As Introduced

127th General Assembly Regular Session 2007-2008

H. B. No. 493

Representative Daniels 

Cosponsors: Representatives Ujvagi, Flowers, Goodwin, Collier, Zehringer, Strahorn 

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A BILL

To amend section 4731.22 and to enact sections

1

3701.86, 3701.861, 3701.862, 4731.72, 4731.721,

2

4731.722, and 4731.723 of the Revised Code

3

regarding billing for anatomic pathology

4

services.

5

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

Section 1. That section 4731.22 be amended and sections	6
3701.86, 3701.861, 3701.862, 4731.72, 4731.721, 4731.722, and	7
4731.723 of the Revised Code be enacted to read as follows:	8

Sec. 3701.86.  As used in this section and in sections	9
3701.861 and 3701.862 of the Revised Code:	10

(A) "Anatomic pathology services" means all of the following:

11

(1) Histopathology or surgical pathology;

12

(2) Cytopathology;

13

(3) Hematology;

14

(4) Subcellular or molecular pathology;

15

(5) Blood banking services performed by pathologists.

16

(B) "Assignment of benefits" means the transfer of health	17
care coverage reimbursement benefits or other rights under an	18
insurance policy, subscription contract, or health care plan by an	19
insured, subscriber, or plan enrollee to a health care provider,	20
hospital, or other health care facility.	21

(C) "Clinical laboratory" means a facility for the	22
biological, microbiological, serological, chemical,	23
immunohematological, hematological, biophysical, cytological,	24
pathological, or other examination of substances derived from the	25
human body for the purpose of providing information for the	26
diagnosis, prevention, or treatment of any disease, or in the	27
assessment or impairment of the health of human beings.	28

(D) "Cytopathology" means the microscopic examination of	29
cells from fluids, aspirates, washings, brushings, or smears,	30
including a Papanicolaou smear (PAP smear or test).	31

(E) "Hematology" means the microscopic evaluation of bone	32
marrow aspirates and biopsies performed by a physician or under	33
the supervision of a physician and peripheral blood smears when	34
the attending or treating physician or technologist requests that	35
a blood smear be reviewed by a pathologist.	36

(F) "Histopathology" or "surgical pathology" means the gross	37
and microscopic examination and histologic processing of organ	38
tissue performed by a physician or under the supervision of a	39
physician.	40

(G) "Insurer" means a person authorized under Title XXXIX of	41
the Revised Code to engage in the business of insurance in this	42
state, a health insuring corporation, or an entity that is	43
self-insured and provides benefits to its employees or members.	44

(H) "Physician" means an individual authorized by Chapter	45
4731. of the Revised Code to practice medicine and surgery,	46
osteopathic medicine and surgery, or podiatric medicine and	47
surgery.	48

(I) "Referring clinical laboratory" means a clinical	49
laboratory that refers a patient specimen to another clinical	50
laboratory for an anatomic pathology service, but excludes a	51
laboratory in the office of one or more physicians that refers a	52
specimen and does not perform the professional component of the	53
anatomic pathology service.	54

(J) "Subcellular or molecular pathology" means the assessment	55
of a patient specimen for the detection, localization,	56
measurement, or analysis of one or more protein or nucleic acid	57
targets performed or interpreted by or under supervision of a	58
pathologist.	59

Sec. 3701.861. No clinical laboratory shall present or cause	60
to be presented a claim, bill, or demand for payment for anatomic	61
pathology services to any person other than the following:	62

(A) The patient who receives the services or another	63
individual, such as a parent, spouse, or guardian, who is	64
responsible for the patient's bills;	65

(B) A responsible insurer or other third-party payor of a	66
patient who receives the services;	67

(C) A hospital, public health clinic, or not-for-profit	68
health clinic ordering the services;	69

(D) A referring clinical laboratory;

70

(E) A governmental agency or any person acting on behalf of a	71
governmental agency.	72

Sec. 3701.862.  Nothing in section 3701.861 of the Revised	73
Code shall be construed to do either of the following:	74

(A) Mandate the assignment of benefits for anatomic pathology	75
services;	76

(B) Prohibit a clinical laboratory that provides anatomic	77
pathology services from billing a referring clinical laboratory	78
for anatomic pathology services in instances in which the	79
referring clinical laboratory must send one or more samples to a	80
specialist for analysis, consultation, or histologic processing.	81

Sec. 4731.22.  (A) The state medical board, by an affirmative	82
vote of not fewer than six of its members, may revoke or may	83
refuse to grant a certificate to a person found by the board to	84
have committed fraud during the administration of the examination	85
for a certificate to practice or to have committed fraud,	86
misrepresentation, or deception in applying for or securing any	87
certificate to practice or certificate of registration issued by	88
the board.	89

