatrist to enter into a	1315
standard care arrangement with a clinical nurse specialist,	1316
certified nurse-midwife, or certified nurse practitioner with whom	1317
the physician or podiatrist is in collaboration pursuant to	1318
section 4731.27 of the Revised Code or failure to fulfill the	1319
responsibilities of collaboration after entering into a standard	1320
care arrangement;	1321

(34) Failure to comply with the terms of a consult agreement	1322
entered into with a pharmacist pursuant to section 4729.39 of the	1323
Revised Code;	1324

(35) Failure to cooperate in an investigation conducted by	1325
the board under division (F) of this section, including failure to	1326
comply with a subpoena or order issued by the board or failure to	1327
answer truthfully a question presented by the board at a	1328
deposition or in written interrogatories, except that failure to	1329
cooperate with an investigation shall not constitute grounds for	1330
discipline under this section if a court of competent jurisdiction	1331
has issued an order that either quashes a subpoena or permits the	1332
individual to withhold the testimony or evidence in issue;	1333

(36) Failure to supervise an acupuncturist in accordance	1334
with Chapter 4762. of the Revised Code and the board's rules for	1335
supervision of an acupuncturist;	1336

(37) Failure to supervise an anesthesiologist assistant in	1337
accordance with Chapter 4760. of the Revised Code and the board's	1338
rules for supervision of an anesthesiologist assistant.	1339

(C) Disciplinary actions taken by the board under divisions	1340
(A) and (B) of this section shall be taken pursuant to an	1341
adjudication under Chapter 119. of the Revised Code, except that	1342
in lieu of an adjudication, the board may enter into a consent	1343
agreement with an individual to resolve an allegation of a	1344
violation of this chapter or any rule adopted under it. A consent	1345
agreement, when ratified by an affirmative vote of not fewer than	1346
six members of the board, shall constitute the findings and order	1347
of the board with respect to the matter addressed in the	1348
agreement. If the board refuses to ratify a consent agreement,	1349
the admissions and findings contained in the consent agreement	1350
shall be of no force or effect.	1351

(D) For purposes of divisions (B)(10), (12), and (14) of	1352
this section, the commission of the act may be established by a	1353
finding by the board, pursuant to an adjudication under Chapter	1354
119. of the Revised Code, that the individual committed the act.	1355
The board does not have jurisdiction under those divisions if the	1356
trial court renders a final judgment in the individual's favor and	1357
that judgment is based upon an adjudication on the merits. The	1358
board has jurisdiction under those divisions if the trial court	1359
issues an order of dismissal upon technical or procedural grounds.	1360

(E) The sealing of conviction records by any court shall	1361
have no effect upon a prior board order entered under this section	1362
or upon the board's jurisdiction to take action under this section	1363
if, based upon a plea of guilty, a judicial finding of guilt, or a	1364
judicial finding of eligibility for intervention in lieu of	1365
conviction, the board issued a notice of opportunity for a hearing	1366
prior to the court's order to seal the records. The board shall	1367
not be required to seal, destroy, redact, or otherwise modify its	1368
records to reflect the court's sealing of conviction records.	1369

(F)(1) The board shall investigate evidence that appears to	1370
show that a person has violated any provision of this chapter or	1371
any rule adopted under it. Any person may report to the board in	1372
a signed writing any information that the person may have that	1373
appears to show a violation of any provision of this chapter or	1374
any rule adopted under it. In the absence of bad faith, any	1375
person who reports information of that nature or who testifies	1376
before the board in any adjudication conducted under Chapter 119.	1377
of the Revised Code shall not be liable in damages in a civil	1378
action as a result of the report or testimony. Each complaint or	1379
allegation of a violation received by the board shall be assigned	1380
a case number and shall be recorded by the board.	1381

(2) Investigations of alleged violations of this chapter or	1382
any rule adopted under it shall be supervised by the supervising	1383
member elected by the board in accordance with section 4731.02 of	1384
the Revised Code and by the secretary as provided in section	1385
4731.39 of the Revised Code. The president may designate another	1386
member of the board to supervise the investigation in place of the	1387
supervising member. No member of the board who supervises the	1388
investigation of a case shall participate in further adjudication	1389
of the case.	1390

