As Passed by the House

127th General Assembly Regular Session 2007-2008

Sub. H. B. No. 493

Representative Daniels 

Cosponsors: Representatives Ujvagi, Flowers, Goodwin, Collier, Zehringer, Strahorn, Otterman, J., Hagan, R., Budish, Chandler, Combs, Domenick, Evans, Gerberry, Harwood, Letson, Szollosi 

---

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) "Histologic processing" means fixation, processing,	37
embedding, microtomy, and other special staining, including	38
histochemical or immunohistochemical staining and in situ	39
hybridization of clinical human tissues or cells, for pathological	40
examination.	41

(G) "Histopathology" or "surgical pathology" means the gross	42
and microscopic examination and histologic processing of organ	43
tissue performed by a physician or under the supervision of a	44
physician.	45

(H) "Insurer" means a person authorized under Title XXXIX of	46
the Revised Code to engage in the business of insurance in this	47
state, a health insuring corporation, or an entity that is	48
self-insured and provides benefits to its employees or members.	49

(I) "Physician" means an individual authorized by Chapter	50
4731. of the Revised Code to practice medicine and surgery,	51
osteopathic medicine and surgery, or podiatric medicine and	52
surgery.	53

(J) "Referring clinical laboratory" means a clinical	54
laboratory that refers a patient specimen to another clinical	55
laboratory for an anatomic pathology service, but excludes a	56
laboratory in the office of one or more physicians that refers a	57
specimen and does not perform the professional component of the	58
anatomic pathology service.	59

(K) "Subcellular or molecular pathology" means the assessment	60
of a patient specimen for the detection, localization,	61
measurement, or analysis of one or more protein or nucleic acid	62
targets performed or interpreted by or under supervision of a	63
pathologist.	64

Sec. 3701.861. No clinical laboratory shall present or cause	65
to be presented a claim, bill, or demand for payment for anatomic	66
pathology services to any person other than the following:	67

(A) The patient who receives the services or another	68
individual, such as a parent, spouse, or guardian, who is	69
responsible for the patient's bills;	70

(B) A responsible insurer or other third-party payor of a	71
patient who receives the services;	72

(C) A hospital, public health clinic, or not-for-profit	73
health clinic ordering the services;	74

(D) A referring clinical laboratory;

75

(E) A governmental agency or any person acting on behalf of a	76
governmental agency.	77

Sec. 3701.862.  Nothing in section 3701.861 of the Revised	78
Code shall be construed to do either of the following:	79

(A) Mandate the assignment of benefits for anatomic pathology	80
services;	81

(B) Prohibit a clinical laboratory that provides anatomic	82
pathology services from billing a referring clinical laboratory	83
for anatomic pathology services in instances in which the	84
referring clinical laboratory must send one or more samples to a	85
specialist for analysis, consultation, or histologic processing.	86

Sec. 4731.22.  (A) The state medical board, by an affirmative	87
vote of not fewer than six of its members, may revoke or may	88
refuse to grant a certificate to a person found by the board to	89
have committed fraud during the administration of the examination	90
for a certificate to practice or to have committed fraud,	91
misrepresentation, or deception in applying for or securing any	92
certificate to practice or certificate of registration issued by	93
the board.	94

(B) The board, by an affirmative vote of not fewer than six	95
members, shall, to the extent permitted by law, limit, revoke, or	96
suspend an individual's certificate to practice, refuse to	97
register an individual, refuse to reinstate a certificate, or	98
reprimand or place on probation the holder of a certificate for	99
one or more of the following reasons:	100

(1) Permitting one's name or one's certificate to practice or	101
certificate of registration to be used by a person, group, or	102
corporation when the individual concerned is not actually	103
directing the treatment given;	104

(2) Failure to maintain minimal standards applicable to the	105
selection or administration of drugs, or failure to employ	106
acceptable scientific methods in the selection of drugs or other	107
modalities for treatment of disease;	108

(3) Selling, giving away, personally furnishing, prescribing,	109
or administering drugs for other than legal and legitimate	110
therapeutic purposes or a plea of guilty to, a judicial finding of	111
guilt of, or a judicial finding of eligibility for intervention in	112
lieu of conviction of, a violation of any federal or state law	113
regulating the possession, distribution, or use of any drug;	114

(4) Willfully betraying a professional confidence.