(B) The board, by an affirmative vote of not fewer than six	90
members, shall, to the extent permitted by law, limit, revoke, or	91
suspend an individual's certificate to practice, refuse to	92
register an individual, refuse to reinstate a certificate, or	93
reprimand or place on probation the holder of a certificate for	94
one or more of the following reasons:	95

(1) Permitting one's name or one's certificate to practice or	96
certificate of registration to be used by a person, group, or	97
corporation when the individual concerned is not actually	98
directing the treatment given;	99

(2) Failure to maintain minimal standards applicable to the	100
selection or administration of drugs, or failure to employ	101
acceptable scientific methods in the selection of drugs or other	102
modalities for treatment of disease;	103

(3) Selling, giving away, personally furnishing, prescribing,	104
or administering drugs for other than legal and legitimate	105
therapeutic purposes or a plea of guilty to, a judicial finding of	106
guilt of, or a judicial finding of eligibility for intervention in	107
lieu of conviction of, a violation of any federal or state law	108
regulating the possession, distribution, or use of any drug;	109

(4) Willfully betraying a professional confidence.

110

For purposes of this division, "willfully betraying a	111
professional confidence" does not include providing any	112
information, documents, or reports to a child fatality review	113
board under sections 307.621 to 307.629 of the Revised Code and	114
does not include the making of a report of an employee's use of a	115
drug of abuse, or a report of a condition of an employee other	116
than one involving the use of a drug of abuse, to the employer of	117
the employee as described in division (B) of section 2305.33 of	118
the Revised Code. Nothing in this division affects the immunity	119
from civil liability conferred by that section upon a physician	120
who makes either type of report in accordance with division (B) of	121
that section. As used in this division, "employee," "employer,"	122
and "physician" have the same meanings as in section 2305.33 of	123
the Revised Code.	124

(5) Making a false, fraudulent, deceptive, or misleading	125
statement in the solicitation of or advertising for patients; in	126
relation to the practice of medicine and surgery, osteopathic	127
medicine and surgery, podiatric medicine and surgery, or a limited	128
branch of medicine; or in securing or attempting to secure any	129
certificate to practice or certificate of registration issued by	130
the board.	131

As used in this division, "false, fraudulent, deceptive, or	132
misleading statement" means a statement that includes a	133
misrepresentation of fact, is likely to mislead or deceive because	134
of a failure to disclose material facts, is intended or is likely	135
to create false or unjustified expectations of favorable results,	136
or includes representations or implications that in reasonable	137
probability will cause an ordinarily prudent person to	138
misunderstand or be deceived.	139

(6) A departure from, or the failure to conform to, minimal	140
standards of care of similar practitioners under the same or	141
similar circumstances, whether or not actual injury to a patient	142
is established;	143

(7) Representing, with the purpose of obtaining compensation	144
or other advantage as personal gain or for any other person, that	145
an incurable disease or injury, or other incurable condition, can	146
be permanently cured;	147

(8) The obtaining of, or attempting to obtain, money or	148
anything of value by fraudulent misrepresentations in the course	149
of practice;	150

(9) A plea of guilty to, a judicial finding of guilt of, or a	151
judicial finding of eligibility for intervention in lieu of	152
conviction for, a felony;	153

(10) Commission of an act that constitutes a felony in this	154
state, regardless of the jurisdiction in which the act was	155
committed;	156

(11) A plea of guilty to, a judicial finding of guilt of, or	157
a judicial finding of eligibility for intervention in lieu of	158
conviction for, a misdemeanor committed in the course of practice;	159

(12) Commission of an act in the course of practice that	160
constitutes a misdemeanor in this state, regardless of the	161
jurisdiction in which the act was committed;	162

(13) A plea of guilty to, a judicial finding of guilt of, or	163
a judicial finding of eligibility for intervention in lieu of	164
conviction for, a misdemeanor involving moral turpitude;	165

(14) Commission of an act involving moral turpitude that	166
constitutes a misdemeanor in this state, regardless of the	167
jurisdiction in which the act was committed;	168

(15) Violation of the conditions of limitation placed by the	169
board upon a certificate to practice;	170

(16) Failure to pay license renewal fees specified in this	171
chapter;	172

(17) Except as authorized in section 4731.31 of the Revised	173
Code, engaging in the division of fees for referral of patients,	174
or the receiving of a thing of value in return for a specific	175
referral of a patient to utilize a particular service or business;	176

(18) Subject to section 4731.226 of the Revised Code,	177
violation of any provision of a code of ethics of the American	178
medical association, the American osteopathic association, the	179
American podiatric medical association, or any other national	180
professional organizations that the board specifies by rule. The	181
state medical board shall obtain and keep on file current copies	182
of the codes of ethics of the various national professional	183
organizations. The individual whose certificate is being suspended	184
or revoked shall not be found to have violated any provision of a	185
code of ethics of an organization not appropriate to the	186
individual's profession.	187