(3) In investigating a possible violation of this chapter or	1391
any rule adopted under this chapter, the board may administer	1392
oaths, order the taking of depositions, issue subpoenas, and	1393
compel the attendance of witnesses and production of books,	1394
accounts, papers, records, documents, and testimony, except that a	1395
subpoena for patient record information shall not be issued	1396
without consultation with the attorney general's office and	1397
approval of the secretary and supervising member of the board.	1398
Before issuance of a subpoena for patient record information, the	1399
secretary and supervising member shall determine whether there is	1400
probable cause to believe that the complaint filed alleges a	1401
violation of this chapter or any rule adopted under it and that	1402
the records sought are relevant to the alleged violation and	1403
material to the investigation. The subpoena may apply only to	1404
records that cover a reasonable period of time surrounding the	1405
alleged violation.	1406

On failure to comply with any subpoena issued by the board	1407
and after reasonable notice to the person being subpoenaed, the	1408
board may move for an order compelling the production of persons	1409
or records pursuant to the Rules of Civil Procedure.	1410

A subpoena issued by the board may be served by a sheriff,	1411
the sheriff's deputy, or a board employee designated by the board.	1412
Service of a subpoena issued by the board may be made by	1413
delivering a copy of the subpoena to the person named therein,	1414
reading it to the person, or leaving it at the person's usual	1415
place of residence. When the person being served is a person	1416
whose practice is authorized by this chapter, service of the	1417
subpoena may be made by certified mail, restricted delivery,	1418
return receipt requested, and the subpoena shall be deemed served	1419
on the date delivery is made or the date the person refuses to	1420
accept delivery.	1421

A sheriff's deputy who serves a subpoena shall receive the	1422
same fees as a sheriff. Each witness who appears before the board	1423
in obedience to a subpoena shall receive the fees and mileage	1424
provided for witnesses in civil cases in the courts of common	1425
pleas.	1426

(4) All hearings and investigations of the board shall be	1427
considered civil actions for the purposes of section 2305.251	1428
2305.252 of the Revised Code.	1429

(5) Information received by the board pursuant to an	1430
investigation is confidential and not subject to discovery in any	1431
civil action.	1432

The board shall conduct all investigations and proceedings in	1433
a manner that protects the confidentiality of patients and persons	1434
who file complaints with the board. The board shall not make	1435
public the names or any other identifying information about	1436
patients or complainants unless proper consent is given or, in the	1437
case of a patient, a waiver of the patient privilege exists under	1438
division (B) of section 2317.02 of the Revised Code, except that	1439
consent or a waiver of that nature is not required if the board	1440
possesses reliable and substantial evidence that no bona fide	1441
physician-patient relationship exists.	1442

The board may share any information it receives pursuant to	1443
an investigation, including patient records and patient record	1444
information, with law enforcement agencies, other licensing	1445
boards, and other governmental agencies that are prosecuting,	1446
adjudicating, or investigating alleged violations of statutes or	1447
administrative rules. An agency or board that receives the	1448
information shall comply with the same requirements regarding	1449
confidentiality as those with which the state medical board must	1450
comply, notwithstanding any conflicting provision of the Revised	1451
Code or procedure of the agency or board that applies when it is	1452
dealing with other information in its possession. In a judicial	1453
proceeding, the information may be admitted into evidence only in	1454
accordance with the Rules of Evidence, but the court shall require	1455
that appropriate measures are taken to ensure that confidentiality	1456
is maintained with respect to any part of the information that	1457
contains names or other identifying information about patients or	1458
complainants whose confidentiality was protected by the state	1459
medical board when the information was in the board's possession.	1460
Measures to ensure confidentiality that may be taken by the court	1461
include sealing its records or deleting specific information from	1462
its records.	1463

(6) On a quarterly basis, the board shall prepare a report	1464
that documents the disposition of all cases during the preceding	1465
three months. The report shall contain the following information	1466
for each case with which the board has completed its activities:	1467

(a) The case number assigned to the complaint or alleged	1468
violation;	1469

(b) The type of certificate to practice, if any, held by the	1470
individual against whom the complaint is directed;	1471

(c) A description of the allegations contained in the	1472
complaint;	1473

(d) The disposition of the case.

