Enact the Healthy Cardiac Monitoring Act

As Passed by the House

136th
General Assembly

Regular
Session
Sub. H. B. No. 437

2025-2026

Representatives Rader, Schmidt

Cosponsors: Representatives
Brennan, Brewer, Brownlee, Grim, Rogers, Russo, Miller, J., Somani,
Abdullahi, Baker, Brent, Bryant Bailey, Cockley, Glassburn, Hall, D.,
Hiner, Isaacsohn, Jarrells, John, Kishman, Lawson-Rowe, Lett,
Manning, Piccolantonio, Robb Blasdel, Robinson, Roemer, Sigrist,
Stephens, Synenberg, Thomas, C., Thomas, D., Tims, Troy, Upchurch,
White, A., White, E., Willis, Young

To
amend sections 3313.5310, 3707.58, 3707.59, 4723.24, 4723.28,
4730.14, 4730.25, 4731.22, and 4731.281 and to enact sections
3707.591, 3707.592, 4723.484, 4730.46, 4731.89, and 5164.21 of the
Revised Code
regarding
cardiac monitoring for youth and to name the amendments and
enactments by this act the Healthy Cardiac Monitoring Act.

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

Section
1.
That
sections 3313.5310, 3707.58, 3707.59, 4723.24, 4723.28, 4730.14,
4730.25, 4731.22,

and

4731.281 be amended and sections 3707.591
,
3707.592
,
4723.484, 4730.46, 4731.89, and 5164.21 of the Revised Code be
enacted to read as follows:

Sec.
3313.5310.
(A)(1)
This section applies to both of the following:

(a)
Any school operated by a school district board of education;

(b)
Any chartered or nonchartered nonpublic school that is subject to the
rules of an interscholastic conference or an organization that
regulates interscholastic conferences or events.

(2)
As used in this section
,
"athletic
:

(a)
"Advanced practice registered nurse" means an individual
who holds a current, valid license issued under Chapter 4723. of the
Revised Code that authorizes the practice of nursing as an advanced
practice registered nurse and is designated as a clinical nurse
specialist or certified nurse practitioner.

(b)
"Athletic
activity"
means all of the following:

(a)
(i)

Interscholastic athletics;

(b)
(ii)

An athletic contest or competition that is sponsored by or associated
with a school that is subject to this section, including
cheerleading, club-sponsored sports activities, and sports activities
sponsored by school-affiliated organizations;

(c)
(iii)

Noncompetitive cheerleading that is sponsored by school-affiliated
organizations;

(d)
(iv)

Practices, interschool practices, and scrimmages for all of the
activities described in divisions
(A)(2)(a),
(b), and (c)
(A)(2)(b)(i),
(ii), and (iii)

of this section.

(c)
"Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery.

(d)
"Physician assistant" means an individual who is licensed
to practice as a physician assistant under Chapter 4730. of the
Revised Code.

(B)
Prior to the start of each athletic season, a school that is subject
to this section shall hold an informational meeting for students,
parents, guardians, other persons having care or charge of a student,
physicians, pediatric cardiologists, athletic trainers, and any other
persons regarding the symptoms and warning signs of sudden cardiac
arrest for all ages of students.

(C)
No student shall participate in an athletic activity until the
student has submitted to a designated school official a form signed
by the student and the parent, guardian, or other person having care
or charge of the student stating that the student and the parent,
guardian, or other person having care or charge of the student have
received and reviewed a copy of the information jointly developed by
the department of health and the department of education and
workforce and posted on their respective web sites
,
and, once produced, copies of the guidelines and other relevant
educational materials,

as required by section 3707.59 of the Revised Code. A completed form
shall be submitted each school year, as defined in section 3313.62 of
the Revised Code, in which the student participates in an athletic
activity.

(D)
No individual, including coaches and assistant coaches, shall coach
an athletic activity unless the individual has completed the sudden
cardiac arrest training course approved by the department of health
under division (C) of section 3707.59 of the Revised Code in
accordance with section 3319.303 of the Revised Code.

(E)(1)

(E)
Beginning one year after the effective date of this amendment, a
student shall not be allowed to participate in an athletic activity
unless the student has a physical examination performed by an
advanced practice registered nurse, physician, or physician
assistant, and the provider of the examination completes the
preparticipation physical evaluation form created by the department
of health pursuant to division (D) of section 3707.59 of the Revised
Code.

The
preparticipation physical examination is valid for all athletic
activities for thirteen months.

Each
school subject to this section shall retain all original, signed
preparticipation physical evaluation forms, but may share forms
across organizations if a student participates in more than one
athletic activity.

(F)(1)

A
student shall not be allowed to participate in an athletic activity
if
either
of the following is the case:

(a)
The student's biological parent, biological sibling, or biological
child has previously experienced sudden cardiac arrest, and the
student has not been evaluated and cleared for participation in an
athletic activity by a physician authorized under Chapter 4731. of
the Revised Code to practice medicine and surgery or osteopathic
medicine and surgery.

(b)
The
the

student
is known to have exhibited syncope or fainting at any time prior to
or following an athletic activity and has not been evaluated and
cleared for return under division
(E)(3)
(E)
or (F)(3)

of this section after exhibiting syncope or fainting.

(2)
A student shall be removed by the student's coach from participation
in an athletic activity if the student exhibits syncope or fainting.

(3)
If a student is not allowed to participate in or is removed from
participation in an athletic activity under division
(E)(1)
(F)(1)

or (2) of this section, the student shall not be allowed to return to
participation until the student is evaluated and cleared for return
in writing by any of the following:

(a)
A physician

authorized under Chapter 4731. of the Revised Code to practice
medicine and surgery or osteopathic medicine and surgery
,
including a physician who specializes in cardiology;

(b)

A
certified nurse practitioner, clinical nurse specialist, or certified
nurse-midwife who holds a certificate of authority issued under
Chapter 4723. of the Revised Code
An
advanced practice registered nurse
;

(c)
A physician assistant

licensed under Chapter 4730. of the Revised Code
;

(d)
An athletic trainer licensed under Chapter 4755. of the Revised Code.

The
licensed health care providers specified in divisions

(E)(3)(a)
(F)(3)(a)

to (d) of this section may consult with any other licensed or
certified health care providers in order to determine whether a
student is ready to return to participation.

(F)
(G)

A school that is subject to this section shall establish penalties
for a coach who violates the provisions of division
(E)
(F)

of this section.

(G)
(H)

Nothing in this section shall be construed to abridge or limit any
rights provided under a collective bargaining agreement entered into
under Chapter 4117. of the Revised Code prior to March 14, 2017.

(H)(1)
(I)(1)

A school district, member of a school district board of education, or
school district employee or volunteer, including a coach, is not
liable in damages in a civil action for injury, death, or loss to
person or property allegedly arising from providing services or
performing duties under this section, unless the act or omission
constitutes willful or wanton misconduct.

This
section does not eliminate, limit, or reduce any other immunity or
defense that a school district, member of a school district board of
education, or school district employee or volunteer, including a
coach, may be entitled to under Chapter 2744. or any other provision
of the Revised Code or under the common law of this state.

(2)
A chartered or nonchartered nonpublic school or any officer,
director, employee, or volunteer of the school, including a coach, is
not liable in damages in a civil action for injury, death, or loss to
person or property allegedly arising from providing services or
performing duties under this section, unless the act or omission
constitutes willful or wanton misconduct.

Sec.
3707.58.
(A)
As used in this section:

(1)

"Advanced
practice registered nurse" means an individual who holds a
current, valid license issued under Chapter 4723. of the Revised Code
that authorizes the practice of nursing as an advanced practice
registered nurse and is designated as a clinical nurse specialist or
certified nurse practitioner.

(2)
"Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery.

(3)
"Physician assistant" means an individual who is licensed
to practice as a physician assistant under Chapter 4730. of the
Revised Code.

(4)

"Youth
athlete" means an individual who wishes to practice for or
compete in athletic activities organized by a youth sports
organization;

(2)
(5)

"Youth sports organization" has the same meaning as in
section 3707.51 of the Revised Code.

(B)
Prior to the start of each athletic season, a youth sports
organization that is subject to this section shall hold an
informational meeting for youth athletes, parents, guardians, other
persons having care or charge of a youth athlete, physicians,
pediatric cardiologists, athletic trainers, and any other persons
regarding the symptoms and warning signs of sudden cardiac arrest for
all ages of youth athletes.

(C)
No youth athlete shall participate in an athletic activity organized
by a youth sports organization until the youth athlete has submitted
to a designated official of the youth sports organization a form
signed by the youth athlete and the parent, guardian, or other person
having care or charge of the youth athlete stating that the youth
athlete and the parent, guardian, or other person having care or
charge of the youth athlete have received and reviewed a copy of the
information developed by the department of health and the department
of education and workforce and posted on their respective internet
web sites
,
and, once produced, copies of the guidelines and other relevant
educational materials,

as required by section 3707.59 of the Revised Code. A completed form
shall be submitted each calendar year to each youth sports
organization that organizes an athletic activity in which the youth
athlete participates.

(D)
No individual shall coach an athletic activity organized by a youth
sports organization unless the individual has completed, on an annual
basis, the sudden cardiac arrest training course approved by the
department of health under division (C) of section 3707.59 of the
Revised Code.

(E)(1)
(E)
Beginning one year after the effective date of this amendment, a
youth athlete shall not be allowed to participate in an athletic
activity organized by a youth sports organization unless the athlete
has a physical examination performed by an advanced practice
registered nurse, physician, or physician assistant, and the provider
of the examination completes the preparticipation physical evaluation
form created by the department of health pursuant to division (D) of
section 3707.59 of the Revised Code.

The
preparticipation physical evaluation is valid for all athletic
activities for thirteen months.

A
youth sports organization shall require an athlete, the athlete's
parent or guardian, or another person having care or charge of the
athlete to certify that the athlete has received the preparticipation
physical examination required by this division. The youth sports
organization shall retain a copy of the certification each year the
certification is submitted but may share certifications across
organizations if an athlete participates in more than one athletic
activity.

(F)(1)

A youth athlete shall not be allowed to participate in an athletic
activity organized by a youth sports organization if
either
of the following is the case:

(a)
The youth athlete's biological parent, biological sibling, or
biological child has previously experienced sudden cardiac arrest,
and the youth athlete has not been evaluated and cleared for
participation in an athletic activity organized by a youth sports
organization by a physician authorized under Chapter 4731. of the
Revised Code to practice medicine and surgery or osteopathic medicine
and surgery.