For purposes of this division, a "provision of a code of	188
ethics of a national professional organization" does not include	189
any provision that would preclude the making of a report by a	190
physician of an employee's use of a drug of abuse, or of a	191
condition of an employee other than one involving the use of a	192
drug of abuse, to the employer of the employee as described in	193
division (B) of section 2305.33 of the Revised Code. Nothing in	194
this division affects the immunity from civil liability conferred	195
by that section upon a physician who makes either type of report	196
in accordance with division (B) of that section. As used in this	197
division, "employee," "employer," and "physician" have the same	198
meanings as in section 2305.33 of the Revised Code.	199

(19) Inability to practice according to acceptable and	200
prevailing standards of care by reason of mental illness or	201
physical illness, including, but not limited to, physical	202
deterioration that adversely affects cognitive, motor, or	203
perceptive skills.	204

In enforcing this division, the board, upon a showing of a	205
possible violation, may compel any individual authorized to	206
practice by this chapter or who has submitted an application	207
pursuant to this chapter to submit to a mental examination,	208
physical examination, including an HIV test, or both a mental and	209
a physical examination. The expense of the examination is the	210
responsibility of the individual compelled to be examined. Failure	211
to submit to a mental or physical examination or consent to an HIV	212
test ordered by the board constitutes an admission of the	213
allegations against the individual unless the failure is due to	214
circumstances beyond the individual's control, and a default and	215
final order may be entered without the taking of testimony or	216
presentation of evidence. If the board finds an individual unable	217
to practice because of the reasons set forth in this division, the	218
board shall require the individual to submit to care, counseling,	219
or treatment by physicians approved or designated by the board, as	220
a condition for initial, continued, reinstated, or renewed	221
authority to practice. An individual affected under this division	222
shall be afforded an opportunity to demonstrate to the board the	223
ability to resume practice in compliance with acceptable and	224
prevailing standards under the provisions of the individual's	225
certificate. For the purpose of this division, any individual who	226
applies for or receives a certificate to practice under this	227
chapter accepts the privilege of practicing in this state and, by	228
so doing, shall be deemed to have given consent to submit to a	229
mental or physical examination when directed to do so in writing	230
by the board, and to have waived all objections to the	231
admissibility of testimony or examination reports that constitute	232
a privileged communication.	233

(20) Except when civil penalties are imposed under section	234
4731.225 or 4731.281 of the Revised Code, and subject to section	235
4731.226 of the Revised Code, violating or attempting to violate,	236
directly or indirectly, or assisting in or abetting the violation	237
of, or conspiring to violate, any provisions of this chapter or	238
any rule promulgated by the board.	239

This division does not apply to a violation or attempted	240
violation of, assisting in or abetting the violation of, or a	241
conspiracy to violate, any provision of this chapter or any rule	242
adopted by the board that would preclude the making of a report by	243
a physician of an employee's use of a drug of abuse, or of a	244
condition of an employee other than one involving the use of a	245
drug of abuse, to the employer of the employee as described in	246
division (B) of section 2305.33 of the Revised Code. Nothing in	247
this division affects the immunity from civil liability conferred	248
by that section upon a physician who makes either type of report	249
in accordance with division (B) of that section. As used in this	250
division, "employee," "employer," and "physician" have the same	251
meanings as in section 2305.33 of the Revised Code.	252

(21) The violation of section 3701.79 of the Revised Code or	253
of any abortion rule adopted by the public health council pursuant	254
to section 3701.341 of the Revised Code;	255

(22) Any of the following actions taken by the agency	256
responsible for regulating the practice of medicine and surgery,	257
osteopathic medicine and surgery, podiatric medicine and surgery,	258
or the limited branches of medicine in another jurisdiction, for	259
any reason other than the nonpayment of fees: the limitation,	260
revocation, or suspension of an individual's license to practice;	261
acceptance of an individual's license surrender; denial of a	262
license; refusal to renew or reinstate a license; imposition of	263
probation; or issuance of an order of censure or other reprimand;	264

(23) The violation of section 2919.12 of the Revised Code or	265
the performance or inducement of an abortion upon a pregnant woman	266
with actual knowledge that the conditions specified in division	267
(B) of section 2317.56 of the Revised Code have not been satisfied	268
or with a heedless indifference as to whether those conditions	269
have been satisfied, unless an affirmative defense as specified in	270
division (H)(2) of that section would apply in a civil action	271
authorized by division (H)(1) of that section;	272