115

For purposes of this division, "willfully betraying a	116
professional confidence" does not include providing any	117
information, documents, or reports to a child fatality review	118
board under sections 307.621 to 307.629 of the Revised Code and	119
does not include the making of a report of an employee's use of a	120
drug of abuse, or a report of a condition of an employee other	121
than one involving the use of a drug of abuse, to the employer of	122
the employee as described in division (B) of section 2305.33 of	123
the Revised Code. Nothing in this division affects the immunity	124
from civil liability conferred by that section upon a physician	125
who makes either type of report in accordance with division (B) of	126
that section. As used in this division, "employee," "employer,"	127
and "physician" have the same meanings as in section 2305.33 of	128
the Revised Code.	129

(5) Making a false, fraudulent, deceptive, or misleading	130
statement in the solicitation of or advertising for patients; in	131
relation to the practice of medicine and surgery, osteopathic	132
medicine and surgery, podiatric medicine and surgery, or a limited	133
branch of medicine; or in securing or attempting to secure any	134
certificate to practice or certificate of registration issued by	135
the board.	136

As used in this division, "false, fraudulent, deceptive, or	137
misleading statement" means a statement that includes a	138
misrepresentation of fact, is likely to mislead or deceive because	139
of a failure to disclose material facts, is intended or is likely	140
to create false or unjustified expectations of favorable results,	141
or includes representations or implications that in reasonable	142
probability will cause an ordinarily prudent person to	143
misunderstand or be deceived.	144

(6) A departure from, or the failure to conform to, minimal	145
standards of care of similar practitioners under the same or	146
similar circumstances, whether or not actual injury to a patient	147
is established;	148

(7) Representing, with the purpose of obtaining compensation	149
or other advantage as personal gain or for any other person, that	150
an incurable disease or injury, or other incurable condition, can	151
be permanently cured;	152

(8) The obtaining of, or attempting to obtain, money or	153
anything of value by fraudulent misrepresentations in the course	154
of practice;	155

(9) A plea of guilty to, a judicial finding of guilt of, or a	156
judicial finding of eligibility for intervention in lieu of	157
conviction for, a felony;	158

(10) Commission of an act that constitutes a felony in this	159
state, regardless of the jurisdiction in which the act was	160
committed;	161

(11) A plea of guilty to, a judicial finding of guilt of, or	162
a judicial finding of eligibility for intervention in lieu of	163
conviction for, a misdemeanor committed in the course of practice;	164

(12) Commission of an act in the course of practice that	165
constitutes a misdemeanor in this state, regardless of the	166
jurisdiction in which the act was committed;	167

(13) A plea of guilty to, a judicial finding of guilt of, or	168
a judicial finding of eligibility for intervention in lieu of	169
conviction for, a misdemeanor involving moral turpitude;	170

(14) Commission of an act involving moral turpitude that	171
constitutes a misdemeanor in this state, regardless of the	172
jurisdiction in which the act was committed;	173

(15) Violation of the conditions of limitation placed by the	174
board upon a certificate to practice;	175

(16) Failure to pay license renewal fees specified in this	176
chapter;	177

(17) Except as authorized in section 4731.31 of the Revised	178
Code, engaging in the division of fees for referral of patients,	179
or the receiving of a thing of value in return for a specific	180
referral of a patient to utilize a particular service or business;	181

(18) Subject to section 4731.226 of the Revised Code,	182
violation of any provision of a code of ethics of the American	183
medical association, the American osteopathic association, the	184
American podiatric medical association, or any other national	185
professional organizations that the board specifies by rule. The	186
state medical board shall obtain and keep on file current copies	187
of the codes of ethics of the various national professional	188
organizations. The individual whose certificate is being suspended	189
or revoked shall not be found to have violated any provision of a	190
code of ethics of an organization not appropriate to the	191
individual's profession.	192

For purposes of this division, a "provision of a code of	193
ethics of a national professional organization" does not include	194
any provision that would preclude the making of a report by a	195
physician of an employee's use of a drug of abuse, or of a	196
condition of an employee other than one involving the use of a	197
drug of abuse, to the employer of the employee as described in	198
division (B) of section 2305.33 of the Revised Code. Nothing in	199
this division affects the immunity from civil liability conferred	200
by that section upon a physician who makes either type of report	201
in accordance with division (B) of that section. As used in this	202
division, "employee," "employer," and "physician" have the same	203
meanings as in section 2305.33 of the Revised Code.	204

(19) Inability to practice according to acceptable and	205
prevailing standards of care by reason of mental illness or	206
physical illness, including, but not limited to, physical	207
deterioration that adversely affects cognitive, motor, or	208
perceptive skills.	209

