Bill Text: OH HB200 | 2013-2014 | 130th General Assembly | Introduced

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Bill Title: To modify the notification requirements given by a physician 48 hours prior to the performance or inducement of an abortion, to require the physician to perform an obstetric ultrasound examination 48 hours prior to the performance or inducement of an abortion, to modify the definition of medical emergency that applies to the law regulating abortion, and to eliminate medical necessity as a reason to perform an abortion without complying with the 48-hour notification requirements.

Spectrum: Partisan Bill (Republican 35-0)

Status: (Introduced - Dead) 2013-06-11 - To Health and Aging [HB200 Detail]

Download: Ohio-2013-HB200-Introduced.html

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As Introduced

130th General Assembly Regular Session 2013-2014

H. B. No. 200

Representative Hood 

Cosponsors: Representatives Beck, Young, Huffman, Becker, Terhar, Hill, Blessing, Roegner, Maag, Hottinger, Brenner, Burkley, Schuring, Buchy, Boose, Hayes, Adams, J., Butler, Lynch, Retherford, Stautberg, Thompson, Wachtmann, Blair, Hall, Henne, McClain, Rosenberger, Slaby, Sprague, Johnson, Smith, Scherer, Romanchuk 

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A BILL

To amend sections 2305.11, 2317.56, 2919.171, and

1

4731.22 and to repeal section 2317.561 of the

2

Revised Code to modify the notification

3

requirements given by a physician 48 hours prior

4

to the performance or inducement of an abortion,

5

to require the physician to perform an obstetric

6

ultrasound examination 48 hours prior to the

7

performance or inducement of an abortion, to

8

modify the definition of medical emergency that

9

applies to the law regulating abortion, and to

10

eliminate medical necessity as a reason to perform

11

an abortion without complying with the 48-hour

12

notification requirements.

13

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

Section 1. That sections 2305.11, 2317.56, 2919.171, and	14
4731.22 of the Revised Code be amended to read as follows:	15

Sec. 2305.11.  (A) An action for libel, slander, malicious	16
prosecution, or false imprisonment, an action for malpractice	17
other than an action upon a medical, dental, optometric, or	18
chiropractic claim, or an action upon a statute for a penalty or	19
forfeiture shall be commenced within one year after the cause of	20
action accrued, provided that an action by an employee for the	21
payment of unpaid minimum wages, unpaid overtime compensation, or	22
liquidated damages by reason of the nonpayment of minimum wages or	23
overtime compensation shall be commenced within two years after	24
the cause of action accrued.	25

(B) A civil action for unlawful abortion pursuant to section	26
2919.12 of the Revised Code, a civil action authorized by division	27
(H)(J) of section 2317.56 of the Revised Code, a civil action	28
pursuant to division (B)(1) or (2) of section 2307.51 of the	29
Revised Code for performing a dilation and extraction procedure or	30
attempting to perform a dilation and extraction procedure in	31
violation of section 2919.15 of the Revised Code, and a civil	32
action pursuant to division (B) of section 2307.52 of the Revised	33
Code for terminating or attempting to terminate a human pregnancy	34
after viability in violation of division (A) of section 2919.17 of	35
the Revised Code shall be commenced within one year after the	36
performance or inducement of the abortion, within one year after	37
the attempt to perform or induce the abortion in violation of	38
division (A) of section 2919.17 of the Revised Code, within one	39
year after the performance of the dilation and extraction	40
procedure, or, in the case of a civil action pursuant to division	41
(B)(2) of section 2307.51 of the Revised Code, within one year	42
after the attempt to perform the dilation and extraction	43
procedure.	44

(C) As used in this section, "medical claim," "dental claim,"	45
"optometric claim," and "chiropractic claim" have the same	46
meanings as in section 2305.113 of the Revised Code.	47

Sec. 2317.56.  (A) As used in this section:

48

(1) "Medical emergency" means a condition of a pregnant woman	49
that, in the reasonable judgment of the physician who is attending	50
the woman, creates an immediate threat of serious risk to the life	51
or physical healthso complicates the medical condition of the	52
woman from the continuation ofthat the death of the woman would	53
result from the failure to immediately terminate the pregnancy	54
necessitating the immediate performance or inducement of an	55
abortion.	56

(2) "Medical necessity" means a medical condition of a	57
pregnant woman that, in the reasonable judgment of the physician	58
who is attending the woman, so complicates the pregnancy that it	59
necessitates the immediate performance or inducement of an	60
abortion.	61