(24) The revocation, suspension, restriction, reduction, or	273
termination of clinical privileges by the United States department	274
of defense or department of veterans affairs or the termination or	275
suspension of a certificate of registration to prescribe drugs by	276
the drug enforcement administration of the United States	277
department of justice;	278

(25) Termination or suspension from participation in the	279
medicare or medicaid programs by the department of health and	280
human services or other responsible agency for any act or acts	281
that also would constitute a violation of division (B)(2), (3),	282
(6), (8), or (19) of this section;	283

(26) Impairment of ability to practice according to	284
acceptable and prevailing standards of care because of habitual or	285
excessive use or abuse of drugs, alcohol, or other substances that	286
impair ability to practice.	287

For the purposes of this division, any individual authorized	288
to practice by this chapter accepts the privilege of practicing in	289
this state subject to supervision by the board. By filing an	290
application for or holding a certificate to practice under this	291
chapter, an individual shall be deemed to have given consent to	292
submit to a mental or physical examination when ordered to do so	293
by the board in writing, and to have waived all objections to the	294
admissibility of testimony or examination reports that constitute	295
privileged communications.	296

If it has reason to believe that any individual authorized to	297
practice by this chapter or any applicant for certification to	298
practice suffers such impairment, the board may compel the	299
individual to submit to a mental or physical examination, or both.	300
The expense of the examination is the responsibility of the	301
individual compelled to be examined. Any mental or physical	302
examination required under this division shall be undertaken by a	303
treatment provider or physician who is qualified to conduct the	304
examination and who is chosen by the board.	305

Failure to submit to a mental or physical examination ordered	306
by the board constitutes an admission of the allegations against	307
the individual unless the failure is due to circumstances beyond	308
the individual's control, and a default and final order may be	309
entered without the taking of testimony or presentation of	310
evidence. If the board determines that the individual's ability to	311
practice is impaired, the board shall suspend the individual's	312
certificate or deny the individual's application and shall require	313
the individual, as a condition for initial, continued, reinstated,	314
or renewed certification to practice, to submit to treatment.	315

Before being eligible to apply for reinstatement of a	316
certificate suspended under this division, the impaired	317
practitioner shall demonstrate to the board the ability to resume	318
practice in compliance with acceptable and prevailing standards of	319
care under the provisions of the practitioner's certificate. The	320
demonstration shall include, but shall not be limited to, the	321
following:	322

(a) Certification from a treatment provider approved under	323
section 4731.25 of the Revised Code that the individual has	324
successfully completed any required inpatient treatment;	325

(b) Evidence of continuing full compliance with an aftercare	326
contract or consent agreement;	327

(c) Two written reports indicating that the individual's	328
ability to practice has been assessed and that the individual has	329
been found capable of practicing according to acceptable and	330
prevailing standards of care. The reports shall be made by	331
individuals or providers approved by the board for making the	332
assessments and shall describe the basis for their determination.	333

The board may reinstate a certificate suspended under this	334
division after that demonstration and after the individual has	335
entered into a written consent agreement.	336

When the impaired practitioner resumes practice, the board	337
shall require continued monitoring of the individual. The	338
monitoring shall include, but not be limited to, compliance with	339
the written consent agreement entered into before reinstatement or	340
with conditions imposed by board order after a hearing, and, upon	341
termination of the consent agreement, submission to the board for	342
at least two years of annual written progress reports made under	343
penalty of perjury stating whether the individual has maintained	344
sobriety.	345

(27) A second or subsequent violation of section 4731.66 or	346
4731.69 of the Revised Code;	347

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

348

(a) Waiving the payment of all or any part of a deductible or	349
copayment that a patient, pursuant to a health insurance or health	350
care policy, contract, or plan that covers the individual's	351
services, otherwise would be required to pay if the waiver is used	352
as an enticement to a patient or group of patients to receive	353
health care services from that individual;	354

(b) Advertising that the individual will waive the payment of	355
all or any part of a deductible or copayment that a patient,	356
pursuant to a health insurance or health care policy, contract, or	357
plan that covers the individual's services, otherwise would be	358
required to pay.	359

(29) Failure to use universal blood and body fluid	360
precautions established by rules adopted under section 4731.051 of	361
the Revised Code;	362

(30) Failure to provide notice to, and receive acknowledgment	363
of the notice from, a patient when required by section 4731.143 of	364
the Revised Code prior to providing nonemergency professional	365
services, or failure to maintain that notice in the patient's	366
file;	367

(31) Failure of a physician supervising a physician assistant	368
to maintain supervision in accordance with the requirements of	369
Chapter 4730. of the Revised Code and the rules adopted under that	370
chapter;	371

