Additional Resources

• Statutes & Rules

  Indiana Statutes

  Title 25 Article 1  - Professions and Occupations

  Title 25 Article 1 Chapter 9 - Health Professions Standards of Practice

  Title 25 Article 22.5 - Physicians

  Indiana Administrative Rules

  Title 760 Article 1, Rule 71 - Copies of Medical Records

  Title 844 Article 1 - General Provisions

• Board Approved Psychiatrists & Addictionologists

  BOARD APPROVED PSYCHIATRISTS* by City, Name                            revised: 02.22.2016

  City	Specialty Name	Practitioner and Phone #	Notes/Others
  Anderson	Psychiatrist	Andrew Skinner, M.D.  765-646-8444	ASAM Certified
  Bloomington	Psychiatrist	Joel Griffith, M.D.  812-353-3450
  Carmel	Psychiatrist	Christopher D. Bojrab, M.D. 317-843-9922	ASAM Certified
  Carmel	Psychiatrist	Ned Masbaum, M.D. 317-846-7727
  Danville	Psychiatrist	Gabe Gachaw, M.D.  317-272-2190
  Ft. Wayne	Psychiatrist	Prevesh Rustagi, M.D. 260-484-1312
  Indianapolis	Psychiatrist	Judith Cecil, M.D. 317-355-5009
  Indianapolis	Psychiatrist	Elizabeth Cunningham, M.D. 317-621-6090
  Indianapolis	Psychiatrist	Anne Gilbert, M.D. 317-329-7300
  Indianapolis	Psychiatrist	Tracy D. Gunter, M.D. 317-963-7300
  Indianapolis	Psychiatrist	P. Ryan Moe, M.D. 317-788-6560	ASAM Certified
  Indianapolis	Psychiatrist	George F. Parker, M.D. 317-278-4120
  Indianapolis	Psychiatrist	Amy K. Ricke, M.D.  317-843-9922
  Lafayette	Psychiatrist	Nizar El-Khalili, M.D. 317-448-4535	added quals. w/substance abuse & addiction medicine
  Louisville, KY	Psychiatrist	Daniel Hackman, M.D.  502-509-3708
  Mishawaka	Psychiatrist	David Sonego, M.D. 574-271-8222
  South Bend	Psychiatrist	Kearn Hinchman, D.O.  574-258-6316

  *This list represents individuals whom the Medical Licensing Board of Indiana has recognized as service providers for Board mandated evaluations. The provision of this list does not in any way imply that individuals may not choose an alternate to provide similar services with Board approval. The Board does not guarantee your satisfaction with the services provided by any these practitioners.

• Physician Assessment and Remedial Education Programs
  • Directory of Physician Assessment and Remedial Education Programs
• High Breast Density Information

  This page is being provided as an educational resource on high breast density, pursuant to 844 IAC 16.  The Board does not make any claims with regard to these links.  Please consult with a healthcare provider to discuss treatment and evaluation that is appropriate for you.

  • 844 IAC 16 High Breast Density Guidelines
  • Go to "Are You Dense.org"
  • Densebreast-info.org
  • American College of Radiology - Breast Density Guide
  • American Cancer Society - Breast Density Guide
  • Breastdensity.info
  • National Cancer Institute
  • U.S. Preventative Services Taskforce Guidelines
• LCME Standards

  Standards for Accreditation of Medical Education Programs Leading to M.D. Degree

  To obtain information concerning the LCME Standards please visit the LCME website.  LCME standards can be found here http://lcme.org/publications/.

• Office Based Procedures

  The information below is provided as a resource only.  This does not constitute legal advice.  For assistance in interpreting and applying this rule please consult with private counsel.

  844 IAC 5-5 Standards for Procedures Performed in Office-Based Setting that Require Moderate Sedation/Analgesia, Deep Sedation/Analgesia, General Anesthesia, or Regional Anesthesia

  Accrediting Agencies

  • AAAASF (QuadASF) – American Association for Accreditation of Ambulatory Surgery Facilities, Inc.
  • AAAHC (TripleAHC) – Accreditation Association for Ambulatory Health Care, Inc.
  • JC – Joint Commission
  • HFAP – Health Facilities Accreditation Program

