Indiana

Prior authorization requirements are up to the discretion of the state Medicaid program or insurance company.

Indiana credentials two types of addiction counselors. A Licensed Addiction Counselor requires a bachelor’s degree with relevant education and two years of post-degree experience. A Licensed Clinical Addiction Counselor requires a master’s or doctoral degree with relevant education and two years of post-degree experience. Ind. Code §25-23.6-10.5 and Indiana Professional Licensing Agency

Licensed mental health counselors use counseling to provide a mental health diagnosis and treat emotional and mental problems and conditions in a variety of settings, including mental and physical health facilities, child and family service agencies, or private practice, and including the use of accepted evaluation classifications. Ind. Code §25-23.6-1-7.5

The standards and requirements for the certification of recovery specialists and peer addiction recovery coaches (I and II) are developed and administered by third-party, non-profit certification providers.

Physician relationship required for practice and prescriptive authority.

A collaboration agreement is required that sets forth the manner in which the NP and the supervising physician will cooperate, coordinate and consult with each other in the provision of health care to patients. Provisions must include the type of collaboration and timely review of prescribing practices. A nurse midwife shall perform as an independent and interdependent member of the health care team. Ind. Code §25-23-1-19.4

An APRN may be authorized to prescribe legend drugs, including controlled substances if the APRN submits an application to the board, submits proof of holding an active, unrestricted license, has completed a graduate level pharmacology course (at least two semester hours) and has submitted proof of the collaboration agreement.  848 Ind. Admin. Code §3-3-1; 848 Ind. Admin. Code §5-1-1

Physician relationship required for practice and prescriptive authority.

A collaboration agreement is required that sets forth the manner in which the NP and the supervising physician will cooperate, coordinate and consult with each other in the provision of health care to patients. Provisions must include the type of collaboration and timely review of prescribing practices. 848 Ind. Admin. Code §5-1-1(7)

An NP may prescribe prescription drugs and Schedules II-V controlled substances if outlined in the written collaboration agreement and after certain requirements are met. 848 Ind. Admin. Code §5-1-1

In addition to physicians, NPs may sign physician order for scope of treatment forms. Ind. Code Ann. §16-36-6

NPs are not explicitly recognized in state policy as primary care providers.

Optometrists may perform all procedures included in their full scope of practice. This includes surgical procedures and laser privileges. Ind. Code §25-24-1-4

The practice of optometry is hereby defined to be any one of the following acts, or any combination of, or part of the following acts:

(a) The examination or diagnosis of the human eye, to ascertain the presence of abnormal conditions or functions which may be diagnosed, corrected, remedied or relieved, or the application or prescription of lenses, prisms, exercises, or any physical, mechanical, physiological or psychological therapy, or the employment of any means, for the purpose of detecting any diseased or pathological condition of the eye, or the effects of any diseased or pathological condition of the eye, which may have any significance in a complete optometric diagnosis of the eye or its associated structures.

(b) The application, use, or adaption of physical, anatomical, physiological, psychological or any other principles through scientific professional methods and devices, to the examination of the eyes and vision, measuring their function for the purpose of determining the nature and degree of their departure from the normal, if any, and adopting optical, physiological and psychological measures and/or the furnishing or providing any prosthetic or therapeutic devices for the emendation thereof.

Optometrists may administer all pharmaceutical agents for the diagnosis and treatment of eye diseases, including epinephrine auto-injections to counter anaphylaxis. Ind. Code §25-24-3-9

Optometrists may not prescribe controlled substances. Ind. Code §25-24-3-16.5

A dental hygienist may practice in any setting or facility that is documented in the dental hygienist’s access practice agreement. Ind. Code §25-13-1-10

Statute does not identify dental therapists as an oral health provider.

Indiana does not explicitly allow for the practice of teledentistry.

A pharmacist may administer the COVID-19 vaccine immunization under a drug order, prescription, or according to a protocol approved by a physician. Ind. Code §25-26-13-31.2

Pharmacists may modify prescriptions after obtaining consent from the patient. The pharmacist may modify the quantity, dosage and complete missing information. Ind. Code §25-26-13-25

Indiana allows pharmacists to prescribe hormonal contraceptives.

A pharmacist may prescribe and dispense hormonal contraceptive patches and self-administered hormonal contraceptives to a woman who is at least eighteen (18) years of age, regardless of whether the woman has evidence of a previous prescription from a primary care practitioner or women’s health care practitioner for a hormonal contraceptive patch or self-administered hormonal contraceptive.
(a) The state health commissioner or designated public health authority shall issue a standing order that concerns standard procedures for the prescribing of hormonal contraceptive patches and self-administered hormonal contraceptives by pharmacists and that is effective until the board adopts rules under this chapter. Ind. Code §25-26-25

Indiana allows for pharmacists to screen, prescribe and dispense appropriate medication for smoking cessation. The individual must be 18 years or older,  ready to quit based on individual assessment and not determined to be high-risk after a health screening. Indiana Standing Order for Tobacco Cessation Products

Collaboration allowed with a physician for practice and prescriptive authority.

A PA must engage in a dependent practice with a collaborating physician and may not be independent from the collaborating physician, including any of the activities of other health care providers. A PA may perform, under a collaborative agreement, the duties and responsibilities that are delegated by the collaborating physician and that are within the collaborating physician’s scope of practice, including prescribing and dispensing drugs and medical devices. IND. CODE § 25-27.5-5-2(a),(b)

A PA’s collaborative agreement with a collaborating physician must specify the protocol the PA shall follow in prescribing a drug. IND. CODE § 25-27.5-5-6

Statute limits the number of PAs a physician may supervise.

A physician may enter into collaborative agreement with more than four (4) PAs but may not collaborate with more than four (4) PAs at the same time. IND. CODE § 25-27.5-6-2

Chart co-signatures are required by statute to practice or prescribe as a PA.

A collaborating physician or physician designee shall review patient encounters not later than ten (10) business days, and within a reasonable time, as established in the collaborative agreement, after the PA has seen the patient, that is appropriate for the maintenance of quality medical care.

The collaborating physician or physician designee shall review within a reasonable time that is not later than ten (10) business days after a patient encounter, that is appropriate for the maintenance of quality medical care, at least the following percentages of the patient charts: (1) For the first year in which a PA  obtains authority to prescribe, at least 10% of the patient’s records for any prescription prescribed or administered by the physician assistant. (2) For each subsequent year of practice of the PA, the percentage of charts that the collaborating physician or physician designee determines to be reasonable for the particular practice setting and level of experience of the physician assistant, as stated in the collaborative agreement, that is appropriate for the maintenance of quality medical care. IND. CODE § 25-27.5-6-1(b)-(c)

Statute allows adaptable proximity.

When the collaborating physician or the physician designee is not physically present at the location at which services are rendered or tasks are performed by the physician assistant, the collaborating physician or the physician designee is able to personally ensure proper care of the patient and is: (A) immediately available through the use of telecommunications or other electronic means; and (B) able to see the person within a medically appropriate time frame; for consultation, if requested by the patient or the PA. IND. CODE § 25-27.5-2-4.9

A collaborating physician or physician designee has the authority to delegate, as the physician determines is appropriate, those tasks or services the physician assistant typically performs and is qualified to perform. Ind. Code §25-27.5-1-2