(32) Failure of a physician or podiatrist to enter into a	372
standard care arrangement with a clinical nurse specialist,	373
certified nurse-midwife, or certified nurse practitioner with whom	374
the physician or podiatrist is in collaboration pursuant to	375
section 4731.27 of the Revised Code or failure to fulfill the	376
responsibilities of collaboration after entering into a standard	377
care arrangement;	378

(33) Failure to comply with the terms of a consult agreement	379
entered into with a pharmacist pursuant to section 4729.39 of the	380
Revised Code;	381

(34) Failure to cooperate in an investigation conducted by	382
the board under division (F) of this section, including failure to	383
comply with a subpoena or order issued by the board or failure to	384
answer truthfully a question presented by the board at a	385
deposition or in written interrogatories, except that failure to	386
cooperate with an investigation shall not constitute grounds for	387
discipline under this section if a court of competent jurisdiction	388
has issued an order that either quashes a subpoena or permits the	389
individual to withhold the testimony or evidence in issue;	390

(35) Failure to supervise an acupuncturist in accordance with	391
Chapter 4762. of the Revised Code and the board's rules for	392
supervision of an acupuncturist;	393

(36) Failure to supervise an anesthesiologist assistant in	394
accordance with Chapter 4760. of the Revised Code and the board's	395
rules for supervision of an anesthesiologist assistant;	396

(37) Assisting suicide as defined in section 3795.01 of the	397
Revised Code;	398

(38) Violation of a prohibition in section 4731.721 or	399
4731.722 of the Revised Code regarding billing for anatomical	400
pathology services.	401

(C) Disciplinary actions taken by the board under divisions	402
(A) and (B) of this section shall be taken pursuant to an	403
adjudication under Chapter 119. of the Revised Code, except that	404
in lieu of an adjudication, the board may enter into a consent	405
agreement with an individual to resolve an allegation of a	406
violation of this chapter or any rule adopted under it. A consent	407
agreement, when ratified by an affirmative vote of not fewer than	408
six members of the board, shall constitute the findings and order	409
of the board with respect to the matter addressed in the	410
agreement. If the board refuses to ratify a consent agreement, the	411
admissions and findings contained in the consent agreement shall	412
be of no force or effect.	413

If the board takes disciplinary action against an individual	414
under division (B) of this section for a second or subsequent plea	415
of guilty to, or judicial finding of guilt of, a violation of	416
section 2919.123 of the Revised Code, the disciplinary action	417
shall consist of a suspension of the individual's certificate to	418
practice for a period of at least one year or, if determined	419
appropriate by the board, a more serious sanction involving the	420
individual's certificate to practice. Any consent agreement	421
entered into under this division with an individual that pertains	422
to a second or subsequent plea of guilty to, or judicial finding	423
of guilt of, a violation of that section shall provide for a	424
suspension of the individual's certificate to practice for a	425
period of at least one year or, if determined appropriate by the	426
board, a more serious sanction involving the individual's	427
certificate to practice.	428

(D) For purposes of divisions (B)(10), (12), and (14) of this	429
section, the commission of the act may be established by a finding	430
by the board, pursuant to an adjudication under Chapter 119. of	431
the Revised Code, that the individual committed the act. The board	432
does not have jurisdiction under those divisions if the trial	433
court renders a final judgment in the individual's favor and that	434
judgment is based upon an adjudication on the merits. The board	435
has jurisdiction under those divisions if the trial court issues	436
an order of dismissal upon technical or procedural grounds.	437

(E) The sealing of conviction records by any court shall have	438
no effect upon a prior board order entered under this section or	439
upon the board's jurisdiction to take action under this section	440
if, based upon a plea of guilty, a judicial finding of guilt, or a	441
judicial finding of eligibility for intervention in lieu of	442
conviction, the board issued a notice of opportunity for a hearing	443
prior to the court's order to seal the records. The board shall	444
not be required to seal, destroy, redact, or otherwise modify its	445
records to reflect the court's sealing of conviction records.	446

(F)(1) The board shall investigate evidence that appears to	447
show that a person has violated any provision of this chapter or	448
any rule adopted under it. Any person may report to the board in a	449
signed writing any information that the person may have that	450
appears to show a violation of any provision of this chapter or	451
any rule adopted under it. In the absence of bad faith, any person	452
who reports information of that nature or who testifies before the	453
board in any adjudication conducted under Chapter 119. of the	454
Revised Code shall not be liable in damages in a civil action as a	455
result of the report or testimony. Each complaint or allegation of	456
a violation received by the board shall be assigned a case number	457
and shall be recorded by the board.	458

(2) Investigations of alleged violations of this chapter or	459
any rule adopted under it shall be supervised by the supervising	460
member elected by the board in accordance with section 4731.02 of	461
the Revised Code and by the secretary as provided in section	462
4731.39 of the Revised Code. The president may designate another	463
member of the board to supervise the investigation in place of the	464
supervising member. No member of the board who supervises the	465
investigation of a case shall participate in further adjudication	466
of the case.	467