1474

The report shall state how many cases are still pending and	1475
shall be prepared in a manner that protects the identity of each	1476
person involved in each case. The report shall be a public record	1477
under section 149.43 of the Revised Code.	1478

(G) If the secretary and supervising member determine that	1479
there is clear and convincing evidence that an individual has	1480
violated division (B) of this section and that the individual's	1481
continued practice presents a danger of immediate and serious harm	1482
to the public, they may recommend that the board suspend the	1483
individual's certificate to practice without a prior hearing.	1484
Written allegations shall be prepared for consideration by the	1485
board.	1486

The board, upon review of those allegations and by an	1487
affirmative vote of not fewer than six of its members, excluding	1488
the secretary and supervising member, may suspend a certificate	1489
without a prior hearing. A telephone conference call may be	1490
utilized for reviewing the allegations and taking the vote on the	1491
summary suspension.	1492

The board shall issue a written order of suspension by	1493
certified mail or in person in accordance with section 119.07 of	1494
the Revised Code. The order shall not be subject to suspension by	1495
the court during pendency of any appeal filed under section 119.12	1496
of the Revised Code. If the individual subject to the summary	1497
suspension requests an adjudicatory hearing by the board, the date	1498
set for the hearing shall be within fifteen days, but not earlier	1499
than seven days, after the individual requests the hearing, unless	1500
otherwise agreed to by both the board and the individual.	1501

Any summary suspension imposed under this division shall	1502
remain in effect, unless reversed on appeal, until a final	1503
adjudicative order issued by the board pursuant to this section	1504
and Chapter 119. of the Revised Code becomes effective. The board	1505
shall issue its final adjudicative order within sixty days after	1506
completion of its hearing. A failure to issue the order within	1507
sixty days shall result in dissolution of the summary suspension	1508
order but shall not invalidate any subsequent, final adjudicative	1509
order.	1510

(H) If the board takes action under division (B)(9), (11),	1511
or (13) of this section and the judicial finding of guilt, guilty	1512
plea, or judicial finding of eligibility for intervention in lieu	1513
of conviction is overturned on appeal, upon exhaustion of the	1514
criminal appeal, a petition for reconsideration of the order may	1515
be filed with the board along with appropriate court documents.	1516
Upon receipt of a petition of that nature and supporting court	1517
documents, the board shall reinstate the individual's certificate	1518
to practice. The board may then hold an adjudication under	1519
Chapter 119. of the Revised Code to determine whether the	1520
individual committed the act in question. Notice of an	1521
opportunity for a hearing shall be given in accordance with	1522
Chapter 119. of the Revised Code. If the board finds, pursuant to	1523
an adjudication held under this division, that the individual	1524
committed the act or if no hearing is requested, the board may	1525
order any of the sanctions identified under division (B) of this	1526
section.	1527

(I) The certificate to practice issued to an individual	1528
under this chapter and the individual's practice in this state are	1529
automatically suspended as of the date the individual pleads	1530
guilty to, is found by a judge or jury to be guilty of, or is	1531
subject to a judicial finding of eligibility for intervention in	1532
lieu of conviction in this state or treatment or intervention in	1533
lieu of conviction in another jurisdiction for any of the	1534
following criminal offenses in this state or a substantially	1535
equivalent criminal offense in another jurisdiction: aggravated	1536
murder, murder, voluntary manslaughter, felonious assault,	1537
kidnapping, rape, sexual battery, gross sexual imposition,	1538
aggravated arson, aggravated robbery, or aggravated burglary.	1539
Continued practice after suspension shall be considered practicing	1540
without a certificate.	1541

The board shall notify the individual subject to the	1542
suspension by certified mail or in person in accordance with	1543
section 119.07 of the Revised Code. If an individual whose	1544
certificate is suspended under this division fails to make a	1545
timely request for an adjudication under Chapter 119. of the	1546
Revised Code, the board shall enter a final order permanently	1547
revoking the individual's certificate to practice.	1548

(J) If the board is required by Chapter 119. of the Revised	1549
Code to give notice of an opportunity for a hearing and if the	1550
individual subject to the notice does not timely request a hearing	1551
in accordance with section 119.07 of the Revised Code, the board	1552
is not required to hold a hearing, but may adopt, by an	1553
affirmative vote of not fewer than six of its members, a final	1554
order that contains the board's findings. In that final order,	1555
the board may order any of the sanctions identified under division	1556
(A) or (B) of this section.	1557