In enforcing this division, the board, upon a showing of a	210
possible violation, may compel any individual authorized to	211
practice by this chapter or who has submitted an application	212
pursuant to this chapter to submit to a mental examination,	213
physical examination, including an HIV test, or both a mental and	214
a physical examination. The expense of the examination is the	215
responsibility of the individual compelled to be examined. Failure	216
to submit to a mental or physical examination or consent to an HIV	217
test ordered by the board constitutes an admission of the	218
allegations against the individual unless the failure is due to	219
circumstances beyond the individual's control, and a default and	220
final order may be entered without the taking of testimony or	221
presentation of evidence. If the board finds an individual unable	222
to practice because of the reasons set forth in this division, the	223
board shall require the individual to submit to care, counseling,	224
or treatment by physicians approved or designated by the board, as	225
a condition for initial, continued, reinstated, or renewed	226
authority to practice. An individual affected under this division	227
shall be afforded an opportunity to demonstrate to the board the	228
ability to resume practice in compliance with acceptable and	229
prevailing standards under the provisions of the individual's	230
certificate. For the purpose of this division, any individual who	231
applies for or receives a certificate to practice under this	232
chapter accepts the privilege of practicing in this state and, by	233
so doing, shall be deemed to have given consent to submit to a	234
mental or physical examination when directed to do so in writing	235
by the board, and to have waived all objections to the	236
admissibility of testimony or examination reports that constitute	237
a privileged communication.	238

(20) Except when civil penalties are imposed under section	239
4731.225 or 4731.281 of the Revised Code, and subject to section	240
4731.226 of the Revised Code, violating or attempting to violate,	241
directly or indirectly, or assisting in or abetting the violation	242
of, or conspiring to violate, any provisions of this chapter or	243
any rule promulgated by the board.	244

This division does not apply to a violation or attempted	245
violation of, assisting in or abetting the violation of, or a	246
conspiracy to violate, any provision of this chapter or any rule	247
adopted by the board that would preclude the making of a report by	248
a physician of an employee's use of a drug of abuse, or of a	249
condition of an employee other than one involving the use of a	250
drug of abuse, to the employer of the employee as described in	251
division (B) of section 2305.33 of the Revised Code. Nothing in	252
this division affects the immunity from civil liability conferred	253
by that section upon a physician who makes either type of report	254
in accordance with division (B) of that section. As used in this	255
division, "employee," "employer," and "physician" have the same	256
meanings as in section 2305.33 of the Revised Code.	257

(21) The violation of section 3701.79 of the Revised Code or	258
of any abortion rule adopted by the public health council pursuant	259
to section 3701.341 of the Revised Code;	260

(22) Any of the following actions taken by the agency	261
responsible for regulating the practice of medicine and surgery,	262
osteopathic medicine and surgery, podiatric medicine and surgery,	263
or the limited branches of medicine in another jurisdiction, for	264
any reason other than the nonpayment of fees: the limitation,	265
revocation, or suspension of an individual's license to practice;	266
acceptance of an individual's license surrender; denial of a	267
license; refusal to renew or reinstate a license; imposition of	268
probation; or issuance of an order of censure or other reprimand;	269

(23) The violation of section 2919.12 of the Revised Code or	270
the performance or inducement of an abortion upon a pregnant woman	271
with actual knowledge that the conditions specified in division	272
(B) of section 2317.56 of the Revised Code have not been satisfied	273
or with a heedless indifference as to whether those conditions	274
have been satisfied, unless an affirmative defense as specified in	275
division (H)(2) of that section would apply in a civil action	276
authorized by division (H)(1) of that section;	277

(24) The revocation, suspension, restriction, reduction, or	278
termination of clinical privileges by the United States department	279
of defense or department of veterans affairs or the termination or	280
suspension of a certificate of registration to prescribe drugs by	281
the drug enforcement administration of the United States	282
department of justice;	283

(25) Termination or suspension from participation in the	284
medicare or medicaid programs by the department of health and	285
human services or other responsible agency for any act or acts	286
that also would constitute a violation of division (B)(2), (3),	287
(6), (8), or (19) of this section;	288

(26) Impairment of ability to practice according to	289
acceptable and prevailing standards of care because of habitual or	290
excessive use or abuse of drugs, alcohol, or other substances that	291
impair ability to practice.	292

For the purposes of this division, any individual authorized	293
to practice by this chapter accepts the privilege of practicing in	294
this state subject to supervision by the board. By filing an	295
application for or holding a certificate to practice under this	296
chapter, an individual shall be deemed to have given consent to	297
submit to a mental or physical examination when ordered to do so	298
by the board in writing, and to have waived all objections to the	299
admissibility of testimony or examination reports that constitute	300
privileged communications.	301