(3) In investigating a possible violation of this chapter or	468
any rule adopted under this chapter, the board may administer	469
oaths, order the taking of depositions, issue subpoenas, and	470
compel the attendance of witnesses and production of books,	471
accounts, papers, records, documents, and testimony, except that a	472
subpoena for patient record information shall not be issued	473
without consultation with the attorney general's office and	474
approval of the secretary and supervising member of the board.	475
Before issuance of a subpoena for patient record information, the	476
secretary and supervising member shall determine whether there is	477
probable cause to believe that the complaint filed alleges a	478
violation of this chapter or any rule adopted under it and that	479
the records sought are relevant to the alleged violation and	480
material to the investigation. The subpoena may apply only to	481
records that cover a reasonable period of time surrounding the	482
alleged violation.	483

On failure to comply with any subpoena issued by the board	484
and after reasonable notice to the person being subpoenaed, the	485
board may move for an order compelling the production of persons	486
or records pursuant to the Rules of Civil Procedure.	487

A subpoena issued by the board may be served by a sheriff,	488
the sheriff's deputy, or a board employee designated by the board.	489
Service of a subpoena issued by the board may be made by	490
delivering a copy of the subpoena to the person named therein,	491
reading it to the person, or leaving it at the person's usual	492
place of residence. When the person being served is a person whose	493
practice is authorized by this chapter, service of the subpoena	494
may be made by certified mail, restricted delivery, return receipt	495
requested, and the subpoena shall be deemed served on the date	496
delivery is made or the date the person refuses to accept	497
delivery.	498

A sheriff's deputy who serves a subpoena shall receive the	499
same fees as a sheriff. Each witness who appears before the board	500
in obedience to a subpoena shall receive the fees and mileage	501
provided for witnesses in civil cases in the courts of common	502
pleas.	503

(4) All hearings and investigations of the board shall be	504
considered civil actions for the purposes of section 2305.252 of	505
the Revised Code.	506

(5) Information received by the board pursuant to an	507
investigation is confidential and not subject to discovery in any	508
civil action.	509

The board shall conduct all investigations and proceedings in	510
a manner that protects the confidentiality of patients and persons	511
who file complaints with the board. The board shall not make	512
public the names or any other identifying information about	513
patients or complainants unless proper consent is given or, in the	514
case of a patient, a waiver of the patient privilege exists under	515
division (B) of section 2317.02 of the Revised Code, except that	516
consent or a waiver of that nature is not required if the board	517
possesses reliable and substantial evidence that no bona fide	518
physician-patient relationship exists.	519

The board may share any information it receives pursuant to	520
an investigation, including patient records and patient record	521
information, with law enforcement agencies, other licensing	522
boards, and other governmental agencies that are prosecuting,	523
adjudicating, or investigating alleged violations of statutes or	524
administrative rules. An agency or board that receives the	525
information shall comply with the same requirements regarding	526
confidentiality as those with which the state medical board must	527
comply, notwithstanding any conflicting provision of the Revised	528
Code or procedure of the agency or board that applies when it is	529
dealing with other information in its possession. In a judicial	530
proceeding, the information may be admitted into evidence only in	531
accordance with the Rules of Evidence, but the court shall require	532
that appropriate measures are taken to ensure that confidentiality	533
is maintained with respect to any part of the information that	534
contains names or other identifying information about patients or	535
complainants whose confidentiality was protected by the state	536
medical board when the information was in the board's possession.	537
Measures to ensure confidentiality that may be taken by the court	538
include sealing its records or deleting specific information from	539
its records.	540

(6) On a quarterly basis, the board shall prepare a report	541
that documents the disposition of all cases during the preceding	542
three months. The report shall contain the following information	543
for each case with which the board has completed its activities:	544

(a) The case number assigned to the complaint or alleged	545
violation;	546

(b) The type of certificate to practice, if any, held by the	547
individual against whom the complaint is directed;	548

(c) A description of the allegations contained in the	549
complaint;	550

(d) The disposition of the case.