(3) "Probable gestational age of the embryo or fetus" means	62
the gestational age that, in the judgment of a physician, is, with	63
reasonable probability, the gestational age of the embryo or fetus	64
at the time that the physician informs a pregnant woman pursuant	65
to division (B)(1)(b) of this section.	66

(3) "Conflict of interest disclaimer" means a written	67
statement divulging the gross income from the previous year of a	68
physician who performs or induces an abortion or of a facility	69
where an abortion is performed or induced, the percentage of that	70
income that was obtained as fees for the performance of an	71
abortion, and a statement concerning the monetary loss to the	72
physician or facility that would result from the woman's decision	73
to carry the woman's pregnancy to term.	74

(4) "Viable pregnancy" means a pregnancy in which a fetal sac	75
is located inside the pregnant woman's uterus and fetal cardiac	76
activity is present within the fetal sac.	77

(B) Except when there is a medical emergency or medical	78
necessity, an abortion shall be performed or induced only if all	79
of the following conditions are satisfied:	80

(1) At least twenty-fourforty-eight hours prior to the	81
performance or inducement of the abortion, a physician meets with	82
the pregnant woman in person in an individual, private setting and	83
gives her an adequate opportunity to ask questions about the	84
abortion that will be performed or induced. At this meeting, the	85
physician shall inform the pregnant woman, verbally or, if she is	86
hearing impaired, by other means of communication,and in writing	87
of all of the following:	88

(a) The nature and purpose of the particular abortion	89
procedure to be used and the medical risks associated with that	90
procedure, including the risk of infection, hemorrhage, cervical	91
or uterine perforation, and infertility, the risk to subsequent	92
pregnancies, and the increased risk of breast cancer;	93

(b) The probable gestational age of the embryo or fetus and	94
the probable anatomical and physiological characteristics of the	95
embryo or fetus at that age;	96

(c) The medical risks associated with the pregnant woman	97
carrying the pregnancy to term.	98

The meeting need not occur at the facility where the abortion	99
is to be performed or induced, and the physician involved in the	100
meeting need not be affiliated with that facility or with the	101
physician who is scheduled to perform or induce the abortion.	102

(2) At least twenty-fourforty-eight hours prior to the	103
performance or inducement of the abortion, one or more physicians	104
or one or more agents of one or more physicians do each of the	105
following in person,or by telephone,and by certified mail,	106
return receipt requested, or by regular mail evidenced by a	107
certificate of mailing:	108

(a) Inform the pregnant woman of the name of the physician	109
who is scheduled to perform or induce the abortion;	110

(b) Give the pregnant woman copies of the published materials	111
described in division (C)(D) of this section;	112

(c) Inform the pregnant woman that the materials given	113
pursuant to division (B)(2)(b) of this section are published by	114
the state and that they describe the embryo or fetus and list	115
agencies that offer alternatives to abortion. The pregnant woman	116
may choose to examine or not to examine the materials. A physician	117
or an agent of a physician may choose to be disassociated from the	118
materials and may choose to comment or not comment on the	119
materials;	120

(d) Provide the pregnant woman with a conflict of interest	121
disclaimer;	122

(e) Perform an obstetric ultrasound examination that portrays	123
the entire body of the embryo or fetus and provide the pregnant	124
woman with all of the following:	125

(i) A verbal description of all relevant features of the	126
ultrasound, including an audible heartbeat, if present;	127

(ii) Upon request and at no additional charge to the pregnant	128
woman, a physical picture of the ultrasound image of the embryo or	129
fetus of a quality consistent with current standard medical	130
practice;	131

(iii) A written document and verbal description stating	132
whether or not the pregnant woman has a viable pregnancy, the	133
location of the fetal sac, and the presence or absence of cardiac	134
activity within the fetal sac. If the pregnancy is not a viable	135
pregnancy, the physician shall advise the pregnant woman that the	136
pregnant woman will suffer a miscarriage with no further	137
intervention unless the physician has evidence to the contrary.	138

(iv) A list of all known obstetric ultrasound providers	139
within a ten-mile radius of the physician who intends to perform	140
or induce the abortion or, if there is no obstetric ultrasound	141
provider within that ten-mile radius, a list of all known	142
obstetric ultrasound providers within a fifty-mile radius of the	143
physician who intends to perform or induce the abortion.	144