(K) Any action taken by the board under division (B) of this	1558
section resulting in a suspension from practice shall be	1559
accompanied by a written statement of the conditions under which	1560
the individual's certificate to practice may be reinstated. The	1561
board shall adopt rules governing conditions to be imposed for	1562
reinstatement. Reinstatement of a certificate suspended pursuant	1563
to division (B) of this section requires an affirmative vote of	1564
not fewer than six members of the board.	1565

(L) When the board refuses to grant a certificate to an	1566
applicant, revokes an individual's certificate to practice,	1567
refuses to register an applicant, or refuses to reinstate an	1568
individual's certificate to practice, the board may specify that	1569
its action is permanent. An individual subject to a permanent	1570
action taken by the board is forever thereafter ineligible to hold	1571
a certificate to practice and the board shall not accept an	1572
application for reinstatement of the certificate or for issuance	1573
of a new certificate.	1574

(M) Notwithstanding any other provision of the Revised Code,	1575
all of the following apply:	1576

(1) The surrender of a certificate issued under this chapter	1577
shall not be effective unless or until accepted by the board.	1578
Reinstatement of a certificate surrendered to the board requires	1579
an affirmative vote of not fewer than six members of the board.	1580

(2) An application for a certificate made under the	1581
provisions of this chapter may not be withdrawn without approval	1582
of the board.	1583

(3) Failure by an individual to renew a certificate of	1584
registration in accordance with this chapter shall not remove or	1585
limit the board's jurisdiction to take any disciplinary action	1586
under this section against the individual.	1587

(N) Sanctions shall not be imposed under division (B)(28) of	1588
this section against any person who waives deductibles and	1589
copayments as follows:	1590

(1) In compliance with the health benefit plan that	1591
expressly allows such a practice. Waiver of the deductibles or	1592
copayments shall be made only with the full knowledge and consent	1593
of the plan purchaser, payer, and third-party administrator.	1594
Documentation of the consent shall be made available to the board	1595
upon request.	1596

(2) For professional services rendered to any other person	1597
authorized to practice pursuant to this chapter, to the extent	1598
allowed by this chapter and rules adopted by the board.	1599

(O) Under the board's investigative duties described in this	1600
section and subject to division (F) of this section, the board	1601
shall develop and implement a quality intervention program	1602
designed to improve through remedial education the clinical and	1603
communication skills of individuals authorized under this chapter	1604
to practice medicine and surgery, osteopathic medicine and	1605
surgery, and podiatric medicine and surgery. In developing and	1606
implementing the quality intervention program, the board may do	1607
all of the following:	1608

(1) Offer in appropriate cases as determined by the board an	1609
educational and assessment program pursuant to an investigation	1610
the board conducts under this section;	1611

(2) Select providers of educational and assessment services,	1612
including a quality intervention program panel of case reviewers;	1613

(3) Make referrals to educational and assessment service	1614
providers and approve individual educational programs recommended	1615
by those providers. The board shall monitor the progress of each	1616
individual undertaking a recommended individual educational	1617
program.	1618

(4) Determine what constitutes successful completion of an	1619
individual educational program and require further monitoring of	1620
the individual who completed the program or other action that the	1621
board determines to be appropriate;	1622

(5) Adopt rules in accordance with Chapter 119. of the	1623
Revised Code to further implement the quality intervention	1624
program.	1625

An individual who participates in an individual educational	1626
program pursuant to this division shall pay the financial	1627
obligations arising from that educational program.	1628

Sec. 4731.36.  (A) Sections 4731.01 to 4731.47 of the	1629
Revised Code shall not prohibit service in case of emergency,	1630
domestic administration of family remedies, or provision of	1631
assistance to another individual who is self-administering drugs.	1632

Sections 4731.01 to 4731.47 of the Revised Code shall not	1633
apply to any of the following:	1634

(1) A commissioned medical officer of the United States	1635
armed forces, as defined in section 5903.11 of the Revised Code,	1636
or an employee of the veterans administration of the United States	1637
or the United States public health service in the discharge of the	1638
officer's or employee's professional duties;	1639

(2) A dentist authorized under Chapter 4715. of the Revised	1640
Code to practice dentistry when engaged exclusively in the	1641
practice of dentistry or when administering anesthetics in the	1642
practice of dentistry;	1643

(3) A physician or surgeon in another state or territory	1644
who is a legal practitioner of medicine or surgery therein when	1645
providing consultation to an individual holding a certificate to	1646
practice issued under this chapter who is responsible for the	1647
examination, diagnosis, and treatment of the patient who is the	1648
subject of the consultation, if one of the following applies:	1649