551

The report shall state how many cases are still pending and	552
shall be prepared in a manner that protects the identity of each	553
person involved in each case. The report shall be a public record	554
under section 149.43 of the Revised Code.	555

(G) If the secretary and supervising member determine that	556
there is clear and convincing evidence that an individual has	557
violated division (B) of this section and that the individual's	558
continued practice presents a danger of immediate and serious harm	559
to the public, they may recommend that the board suspend the	560
individual's certificate to practice without a prior hearing.	561
Written allegations shall be prepared for consideration by the	562
board.	563

The board, upon review of those allegations and by an	564
affirmative vote of not fewer than six of its members, excluding	565
the secretary and supervising member, may suspend a certificate	566
without a prior hearing. A telephone conference call may be	567
utilized for reviewing the allegations and taking the vote on the	568
summary suspension.	569

The board shall issue a written order of suspension by	570
certified mail or in person in accordance with section 119.07 of	571
the Revised Code. The order shall not be subject to suspension by	572
the court during pendency of any appeal filed under section 119.12	573
of the Revised Code. If the individual subject to the summary	574
suspension requests an adjudicatory hearing by the board, the date	575
set for the hearing shall be within fifteen days, but not earlier	576
than seven days, after the individual requests the hearing, unless	577
otherwise agreed to by both the board and the individual.	578

Any summary suspension imposed under this division shall	579
remain in effect, unless reversed on appeal, until a final	580
adjudicative order issued by the board pursuant to this section	581
and Chapter 119. of the Revised Code becomes effective. The board	582
shall issue its final adjudicative order within seventy-five days	583
after completion of its hearing. A failure to issue the order	584
within seventy-five days shall result in dissolution of the	585
summary suspension order but shall not invalidate any subsequent,	586
final adjudicative order.	587

(H) If the board takes action under division (B)(9), (11), or	588
(13) of this section and the judicial finding of guilt, guilty	589
plea, or judicial finding of eligibility for intervention in lieu	590
of conviction is overturned on appeal, upon exhaustion of the	591
criminal appeal, a petition for reconsideration of the order may	592
be filed with the board along with appropriate court documents.	593
Upon receipt of a petition of that nature and supporting court	594
documents, the board shall reinstate the individual's certificate	595
to practice. The board may then hold an adjudication under Chapter	596
119. of the Revised Code to determine whether the individual	597
committed the act in question. Notice of an opportunity for a	598
hearing shall be given in accordance with Chapter 119. of the	599
Revised Code. If the board finds, pursuant to an adjudication held	600
under this division, that the individual committed the act or if	601
no hearing is requested, the board may order any of the sanctions	602
identified under division (B) of this section.	603

(I) The certificate to practice issued to an individual under	604
this chapter and the individual's practice in this state are	605
automatically suspended as of the date of the individual's second	606
or subsequent plea of guilty to, or judicial finding of guilt of,	607
a violation of section 2919.123 of the Revised Code, or the date	608
the individual pleads guilty to, is found by a judge or jury to be	609
guilty of, or is subject to a judicial finding of eligibility for	610
intervention in lieu of conviction in this state or treatment or	611
intervention in lieu of conviction in another jurisdiction for any	612
of the following criminal offenses in this state or a	613
substantially equivalent criminal offense in another jurisdiction:	614
aggravated murder, murder, voluntary manslaughter, felonious	615
assault, kidnapping, rape, sexual battery, gross sexual	616
imposition, aggravated arson, aggravated robbery, or aggravated	617
burglary. Continued practice after suspension shall be considered	618
practicing without a certificate.	619

The board shall notify the individual subject to the	620
suspension by certified mail or in person in accordance with	621
section 119.07 of the Revised Code. If an individual whose	622
certificate is automatically suspended under this division fails	623
to make a timely request for an adjudication under Chapter 119. of	624
the Revised Code, the board shall do whichever of the following is	625
applicable:	626

(1) If the automatic suspension under this division is for a	627
second or subsequent plea of guilty to, or judicial finding of	628
guilt of, a violation of section 2919.123 of the Revised Code, the	629
board shall enter an order suspending the individual's certificate	630
to practice for a period of at least one year or, if determined	631
appropriate by the board, imposing a more serious sanction	632
involving the individual's certificate to practice.	633

(2) In all circumstances in which division (I)(1) of this	634
section does not apply, enter a final order permanently revoking	635
the individual's certificate to practice.	636

(J) If the board is required by Chapter 119. of the Revised	637
Code to give notice of an opportunity for a hearing and if the	638
individual subject to the notice does not timely request a hearing	639
in accordance with section 119.07 of the Revised Code, the board	640
is not required to hold a hearing, but may adopt, by an	641
affirmative vote of not fewer than six of its members, a final	642
order that contains the board's findings. In that final order, the	643
board may order any of the sanctions identified under division (A)	644
or (B) of this section.	645

(K) Any action taken by the board under division (B) of this	646
section resulting in a suspension from practice shall be	647
accompanied by a written statement of the conditions under which	648
the individual's certificate to practice may be reinstated. The	649
board shall adopt rules governing conditions to be imposed for	650
reinstatement. Reinstatement of a certificate suspended pursuant	651
to division (B) of this section requires an affirmative vote of	652
not fewer than six members of the board.	653