(f) Describe the development of nerve endings of the embryo	145
or fetus and the ability of the embryo or fetus to feel pain at	146
each stage of development;	147

(g) Provide the pregnant woman with a statement that the	148
pregnant woman is free to withhold or withdraw the pregnant	149
woman's consent to the abortion at any time without affecting the	150
pregnant woman's right to care or treatment in the future and	151
without the loss of any state or federal benefits to which she may	152
otherwise be entitled;	153

(h) Provide the pregnant woman with any other medical or	154
other information that a reasonable person would consider material	155
to the decision of whether or not to have an abortion.	156

(3) Nothing in this section prohibits a pregnant woman from	157
refusing to listen to the sounds detected by a fetal heart monitor	158
or from refusing to view the images displayed by the obstetric	159
ultrasound examination.	160

(4) Prior to the performance or inducement of the abortion,	161
the pregnant woman signs a form consenting to the abortion and	162
certifies both of the following on that form:	163

(a) She has received the information and materials described	164
in divisions (B)(1) and (2) of this section, and her questions	165
about the abortion that will be performed or induced have been	166
answered in a satisfactory manner.	167

(b) She consents to the particular abortion voluntarily,	168
knowingly, intelligently, and without coercion by any person, and	169
she is not under the influence of any drug of abuse or alcohol.	170

(4)(5) Prior to the performance or inducement of the	171
abortion, the physician who is scheduled to perform or induce the	172
abortion or the physician's agent receives a copy of the pregnant	173
woman's signed form on which she consents to the abortion and that	174
includes the certification required by division (B)(3) of this	175
section;	176

(6) Prior to the performance or inducement of the abortion,	177
the physician who is scheduled to perform or induce the abortion	178
shall provide, under oath and under penalty of perjury, a signed	179
statement that the physician has complied with the requirements of	180
divisions (B)(2), (3), (4), and (5) of this section.	181

(C) The information provided in divisions (B)(2), (3), (4),	182
and (5) of this section shall be provided in a private room, and	183
the pregnant woman shall be provided with sufficient time to ask	184
questions and receive answers that the pregnant woman can	185
understand. If the pregnant woman is unable to read any written	186
materials provided to her, the materials shall be read to her and,	187
if necessary, shall be explained in a way that is understandable	188
to the pregnant woman.	189

(D) The department of health shall publish in English and in	190
Spanish, in a typeface large enough to be clearly legible, and in	191
an easily comprehensible format, the following materials on the	192
department's web site:	193

(1) Materials that inform the pregnant woman about family	194
planning information, of publicly funded agencies that are	195
available to assist in family planning, and of public and private	196
agencies and services that are available to assist her through the	197
pregnancy, upon childbirth, and while the child is dependent,	198
including, but not limited to, adoption agencies. The materials	199
shall be geographically indexed; include a comprehensive list of	200
the available agencies, a description of the services offered by	201
the agencies, and the telephone numbers and addresses of the	202
agencies; and inform the pregnant woman about available medical	203
assistance benefits for prenatal care, childbirth, and neonatal	204
care and about the support obligations of the father of a child	205
who is born alive. The department shall ensure that the materials	206
described in division (C)(D)(1) of this section are comprehensive	207
and do not directly or indirectly promote, exclude, or discourage	208
the use of any agency or service described in this division.	209

(2) Materials, including color photographs, that inform the	210
pregnant woman of the probable anatomical and physiological	211
characteristics of the zygote, blastocyte, embryo, or fetus at	212
two-week gestational increments for the first sixteen weeks of	213
pregnancy and at four-week gestational increments from the	214
seventeenth week of pregnancy to full term, including any relevant	215
information regarding the time at which the fetus possibly would	216
be viable. The department shall cause these materials to be	217
published only after it consults with the Ohio state medical	218
association and the Ohio section of the American college of	219
obstetricians and gynecologists relative to the probable	220
anatomical and physiological characteristics of a zygote,	221
blastocyte, embryo, or fetus at the various gestational	222
increments. The materials shall use language that is	223
understandable by the average person who is not medically trained,	224
shall be objective and nonjudgmental, and shall include only	225
accurate scientific information about the zygote, blastocyte,	226
embryo, or fetus at the various gestational increments. If the	227
materials use a pictorial, photographic, or other depiction to	228
provide information regarding the zygote, blastocyte, embryo, or	229
fetus, the materials shall include, in a conspicuous manner, a	230
scale or other explanation that is understandable by the average	231
person and that can be used to determine the actual size of the	232
zygote, blastocyte, embryo, or fetus at a particular gestational	233
increment as contrasted with the depicted size of the zygote,	234
blastocyte, embryo, or fetus at that gestational increment.	235