If it has reason to believe that any individual authorized to	302
practice by this chapter or any applicant for certification to	303
practice suffers such impairment, the board may compel the	304
individual to submit to a mental or physical examination, or both.	305
The expense of the examination is the responsibility of the	306
individual compelled to be examined. Any mental or physical	307
examination required under this division shall be undertaken by a	308
treatment provider or physician who is qualified to conduct the	309
examination and who is chosen by the board.	310

Failure to submit to a mental or physical examination ordered	311
by the board constitutes an admission of the allegations against	312
the individual unless the failure is due to circumstances beyond	313
the individual's control, and a default and final order may be	314
entered without the taking of testimony or presentation of	315
evidence. If the board determines that the individual's ability to	316
practice is impaired, the board shall suspend the individual's	317
certificate or deny the individual's application and shall require	318
the individual, as a condition for initial, continued, reinstated,	319
or renewed certification to practice, to submit to treatment.	320

Before being eligible to apply for reinstatement of a	321
certificate suspended under this division, the impaired	322
practitioner shall demonstrate to the board the ability to resume	323
practice in compliance with acceptable and prevailing standards of	324
care under the provisions of the practitioner's certificate. The	325
demonstration shall include, but shall not be limited to, the	326
following:	327

(a) Certification from a treatment provider approved under	328
section 4731.25 of the Revised Code that the individual has	329
successfully completed any required inpatient treatment;	330

(b) Evidence of continuing full compliance with an aftercare	331
contract or consent agreement;	332

(c) Two written reports indicating that the individual's	333
ability to practice has been assessed and that the individual has	334
been found capable of practicing according to acceptable and	335
prevailing standards of care. The reports shall be made by	336
individuals or providers approved by the board for making the	337
assessments and shall describe the basis for their determination.	338

The board may reinstate a certificate suspended under this	339
division after that demonstration and after the individual has	340
entered into a written consent agreement.	341

When the impaired practitioner resumes practice, the board	342
shall require continued monitoring of the individual. The	343
monitoring shall include, but not be limited to, compliance with	344
the written consent agreement entered into before reinstatement or	345
with conditions imposed by board order after a hearing, and, upon	346
termination of the consent agreement, submission to the board for	347
at least two years of annual written progress reports made under	348
penalty of perjury stating whether the individual has maintained	349
sobriety.	350

(27) A second or subsequent violation of section 4731.66 or	351
4731.69 of the Revised Code;	352

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

353

(a) Waiving the payment of all or any part of a deductible or	354
copayment that a patient, pursuant to a health insurance or health	355
care policy, contract, or plan that covers the individual's	356
services, otherwise would be required to pay if the waiver is used	357
as an enticement to a patient or group of patients to receive	358
health care services from that individual;	359

(b) Advertising that the individual will waive the payment of	360
all or any part of a deductible or copayment that a patient,	361
pursuant to a health insurance or health care policy, contract, or	362
plan that covers the individual's services, otherwise would be	363
required to pay.	364

(29) Failure to use universal blood and body fluid	365
precautions established by rules adopted under section 4731.051 of	366
the Revised Code;	367

(30) Failure to provide notice to, and receive acknowledgment	368
of the notice from, a patient when required by section 4731.143 of	369
the Revised Code prior to providing nonemergency professional	370
services, or failure to maintain that notice in the patient's	371
file;	372

(31) Failure of a physician supervising a physician assistant	373
to maintain supervision in accordance with the requirements of	374
Chapter 4730. of the Revised Code and the rules adopted under that	375
chapter;	376

(32) Failure of a physician or podiatrist to enter into a	377
standard care arrangement with a clinical nurse specialist,	378
certified nurse-midwife, or certified nurse practitioner with whom	379
the physician or podiatrist is in collaboration pursuant to	380
section 4731.27 of the Revised Code or failure to fulfill the	381
responsibilities of collaboration after entering into a standard	382
care arrangement;	383

(33) Failure to comply with the terms of a consult agreement	384
entered into with a pharmacist pursuant to section 4729.39 of the	385
Revised Code;	386

(34) Failure to cooperate in an investigation conducted by	387
the board under division (F) of this section, including failure to	388
comply with a subpoena or order issued by the board or failure to	389
answer truthfully a question presented by the board at a	390
deposition or in written interrogatories, except that failure to	391
cooperate with an investigation shall not constitute grounds for	392
discipline under this section if a court of competent jurisdiction	393
has issued an order that either quashes a subpoena or permits the	394
individual to withhold the testimony or evidence in issue;	395