(b)
The
the

youth
athlete is known to have exhibited syncope or fainting at any time
prior to or following an athletic activity and has not been evaluated
and cleared for return under division
(E)(3)
(E)
or (F)(3)

of this section after exhibiting syncope or fainting.

(2)
A youth athlete shall be removed by the youth athlete's coach from
participation in an athletic activity organized by a youth sports
organization if the youth athlete exhibits syncope or fainting.

(3)
If a youth athlete is not allowed to participate in or is removed
from participation in an athletic activity organized by a youth
sports organization under division
(E)(1)
(F)(1)

or (2) of this section, the youth athlete shall not be allowed to
return to participation until the youth athlete is evaluated and
cleared for return in writing by any of the following:

(a)
A physician

authorized under Chapter 4731. of the Revised Code to practice
medicine and surgery or osteopathic medicine and surgery
,
including a physician who specializes in cardiology;

(b)

A
certified nurse practitioner, clinical nurse specialist, or certified
nurse-midwife who holds a certificate of authority issued under
Chapter 4723. of the Revised Code
An
advanced practice registered nurse;

(c)
A physician assistant
.

The
licensed health care providers specified in divisions
(E)(3)(a)
and
(F)(3)(a),

(b)
,
and (c)

of this section may consult with any other licensed or certified
health care providers in order to determine whether a youth athlete
is ready to return to participation.

(F)
(G)

A youth sports organization that is subject to this section shall
establish penalties for a coach who violates the provisions of
division
(E)
(F)

of this section.

(G)(1)
(H)(1)

A youth sports organization or official, employee, or volunteer of a
youth sports organization, including a coach, is not liable in
damages in a civil action for injury, death, or loss to person or
property allegedly arising from providing services or performing
duties under this section, unless the act or omission constitutes
willful or wanton misconduct.

(2)
This section does not eliminate, limit, or reduce any other immunity
or defense that a public entity, public official, or public employee
may be entitled to under Chapter 2744. or any other provision of the
Revised Code or under the common law of this state.

Sec.
3707.59.
(A)
As used in this section:

(1)
"Athletic activity" means both of the following:

(a)
An athletic activity, as defined in section 3313.5310 of the Revised
Code;

(b)
An athletic activity organized by a youth sports organization.

(2)
"Youth athlete" and "youth sports organization"
have the same meanings as in section 3707.58 of the Revised Code.

(B)
(B)(1)

The department of health and the department of education and
workforce jointly shall develop and
shall

post
on their respective internet web sites guidelines and other relevant

educational

materials
to inform and educate students and youth athletes participating in or
desiring to participate in an athletic activity, their parents, and
their coaches about the nature and warning signs of sudden cardiac
arrest. These guidelines and materials shall address the risks
associated with continuing to participate in an athletic activity
after experiencing one or more symptoms of sudden cardiac arrest,
such as fainting, difficulty breathing, chest pains, dizziness, and
an abnormal racing heart rate. In developing guidelines and other
relevant
educational

materials
under this division, the department of health and the department of
education and workforce shall consult with the Ohio chapter of the
American college of cardiology and with an interscholastic conference
or an organization that regulates interscholastic athletic
competition and conducts interscholastic athletic events.

In
developing guidelines and
other
relevant educational
materials
under this division, the departments may utilize existing materials
developed by the parent heart watch organization, the sudden
arrhythmia death syndromes foundation, and any other organizations
deemed appropriate by the departments.

(2)
The department of education and workforce shall distribute copies of
the guidelines and other relevant educational materials described in
division (B)(1) of this section free of charge to all school
districts in Ohio. The department also shall distribute copies of the
guidelines and materials to any other school on request.

(C)
For purposes of the training required for a coach of an athletic
activity under division (D) of section 3313.5310 or division (D) of
section 3707.58 of the Revised Code, the department of health shall
approve a sudden cardiac arrest training course offered by an outside
entity.

(D)
Not later than one year after the effective date of this amendment,
the department of health shall create a preparticipation physical
evaluation form to be used for purposes of sections 4723.484,
4730.46, and 4731.89 of the Revised Code. The form shall contain all
of the following components:

(1)
A description of key prescreening elements, including the taking of a
patient's personal history, which may include asking about prior
elevated systemic blood pressure, unexplained exertional chest pain
or syncope, palpitations, or decreased exercise tolerance, and the
taking of a patient's family history, which may include asking about
known cardiac conditions such as cardiomyopathy, arrhythmia
syndromes, premature sudden cardiac death, and unexplained drowning
or seizures;

(2)
A physical examination component, which may include efforts to detect
pathologic heart murmurs, irregular rhythms, abnormal pulses, or
other findings suggestive of structural or electrical heart disease;

(3)
A certification to be signed by the health care professional who
performs the physical examination, certifying that the health care
professional has complied with the following:

(a)
For a physician, divisions (B)(2) and (3) of section 4731.89 of the
Revised Code;

(b)
For a physician assistant, divisions (B) and (C) of section 4730.46
of the Revised Code;

(c)
For a clinical nurse specialist or certified nurse practitioner,
divisions (B) and (C) of section 4723.484 of the Revised Code.

Sec.
3707.591.
(A)
Not later than one year after the effective date of this section, the
director of health, in consultation with the department of education
and workforce, shall establish a childhood cardiac screening
professional development module to increase the assessment skills of
health care professionals who perform annual physical examinations
and screenings for children. As part of establishing the module, the
director may develop a module that meets the requirements of division
(B) of this section or may adopt the student-athlete cardiac
assessment professional development module created by the New Jersey
commissioners of education and health.

(B)
If the director of health, in consultation with the department of
education and workforce, develops a module as described in division
(A) of this section, the director and the department of education and
workforce shall do both of the following:

(1)
Consult with the academy of family physicians, the American heart
association, and the Ohio chapter of the American college of
cardiology in developing the module;

(2)
Include all of the following in the module:

(a)
How to complete and review a detailed medical history with an
emphasis on cardiovascular family history and personal reports of
symptoms;

(b)
Identification of symptoms of sudden cardiac arrest that may require
follow up with a cardiologist;

(c)
Recognition of normal structural changes of the athletic heart;

(d)
Recognition of prodromal symptoms that precede sudden cardiac arrest;

(e)
Performance of the cardiovascular physical examination;

(f)
Review of the major etiologies of sudden unexplained cardiac death
with an emphasis on structural abnormalities and acquired conditions;

(g)
When to refer a patient to a cardiologist for further assessment.

(C)
The department of health and the department of education and
workforce shall post the module established pursuant to this section
on their internet web sites. The department of health shall make
internet links to the module available to the American academy of
pediatrics, Ohio academy of family physicians, American heart
association, American college of cardiology, athletic trainers'
society, state medical board, board of nursing, and society of
physician assistants.

(D)
The department of health shall facilitate the database storage of
information related to all health care professionals who complete the
course as required by sections 4723.484, 4730.46, and 4731.89 of the
Revised Code. The department may coordinate with health care
professional licensing boards to store the information on behalf of
the department, as the department considers appropriate. The records
shall be kept for ten years.

(E)
The department of health shall complete an annual report on outcomes
related to the module and health care professional reports under
sections 4723.484, 4730.46, and 4731.89 of the Revised Code. The
department shall post the report on its internet web site and provide
a copy to any member of the public on request.

Sec.
3707.592.
The
department of health, in collaboration with the department of
education and workforce, jointly shall adopt as necessary rules to
implement sections 3707.59 and 3707.591 of the Revised Code. The
rules shall be adopted in accordance with Chapter 119. of the Revised
Code and shall follow nationally recognized, evidence-based
guidelines recommended by organizations focused on cardiovascular
care in pediatric populations.

Sec.
4723.24.
(A)(1)
Except as otherwise provided in this chapter, all of the following
apply with respect to the schedules for renewal of licenses and
certificates issued by the board of nursing:

(a)
An active license to practice nursing as a registered nurse is
subject to renewal in odd-numbered years. An application for renewal
of the license is due on the fifteenth day of September of the
renewal year. A late application may be submitted before the license
lapses. If a license is not renewed or classified as inactive, the
license lapses on the first day of November of the renewal year.

(b)
An active license to practice nursing as a licensed practical nurse
is subject to renewal in even-numbered years. An application for
renewal of the license is due on the fifteenth day of September of
the renewal year. A late application may be submitted before the
license lapses. If a license is not renewed or classified as
inactive, the license lapses on the first day of November of the
renewal year.

(c)
An active license to practice nursing as an advanced practice
registered nurse is subject to renewal in odd-numbered years. An
application for renewal of the license is due on the fifteenth day of
September of the renewal year. A late application may be submitted
before the license lapses. If a license is not renewed or classified
as inactive, the license lapses on the first day of November of the
renewal year.

(d)
All other active licenses and certificates issued under this chapter
are subject to renewal according to a schedule established by the
board in rules adopted under section 4723.07 of the Revised Code.

(2)
The board shall provide an application for renewal to every holder of
an active license or certificate, except when the board is aware that
an individual is ineligible for license or certificate renewal for
any reason, including pending criminal charges in this state or
another jurisdiction, failure to comply with a disciplinary order
from the board or the terms of a consent agreement entered into with
the board, failure to pay fines or fees owed to the board, or failure
to provide on the board's request documentation of having completed
the continuing nursing education requirements specified in division
(C) of this section.

If
the board provides a renewal application by mail, the application
shall be addressed to the last known post-office address of the
license or certificate holder and mailed before the date the
application is due. Failure of the license or certificate holder to
receive an application for renewal from the board shall not excuse
the holder from the requirements contained in this section, except as
provided in section 5903.10 of the Revised Code.

As
applicable, the renewal application shall include a check box for an
advanced practice registered nurse who is subject to section 4723.484
of the Revised Code to certify compliance with divisions (B) and (C)
of that section.

(3)
A license or certificate holder seeking renewal of the license or
certificate shall complete the renewal application and submit it to
the board with the renewal fee established under section 4723.08 of
the Revised Code. If a renewal application is submitted after the
date the application is due, but before the date the license or
certificate lapses, the applicant shall include with the application
the fee established under section 4723.08 of the Revised Code for
processing a late application for renewal.

With
the renewal application, the applicant shall report any conviction,
plea, or judicial finding regarding a criminal offense that
constitutes grounds for the board to impose sanctions under section
4723.28 of the Revised Code since the applicant last submitted an
application to the board.