(D)(E) Upon the submission of a request to the department of	236
health by any person, hospital, physician, or medical facility for	237
one copy of the materials published in accordance with division	238
(C)(D) of this section, the department shall make the requested	239
copy of the materials available to the person, hospital,	240
physician, or medical facility that requested the copy.	241

(E)(F) If a medical emergency or medical necessity compels	242
the performance or inducement of an abortion, the physician who	243
will perform or induce the abortion, prior to its performance or	244
inducement if possible, shall inform the pregnant woman of the	245
medical indications supporting the physician's judgment that an	246
immediate abortion is necessary. Any physician who performs or	247
induces an abortion without the prior satisfaction of the	248
conditions specified in division (B) of this section because of a	249
medical emergency or medical necessity shall enter the reasons for	250
the conclusion that a medical emergency or medical necessity	251
exists in the medical record of the pregnant woman.	252

(F)(G) If the conditions specified in division (B) of this	253
section are satisfied, consent to an abortion shall be presumed to	254
be valid and effective.	255

(G)(H) The performance or inducement of an abortion without	256
the prior satisfaction of the conditions specified in division (B)	257
of this section does not constitute, and shall not be construed as	258
constituting, a violation of division (A) of section 2919.12 of	259
the Revised Code. The failure of a physician to satisfy the	260
conditions of division (B) of this section prior to performing or	261
inducing an abortion upon a pregnant woman may be the basis of	262
both of the following:	263

(1) A civil action for compensatory and exemplary damages as	264
described in division (H)(J) of this section;	265

(2) Disciplinary action under section 4731.22 of the Revised	266
Code.	267

(H)(I) Whoever violates this section or whoever performs or	268
induces an abortion with reason to believe that the abortion was	269
performed or induced in violation of this section is guilty of a	270
felony of the first degree. Notwithstanding division (A)(3) of	271
section 2929.18 of the Revised Code, the offender shall be fined	272
up to one million dollars for a violation of this section or for	273
performing or inducing an abortion with reason to believe that the	274
abortion was performed or induced in violation of this section.	275

(J)(1) Subject to divisions (H)(J)(2) and (3) of this	276
section, any physician who performs or induces an abortion with	277
actual knowledge that the conditions specified in division (B) of	278
this section have not been satisfied or with a heedless	279
indifference as to whether those conditions have been satisfied is	280
liable in compensatory and exemplary damages in a civil action to	281
any person, or the representative of the estate of any person, who	282
sustains injury, death, or loss to person or property as a result	283
of the failure to satisfy those conditions. In the civil action,	284
the court additionally may enter any injunctive or other equitable	285
relief that it considers appropriate.	286

(2) The following shall be affirmative defenses in a civil	287
action authorized by division (H)(J)(1) of this section:	288

(a) The physician performed or induced the abortion under the	289
circumstances described in division (E)(F) of this section.	290

(b) The physician made a good faith effort to satisfy the	291
conditions specified in division (B) of this section.	292

(3) An employer or other principal is not liable in damages	293
in a civil action authorized by division (H)(J)(1) of this section	294
on the basis of the doctrine of respondeat superior unless either	295
of the following applies:	296

(a) The employer or other principal had actual knowledge or,	297
by the exercise of reasonable diligence, should have known that an	298
employee or agent performed or induced an abortion with actual	299
knowledge that the conditions specified in division (B) of this	300
section had not been satisfied or with a heedless indifference as	301
to whether those conditions had been satisfied.	302

(b) The employer or other principal negligently failed to	303
secure the compliance of an employee or agent with division (B) of	304
this section.	305

(4) Notwithstanding division (E) of section 2919.12 of the	306
Revised Code, the civil action authorized by division (H)(J)(1) of	307
this section shall be the exclusive civil remedy for persons, or	308
the representatives of estates of persons, who allegedly sustain	309
injury, death, or loss to person or property as a result of a	310
failure to satisfy the conditions specified in division (B) of	311
this section.	312

(I)(K) The department of job and family services shall	313
prepare and conduct a public information program to inform women	314
of all available governmental programs and agencies that provide	315
services or assistance for family planning, prenatal care, child	316
care, or alternatives to abortion.	317