(35) Failure to supervise an acupuncturist in accordance with	396
Chapter 4762. of the Revised Code and the board's rules for	397
supervision of an acupuncturist;	398

(36) Failure to supervise an anesthesiologist assistant in	399
accordance with Chapter 4760. of the Revised Code and the board's	400
rules for supervision of an anesthesiologist assistant;	401

(37) Assisting suicide as defined in section 3795.01 of the	402
Revised Code;	403

(38) Violation of a prohibition in section 4731.721 or	404
4731.722 of the Revised Code regarding billing for anatomical	405
pathology services.	406

(C) Disciplinary actions taken by the board under divisions	407
(A) and (B) of this section shall be taken pursuant to an	408
adjudication under Chapter 119. of the Revised Code, except that	409
in lieu of an adjudication, the board may enter into a consent	410
agreement with an individual to resolve an allegation of a	411
violation of this chapter or any rule adopted under it. A consent	412
agreement, when ratified by an affirmative vote of not fewer than	413
six members of the board, shall constitute the findings and order	414
of the board with respect to the matter addressed in the	415
agreement. If the board refuses to ratify a consent agreement, the	416
admissions and findings contained in the consent agreement shall	417
be of no force or effect.	418

If the board takes disciplinary action against an individual	419
under division (B) of this section for a second or subsequent plea	420
of guilty to, or judicial finding of guilt of, a violation of	421
section 2919.123 of the Revised Code, the disciplinary action	422
shall consist of a suspension of the individual's certificate to	423
practice for a period of at least one year or, if determined	424
appropriate by the board, a more serious sanction involving the	425
individual's certificate to practice. Any consent agreement	426
entered into under this division with an individual that pertains	427
to a second or subsequent plea of guilty to, or judicial finding	428
of guilt of, a violation of that section shall provide for a	429
suspension of the individual's certificate to practice for a	430
period of at least one year or, if determined appropriate by the	431
board, a more serious sanction involving the individual's	432
certificate to practice.	433

(D) For purposes of divisions (B)(10), (12), and (14) of this	434
section, the commission of the act may be established by a finding	435
by the board, pursuant to an adjudication under Chapter 119. of	436
the Revised Code, that the individual committed the act. The board	437
does not have jurisdiction under those divisions if the trial	438
court renders a final judgment in the individual's favor and that	439
judgment is based upon an adjudication on the merits. The board	440
has jurisdiction under those divisions if the trial court issues	441
an order of dismissal upon technical or procedural grounds.	442

(E) The sealing of conviction records by any court shall have	443
no effect upon a prior board order entered under this section or	444
upon the board's jurisdiction to take action under this section	445
if, based upon a plea of guilty, a judicial finding of guilt, or a	446
judicial finding of eligibility for intervention in lieu of	447
conviction, the board issued a notice of opportunity for a hearing	448
prior to the court's order to seal the records. The board shall	449
not be required to seal, destroy, redact, or otherwise modify its	450
records to reflect the court's sealing of conviction records.	451

(F)(1) The board shall investigate evidence that appears to	452
show that a person has violated any provision of this chapter or	453
any rule adopted under it. Any person may report to the board in a	454
signed writing any information that the person may have that	455
appears to show a violation of any provision of this chapter or	456
any rule adopted under it. In the absence of bad faith, any person	457
who reports information of that nature or who testifies before the	458
board in any adjudication conducted under Chapter 119. of the	459
Revised Code shall not be liable in damages in a civil action as a	460
result of the report or testimony. Each complaint or allegation of	461
a violation received by the board shall be assigned a case number	462
and shall be recorded by the board.	463

(2) Investigations of alleged violations of this chapter or	464
any rule adopted under it shall be supervised by the supervising	465
member elected by the board in accordance with section 4731.02 of	466
the Revised Code and by the secretary as provided in section	467
4731.39 of the Revised Code. The president may designate another	468
member of the board to supervise the investigation in place of the	469
supervising member. No member of the board who supervises the	470
investigation of a case shall participate in further adjudication	471
of the case.	472

(3) In investigating a possible violation of this chapter or	473
any rule adopted under this chapter, the board may administer	474
oaths, order the taking of depositions, issue subpoenas, and	475
compel the attendance of witnesses and production of books,	476
accounts, papers, records, documents, and testimony, except that a	477
subpoena for patient record information shall not be issued	478
without consultation with the attorney general's office and	479
approval of the secretary and supervising member of the board.	480
Before issuance of a subpoena for patient record information, the	481
secretary and supervising member shall determine whether there is	482
probable cause to believe that the complaint filed alleges a	483
violation of this chapter or any rule adopted under it and that	484
the records sought are relevant to the alleged violation and	485
material to the investigation. The subpoena may apply only to	486
records that cover a reasonable period of time surrounding the	487
alleged violation.	488