  Frequently Asked Questions

  • Question - What type of accreditation is needed to perform procedures that require anesthesia in an office-based setting?
    • Answer - A physician may not perform or supervise a procedure that requires anesthesia in an office-based setting unless the office-based setting is accredited by an accreditation agency approved by the board.
  • Question - What is the purpose of the accreditation?
    • Because sedation is a continuum, it is not always possible to predict how a patient will respond.  Physicians administering sedation must be able to rescue a patient whose level of sedation becomes deeper than initially intended.  Physicians administering anesthesia, or supervising or directing the administration of anesthesia, must be knowledgeable about the risks and the interventions required for correcting any adverse physiological consequences that may occur.
  • Question - What accrediting bodies are approved by the Medical Licensing Board?
    • Answer -The following have been approved by the Board to offer this accreditation:
      • (QuadASF) – American Association for Accreditation of Ambulatory Surgery Facilities, Inc.
      • (TripleAHC) – Accreditation Association for Ambulatory Health Care, Inc.
      • Joint Commission
      • (HFAP) Health Facilities Accreditation Program
  • Question - What is considered an “Office-based Setting?”
    • Answer -Office based setting means any facility, clinic, center, office or other setting where procedures are performed that require anesthesia, which includes the following types:  moderate sedation/analgesia, deep sedation/analgesia, general anesthesia or regional anesthesia.  This term does NOT include a hospital operated by the federal government or a setting licensed under IC 16-21-2 as a hospital, ambulatory surgical center, abortion clinic or birthing center.
  • Question - How do I know if I need this accreditation?
    • Answer -If your office based setting described above is administering moderate sedation/analgesia, deep sedation/analgesia, general anesthesia, or regional anesthesia, you will need to be accredited. Accreditation is not required for the administration of local anesthesia, topical anesthesia, superficial nerve blocks, or minimal sedation/anxiolysis.
  • Question - What is the definition of the above types of anesthesia or sedation?
    • Answers -
      • “moderate sedation/analgesia" (also sometimes called "conscious sedation") means a drug induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation.
        The following are conditions that a patient under moderate sedation/analgesia may experience:
        1. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate.
        2. Cardiovascular function is usually maintained.
      • “deep sedation/analgesia" means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. For purposes of this rule, reflex withdrawal from a painful stimulus is not considered a purposeful response.
        The following are conditions that a patient under deep sedation/analgesia may experience:
        1. The ability to independently maintain ventilatory function may be impaired.
        2. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate.
        3. Cardiovascular function is usually maintained.
      • "general anesthesia" means a drug-induced loss of consciousness during which patients are not arousable, even by pain stimulation.
        The following are conditions that a patient under general anesthesia may experience:
        1. The ability to independently maintain ventilatory function is often impaired.
        2. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function.
        3. Cardiovascular function may be impaired.
      • "regional anesthesia" means the administration of anesthetic agents to a patient to interrupt nerve impulses without the loss of consciousness and includes the following:
        1. Major conduction blocks, such as:
           (A) epidural;
           (B) spinal; and
           (C) caudal;
        2. Peripheral nerve blocks, such as:
           (A) brachial;
           (B) lumbar plexus;
           (C) peribulbar; and
           (D) retrobulbar;
        3. Intravenous regional anesthesia, such as Bier blocks.
           Notwithstanding section 2 of this rule, a superficial nerve block or application of a local anesthetic agent in which the total dosage administered exceeds the recommended maximum dosage per body weight described in the manufacturer's package insert shall be considered regional anesthesia for purposes of this rule.
  • Question - Do I need accreditation if I am administering local anesthesia, topical anesthesia, superficial nerve blocks or minimal sedation/anxiolysis?
    • Answer - No, accreditation is not required.  Those are defined as the following:
      • "local anesthesia" means a transient and reversible loss of sensation in a circumscribed portion of the body produced by:  
        1. a local anesthetic agent; or
        2. cooling a circumscribed area of the skin.
           (The term includes subcutaneous infiltration of an agent.)
      • “topical anesthesia" means a transient and reversible loss of sensation to a circumscribed area produced by an anesthetic agent applied directly or by spray to the skin or mucous membranes.
      • "superficial nerve block" means an agent placed in the proximity of any nerve or group of nerves outside of the vertebral canal to produce a loss of sensation in an anatomic or circumscribed area. The term is limited to the following blocks:
        1. ankle;
        2. metacarpal;
        3. digit; and
        4. paracervical;
      • "minimal sedation/anxiolysis" means a drug-induced state during which a patient responds normally to verbal commands. Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are usually not affected.
  • Question - What else is required of a physician?
    • Answers - 
      • A physician who performs a procedure that requires anesthesia in an office-based setting, or who directs or supervises the administration of anesthesia in an office-based setting, must have:
      • Admitting privileges at a nearby hospital;
      • A transfer agreement with another practitioner who has admitting privileges at a nearby hospital;
      • An emergency transfer agreement with a nearby hospital.
      • Agreements with local emergency medical services (EMS) for the purposes of transfer of patients to the hospital in case of an emergency.
• Indiana State Medical Association Physician Assistance Program (ISMAPAP, Impaired Physicians Program)
  • Physician Assistance Program
• Practice Related FAQs