(L) No physician may accept payment nor legally or otherwise	318
require a pregnant woman to make a payment for performing or	319
inducing an abortion prior to the expiration of the forty-eight	320
hour period before the physician's fulfillment of all of the	321
requirements of divisions (B)(2), (3), (4), and (5) of this	322
section.	323

Sec. 2919.171. (A) A physician who performs or induces or	324
attempts to perform or induce an abortion on a pregnant woman	325
shall submit a report to the department of health in accordance	326
with the forms, rules, and regulations adopted by the department	327
that includes all of the information the physician is required to	328
certify in writing or determine under sections 2919.17 and 2919.18	329
of the Revised Code:	330

(B) By September 30 of each year, the department of health	331
shall issue a public report that provides statistics for the	332
previous calendar year compiled from all of the reports covering	333
that calendar year submitted to the department in accordance with	334
this section for each of the items listed in division (A) of this	335
section. The report shall also provide the statistics for each	336
previous calendar year in which a report was filed with the	337
department pursuant to this section, adjusted to reflect any	338
additional information that a physician provides to the department	339
in a late or corrected report. The department shall ensure that	340
none of the information included in the report could reasonably	341
lead to the identification of any pregnant woman upon whom an	342
abortion is performed.	343

(C)(1) The physician shall submit the report described in	344
division (A) of this section to the department of health within	345
fifteen days after the woman is discharged. If the physician fails	346
to submit the report more than thirty days after that fifteen-day	347
deadline, the physician shall be subject to a late fee of five	348
hundred dollars for each additional thirty-day period or portion	349
of a thirty-day period the report is overdue. A physician who is	350
required to submit to the department of health a report under	351
division (A) of this section and who has not submitted a report or	352
has submitted an incomplete report more than one year following	353
the fifteen-day deadline may, in an action brought by the	354
department of health, be directed by a court of competent	355
jurisdiction to submit a complete report to the department of	356
health within a period of time stated in a court order or be	357
subject to contempt of court.	358

(2) If a physician fails to comply with the requirements of	359
this section, other than filing a late report with the department	360
of health, or fails to submit a complete report to the department	361
of health in accordance with a court order, the physician is	362
subject to division (B)(41)(43) of section 4731.22 of the Revised	363
Code.	364

(3) No person shall falsify any report required under this	365
section. Whoever violates this division is guilty of abortion	366
report falsification, a misdemeanor of the first degree.	367

(D) Within ninety days of the effective date of this section	368
October 20, 2011, the department of health shall adopt rules	369
pursuant to section 111.15 of the Revised Code to assist in	370
compliance with this section.	371

Sec. 4731.22.  (A) The state medical board, by an affirmative	372
vote of not fewer than six of its members, may limit, revoke, or	373
suspend an individual's certificate to practice, refuse to grant a	374
certificate to an individual, refuse to register an individual,	375
refuse to reinstate a certificate, or reprimand or place on	376
probation the holder of a certificate if the individual or	377
certificate holder is found by the board to have committed fraud	378
during the administration of the examination for a certificate to	379
practice or to have committed fraud, misrepresentation, or	380
deception in applying for or securing any certificate to practice	381
or certificate of registration issued by the board.	382

(B) The board, by an affirmative vote of not fewer than six	383
members, shall, to the extent permitted by law, limit, revoke, or	384
suspend an individual's certificate to practice, refuse to	385
register an individual, refuse to reinstate a certificate, or	386
reprimand or place on probation the holder of a certificate for	387
one or more of the following reasons:	388

(1) Permitting one's name or one's certificate to practice or	389
certificate of registration to be used by a person, group, or	390
corporation when the individual concerned is not actually	391
directing the treatment given;	392

(2) Failure to maintain minimal standards applicable to the	393
selection or administration of drugs, or failure to employ	394
acceptable scientific methods in the selection of drugs or other	395
modalities for treatment of disease;	396

(3) Selling, giving away, personally furnishing, prescribing,	397
or administering drugs for other than legal and legitimate	398
therapeutic purposes or a plea of guilty to, a judicial finding of	399
guilt of, or a judicial finding of eligibility for intervention in	400
lieu of conviction of, a violation of any federal or state law	401
regulating the possession, distribution, or use of any drug;	402

(4) Willfully betraying a professional confidence.