(4)
On receipt of the renewal application, the board shall verify whether
the applicant meets the renewal requirements. If the applicant meets
the requirements, the board shall renew the license or certificate.

(B)
Every license or certificate holder shall give written notice to the
board of any change of name or address within thirty days of the
change. The board shall require the holder to document a change of
name in a manner acceptable to the board.

(C)(1)
Except in the case of a first renewal after licensure by examination,
to be eligible for renewal of an active license to practice nursing
as a registered nurse or licensed practical nurse, each individual
who holds an active license shall, in each two-year period specified
by the board, complete continuing nursing education as follows:

(a)
For renewal of a license that was issued for a two-year renewal
period, twenty-four hours of continuing nursing education;

(b)
For renewal of a license that was issued for less than a two-year
renewal period, the number of hours of continuing nursing education
specified by the board in rules adopted in accordance with Chapter
119. of the Revised Code;

(c)
Of the hours of continuing nursing education completed in any renewal
period, at least one hour of the education must be directly related
to the statutes and rules pertaining to the practice of nursing in
this state.

(2)
To be eligible for renewal of an active license to practice nursing
as an advanced practice registered nurse, each individual who holds
an active license shall, in each two-year period specified by the
board, complete continuing education as follows:

(a)
For renewal of a license that was issued for a two-year renewal
period, twenty-four hours of continuing nursing education;

(b)
For renewal of a license that was issued for less than a two-year
renewal period, the number of hours of continuing nursing education
specified by the board in rules adopted in accordance with Chapter
119. of the Revised Code, including the number of hours of continuing
education in advanced pharmacology;

(c)
In the case of an advanced practice registered nurse who is
designated as a clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner, of the hours of continuing nursing
education completed in any renewal period, at least twelve hours of
the education must be in advanced pharmacology and be received from
an accredited institution recognized by the board.

(d)
The continuing education required by division (C)(2)(a) or (b) of
this section is in addition to the continuing education required by
division (C)(1)(a) or (b) of this section.

(3)
The board shall adopt rules establishing the procedure for a license
holder to certify to the board completion of the required continuing
nursing education. The board may conduct a random sample of license
holders and require that the license holders included in the sample
submit satisfactory documentation of having completed the
requirements for continuing nursing education. On the board's
request, a license holder included in the sample shall submit the
required documentation.

(4)
An educational activity may be applied toward meeting the continuing
nursing education requirement only if it is obtained through a
program or course approved by the board or a person the board has
authorized to approve continuing nursing education programs and
courses.

(5)
The continuing education required of a certified registered nurse
anesthetist, clinical nurse specialist, certified nurse-midwife, or
certified nurse practitioner to maintain certification by a national
certifying organization shall be applied toward the continuing
education requirements for renewal of the following if the continuing
education is obtained through a program or course approved by the
board or a person the board has authorized to approve continuing
nursing education programs and courses:

(a)
A license to practice nursing as a registered nurse;

(b)
A license to practice nursing as an advanced practice registered
nurse.

(D)
Except as otherwise provided in section 4723.28 of the Revised Code,
an individual who holds an active license to practice nursing as a
registered nurse or licensed practical nurse and who does not intend
to practice in Ohio may send to the board written notice to that
effect on or before the date the license lapses, and the board shall
classify the license as inactive. During the period that the license
is classified as inactive, the holder may not engage in the practice
of nursing as a registered nurse or licensed practical nurse in Ohio
and is not required to pay the renewal fee.

The
holder of an inactive license to practice nursing as a registered
nurse or licensed practical nurse or an individual who has failed to
renew the individual's license to practice nursing as a registered
nurse or licensed practical nurse may have the license reactivated or
reinstated upon doing the following, as applicable to the holder or
individual:

(1)
Applying to the board for license reactivation or reinstatement on
forms provided by the board;

(2)
Meeting the requirements for reactivating or reinstating licenses
established in rules adopted under section 4723.07 of the Revised
Code or, if the individual did not renew because of service in the
armed forces of the United States or a reserve component of the armed
forces of the United States, including the Ohio national guard or the
national guard of any other state, as provided in section 5903.10 of
the Revised Code;

(3)
If the license has been inactive for at least five years from the
date of application for reactivation or has lapsed for at least five
years from the date of application for reinstatement, submitting a
request to the bureau of criminal identification and investigation
for a criminal records check and check of federal bureau of
investigation records pursuant to section 4723.091 of the Revised
Code.

(E)
Except as otherwise provided in section 4723.28 of the Revised Code,
an individual who holds an active license to practice nursing as an
advanced practice registered nurse and does not intend to practice in
Ohio as an advanced practice registered nurse may send to the board
written notice to that effect on or before the renewal date, and the
board shall classify the license as inactive. During the period that
the license is classified as inactive, the holder may not engage in
the practice of nursing as an advanced practice registered nurse in
Ohio and is not required to pay the renewal fee.

The
holder of an inactive license to practice nursing as an advanced
practice registered nurse or an individual who has failed to renew
the individual's license to practice nursing as an advanced practice
registered nurse may have the license reactivated or reinstated upon
doing the following, as applicable to the holder or individual:

(1)
Applying to the board for license reactivation or reinstatement on
forms provided by the board;

(2)
Meeting the requirements for reactivating or reinstating licenses
established in rules adopted under section 4723.07 of the Revised
Code or, if the individual did not renew because of service in the
armed forces of the United States or a reserve component of the armed
forces of the United States, including the Ohio national guard or the
national guard of any other state, as provided in section 5903.10 of
the Revised Code.

Sec.
4723.28.
(A)
The board of nursing, by a vote of a quorum, may impose one or more
of the following sanctions if it finds that a person committed fraud
in passing an examination required to obtain a nursing license or
dialysis technician certificate issued by the board or committed
fraud, misrepresentation, or deception in applying for or securing a
nursing license or dialysis technician certificate issued by the
board: deny, revoke, suspend, or place restrictions on any nursing
license or dialysis technician certificate issued by the board;
reprimand or otherwise discipline a holder of a nursing license or
dialysis technician certificate; or impose a fine of not more than
five hundred dollars per violation.

(B)
Except as provided in section 4723.092 of the Revised Code, the board
of nursing, by a vote of a quorum, may impose one or more of the
following sanctions: deny, revoke, suspend, or place restrictions on
any nursing license or dialysis technician certificate issued by the
board; reprimand or otherwise discipline a holder of a nursing
license or dialysis technician certificate; or impose a fine of not
more than five hundred dollars per violation. The sanctions may be
imposed for any of the following:

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

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

(3)
Conviction of, a plea of guilty to, a judicial finding of guilt of, a
judicial finding of guilt resulting from a plea of no contest to, or
a judicial finding of eligibility for a pretrial diversion or similar
program or for intervention in lieu of conviction for, a misdemeanor
committed in the course of practice;

(4)
Conviction of, a plea of guilty to, a judicial finding of guilt of, a
judicial finding of guilt resulting from a plea of no contest to, or
a judicial finding of eligibility for a pretrial diversion or similar
program or for intervention in lieu of conviction for, any felony or
of any crime involving gross immorality or moral turpitude;

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

(6)
Conviction of, a plea of guilty to, a judicial finding of guilt of, a
judicial finding of guilt resulting from a plea of no contest to, or
a judicial finding of eligibility for a pretrial diversion or similar
program or for intervention in lieu of conviction for, an act in
another jurisdiction that would constitute a felony or a crime of
moral turpitude in Ohio;

(7)
Conviction of, a plea of guilty to, a judicial finding of guilt of, a
judicial finding of guilt resulting from a plea of no contest to, or
a judicial finding of eligibility for a pretrial diversion or similar
program or for intervention in lieu of conviction for, an act in the
course of practice in another jurisdiction that would constitute a
misdemeanor in Ohio;

(8)
Self-administering or otherwise taking into the body any dangerous
drug, as defined in section 4729.01 of the Revised Code, in any way
that is not in accordance with a legal, valid prescription issued for
that individual, or self-administering or otherwise taking into the
body any drug that is a schedule I controlled substance;

(9)
Habitual or excessive use of controlled substances, other
habit-forming drugs, or alcohol or other chemical substances to an
extent that impairs the individual's ability to provide safe nursing
care or safe dialysis care;

(10)
Impairment of the ability to practice according to acceptable and
prevailing standards of safe nursing care or safe dialysis care
because of the use of drugs, alcohol, or other chemical substances;

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

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

(13)
Misappropriation or attempted misappropriation of money or anything
of value in the course of practice;

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

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

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

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

(18)
Failure to use universal and standard precautions established by
rules adopted under section 4723.07 of the Revised Code;

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

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

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

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

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

(24)
In the case of an advanced practice registered nurse, except as
provided in division (M) of this section, either of the following:

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

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

(25)
Failure to comply with the terms and conditions of participation in
the safe haven program conducted under sections 4723.35 and 4723.351
of the Revised Code;

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

(27)
In the case of an advanced practice registered nurse:

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

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

(28)
In the case of an advanced practice registered nurse other than a
certified registered nurse anesthetist, failure to maintain a
standard care arrangement in accordance with section 4723.431 of the
Revised Code or to practice in accordance with the standard care
arrangement;

(29)
In the case of an advanced practice registered nurse who is
designated as a clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner, failure to prescribe drugs and
therapeutic devices in accordance with section 4723.481 of the
Revised Code;

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

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

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

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

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

(33)
Assisting suicide, as defined in section 3795.01 of the Revised Code;

(34)
Failure to comply with the requirements in section 3719.061 of the
Revised Code before issuing for a minor a prescription for an opioid
analgesic, as defined in section 3719.01 of the Revised Code;

(35)
Failure to comply with section 4723.487 of the Revised Code, unless
the state board of pharmacy no longer maintains a drug database
pursuant to section 4729.75 of the Revised Code;

(36)
The revocation, suspension, restriction, reduction, or termination of
clinical privileges by the United States department of defense or
department of veterans affairs or the termination or suspension of a
certificate of registration to prescribe drugs by the drug
enforcement administration of the United States department of
justice;

(37)
In the case of an advanced practice registered nurse who is
designated as a clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner, failure to comply with the terms of
a consult agreement entered into with a pharmacist pursuant to
section 4729.39 of the Revised Code;

(38)
Violation of section 4723.93 of the Revised Code;

(39)
Failure to cooperate with an investigation conducted by the board
under this chapter, including failure to comply with a subpoena or
order issued by the board or failure to answer truthfully a question
presented by the board in an investigative interview, in an
investigative office conference, at a deposition, or in written
interrogatories, except that failure to cooperate with an
investigation does not constitute grounds for discipline if a court
of competent jurisdiction has issued an order that either quashes a
subpoena or permits the individual to withhold testimony or evidence
at issue
;

(40)
In the case of an advanced practice registered nurse who is
designated as a clinical nurse specialist or certified nurse
practitioner, failure to comply with division (B) or (C) of section
4723.484 of the Revised Code
.