(a) The physician or surgeon does not provide consultation	1650
in this state on a regular or frequent basis.	1651

(b) The physician or surgeon provides the consultation	1652
without compensation of any kind, direct or indirect, for the	1653
consultation.	1654

(c) The consultation is part of the curriculum of a medical	1655
school or osteopathic medical school of this state or a program	1656
described in division (A)(2) of section 4731.291 of the Revised	1657
Code.	1658

(4) A physician or surgeon in another state or territory who	1659
is a legal practitioner of medicine or surgery therein and	1660
provided services to a patient in that state or territory, when	1661
providing, not later than one year after the last date services	1662
were provided in another state or territory, follow-up services in	1663
person or through the use of any communication, including oral,	1664
written, or electronic communication, in this state to the patient	1665
for the same condition;	1666

(5) A physician or surgeon residing on the border of a	1667
contiguous state and authorized under the laws thereof to practice	1668
medicine and surgery therein, whose practice extends within the	1669
limits of this state. Such practitioner shall not either in	1670
person or through the use of any communication, including oral,	1671
written, or electronic communication, open an office or appoint a	1672
place to see patients or receive calls within the limits of this	1673
state.	1674

(6) A board, committee, or corporation engaged in the	1675
conduct described in division (A) of section 2305.252305.251 of	1676
the Revised Code when acting within the scope of the functions of	1677
the board, committee, or corporation;	1678

(7) The conduct of an independent review organization	1679
accredited by the superintendent of insurance under section	1680
3901.80 of the Revised Code for the purpose of external reviews	1681
conducted under sections 1751.84, 1751.85, 3923.67, 3923.68,	1682
3923.76, and 3923.77 of the Revised Code.	1683

(B) Sections 4731.51 to 4731.61 of the Revised Code do not	1684
apply to any graduate of a podiatric school or college while	1685
performing those acts that may be prescribed by or incidental to	1686
participation in an accredited podiatric internship, residency, or	1687
fellowship program situated in this state approved by the state	1688
medical board.	1689

(C) This chapter does not apply to an acupuncturist who	1690
complies with Chapter 4762. of the Revised Code.	1691

(D) This chapter does not prohibit the administration of	1692
drugs by any of the following:	1693

(1) An individual who is licensed or otherwise specifically	1694
authorized by the Revised Code to administer drugs;	1695

(2) An individual who is not licensed or otherwise	1696
specifically authorized by the Revised Code to administer drugs,	1697
but is acting pursuant to the rules for delegation of medical	1698
tasks adopted under section 4731.053 of the Revised Code;	1699

(3) An individual specifically authorized to administer	1700
drugs pursuant to a rule adopted under the Revised Code that is in	1701
effect on the effective date of this amendment, as long as the	1702
rule remains in effect, specifically authorizing an individual to	1703
administer drugs.	1704

(E) The exemptions described in divisions (A)(3), (4), and	1705
(5) of this section do not apply to a physician or surgeon whose	1706
certificate to practice issued under this chapter is under	1707
suspension or has been revoked or permanently revoked by action of	1708
the state medical board.	1709

Sec. 4734.45.  (A) The state chiropractic board shall	1710
investigate evidence that appears to show that a person has	1711
violated any provision of this chapter or the rules adopted under	1712
it. Any person may report to the board in writing or by other	1713
means any information the person has that appears to show a	1714
violation of any provision of this chapter or the rules adopted	1715
under it. In the absence of bad faith, a person who reports to	1716
the board, cooperates in an investigation, or testifies before the	1717
board in an adjudication shall not be liable for civil damages as	1718
a result of reporting, cooperating, or providing testimony.	1719

(B) Information received by the board pursuant to an	1720
investigation is confidential and not subject to discovery in any	1721
civil action, except that for good cause, the board or its	1722
executive director may disclose or authorize disclosure of	1723
information gathered pursuant to an investigation.	1724

The board and its employees may share appropriate information	1725
in the board's possession with any federal, state, or local law	1726
enforcement, prosecutorial, or regulatory agency or its officers	1727
or agents engaging in an investigation. The board and its	1728
employees may cooperate in any other manner with the agency or its	1729
officers or agents engaging in an investigation.	1730