  This information is provided as a resource only and does not constitute legal advice.  For legal advice please consult with an attorney.

  • Question - I am concerned that I may have a problem with alcohol/drug impairment or abuse.  Where can I go to get help?
    • Answers - You should contact  the Indiana State Medical Association Physician Assistance Program, immediately at (317) 261-2060.  For more information go to ISMA Website.  Peer review laws allow for a physician to get assistance without the risk of license discipline as long as they are compliant with ISMA’s treatment recommendations.
  • Question - If I suspect that a colleague has violated the medical practice act, am I obligated to report it?
    • Answers - A practitioner who has personal knowledge based upon a reasonable belief that another practitioner holding the same licenses has engaged in illegal, unlawful, incompetent, or fraudulent conduct in the practice of medicine SHALL promptly report such conduct to either a peer assistance program, the Board or the Office of the Attorney General.
  • Question - I am going to close my practice what do I need to do?
    • Answers - See 844 IAC 5-2-16  which includes in part the following:
      • (a) A practitioner, upon his/her retirement, or upon discontinuation of the practice of medicine or osteopathic medicine, or upon leaving or moving from a community, shall notify all of his/her active patients in writing, or by publication once a week for three (3) consecutive weeks in a newspaper of general circulation in the community, that he/she intends to discontinue his/her practice of medicine or osteopathic medicine in the community, and shall encourage his/her patients to seek the services of another practitioner, provided, however, that this section shall not apply to practitioners solely engaged in internship, residency, preceptorship, fellowship, teaching, or other postgraduate medical education or training programs. The practitioner discontinuing his/her practice shall make reasonable arrangements with his/her active patients for the transfer of his/her records, or copies thereof, to the succeeding practitioner, or to a program conducted by a medical society or association approved by the medical licensing board.
      • You may also contact the Indiana State Medical Association as they have written information explaining what steps a physician needs to take to retire/close a practice.  You can contact ISMA at (317) 261-2060
  • Question - I am located in another state and will be reading x-rays or tests of a patient in Indiana.  Do I need an Indiana license to perform this?
    • Answers - Please review IC 25-22.5-1-1.1
      • “Practice of medicine or osteopathic medicine” means any one or a combination of the following:
        (4) Providing diagnostic or treatment services to a person in Indiana when the diagnostic or treatment services:
        (a) are transmitted through electronic communications; and
        (b) are on a regular, routine, and non-episodic basis or under an oral or written agreement to regularly provide medical services……etc.
      • If you meet 4a & b above you would need a license in Indiana before proceeding.  If you are unsure you should consult your own counsel.
  • Question - I have just settled a malpractice action; do I need to report this to the Board?
    • Answers - All malpractice settlements and/or judgments must be reported on the renewal following the settlement/judgment.  You do not need to report it prior to that.
• Scope of Practice Rulings

  Licensed practitioners that have a specific question or questions about the scope of practice of their licensed profession may request a "practice ruling" from the Indiana Professional Licensing Agency (PLA) and the Medical Licensing Board of Indiana (the Board). The PLA and the Board may provide a formal determination/interpretation based on the practitioner's factual situations/circumstances. Licensed practitioners may submit a "Request for Practice Ruling" through the web-based form provided on the PLA's "Request for Practice Ruling" web page. Additional information and instructions for submitting a "Request for Practice Ruling " are provided on the web page.

  All requests will be reviewed by the PLA's legal team, and PLA's legal team will draft a ruling for the Board's consideration and potential adoption. All rulings adopted by the Board will be posted to the Indiana Register as well as the comprehensive list provided on the the PLA's "Request for Practice Ruling" web page.