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

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

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

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

If
the board takes action on the basis of a conviction, plea, or a
judicial finding as described in divisions (B)(3) to (7) of this
section that is overturned on appeal, the registered nurse, licensed
practical nurse, or dialysis technician may, on exhaustion of the
appeal process, petition the board for reconsideration of its action.
On receipt of the petition and supporting court documents, the board
shall temporarily rescind its action. If the board determines that
the decision on appeal was a decision on the merits, it shall
permanently rescind its action. If the board determines that the
decision on appeal was not a decision on the merits, it shall conduct
an adjudication to determine whether the registered nurse, licensed
practical nurse, or dialysis technician committed the act on which
the original conviction, plea, or judicial finding was based. If the
board determines on the basis of the adjudication that the registered
nurse, licensed practical nurse, or dialysis technician committed
such act, or if the registered nurse, licensed practical nurse, or
dialysis technician does not request an adjudication, the board shall
reinstate its action; otherwise, the board shall permanently rescind
its action.

Notwithstanding
the provision of division (D)(2) of section 2953.32 or division
(F)(1) of section 2953.39 of the Revised Code specifying that if
records pertaining to a criminal case are sealed or expunged under
that section the proceedings in the case shall be deemed not to have
occurred, sealing or expungement of the following records on which
the board has based an action under this section shall have no effect
on the board's action or any sanction imposed by the board under this
section: records of any conviction, guilty plea, judicial finding of
guilt resulting from a plea of no contest, or a judicial finding of
eligibility for a pretrial diversion program or intervention in lieu
of conviction.

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

(F)
The board may investigate an individual's criminal background in
performing its duties under this section. As part of such
investigation, the board may order the individual to submit, at the
individual's expense, a request to the bureau of criminal
identification and investigation for a criminal records check and
check of federal bureau of investigation records pursuant to section
4723.091 of the Revised Code.

(G)
During the course of an investigation conducted under this section,
the board may compel any registered nurse, licensed practical nurse,
or dialysis technician or applicant under this chapter to submit to a
mental or physical examination, or both, as required by the board and
at the expense of the individual, if the board finds reason to
believe that the individual under investigation may have a physical
or mental impairment that may affect the individual's ability to
provide safe nursing or dialysis care.

The
board shall not compel an individual who has been referred to the
safe haven program as described in sections 4723.35 and 4723.351 of
the Revised Code to submit to a mental or physical examination.

Failure
of any individual to submit to a mental or physical examination when
directed constitutes an admission of the allegations, unless the
failure is due to circumstances beyond the individual's control, and
a default and final order may be entered without the taking of
testimony or presentation of evidence.

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

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

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

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

(1)
Information received by the board pursuant to a complaint or an
investigation is confidential and not subject to discovery in any
civil action, except that the board may disclose information to law
enforcement officers and government entities for purposes of an
investigation of either a licensed health care professional,
including a registered nurse, licensed practical nurse, or dialysis
technician, or a person who may have engaged in the unauthorized
practice of nursing or dialysis care. No law enforcement officer or
government entity with knowledge of any information disclosed by the
board pursuant to this division shall divulge the information to any
other person or government entity except for the purpose of a
government investigation, a prosecution, or an adjudication by a
court or government entity.

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

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

(4)
Any board activity that involves continued monitoring of an
individual as part of or following any disciplinary action taken
under this section shall be conducted in a manner that maintains the
individual's confidentiality. Information received or maintained by
the board with respect to the board's monitoring activities is not
subject to discovery in any civil action and is confidential, except
that the board may disclose information to law enforcement officers
and government entities for purposes of an investigation of a
licensee or certificate holder.

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

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

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

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

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

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

Sec.
4723.484.
Beginning
one year after the effective date of this section, a certified nurse
practitioner or clinical nurse specialist who performs annual
physical examinations on individuals who are nineteen years of age or
younger, or who performs examinations for purposes of division (E) of
section 3313.5310 of the Revised Code, shall do all of the following:

(A)
For each such examination, complete the preparticipation physical
evaluation form created pursuant to division (D) of section 3707.59
of the Revised Code;

(B)
At least once every four years, complete the childhood cardiac
screening professional development module established under section
3707.591 of the Revised Code. The certified nurse practitioner or
clinical nurse specialist shall retain on file at the nurse's primary
place of practice a hard copy of the certificate of completion, and
shall make it available to the board of nursing on request.

(C)
At least once every four years, read the guidelines and other
relevant educational materials developed under division (B)(1) of
section 3707.59 of the Revised Code;

(D)
Annually report to the department of health the total number of
examinations for which the preparticipation physical evaluation form
was completed and the total number of cardiology referrals resulting
from those examinations.

Sec.
4730.14.
(A)
A license to practice as a physician assistant shall be valid for a
two-year period unless revoked or suspended, shall expire on the date
that is two years after the date of issuance, and may be renewed for
additional two-year periods in accordance with this section. A person
seeking to renew a license shall apply to the state medical board for
renewal prior to the license's expiration date. The board shall
provide renewal notices to license holders at least one month prior
to the expiration date.

Applications
shall be submitted to the board in a manner prescribed by the board.
Each
renewal

application
shall
be

include
a check box for a physician assistant who is subject to section
4730.46 of the Revised Code to certify compliance with divisions (B)
and (C) of that section.

Each
application shall be
accompanied
by a biennial renewal fee of two hundred dollars. The board shall
deposit the fees in accordance with section 4731.24 of the Revised
Code.

The
applicant shall report any criminal offense that constitutes grounds
for refusing to issue a license to practice under section 4730.25 of
the Revised Code to which the applicant has pleaded guilty, of which
the applicant has been found guilty, or for which the applicant has
been found eligible for intervention in lieu of conviction, since
last signing an application for a license to practice as a physician
assistant.

(B)
To be eligible for renewal of a license, an applicant is subject to
all of the following:

(1)
The applicant must certify to the board that the applicant has
maintained certification by the national commission on certification
of physician assistants or a successor organization that is
recognized by the board by meeting the standards to hold current
certification from the commission or its successor, including passing
periodic recertification examinations;

(2)
Except as provided in section 5903.12 of the Revised Code, the
applicant must certify to the board that the applicant is in
compliance with the continuing medical education requirements
necessary to hold current certification from the commission or its
successor.

(3)
The applicant must comply with the renewal eligibility requirements
established under section 4730.49 of the Revised Code that pertain to
the applicant.

(C)
If an applicant submits a complete renewal application and qualifies
for renewal pursuant to division (B) of this section, the board shall
issue to the applicant a renewed license to practice as a physician
assistant.

(D)
The board may require a random sample of physician assistants to
submit materials documenting both of the following:

(1)
Certification by the national commission on certification of
physician assistants or a successor organization that is recognized
by the board;

(2)
Completion of the continuing medical education required to hold
current certification from the commission or its successor.

Division
(D) of this section does not limit the board's authority to conduct
investigations pursuant to section 4730.25 of the Revised Code.

(E)
A license to practice that is not renewed on or before its expiration
date is automatically suspended on its expiration date. Continued
practice after suspension of the license shall be considered as
practicing in violation of division (A) of section 4730.02 of the
Revised Code.

(F)
If a license has been suspended pursuant to division (E) of this
section for two years or less, it may be reinstated. The board shall
reinstate a license suspended for failure to renew upon an
applicant's submission of a renewal application, the biennial renewal
fee, and any applicable monetary penalty.

If
a license has been suspended pursuant to division (E) of this section
for more than two years, it may be restored. In accordance with
section 4730.28 of the Revised Code, the board may restore a license
suspended for failure to renew upon an applicant's submission of a
restoration application, the biennial renewal fee, and any applicable
monetary penalty and compliance with sections 4776.01 to 4776.04 of
the Revised Code. The board shall not restore to an applicant a
license to practice as a physician assistant unless the board, in its
discretion, decides that the results of the criminal records check do
not make the applicant ineligible for a license issued pursuant to
section 4730.12 of the Revised Code.

The
penalty for reinstatement shall be fifty dollars and the penalty for
restoration shall be one hundred dollars. The board shall deposit
penalties in accordance with section 4731.24 of the Revised Code.

(G)(1)
If, through a random sample conducted under division (D) of this
section or through any other means, the board finds that an
individual who certified completion of the continuing medical
education required to renew, reinstate, restore, or reactivate a
license to practice did not complete the requisite continuing medical
education, the board may do either of the following:

(a)
Take disciplinary action against the individual under section 4730.25
of the Revised Code, impose a civil penalty, or both;

(b)
Permit the individual to agree in writing to complete the continuing
medical education and pay a civil penalty.

(2)
The board's finding in any disciplinary action taken under division
(G)(1)(a) of this section shall be made pursuant to an adjudication
under Chapter 119. of the Revised Code and by an affirmative vote of
not fewer than six of its members.

(3)
A civil penalty imposed under division (G)(1)(a) of this section or
paid under division (G)(1)(b) of this section shall be in an amount
specified by the board of not more than five thousand dollars. The
board shall deposit civil penalties in accordance with section
4731.24 of the Revised Code.

Sec.
4730.25.
(A)
The state medical board, by an affirmative vote of not fewer than six
members, may refuse to grant a license to practice as a physician
assistant to, or may revoke the license held by, an individual found
by the board to have committed fraud, misrepresentation, or deception
in applying for or securing the license.