On failure to comply with any subpoena issued by the board	489
and after reasonable notice to the person being subpoenaed, the	490
board may move for an order compelling the production of persons	491
or records pursuant to the Rules of Civil Procedure.	492

A subpoena issued by the board may be served by a sheriff,	493
the sheriff's deputy, or a board employee designated by the board.	494
Service of a subpoena issued by the board may be made by	495
delivering a copy of the subpoena to the person named therein,	496
reading it to the person, or leaving it at the person's usual	497
place of residence. When the person being served is a person whose	498
practice is authorized by this chapter, service of the subpoena	499
may be made by certified mail, restricted delivery, return receipt	500
requested, and the subpoena shall be deemed served on the date	501
delivery is made or the date the person refuses to accept	502
delivery.	503

A sheriff's deputy who serves a subpoena shall receive the	504
same fees as a sheriff. Each witness who appears before the board	505
in obedience to a subpoena shall receive the fees and mileage	506
provided for witnesses in civil cases in the courts of common	507
pleas.	508

(4) All hearings and investigations of the board shall be	509
considered civil actions for the purposes of section 2305.252 of	510
the Revised Code.	511

(5) Information received by the board pursuant to an	512
investigation is confidential and not subject to discovery in any	513
civil action.	514

The board shall conduct all investigations and proceedings in	515
a manner that protects the confidentiality of patients and persons	516
who file complaints with the board. The board shall not make	517
public the names or any other identifying information about	518
patients or complainants unless proper consent is given or, in the	519
case of a patient, a waiver of the patient privilege exists under	520
division (B) of section 2317.02 of the Revised Code, except that	521
consent or a waiver of that nature is not required if the board	522
possesses reliable and substantial evidence that no bona fide	523
physician-patient relationship exists.	524

The board may share any information it receives pursuant to	525
an investigation, including patient records and patient record	526
information, with law enforcement agencies, other licensing	527
boards, and other governmental agencies that are prosecuting,	528
adjudicating, or investigating alleged violations of statutes or	529
administrative rules. An agency or board that receives the	530
information shall comply with the same requirements regarding	531
confidentiality as those with which the state medical board must	532
comply, notwithstanding any conflicting provision of the Revised	533
Code or procedure of the agency or board that applies when it is	534
dealing with other information in its possession. In a judicial	535
proceeding, the information may be admitted into evidence only in	536
accordance with the Rules of Evidence, but the court shall require	537
that appropriate measures are taken to ensure that confidentiality	538
is maintained with respect to any part of the information that	539
contains names or other identifying information about patients or	540
complainants whose confidentiality was protected by the state	541
medical board when the information was in the board's possession.	542
Measures to ensure confidentiality that may be taken by the court	543
include sealing its records or deleting specific information from	544
its records.	545

(6) On a quarterly basis, the board shall prepare a report	546
that documents the disposition of all cases during the preceding	547
three months. The report shall contain the following information	548
for each case with which the board has completed its activities:	549

(a) The case number assigned to the complaint or alleged	550
violation;	551

(b) The type of certificate to practice, if any, held by the	552
individual against whom the complaint is directed;	553

(c) A description of the allegations contained in the	554
complaint;	555

(d) The disposition of the case.

556

The report shall state how many cases are still pending and	557
shall be prepared in a manner that protects the identity of each	558
person involved in each case. The report shall be a public record	559
under section 149.43 of the Revised Code.	560

(G) If the secretary and supervising member determine that	561
there is clear and convincing evidence that an individual has	562
violated division (B) of this section and that the individual's	563
continued practice presents a danger of immediate and serious harm	564
to the public, they may recommend that the board suspend the	565
individual's certificate to practice without a prior hearing.	566
Written allegations shall be prepared for consideration by the	567
board.	568

The board, upon review of those allegations and by an	569
affirmative vote of not fewer than six of its members, excluding	570
the secretary and supervising member, may suspend a certificate	571
without a prior hearing. A telephone conference call may be	572
utilized for reviewing the allegations and taking the vote on the	573
summary suspension.	574