An agency that receives confidential information shall comply	1731
with the same requirements regarding confidentiality as those with	1732
which the board must comply, notwithstanding any conflicting	1733
provision of the Revised Code or procedure of the agency that	1734
applies when the agency is dealing with other information in its	1735
possession. The information may be admitted into evidence in a	1736
criminal trial in accordance with the Rules of Evidence, or in an	1737
administrative hearing conducted by an agency, but the court or	1738
agency shall require that appropriate measures be taken to ensure	1739
that confidentiality is maintained with respect to any part of the	1740
information that contains names or other identifying information	1741
about patients, complainants, or others whose confidentiality was	1742
protected by the state chiropractic board when the information was	1743
in the board's possession. Measures to ensure confidentiality	1744
that may be taken by the court or agency include sealing its	1745
records or redacting specific information from its records.	1746

(C) All hearings and investigations of the board shall be	1747
considered civil actions for the purposes of section 2305.251	1748
2305.252 of the Revised Code.	1749

Sec. 4760.14.  (A) The state medical board shall investigate	1750
evidence that appears to show that any person has violated this	1751
chapter or the rules adopted under it. Any person may report to	1752
the board in a signed writing any information the person has that	1753
appears to show a violation of any provision of this chapter or	1754
the rules adopted under it. In the absence of bad faith, a person	1755
who reports such information or testifies before the board in an	1756
adjudication conducted under Chapter 119. of the Revised Code	1757
shall not be liable for civil damages as a result of reporting the	1758
information or providing testimony. Each complaint or allegation	1759
of a violation received by the board shall be assigned a case	1760
number and be recorded by the board.	1761

(B) Investigations of alleged violations of this chapter or	1762
rules adopted under it shall be supervised by the supervising	1763
member elected by the board in accordance with section 4731.02 of	1764
the Revised Code and by the secretary as provided in section	1765
4760.15 of the Revised Code. The board's president may designate	1766
another member of the board to supervise the investigation in	1767
place of the supervising member. A member of the board who	1768
supervises the investigation of a case shall not participate in	1769
further adjudication of the case.	1770

(C) In investigating a possible violation of this chapter or	1771
the rules adopted under it, the board may administer oaths, order	1772
the taking of depositions, issue subpoenas, and compel the	1773
attendance of witnesses and production of books, accounts, papers,	1774
records, documents, and testimony, except that a subpoena for	1775
patient record information shall not be issued without	1776
consultation with the attorney general's office and approval of	1777
the secretary and supervising member of the board. Before	1778
issuance of a subpoena for patient record information, the	1779
secretary and supervising member shall determine whether there is	1780
probable cause to believe that the complaint filed alleges a	1781
violation of this chapter or the rules adopted under it and that	1782
the records sought are relevant to the alleged violation and	1783
material to the investigation. The subpoena may apply only to	1784
records that cover a reasonable period of time surrounding the	1785
alleged violation.	1786

On failure to comply with any subpoena issued by the board	1787
and after reasonable notice to the person being subpoenaed, the	1788
board may move for an order compelling the production of persons	1789
or records pursuant to the Rules of Civil Procedure.	1790

A subpoena issued by the board may be served by a sheriff,	1791
the sheriff's deputy, or a board employee designated by the board.	1792
Service of a subpoena issued by the board may be made by	1793
delivering a copy of the subpoena to the person named therein,	1794
reading it to the person, or leaving it at the person's usual	1795
place of residence. When the person being served is an	1796
anesthesiologist assistant, service of the subpoena may be made by	1797
certified mail, restricted delivery, return receipt requested, and	1798
the subpoena shall be deemed served on the date delivery is made	1799
or the date the person refuses to accept delivery.	1800

A sheriff's deputy who serves a subpoena shall receive the	1801
same fees as a sheriff. Each witness who appears before the board	1802
in obedience to a subpoena shall receive the fees and mileage	1803
provided for witnesses in civil cases in the courts of common	1804
pleas.	1805

(D) All hearings and investigations of the board shall be	1806
considered civil actions for the purposes of section 2305.251	1807
2305.252 of the Revised Code.	1808

(E) Information received by the board pursuant to an	1809
investigation is confidential and not subject to discovery in any	1810
civil action.	1811