(B)
Except as provided in division (N) of this section, the board, by an
affirmative vote of not fewer than six members, shall, to the extent
permitted by law, limit, revoke, or suspend an individual's license
to practice as a physician assistant or prescriber number, refuse to
issue a license to an applicant, refuse to renew a license, refuse to
reinstate a license, or reprimand or place on probation the holder of
a license for any of the following reasons:

(1)
Failure to practice in accordance with the supervising physician's
supervision agreement with the physician assistant, including, if
applicable, the policies of the health care facility in which the
supervising physician and physician assistant are practicing;

(2)
Failure to comply with the requirements of this chapter, Chapter
4731. of the Revised Code, or any rules adopted by the board;

(3)
Violating or attempting to violate, directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
any provision of this chapter, Chapter 4731. of the Revised Code, or
the rules adopted by the board;

(4)
Inability to practice according to acceptable and prevailing
standards of care by reason of mental illness or physical illness,
including physical deterioration that adversely affects cognitive,
motor, or perceptive skills;

(5)
Impairment of ability to practice according to acceptable and
prevailing standards of care because of substance use disorder or
excessive use or abuse of drugs, alcohol, or other substances that
may impair ability to practice;

(6)
Administering drugs for purposes other than those authorized under
this chapter;

(7)
Willfully betraying a professional confidence;

(8)
Making a false, fraudulent, deceptive, or misleading statement in
soliciting or advertising for employment as a physician assistant; in
connection with any solicitation or advertisement for patients; in
relation to the practice of medicine as it pertains to physician
assistants; or in securing or attempting to secure a license to
practice as a physician assistant.

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

(9)
Representing, with the purpose of obtaining compensation or other
advantage personally or for any other person, that an incurable
disease or injury, or other incurable condition, can be permanently
cured;

(10)
The obtaining of, or attempting to obtain, money or anything of value
by fraudulent misrepresentations in the course of practice;

(11)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for, a
felony;

(12)
Commission of an act that constitutes a felony in this state,
regardless of the jurisdiction in which the act was committed;

(13)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for, a
misdemeanor committed in the course of practice;

(14)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for, a
misdemeanor involving moral turpitude;

(15)
Commission of an act in the course of practice that constitutes a
misdemeanor in this state, regardless of the jurisdiction in which
the act was committed;

(16)
Commission of an act involving moral turpitude that constitutes a
misdemeanor in this state, regardless of the jurisdiction in which
the act was committed;

(17)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for
violating any state or federal law regulating the possession,
distribution, or use of any drug, including trafficking in drugs;

(18)
Any of the following actions taken by the state agency responsible
for regulating the practice of physician assistants in another state,
for any reason other than the nonpayment of fees: the limitation,
revocation, or suspension of an individual's license to practice;
acceptance of an individual's license surrender; denial of a license;
refusal to renew or reinstate a license; imposition of probation; or
issuance of an order of censure or other reprimand;

(19)
A departure from, or failure to conform to, minimal standards of care
of similar physician assistants under the same or similar
circumstances, regardless of whether actual injury to a patient is
established;

(20)
Violation of the conditions placed by the board on a license to
practice as a physician assistant;

(21)
Failure to use universal blood and body fluid precautions established
by rules adopted under section 4731.051 of the Revised Code;

(22)
Failure to cooperate in an investigation conducted by the board under
section 4730.26 of the Revised Code, including failure to comply with
a subpoena or order issued by the board or failure to answer
truthfully a question presented by the board at a deposition or in
written interrogatories, except that failure to cooperate with an
investigation shall not constitute grounds for discipline under this
section if a court of competent jurisdiction has issued an order that
either quashes a subpoena or permits the individual to withhold the
testimony or evidence in issue;

(23)
Assisting suicide, as defined in section 3795.01 of the Revised Code;

(24)
Prescribing any drug or device to perform or induce an abortion, or
otherwise performing or inducing an abortion;

(25)
Failure to comply with section 4730.53 of the Revised Code, unless
the board no longer maintains a drug database pursuant to section
4729.75 of the Revised Code;

(26)
Failure to comply with the requirements in section 3719.061 of the
Revised Code before issuing for a minor a prescription for an opioid
analgesic, as defined in section 3719.01 of the Revised Code;

(27)
Having certification by the national commission on certification of
physician assistants or a successor organization expire, lapse, or be
suspended or revoked;

(28)
The revocation, suspension, restriction, reduction, or termination of
clinical privileges by the United States department of defense or
department of veterans affairs or the termination or suspension of a
certificate of registration to prescribe drugs by the drug
enforcement administration of the United States department of
justice;

(29)
Failure to comply with terms of a consult agreement entered into with
a pharmacist pursuant to section 4729.39 of the Revised Code;

(30)
Violation of section 4730.57 of the Revised Code
;

(31)
Failure to comply with division (B) or (C) of section 4730.46 of the
Revised Code
.

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

(D)
For purposes of divisions (B)(12), (15), and (16) of this section,
the commission of the act may be established by a finding by the
board, pursuant to an adjudication under Chapter 119. of the Revised
Code, that the applicant or license holder committed the act in
question. The board shall have no jurisdiction under these divisions
in cases where the trial court renders a final judgment in the
license holder's favor and that judgment is based upon an
adjudication on the merits. The board shall have jurisdiction under
these divisions in cases where the trial court issues an order of
dismissal upon technical or procedural grounds.

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

(F)
For purposes of this division, any individual who holds a license
issued under this chapter, or applies for a license issued under this
chapter, shall be deemed to have given consent to submit to a mental
or physical examination when directed to do so in writing by the
board and to have waived all objections to the admissibility of
testimony or examination reports that constitute a privileged
communication.

(1)
In enforcing division (B)(4) of this section, the board, upon a
showing of a possible violation, shall refer any individual who
holds, or has applied for, a license issued under this chapter to the
monitoring organization that conducts the confidential monitoring
program established under section 4731.25 of the Revised Code. The
board also may compel the individual to submit to a mental
examination, physical examination, including an HIV test, or both a
mental and physical examination. The expense of the examination is
the responsibility of the individual compelled to be examined.
Failure to submit to a mental or physical examination or consent to
an HIV test ordered by the board constitutes an admission of the
allegations against the individual unless the failure is due to
circumstances beyond the individual's control, and a default and
final order may be entered without the taking of testimony or
presentation of evidence. If the board finds a physician assistant
unable to practice because of the reasons set forth in division
(B)(4) of this section, the board shall require the physician
assistant to submit to care, counseling, or treatment by physicians
approved or designated by the board, as a condition for an initial,
continued, reinstated, or renewed license. An individual affected
under this division shall be afforded an opportunity to demonstrate
to the board the ability to resume practicing in compliance with
acceptable and prevailing standards of care.

(2)
For purposes of division (B)(5) of this section, if the board has
reason to believe that any individual who holds a license issued
under this chapter or any applicant for a license suffers such
impairment, the board shall refer the individual to the monitoring
organization that conducts the confidential monitoring program
established under section 4731.25 of the Revised Code. The board also
may compel the individual to submit to a mental or physical
examination, or both. The expense of the examination is the
responsibility of the individual compelled to be examined. Any mental
or physical examination required under this division shall be
undertaken by a treatment provider or physician qualified to conduct
such examination and approved under section 4731.251 of the Revised
Code.

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

Before
being eligible to apply for reinstatement of a license suspended
under this division, the physician assistant shall demonstrate to the
board the ability to resume practice or prescribing in compliance
with acceptable and prevailing standards of care. The demonstration
shall include the following:

(a)
Certification from a treatment provider approved under section
4731.251 of the Revised Code that the individual has successfully
completed any required inpatient treatment;

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

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

The
board may reinstate a license suspended under this division after
such demonstration and after the individual has entered into a
written consent agreement.

When
the impaired physician assistant resumes practice or prescribing, the
board shall require continued monitoring of the physician assistant.
The monitoring shall include compliance with the written consent
agreement entered into before reinstatement or with conditions
imposed by board order after a hearing, and, upon termination of the
consent agreement, submission to the board for at least two years of
annual written progress reports made under penalty of falsification
stating whether the physician assistant has maintained sobriety.

(G)(1)
If either of the following circumstances occur, the secretary and
supervising member may recommend that the board suspend the
individual's license without a prior hearing:

(a)
The secretary and supervising member determine that there is clear
and convincing evidence that a physician assistant has violated
division (B) of this section and that the individual's continued
practice or prescribing presents a danger of immediate and serious
harm to the public.

(b)
The board receives verifiable information that a licensee has been
charged in any state or federal court with a crime classified as a
felony under the charging court's law and the conduct charged
constitutes a violation of division (B) of this section.

(2)
If a recommendation is made to suspend without a prior hearing
pursuant to division (G)(1) of this section, written allegations
shall be prepared for consideration by the board.

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

The
board shall serve a written order of suspension in accordance with
sections 119.05 and 119.07 of the Revised Code. If the physician
assistant requests an adjudicatory hearing by the board, the date set
for the hearing shall be within fifteen days, but not earlier than
seven days, after the physician assistant requests the hearing,
unless otherwise agreed to by both the board and the license holder.

(3)
A summary suspension imposed under division (G)(2) of this section is
not a final appealable order and is not an adjudication that may be
appealed under section 119.12 of the Revised Code. The summary
suspension shall remain in effect until a final adjudicative order
issued by the board pursuant to this section and Chapter 119. of the
Revised Code becomes effective. Once a final adjudicative order has
been issued by the board, any party adversely affected by it may file
an appeal in accordance with the requirements of Chapter 119. of the
Revised Code.

The
board shall issue its final adjudicative order within seventy-five
days after completion of its hearing. Failure to issue the order
within seventy-five days shall result in dissolution of the summary
suspension order, but shall not invalidate any subsequent, final
adjudicative order.

(H)
If the board takes action under division (B)(11), (13), or (14) of
this section, and the judicial finding of guilt, guilty plea, or
judicial finding of eligibility for intervention in lieu of
conviction is overturned on appeal, upon exhaustion of the criminal
appeal, a petition for reconsideration of the order may be filed with
the board along with appropriate court documents. Upon receipt of a
petition and supporting court documents, the board shall reinstate
the individual's license. The board may then hold an adjudication
under Chapter 119. of the Revised Code to determine whether the
individual committed the act in question. Notice of opportunity for
hearing shall be given in accordance with Chapter 119. of the Revised
Code. If the board finds, pursuant to an adjudication held under this
division, that the individual committed the act, or if no hearing is
requested, it may order any of the sanctions identified under
division (B) of this section.

(I)
The license to practice issued to a physician assistant and the
physician assistant's practice in this state are automatically
suspended as of the date the physician assistant pleads guilty to, is
found by a judge or jury to be guilty of, or is subject to a judicial
finding of eligibility for intervention in lieu of conviction in this
state or treatment or intervention in lieu of conviction in another
state for any of the following criminal offenses in this state or a
substantially equivalent criminal offense in another jurisdiction:
aggravated murder, murder, voluntary manslaughter, felonious assault,
trafficking in persons, kidnapping, rape, sexual battery, gross
sexual imposition, aggravated arson, aggravated robbery, or
aggravated burglary. Continued practice after the suspension shall be
considered practicing without a license.