(L) When the board refuses to grant a certificate to an	654
applicant, revokes an individual's certificate to practice,	655
refuses to register an applicant, or refuses to reinstate an	656
individual's certificate to practice, the board may specify that	657
its action is permanent. An individual subject to a permanent	658
action taken by the board is forever thereafter ineligible to hold	659
a certificate to practice and the board shall not accept an	660
application for reinstatement of the certificate or for issuance	661
of a new certificate.	662

(M) Notwithstanding any other provision of the Revised Code,	663
all of the following apply:	664

(1) The surrender of a certificate issued under this chapter	665
shall not be effective unless or until accepted by the board.	666
Reinstatement of a certificate surrendered to the board requires	667
an affirmative vote of not fewer than six members of the board.	668

(2) An application for a certificate made under the	669
provisions of this chapter may not be withdrawn without approval	670
of the board.	671

(3) Failure by an individual to renew a certificate of	672
registration in accordance with this chapter shall not remove or	673
limit the board's jurisdiction to take any disciplinary action	674
under this section against the individual.	675

(N) Sanctions shall not be imposed under division (B)(28) of	676
this section against any person who waives deductibles and	677
copayments as follows:	678

(1) In compliance with the health benefit plan that expressly	679
allows such a practice. Waiver of the deductibles or copayments	680
shall be made only with the full knowledge and consent of the plan	681
purchaser, payer, and third-party administrator. Documentation of	682
the consent shall be made available to the board upon request.	683

(2) For professional services rendered to any other person	684
authorized to practice pursuant to this chapter, to the extent	685
allowed by this chapter and rules adopted by the board.	686

(O) Under the board's investigative duties described in this	687
section and subject to division (F) of this section, the board	688
shall develop and implement a quality intervention program	689
designed to improve through remedial education the clinical and	690
communication skills of individuals authorized under this chapter	691
to practice medicine and surgery, osteopathic medicine and	692
surgery, and podiatric medicine and surgery. In developing and	693
implementing the quality intervention program, the board may do	694
all of the following:	695

(1) Offer in appropriate cases as determined by the board an	696
educational and assessment program pursuant to an investigation	697
the board conducts under this section;	698

(2) Select providers of educational and assessment services,	699
including a quality intervention program panel of case reviewers;	700

(3) Make referrals to educational and assessment service	701
providers and approve individual educational programs recommended	702
by those providers. The board shall monitor the progress of each	703
individual undertaking a recommended individual educational	704
program.	705

(4) Determine what constitutes successful completion of an	706
individual educational program and require further monitoring of	707
the individual who completed the program or other action that the	708
board determines to be appropriate;	709

(5) Adopt rules in accordance with Chapter 119. of the	710
Revised Code to further implement the quality intervention	711
program.	712

An individual who participates in an individual educational	713
program pursuant to this division shall pay the financial	714
obligations arising from that educational program.	715

Sec. 4731.72.  As used in this section and in sections	716
4731.721, 4731.722, and 4731.723 of the Revised Code, "anatomic	717
pathology services," "assignment of benefits," "insurer,"	718
"physician," and "referring clinical laboratory" have the same	719
meanings as in section 3701.86 of the Revised Code.	720

Sec. 4731.721. No physician shall present or cause to be	721
presented a claim, bill, or demand for payment for anatomic	722
pathology services to any person other than the following:	723

(A) The patient who receives the services or another	724
individual, such as a parent, spouse, or guardian, who is	725
responsible for the patient's bills;	726

(B) A responsible insurer or other third-party payor of a	727
patient who receives the services;	728

(C) A hospital, public health clinic, or not-for-profit	729
health clinic ordering the services;	730

(D) A referring clinical laboratory;

731

(E) A governmental agency or any person acting on behalf of a	732
governmental agency.	733

Sec. 4731.722. (A) Subject to division (B) of this section,	734
no physician shall charge, bill, or otherwise solicit payment,	735
directly or indirectly, for anatomic pathology services unless	736
the services are personally rendered by the physician or	737
rendered under the direct supervision of the physician in	738
accordance with 42 U.S.C. 263a.	739

(B) Division (A) of this section does not prohibit a	740
physician who performs the professional component of an anatomic	741
pathology service on a patient specimen from billing for analysis,	742
consultation, or histologic processing on that specimen when	743
analysis, consultation, or histologic processing is performed by	744
another physician or clinical laboratory.	745

Sec. 4731.723. Nothing in section 4731.721 or 4731.722 of	746
the Revised Code shall be construed to mandate the assignment of	747
benefits for anatomic pathology services.	748

Section 2. That existing section 4731.22 of the Revised Code	749
is hereby repealed.	750