The board shall conduct all investigations and proceedings in	1812
a manner that protects the confidentiality of patients and persons	1813
who file complaints with the board. The board shall not make	1814
public the names or any other identifying information about	1815
patients or complainants unless proper consent is given.	1816

The board may share any information it receives pursuant to	1817
an investigation, including patient records and patient record	1818
information, with law enforcement agencies, other licensing	1819
boards, and other governmental agencies that are prosecuting,	1820
adjudicating, or investigating alleged violations of statutes or	1821
administrative rules. An agency or board that receives the	1822
information shall comply with the same requirements regarding	1823
confidentiality as those with which the state medical board must	1824
comply, notwithstanding any conflicting provision of the Revised	1825
Code or procedure of the agency or board that applies when it is	1826
dealing with other information in its possession. In a judicial	1827
proceeding, the information may be admitted into evidence only in	1828
accordance with the Rules of Evidence, but the court shall require	1829
that appropriate measures are taken to ensure that confidentiality	1830
is maintained with respect to any part of the information that	1831
contains names or other identifying information about patients or	1832
complainants whose confidentiality was protected by the state	1833
medical board when the information was in the board's possession.	1834
Measures to ensure confidentiality that may be taken by the court	1835
include sealing its records or deleting specific information from	1836
its records.	1837

(F) The state medical board shall develop requirements for	1838
and provide appropriate initial training and continuing education	1839
for investigators employed by the board to carry out its duties	1840
under this chapter. The training and continuing education may	1841
include enrollment in courses operated or approved by the Ohio	1842
peace officer training council that the board considers	1843
appropriate under conditions set forth in section 109.79 of the	1844
Revised Code.	1845

(G) On a quarterly basis, the board shall prepare a report	1846
that documents the disposition of all cases during the preceding	1847
three months. The report shall contain the following information	1848
for each case with which the board has completed its activities:	1849

(1) The case number assigned to the complaint or alleged	1850
violation;	1851

(2) The type of certificate to practice, if any, held by the	1852
individual against whom the complaint is directed;	1853

(3) A description of the allegations contained in the	1854
complaint;	1855

(4) The disposition of the case.

1856

The report shall state how many cases are still pending, and	1857
shall be prepared in a manner that protects the identity of each	1858
person involved in each case. The report is a public record for	1859
purposes of section 149.43 of the Revised Code.	1860

Sec. 4762.14.  (A) The state medical board shall investigate	1861
evidence that appears to show that any person has violated this	1862
chapter or the rules adopted under it. Any person may report to	1863
the board in a signed writing any information the person has that	1864
appears to show a violation of any provision of this chapter or	1865
the rules adopted under it. In the absence of bad faith, a person	1866
who reports such information or testifies before the board in an	1867
adjudication conducted under Chapter 119. of the Revised Code	1868
shall not be liable for civil damages as a result of reporting the	1869
information or providing testimony. Each complaint or allegation	1870
of a violation received by the board shall be assigned a case	1871
number and be recorded by the board.	1872

(B) Investigations of alleged violations of this chapter or	1873
rules adopted under it shall be supervised by the supervising	1874
member elected by the board in accordance with section 4731.02 of	1875
the Revised Code and by the secretary as provided in section	1876
4762.15 of the Revised Code. The board's president may designate	1877
another member of the board to supervise the investigation in	1878
place of the supervising member. A member of the board who	1879
supervises the investigation of a case shall not participate in	1880
further adjudication of the case.	1881

(C) In investigating a possible violation of this chapter or	1882
the rules adopted under it, the board may administer oaths, order	1883
the taking of depositions, issue subpoenas, and compel the	1884
attendance of witnesses and production of books, accounts, papers,	1885
records, documents, and testimony, except that a subpoena for	1886
patient record information shall not be issued without	1887
consultation with the attorney general's office and approval of	1888
the secretary and supervising member of the board. Before	1889
issuance of a subpoena for patient record information, the	1890
secretary and supervising member shall determine whether there is	1891
probable cause to believe that the complaint filed alleges a	1892
violation of this chapter or the rules adopted under it and that	1893
the records sought are relevant to the alleged violation and	1894
material to the investigation. The subpoena may apply only to	1895
records that cover a reasonable period of time surrounding the	1896
alleged violation.	1897

On failure to comply with any subpoena issued by the board	1898
and after reasonable notice to the person being subpoenaed, the	1899
board may move for an order compelling the production of persons	1900
or records pursuant to the Rules of Civil Procedure.	1901