The
board shall notify the individual subject to the suspension in
accordance with sections 119.05 and 119.07 of the Revised Code. If an
individual whose license is suspended under this division fails to
make a timely request for an adjudication under Chapter 119. of the
Revised Code, the board shall enter a final order permanently
revoking the individual's license to practice.

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

(K)
Any action taken by the board under division (B) of this section
resulting in a suspension shall be accompanied by a written statement
of the conditions under which the physician assistant's license may
be reinstated. The board shall adopt rules in accordance with Chapter
119. of the Revised Code governing conditions to be imposed for
reinstatement. Reinstatement of a license suspended pursuant to
division (B) of this section requires an affirmative vote of not
fewer than six members of the board.

(L)
When the board refuses to grant or issue to an applicant a license to
practice as a physician assistant, revokes an individual's license,
refuses to renew an individual's license, or refuses to reinstate an
individual's license, the board may specify that its action is
permanent. An individual subject to a permanent action taken by the
board is forever thereafter ineligible to hold the license and the
board shall not accept an application for reinstatement of the
license or for issuance of a new license.

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

(1)
The surrender of a license issued under this chapter is not effective
unless or until accepted by the board. Reinstatement of a license
surrendered to the board requires an affirmative vote of not fewer
than six members of the board.

(2)
An application made under this chapter for a license may not be
withdrawn without approval of the board.

(3)
Failure by an individual to renew a license in accordance with
section 4730.14 of the Revised Code does not remove or limit the
board's jurisdiction to take disciplinary action under this section
against the individual.

(4)
The placement of an individual's license on retired status, as
described in section 4730.141 of the Revised Code, does not remove or
limit the board's jurisdiction to take any disciplinary action
against the individual with regard to the license as it existed
before being placed on retired status.

(N)
The board shall not refuse to issue a license to an applicant because
of a conviction, plea of guilty, judicial finding of guilt, judicial
finding of eligibility for intervention in lieu of conviction, or the
commission of an act that constitutes a criminal offense, unless the
refusal is in accordance with section 9.79 of the Revised Code.

Sec.
4730.46.
Beginning
one year after the effective date of this section, a physician
assistant who performs annual physical examinations on individuals
who are nineteen years of age or younger, or who performs
examinations for purposes of division (E) of section 3313.5310 of the
Revised Code, shall do all of the following:

(A)
For each such examination, complete the preparticipation physical
evaluation form created pursuant to division (D) of section 3707.59
of the Revised Code;

(B)
At least once every four years, complete the childhood cardiac
screening professional development module established under section
3707.591 of the Revised Code. The physician assistant shall retain on
file at the physician assistant's primary place of practice a hard
copy of the certificate of completion, and shall make it available to
the state medical board on request.

(C)
At least once every four years, read the guidelines and other
relevant educational materials developed under division (B)(1) of
section 3707.59 of the Revised Code;

(D)
Annually report to the department of health the total number of
examinations for which the preparticipation physical evaluation form
was completed and the total number of cardiology referrals resulting
from those examinations.

Sec.
4731.22.
(A)
The state medical board, by an affirmative vote of not fewer than six
of its members, may limit, revoke, or suspend a license or
certificate to practice or certificate to recommend, refuse to grant
a license or certificate, refuse to renew a license or certificate,
refuse to reinstate a license or certificate, or reprimand or place
on probation the holder of a license or certificate if the individual
applying for or holding the license or certificate is found by the
board to have committed fraud during the administration of the
examination for a license or certificate to practice or to have
committed fraud, misrepresentation, or deception in applying for,
renewing, or securing any license or certificate to practice or
certificate to recommend issued by the board.

(B)
Except as provided in division (P) of this section, the board, by an
affirmative vote of not fewer than six members, shall, to the extent
permitted by law, limit, revoke, or suspend a license or certificate
to practice or certificate to recommend, refuse to issue a license or
certificate, refuse to renew a license or certificate, refuse to
reinstate a license or certificate, or reprimand or place on
probation the holder of a license or certificate for one or more of
the following reasons:

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

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

(3)
Except as provided in section 4731.97 of the Revised Code, selling,
giving away, personally furnishing, prescribing, or administering
drugs for other than legal and legitimate therapeutic purposes or a
plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction of, a
violation of any federal or state law regulating the possession,
distribution, or use of any drug;

(4)
Willfully betraying a professional confidence.

For
purposes of this division, "willfully betraying a professional
confidence" does not include providing any information,
documents, or reports under sections 307.621 to 307.629 of the
Revised Code to a child fatality review board; does not include
providing any information, documents, or reports under sections
307.631 to 307.6410 of the Revised Code to a drug overdose fatality
review committee, a suicide fatality review committee, or hybrid drug
overdose fatality and suicide fatality review committee; does not
include providing any information, documents, or reports under
sections 307.651 to 307.659 of the Revised Code to a domestic
violence fatality review board; does not include providing any
information, documents, or reports to the director of health pursuant
to guidelines established under section 3701.70 of the Revised Code;
does not include written notice to a mental health professional under
section 4731.62 of the Revised Code; does not include making a report
as described in division (F) of section 2921.22 and section 4731.224
of the Revised Code; and does not include the making of a report of
an employee's use of a drug of abuse, or a report of a condition of
an employee other than one involving the use of a drug of abuse, to
the employer of the employee as described in division (B) of section
2305.33 of the Revised Code. Nothing in this division affects the
immunity from civil liability conferred by section 2305.33 or 4731.62
of the Revised Code upon a physician who makes a report in accordance
with section 2305.33 or notifies a mental health professional in
accordance with section 4731.62 of the Revised Code. As used in this
division, "employee," "employer," and "physician"
have the same meanings as in section 2305.33 of the Revised Code.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

In
enforcing this division, the board, upon a showing of a possible
violation, shall refer any individual who is authorized to practice
by this chapter or who has submitted an application pursuant to this
chapter to the monitoring organization that conducts the confidential
monitoring program established under section 4731.25 of the Revised
Code. The board also may compel the individual to submit to a mental
examination, physical examination, including an HIV test, or both a
mental and a physical examination. The expense of the examination is
the responsibility of the individual compelled to be examined.
Failure to submit to a mental or physical examination or consent to
an HIV test ordered by the board constitutes an admission of the
allegations against the individual unless the failure is due to
circumstances beyond the individual's control, and a default and
final order may be entered without the taking of testimony or
presentation of evidence. If the board finds an individual unable to
practice because of the reasons set forth in this division, the board
shall require the individual to submit to care, counseling, or
treatment by physicians approved or designated by the board, as a
condition for initial, continued, reinstated, or renewed authority to
practice. An individual affected under this division shall be
afforded an opportunity to demonstrate to the board the ability to
resume practice in compliance with acceptable and prevailing
standards under the provisions of the individual's license or
certificate. For the purpose of this division, any individual who
applies for or receives a license or certificate to practice under
this chapter accepts the privilege of practicing in this state and,
by so doing, shall be deemed to have given consent to submit to a
mental or physical examination when directed to do so in writing by
the board, and to have waived all objections to the admissibility of
testimony or examination reports that constitute a privileged
communication.

(20)
Except as provided in division (F)(1)(b) of section 4731.282 of the
Revised Code or when civil penalties are imposed under section
4731.225 of the Revised Code, and subject to section 4731.226 of the
Revised Code, violating or attempting to violate, directly or
indirectly, or assisting in or abetting the violation of, or
conspiring to violate, any provisions of this chapter or any rule
promulgated by the board.

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

(21)
The violation of section 3701.79 of the Revised Code or of any
abortion rule adopted by the director of health pursuant to section
3701.341 of the Revised Code;

(22)
Any of the following actions taken by an agency responsible for
authorizing, certifying, or regulating an individual to practice a
health care occupation or provide health care services in this state
or another jurisdiction, for any reason other than the nonpayment of
fees: the limitation, revocation, or suspension of an individual's
license to practice; acceptance of an individual's license surrender;
denial of a license; refusal to renew or reinstate a license;
imposition of probation; or issuance of an order of censure or other
reprimand;

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

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

(25)
Termination or suspension from participation in the medicare or
medicaid programs by the department of health and human services or
other responsible agency;

(26)
Impairment of ability to practice according to acceptable and
prevailing standards of care because of substance use disorder or
excessive use or abuse of drugs, alcohol, or other substances that
may impair ability to practice.

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

If
it has reason to believe that any individual authorized to practice
by this chapter or any applicant for licensure or certification to
practice suffers such impairment, the board shall refer the
individual to the monitoring organization that conducts the
confidential monitoring program established under section 4731.25 of
the Revised Code. The board also may compel the individual to submit
to a mental or physical examination, or both. The expense of the
examination is the responsibility of the individual compelled to be
examined. Any mental or physical examination required under this
division shall be undertaken by a treatment provider or physician who
is qualified to conduct the examination and who is approved under
section 4731.251 of the Revised Code.