The board shall issue a written order of suspension by	575
certified mail or in person in accordance with section 119.07 of	576
the Revised Code. The order shall not be subject to suspension by	577
the court during pendency of any appeal filed under section 119.12	578
of the Revised Code. If the individual subject to the summary	579
suspension requests an adjudicatory hearing by the board, the date	580
set for the hearing shall be within fifteen days, but not earlier	581
than seven days, after the individual requests the hearing, unless	582
otherwise agreed to by both the board and the individual.	583

Any summary suspension imposed under this division shall	584
remain in effect, unless reversed on appeal, until a final	585
adjudicative order issued by the board pursuant to this section	586
and Chapter 119. of the Revised Code becomes effective. The board	587
shall issue its final adjudicative order within seventy-five days	588
after completion of its hearing. A failure to issue the order	589
within seventy-five days shall result in dissolution of the	590
summary suspension order but shall not invalidate any subsequent,	591
final adjudicative order.	592

(H) If the board takes action under division (B)(9), (11), or	593
(13) of this section and the judicial finding of guilt, guilty	594
plea, or judicial finding of eligibility for intervention in lieu	595
of conviction is overturned on appeal, upon exhaustion of the	596
criminal appeal, a petition for reconsideration of the order may	597
be filed with the board along with appropriate court documents.	598
Upon receipt of a petition of that nature and supporting court	599
documents, the board shall reinstate the individual's certificate	600
to practice. The board may then hold an adjudication under Chapter	601
119. of the Revised Code to determine whether the individual	602
committed the act in question. Notice of an opportunity for a	603
hearing shall be given in accordance with Chapter 119. of the	604
Revised Code. If the board finds, pursuant to an adjudication held	605
under this division, that the individual committed the act or if	606
no hearing is requested, the board may order any of the sanctions	607
identified under division (B) of this section.	608

(I) The certificate to practice issued to an individual under	609
this chapter and the individual's practice in this state are	610
automatically suspended as of the date of the individual's second	611
or subsequent plea of guilty to, or judicial finding of guilt of,	612
a violation of section 2919.123 of the Revised Code, or the date	613
the individual pleads guilty to, is found by a judge or jury to be	614
guilty of, or is subject to a judicial finding of eligibility for	615
intervention in lieu of conviction in this state or treatment or	616
intervention in lieu of conviction in another jurisdiction for any	617
of the following criminal offenses in this state or a	618
substantially equivalent criminal offense in another jurisdiction:	619
aggravated murder, murder, voluntary manslaughter, felonious	620
assault, kidnapping, rape, sexual battery, gross sexual	621
imposition, aggravated arson, aggravated robbery, or aggravated	622
burglary. Continued practice after suspension shall be considered	623
practicing without a certificate.	624

The board shall notify the individual subject to the	625
suspension by certified mail or in person in accordance with	626
section 119.07 of the Revised Code. If an individual whose	627
certificate is automatically suspended under this division fails	628
to make a timely request for an adjudication under Chapter 119. of	629
the Revised Code, the board shall do whichever of the following is	630
applicable:	631

(1) If the automatic suspension under this division is for a	632
second or subsequent plea of guilty to, or judicial finding of	633
guilt of, a violation of section 2919.123 of the Revised Code, the	634
board shall enter an order suspending the individual's certificate	635
to practice for a period of at least one year or, if determined	636
appropriate by the board, imposing a more serious sanction	637
involving the individual's certificate to practice.	638

(2) In all circumstances in which division (I)(1) of this	639
section does not apply, enter a final order permanently revoking	640
the individual's certificate to practice.	641

(J) If the board is required by Chapter 119. of the Revised	642
Code to give notice of an opportunity for a hearing and if the	643
individual subject to the notice does not timely request a hearing	644
in accordance with section 119.07 of the Revised Code, the board	645
is not required to hold a hearing, but may adopt, by an	646
affirmative vote of not fewer than six of its members, a final	647
order that contains the board's findings. In that final order, the	648
board may order any of the sanctions identified under division (A)	649
or (B) of this section.	650

(K) Any action taken by the board under division (B) of this	651
section resulting in a suspension from practice shall be	652
accompanied by a written statement of the conditions under which	653
the individual's certificate to practice may be reinstated. The	654
board shall adopt rules governing conditions to be imposed for	655
reinstatement. Reinstatement of a certificate suspended pursuant	656
to division (B) of this section requires an affirmative vote of	657
not fewer than six members of the board.	658

(L) When the board refuses to grant a certificate to an	659
applicant, revokes an individual's certificate to practice,	660
refuses to register an applicant, or refuses to reinstate an	661
individual's certificate to practice, the board may specify that	662
its action is permanent. An individual subject to a permanent	663
action taken by the board is forever thereafter ineligible to hold	664
a certificate to practice and the board shall not accept an	665
application for reinstatement of the certificate or for issuance	666
of a new certificate.	667