A subpoena issued by the board may be served by a sheriff,	1902
the sheriff's deputy, or a board employee designated by the board.	1903
Service of a subpoena issued by the board may be made by	1904
delivering a copy of the subpoena to the person named therein,	1905
reading it to the person, or leaving it at the person's usual	1906
place of residence. When the person being served is an	1907
acupuncturist, service of the subpoena may be made by certified	1908
mail, restricted delivery, return receipt requested, and the	1909
subpoena shall be deemed served on the date delivery is made or	1910
the date the person refuses to accept delivery.	1911

A sheriff's deputy who serves a subpoena shall receive the	1912
same fees as a sheriff. Each witness who appears before the board	1913
in obedience to a subpoena shall receive the fees and mileage	1914
provided for witnesses in civil cases in the courts of common	1915
pleas.	1916

(D) All hearings and investigations of the board shall be	1917
considered civil actions for the purposes of section 2305.251	1918
2305.252 of the Revised Code.	1919

(E) Information received by the board pursuant to an	1920
investigation is confidential and not subject to discovery in any	1921
civil action.	1922

The board shall conduct all investigations and proceedings in	1923
a manner that protects the confidentiality of patients and persons	1924
who file complaints with the board. The board shall not make	1925
public the names or any other identifying information about	1926
patients or complainants unless proper consent is given.	1927

The board may share any information it receives pursuant to	1928
an investigation, including patient records and patient record	1929
information, with law enforcement agencies, other licensing	1930
boards, and other governmental agencies that are prosecuting,	1931
adjudicating, or investigating alleged violations of statutes or	1932
administrative rules. An agency or board that receives the	1933
information shall comply with the same requirements regarding	1934
confidentiality as those with which the state medical board must	1935
comply, notwithstanding any conflicting provision of the Revised	1936
Code or procedure of the agency or board that applies when it is	1937
dealing with other information in its possession. In a judicial	1938
proceeding, the information may be admitted into evidence only in	1939
accordance with the Rules of Evidence, but the court shall require	1940
that appropriate measures are taken to ensure that confidentiality	1941
is maintained with respect to any part of the information that	1942
contains names or other identifying information about patients or	1943
complainants whose confidentiality was protected by the state	1944
medical board when the information was in the board's possession.	1945
Measures to ensure confidentiality that may be taken by the court	1946
include sealing its records or deleting specific information from	1947
its records.	1948

(F) The state medical board shall develop requirements for	1949
and provide appropriate initial training and continuing education	1950
for investigators employed by the board to carry out its duties	1951
under this chapter. The training and continuing education may	1952
include enrollment in courses operated or approved by the Ohio	1953
peace officer training council that the board considers	1954
appropriate under conditions set forth in section 109.79 of the	1955
Revised Code.	1956

(G) On a quarterly basis, the board shall prepare a report	1957
that documents the disposition of all cases during the preceding	1958
three months. The report shall contain the following information	1959
for each case with which the board has completed its activities:	1960

(1) The case number assigned to the complaint or alleged	1961
violation;	1962

(2) The type of certificate to practice, if any, held by the	1963
individual against whom the complaint is directed;	1964

(3) A description of the allegations contained in the	1965
complaint;	1966

(4) The disposition of the case.

1967

The report shall state how many cases are still pending, and	1968
shall be prepared in a manner that protects the identity of each	1969
person involved in each case. The report is a public record for	1970
purposes of section 149.43 of the Revised Code.	1971

Section 2. That existing sections 109.36, 1751.21, 2305.25,	1972
2305.251, 2305.38, 3701.74, 4715.03, 4723.28, 4730.26, 4731.22,	1973
4731.36, 4734.45, 4760.14, and 4762.14 of the Revised Code are	1974
hereby repealed.	1975

Section 3.  Section 3701.74 of the Revised Code is presented	1976
in this act as a composite of the section as amended by both Am.	1977
Sub. H.B. 508 and Sub. H.B. 506 of the 123rd General Assembly. The	1978
General Assembly, applying the principle stated in division (B) of	1979
section 1.52 of the Revised Code that amendments are to be	1980
harmonized if reasonably capable of simultaneous operation, finds	1981
that the composite is the resulting version of the section in	1982
effect prior to the effective date of the section as presented in	1983
this act.	1984