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

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

(a)
Certification from a treatment provider approved under section
4731.251 of the Revised Code that the individual has successfully
completed any required inpatient treatment;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(35)
Failure to supervise an anesthesiologist assistant in accordance with
Chapter 4760. of the Revised Code and the board's rules for
supervision of an anesthesiologist assistant;

(36)
Assisting suicide, as defined in section 3795.01 of the Revised Code;

(37)
Failure to comply with the requirements of section 2317.561 of the
Revised Code;

(38)
Failure to supervise a radiologist assistant in accordance with
Chapter 4774. of the Revised Code and the board's rules for
supervision of radiologist assistants;

(39)
Performing or inducing an abortion at an office or facility with
knowledge that the office or facility fails to post the notice
required under section 3701.791 of the Revised Code;

(40)
Failure to comply with the standards and procedures established in
rules under section 4731.054 of the Revised Code for the operation of
or the provision of care at a pain management clinic;

(41)
Failure to comply with the standards and procedures established in
rules under section 4731.054 of the Revised Code for providing
supervision, direction, and control of individuals at a pain
management clinic;

(42)
Failure to comply with the requirements of section 4729.79 or
4731.055 of the Revised Code, unless the state board of pharmacy no
longer maintains a drug database pursuant to section 4729.75 of the
Revised Code;

(43)
Failure to comply with the requirements of section 2919.171,
2919.202, or 2919.203 of the Revised Code or failure to submit to the
department of health in accordance with a court order a complete
report as described in section 2919.171 or 2919.202 of the Revised
Code;

(44)
Practicing at a facility that is subject to licensure as a category
III terminal distributor of dangerous drugs with a pain management
clinic classification unless the person operating the facility has
obtained and maintains the license with the classification;

(45)
Owning a facility that is subject to licensure as a category III
terminal distributor of dangerous drugs with a pain management clinic
classification unless the facility is licensed with the
classification;

(46)
Failure to comply with any of the requirements regarding making or
maintaining medical records or documents described in division (A) of
section 2919.192, division (C) of section 2919.193, division (B) of
section 2919.195, or division (A) of section 2919.196 of the Revised
Code;

(47)
Failure to comply with the requirements in section 3719.061 of the
Revised Code before issuing for a minor a prescription for an opioid
analgesic, as defined in section 3719.01 of the Revised Code;

(48)
Failure to comply with the requirements of section 4731.30 of the
Revised Code or rules adopted under section 4731.301 of the Revised
Code when recommending treatment with medical marijuana;

(49)
A pattern of continuous or repeated violations of division (E)(2) or
(3) of section 3963.02 of the Revised Code;

(50)
Failure to fulfill the responsibilities of a collaboration agreement
entered into with an athletic trainer as described in section
4755.621 of the Revised Code;

(51)
Failure to take the steps specified in section 4731.911 of the
Revised Code following an abortion or attempted abortion in an
ambulatory surgical facility or other location that is not a hospital
when a child is born alive;

(52)
Violation of section 4731.77 of the Revised Code;

(53)
Failure of a physician supervising a certified mental health
assistant to maintain supervision in accordance with the requirements
of Chapter 4772. of the Revised Code and the rules adopted under that
chapter;

(54)
Failure to comply with the requirements of section 3705.16 of the
Revised Code when certifying a decedent's cause of death and
completing and signing the medical certificate of death
;

(55)
Failure to comply with division (B)(2) or (3) of section 4731.89 of
the Revised Code
.

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

A
telephone conference call may be utilized for ratification of a
consent agreement that revokes or suspends an individual's license or
certificate to practice or certificate to recommend. The telephone
conference call shall be considered a special meeting under division
(F) of section 121.22 of the Revised Code.

If
the board takes disciplinary action against an individual under
division (B) of this section for a second or subsequent plea of
guilty to, or judicial finding of guilt of, a violation of section
2919.123 or 2919.124 of the Revised Code, the disciplinary action
shall consist of a suspension of the individual's license or
certificate to practice for a period of at least one year or, if
determined appropriate by the board, a more serious sanction
involving the individual's license or certificate to practice. Any
consent agreement entered into under this division with an individual
that pertains to a second or subsequent plea of guilty to, or
judicial finding of guilt of, a violation of that section shall
provide for a suspension of the individual's license or certificate
to practice for a period of at least one year or, if determined
appropriate by the board, a more serious sanction involving the
individual's license or certificate to practice.

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

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

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

(2)
Investigations of alleged violations of this chapter or any rule
adopted under it shall be supervised by the supervising member
elected by the board in accordance with section 4731.02 of the
Revised Code and by the secretary as provided in section 4731.39 of
the Revised Code. The president may designate another member of the
board to supervise the investigation in place of the supervising
member. Upon a vote of the majority of the board to authorize the
addition of a consumer member in the supervision of any part of any
investigation, the president shall designate a consumer member for
supervision of investigations as determined by the president. The
authorization of consumer member participation in investigation
supervision may be rescinded by a majority vote of the board. No
member of the board who supervises the investigation of a case shall
participate in further adjudication of the case.

(3)
In investigating a possible violation of this chapter or any rule
adopted under this chapter, or in conducting an inspection under
division (E) of section 4731.054 of the Revised Code, the board may
question witnesses, conduct interviews, administer oaths, order the
taking of depositions, inspect and copy any books, accounts, papers,
records, or documents, issue subpoenas, and compel the attendance of
witnesses and production of books, accounts, papers, records,
documents, and testimony, except that a subpoena for patient record
information shall not be issued without consultation with the
attorney general's office and approval of the secretary of the board.

(a)
Before issuance of a subpoena for patient record information, the
secretary shall determine whether there is probable cause to believe
that the complaint filed alleges a violation of this chapter or any
rule adopted under it and that the records sought are relevant to the
alleged violation and material to the investigation. The subpoena may
apply only to records that cover a reasonable period of time
surrounding the alleged violation.

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

(c)
A subpoena issued by the board may be served by a sheriff, the
sheriff's deputy, or a board employee or agent designated by the
board. Service of a subpoena issued by the board may be made by
delivering a copy of the subpoena to the person named therein,
reading it to the person, or leaving it at the person's usual place
of residence, usual place of business, or address on file with the
board. When serving a subpoena to an applicant for or the holder of a
license or certificate issued under this chapter, service of the
subpoena may be made by certified mail, return receipt requested, and
the subpoena shall be deemed served on the date delivery is made or
the date the person refuses to accept delivery. If the person being
served refuses to accept the subpoena or is not located, service may
be made to an attorney who notifies the board that the attorney is
representing the person.

(d)
A sheriff's deputy who serves a subpoena shall receive the same fees
as a sheriff. Each witness who appears before the board in obedience
to a subpoena shall receive the fees and mileage provided for under
section 119.094 of the Revised Code.

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

(5)
A report required to be submitted to the board under this chapter, a
complaint, or information received by the board pursuant to an
investigation or pursuant to an inspection under division (E) of
section 4731.054 of the Revised Code is confidential and not subject
to discovery in any civil action.

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

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

No
person shall knowingly access, use, or disclose confidential
investigatory information in a manner prohibited by law.

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

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

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

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

(d)
Whether witnesses were interviewed;

(e)
Whether the individual against whom the complaint is directed is the
subject of any pending complaints;

(f)
The disposition of the case.

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

(7)
The board may provide a status update regarding an investigation to a
complainant on request if the board verifies the complainant's
identity.

(G)(1)
If either of the following circumstances occur, the secretary and
supervising member may recommend that the board suspend an
individual's license or certificate to practice or certificate to
recommend without a prior hearing:

(a)
The secretary and supervising member determine both of the following:

(i)
That there is clear and convincing evidence that an individual has
violated division (B) of this section;

(ii)
That the individual's continued practice presents a danger of
immediate and serious harm to the public.

(b)
The board receives verifiable information that a licensee has been
charged in any state or federal court with a crime classified as a
felony under the charging court's law and the conduct constitutes a
violation of division (B) of this section.

(2)
If a recommendation is made to suspend without a prior hearing
pursuant to division (G)(1) of this section, written allegations
shall be prepared for consideration by the board. The board, upon
review of those allegations and by an affirmative vote of not fewer
than six of its members, excluding the secretary and supervising
member, may suspend a license or certificate without a prior hearing.
A telephone conference call may be utilized for reviewing the
allegations and taking the vote on the summary suspension.

The
board shall serve a written order of suspension in accordance with
sections 119.05 and 119.07 of the Revised Code. If the individual
subject to the summary suspension requests an adjudicatory hearing by
the board, the date set for the hearing shall be within fifteen days,
but not earlier than seven days, after the individual requests the
hearing, unless otherwise agreed to by both the board and the
individual.

(3)
Any summary suspension imposed under division (G)(2) of this section
is not a final appealable order and is not an adjudication that may
be appealed under section 119.12 of the Revised Code. The summary
suspension shall remain in effect until a final adjudicative order
issued by the board pursuant to this section and Chapter 119. of the
Revised Code becomes effective. Once a final adjudicative order has
been issued by the board, any party adversely affected by it may file
an appeal in accordance with the requirements of Chapter 119. of the
Revised Code.

The
board shall issue its final adjudicative order within seventy-five
days after completion of its hearing. A failure to issue the order
within seventy-five days shall result in dissolution of the summary
suspension order but shall not invalidate any subsequent, final
adjudicative order.

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

(I)
The license or certificate to practice issued to an individual under
this chapter and the individual's practice in this state are
automatically suspended as of the date of the individual's second or
subsequent plea of guilty to, or judicial finding of guilt of, a
violation of section 2919.123 or 2919.124 of the Revised Code. In
addition, the license or certificate to practice or certificate to
recommend issued to an individual under this chapter and the
individual's practice in this state are automatically suspended as of
the date the individual pleads guilty to, is found by a judge or jury
to be guilty of, or is subject to a judicial finding of eligibility
for intervention in lieu of conviction in this state or treatment or
intervention in lieu of conviction in another jurisdiction for any of
the following criminal offenses in this state or a substantially
equivalent criminal offense in another jurisdiction: aggravated
murder, murder, voluntary manslaughter, felonious assault,
trafficking in persons, kidnapping, rape, sexual battery, gross
sexual imposition, aggravated arson, aggravated robbery, or
aggravated burglary. Continued practice after suspension shall be
considered practicing without a license or certificate.

The
board shall notify the individual subject to the suspension in
accordance with sections 119.05 and 119.07 of the Revised Code. If an
individual whose license or certificate is automatically suspended
under this division fails to make a timely request for an
adjudication under Chapter 119. of the Revised Code, the board shall
do whichever of the following is applicable:

(1)
If the automatic suspension under this division is for a second or
subsequent plea of guilty to, or judicial finding of guilt of, a
violation of section 2919.123 or 2919.124 of the Revised Code, the
board shall enter an order suspending the individual's license or
certificate to practice for a period of at least one year or, if
determined appropriate by the board, imposing a more serious sanction
involving the individual's license or certificate to practice.

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

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

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

(L)
When the board refuses to grant or issue a license or certificate to
practice to an applicant, revokes an individual's license or
certificate to practice, refuses to renew an individual's license or
certificate to practice, or refuses to reinstate an individual's
license or certificate to practice, the board may specify that its
action is permanent. An individual subject to a permanent action
taken by the board is forever thereafter ineligible to hold a license
or certificate to practice and the board shall not accept an
application for reinstatement of the license or certificate or for
issuance of a new license or certificate.