(M) Notwithstanding any other provision of the Revised Code,	668
all of the following apply:	669

(1) The surrender of a certificate issued under this chapter	670
shall not be effective unless or until accepted by the board.	671
Reinstatement of a certificate surrendered to the board requires	672
an affirmative vote of not fewer than six members of the board.	673

(2) An application for a certificate made under the	674
provisions of this chapter may not be withdrawn without approval	675
of the board.	676

(3) Failure by an individual to renew a certificate of	677
registration in accordance with this chapter shall not remove or	678
limit the board's jurisdiction to take any disciplinary action	679
under this section against the individual.	680

(N) Sanctions shall not be imposed under division (B)(28) of	681
this section against any person who waives deductibles and	682
copayments as follows:	683

(1) In compliance with the health benefit plan that expressly	684
allows such a practice. Waiver of the deductibles or copayments	685
shall be made only with the full knowledge and consent of the plan	686
purchaser, payer, and third-party administrator. Documentation of	687
the consent shall be made available to the board upon request.	688

(2) For professional services rendered to any other person	689
authorized to practice pursuant to this chapter, to the extent	690
allowed by this chapter and rules adopted by the board.	691

(O) Under the board's investigative duties described in this	692
section and subject to division (F) of this section, the board	693
shall develop and implement a quality intervention program	694
designed to improve through remedial education the clinical and	695
communication skills of individuals authorized under this chapter	696
to practice medicine and surgery, osteopathic medicine and	697
surgery, and podiatric medicine and surgery. In developing and	698
implementing the quality intervention program, the board may do	699
all of the following:	700

(1) Offer in appropriate cases as determined by the board an	701
educational and assessment program pursuant to an investigation	702
the board conducts under this section;	703

(2) Select providers of educational and assessment services,	704
including a quality intervention program panel of case reviewers;	705

(3) Make referrals to educational and assessment service	706
providers and approve individual educational programs recommended	707
by those providers. The board shall monitor the progress of each	708
individual undertaking a recommended individual educational	709
program.	710

(4) Determine what constitutes successful completion of an	711
individual educational program and require further monitoring of	712
the individual who completed the program or other action that the	713
board determines to be appropriate;	714

(5) Adopt rules in accordance with Chapter 119. of the	715
Revised Code to further implement the quality intervention	716
program.	717

An individual who participates in an individual educational	718
program pursuant to this division shall pay the financial	719
obligations arising from that educational program.	720

Sec. 4731.72.  As used in this section and in sections	721
4731.721, 4731.722, and 4731.723 of the Revised Code, "anatomic	722
pathology services," "assignment of benefits," "histologic	723
processing," "insurer," "physician," and "referring clinical	724
laboratory" have the same meanings as in section 3701.86 of the	725
Revised Code.	726

Sec. 4731.721. No physician shall present or cause to be	727
presented a claim, bill, or demand for payment for anatomic	728
pathology services to any person other than the following:	729

(A) The patient who receives the services or another	730
individual, such as a parent, spouse, or guardian, who is	731
responsible for the patient's bills;	732

(B) A responsible insurer or other third-party payor of a	733
patient who receives the services;	734

(C) A hospital, public health clinic, or not-for-profit	735
health clinic ordering the services;	736

(D) A referring clinical laboratory;

737

(E) A governmental agency or any person acting on behalf of a	738
governmental agency.	739

Sec. 4731.722. (A) As used in this section:

740

(1) "Professional component of an anatomic pathology service"	741
means the entire anatomic pathology service other than histologic	742
processing.	743

(2) "Technical component of an anatomic pathology service"	744
means only histologic processing.	745

(B) Subject to division (C) of this section, no physician	746
shall charge, bill, or otherwise solicit payment, directly or	747
indirectly, for anatomic pathology services unless the services	748
are personally rendered by the physician or rendered under the	749
on-site supervision of the physician.	750

(C) Division (B) of this section does not prohibit a	751
physician who performs the professional component of an anatomic	752
pathology service on a patient specimen from billing for the	753
technical component of an anatomic pathology service when that	754
component is performed by a clinical laboratory.	755

Sec. 4731.723. Nothing in section 4731.721 or 4731.722 of	756
the Revised Code shall be construed to mandate the assignment of	757
benefits for anatomic pathology services.	758

Section 2. That existing section 4731.22 of the Revised Code	759
is hereby repealed.	760