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

(1)
The surrender of a license or certificate issued under this chapter
shall not be effective unless or until accepted by the board. A
telephone conference call may be utilized for acceptance of the
surrender of an individual's license or certificate to practice. The
telephone conference call shall be considered a special meeting under
division (F) of section 121.22 of the Revised Code. Reinstatement of
a license or certificate surrendered to the board requires an
affirmative vote of not fewer than six members of the board.

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

(3)
Failure by an individual to renew a license or certificate to
practice in accordance with this chapter or a certificate to
recommend in accordance with rules adopted under section 4731.301 of
the Revised Code does not remove or limit the board's jurisdiction to
take any disciplinary action under this section against the
individual.

(4)
The placement of an individual's license on retired status, as
described in section 4731.283 of the Revised Code, does not remove or
limit the board's jurisdiction to take any disciplinary action
against the individual with regard to the license as it existed
before being placed on retired status.

(5)
At the request of the board, a license or certificate holder shall
immediately surrender to the board a license or certificate that the
board has suspended, revoked, or permanently revoked.

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

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

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

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

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

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

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

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

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

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

(P)
The board shall not refuse to issue a license to an applicant because
of a conviction, plea of guilty, judicial finding of guilt, judicial
finding of eligibility for intervention in lieu of conviction, or the
commission of an act that constitutes a criminal offense, unless the
refusal is in accordance with section 9.79 of the Revised Code.

(Q)
A license or certificate to practice or certificate to recommend
issued to an individual under this chapter and an individual's
practice under this chapter in this state are automatically suspended
if the individual's license or certificate to practice a health care
occupation or provide health care services is suspended, revoked, or
surrendered or relinquished in lieu of discipline by an agency
responsible for authorizing, certifying, or regulating an individual
to practice a health care occupation or provide health care services
in this state or another jurisdiction. The automatic suspension
begins immediately upon entry of the order by the agency and lasts
for ninety days to permit the board to investigate the basis for the
action under this chapter. Continued practice during the automatic
suspension shall be considered practicing without a license or
certificate.

The
board shall notify the individual subject to the automatic suspension
by certified mail or in person in accordance with section 119.07 of
the Revised Code. If an individual subject to an automatic suspension
under this division fails to make a timely request for an
adjudication under Chapter 119. of the Revised Code, the board is not
required to hold a hearing, but may adopt, by an affirmative vote of
not fewer than six of its members, a final order that contains the
board's findings. In that final order, the board may order any of the
sanctions identified under division (A) or (B) of this section.

Sec.
4731.281.
(A)(1)
A license issued under this chapter to practice medicine and surgery,
osteopathic medicine and surgery, or podiatric medicine and surgery
shall be valid for a two-year period unless revoked or suspended. A
license shall expire on the date that is two years from the date of
issuance and may be renewed for additional two-year periods.
Applications for renewal shall be submitted to the state medical
board in a manner prescribed by the board.
Each
renewal application shall include a check box for a physician who is
subject to section 4731.89 of the Revised Code to certify compliance
with divisions (B)(2) and (3) of that section.

Each
application shall be accompanied by a biennial renewal fee of three
hundred five dollars.

The
board shall deposit the fee in accordance with section 4731.24 of the
Revised Code, except that the board shall deposit twenty dollars of
the fee into the state treasury to the credit of the physician loan
repayment fund created by section 3702.78 of the Revised Code.

(2)
The board shall provide a renewal notice to every person holding a
license to practice medicine and surgery, osteopathic medicine and
surgery, or podiatric medicine and surgery, a renewal notice. The
board may provide the notice to the person through the secretary of
any recognized medical, osteopathic, or podiatric society. The notice
shall be provided to the person at least one month prior to the date
on which the person's license expires.

(3)
Failure of any person to receive a notice of renewal from the board
shall not excuse the person from the requirements contained in this
section.

(4)
The board's notice shall inform the applicant of the renewal
procedure. The board shall provide the application for renewal in a
form determined by the board.

(5)
The applicant shall provide in the application the applicant's full
name; the applicant's residence address, business address, and
electronic mail address; the number of the applicant's license to
practice; and any other information required by the board.

(6)(a)
Except as provided in division (A)(6)(b) of this section, in the case
of an applicant who prescribes or personally furnishes opioid
analgesics or benzodiazepines, as defined in section 3719.01 of the
Revised Code, the applicant shall certify to the board whether the
applicant has been granted access to the drug database established
and maintained by the state board of pharmacy pursuant to section
4729.75 of the Revised Code.

(b)
The requirement described in division (A)(6)(a) of this section does
not apply if any of the following is the case:

(i)
The state board of pharmacy notifies the state medical board pursuant
to section 4729.861 of the Revised Code that the applicant has been
restricted from obtaining further information from the drug database.

(ii)
The state board of pharmacy no longer maintains the drug database.

(iii)
The applicant does not practice medicine and surgery, osteopathic
medicine and surgery, or podiatric medicine and surgery in this
state.

(c)
If an applicant certifies to the state medical board that the
applicant has been granted access to the drug database and the board
finds through an audit or other means that the applicant has not been
granted access, the board may take action under section 4731.22 of
the Revised Code.

(7)
The applicant shall indicate whether the applicant currently
collaborates, as that term is defined in section 4723.01 of the
Revised Code, with any clinical nurse specialists, certified
nurse-midwives, or certified nurse practitioners.

(8)
The applicant shall report any criminal offense to which the
applicant has pleaded guilty, of which the applicant has been found
guilty, or for which the applicant has been found eligible for
intervention in lieu of conviction, since last submitting an
application for a license to practice or renewal of a license.

(9)
The applicant shall execute and deliver the application to the board
in a manner prescribed by the board.

(B)
The board shall renew a license under this chapter to practice
medicine and surgery, osteopathic medicine and surgery, or podiatric
medicine and surgery upon application and qualification therefor in
accordance with this section. A renewal shall be valid for a two-year
period.

(C)
Failure of any license holder to renew and comply with this section
shall operate automatically to suspend the holder's license to
practice and if applicable, the holder's certificate to recommend
issued under section 4731.30 of the Revised Code. Continued practice
after the suspension shall be considered as practicing in violation
of section 4731.41, 4731.43, or 4731.60 of the Revised Code.

If
the license has been suspended pursuant to this division for two
years or less, it may be reinstated. The board shall reinstate a
license to practice suspended for failure to renew upon an
applicant's submission of a renewal application and payment of a
reinstatement fee of four hundred five dollars.

If
the license has been suspended pursuant to this division for more
than two years, it may be restored. Subject to section 4731.222 of
the Revised Code, the board may restore a license to practice
suspended for failure to renew upon an applicant's submission of a
restoration application, payment of a restoration fee of five hundred
five dollars, and compliance with sections 4776.01 to 4776.04 of the
Revised Code. The board shall not restore to an applicant a license
unless the board, in its discretion, decides that the results of the
criminal records check do not make the applicant ineligible for a
license issued pursuant to section 4731.14 or 4731.56 of the Revised
Code.

Any
reinstatement or restoration of a license to practice under this
section shall operate automatically to renew the holder's certificate
to recommend.

(D)
The state medical board may obtain information not protected by
statutory or common law privilege from courts and other sources
concerning malpractice claims against any person holding a license to
practice under this chapter or practicing as provided in section
4731.36 of the Revised Code.

(E)
Each renewal notice provided by the board under division (A)(2) of
this section to a person holding a license to practice medicine and
surgery or osteopathic medicine and surgery shall inform the
applicant of the reporting requirement established by division (H) of
section 3701.79 of the Revised Code. At the discretion of the board,
the information may be included on the application for renewal or on
an accompanying page.

(F)
Each person holding a license to practice medicine and surgery,
osteopathic medicine and surgery, or podiatric medicine and surgery
shall give notice to the board of a change in the license holder's
residence address, business address, or electronic mail address not
later than thirty days after the change occurs.

Sec.
4731.89.
(A)
As used in this section, "physician" means an individual
authorized under this chapter to practice medicine and surgery or
osteopathic medicine and surgery.

(B)
Beginning one year after the effective date of this section, a
physician who performs annual physical examinations on individuals
who are nineteen years of age or younger, or who performs
examinations for purposes of division (E) of section 3313.5310 of the
Revised Code, shall do all of the following:

(1)
For each such examination, complete the preparticipation physical
evaluation form created pursuant to division (D) of section 3707.59
of the Revised Code;

(2)
At least once every four years, complete the childhood cardiac
screening professional development module established under section
3707.591 of the Revised Code. The physician shall retain on file at
the physician's primary place of practice a hard copy of the
certificate of completion, and shall make it available to the state
medical board on request.

(3)
At least once every four years, read the guidelines and other
relevant educational materials developed under division (B)(1) of
section 3707.59 of the Revised Code;

(4)
Annually report to the department of health the total number of
examinations for which the preparticipation physical evaluation form
was completed and the total number of cardiology referrals resulting
from those examinations.

Sec.
5164.21.
(A)
A medicaid provider who is a physician to which section 4731.89 of
the Revised Code applies, and who fails to comply with division
(B)(2) or (3) of that section, shall not seek payment from the
medicaid program for any examination to which the failure applies.
Any such physician shall not collect from or bill a medicaid
recipient for any examination for which this division prohibits the
physician from seeking payment from the medicaid program.

(B)
A medicaid provider who is an advanced practice registered nurse to
which section 4723.484 of the Revised Code applies, and who fails to
comply with division (B) or (C) of that section, shall not seek
payment from the medicaid program for any examination to which the
failure applies. Any such advanced practice registered nurse shall
not collect from or bill a medicaid recipient for any examination for
which this division prohibits the physician from seeking payment from
the medicaid program.

(C)
A medicaid provider who is a physician assistant to which section
4730.46 of the Revised Code applies, and who fails to comply with
division (B) or (C) of that section, shall not seek payment from the
medicaid program for any examination to which the failure applies.
Any such physician assistant shall not collect from or bill a
medicaid recipient for any examination for which this division
prohibits the physician from seeking payment from the medicaid
program.

Section
2.
That
existing sections 3313.5310, 3707.58, 3707.59, 4723.24, 4723.28,
4730.14, 4730.25, 4731.22,

and

4731.281 of the Revised Code are hereby repealed.

Section
3.
The
amendment or enactment by this act of sections 3313.5310, 3707.58,
3707.59, 3707.591, 3707.592, 4723.24, 4723.28, 4723.484, 4730.14,
4730.25, 4730.46, 4731.22, 4731.281, 4731.89, and 5164.21 of the
Revised Code shall be known as the Healthy Cardiac Monitoring Act.