403

For purposes of this division, "willfully betraying a	404
professional confidence" does not include providing any	405
information, documents, or reports to a child fatality review	406
board under sections 307.621 to 307.629 of the Revised Code and	407
does not include the making of a report of an employee's use of a	408
drug of abuse, or a report of a condition of an employee other	409
than one involving the use of a drug of abuse, to the employer of	410
the employee as described in division (B) of section 2305.33 of	411
the Revised Code. Nothing in this division affects the immunity	412
from civil liability conferred by that section upon a physician	413
who makes either type of report in accordance with division (B) of	414
that section. As used in this division, "employee," "employer,"	415
and "physician" have the same meanings as in section 2305.33 of	416
the Revised Code.	417

(5) Making a false, fraudulent, deceptive, or misleading	418
statement in the solicitation of or advertising for patients; in	419
relation to the practice of medicine and surgery, osteopathic	420
medicine and surgery, podiatric medicine and surgery, or a limited	421
branch of medicine; or in securing or attempting to secure any	422
certificate to practice or certificate of registration issued by	423
the board.	424

As used in this division, "false, fraudulent, deceptive, or	425
misleading statement" means a statement that includes a	426
misrepresentation of fact, is likely to mislead or deceive because	427
of a failure to disclose material facts, is intended or is likely	428
to create false or unjustified expectations of favorable results,	429
or includes representations or implications that in reasonable	430
probability will cause an ordinarily prudent person to	431
misunderstand or be deceived.	432

(6) A departure from, or the failure to conform to, minimal	433
standards of care of similar practitioners under the same or	434
similar circumstances, whether or not actual injury to a patient	435
is established;	436

(7) Representing, with the purpose of obtaining compensation	437
or other advantage as personal gain or for any other person, that	438
an incurable disease or injury, or other incurable condition, can	439
be permanently cured;	440

(8) The obtaining of, or attempting to obtain, money or	441
anything of value by fraudulent misrepresentations in the course	442
of practice;	443

(9) A plea of guilty to, a judicial finding of guilt of, or a	444
judicial finding of eligibility for intervention in lieu of	445
conviction for, a felony;	446

(10) Commission of an act that constitutes a felony in this	447
state, regardless of the jurisdiction in which the act was	448
committed;	449

(11) A plea of guilty to, a judicial finding of guilt of, or	450
a judicial finding of eligibility for intervention in lieu of	451
conviction for, a misdemeanor committed in the course of practice;	452

(12) Commission of an act in the course of practice that	453
constitutes a misdemeanor in this state, regardless of the	454
jurisdiction in which the act was committed;	455

(13) A plea of guilty to, a judicial finding of guilt of, or	456
a judicial finding of eligibility for intervention in lieu of	457
conviction for, a misdemeanor involving moral turpitude;	458

(14) Commission of an act involving moral turpitude that	459
constitutes a misdemeanor in this state, regardless of the	460
jurisdiction in which the act was committed;	461

(15) Violation of the conditions of limitation placed by the	462
board upon a certificate to practice;	463

(16) Failure to pay license renewal fees specified in this	464
chapter;	465

(17) Except as authorized in section 4731.31 of the Revised	466
Code, engaging in the division of fees for referral of patients,	467
or the receiving of a thing of value in return for a specific	468
referral of a patient to utilize a particular service or business;	469

(18) Subject to section 4731.226 of the Revised Code,	470
violation of any provision of a code of ethics of the American	471
medical association, the American osteopathic association, the	472
American podiatric medical association, or any other national	473
professional organizations that the board specifies by rule. The	474
state medical board shall obtain and keep on file current copies	475
of the codes of ethics of the various national professional	476
organizations. The individual whose certificate is being suspended	477
or revoked shall not be found to have violated any provision of a	478
code of ethics of an organization not appropriate to the	479
individual's profession.	480

For purposes of this division, a "provision of a code of	481
ethics of a national professional organization" does not include	482
any provision that would preclude the making of a report by a	483
physician of an employee's use of a drug of abuse, or of a	484
condition of an employee other than one involving the use of a	485
drug of abuse, to the employer of the employee as described in	486
division (B) of section 2305.33 of the Revised Code. Nothing in	487
this division affects the immunity from civil liability conferred	488
by that section upon a physician who makes either type of report	489
in accordance with division (B) of that section. As used in this	490
division, "employee," "employer," and "physician" have the same	491
meanings as in section 2305.33 of the Revised Code.	492

(19) Inability to practice according to acceptable and	493
prevailing standards of care by reason of mental illness or	494
physical illness, including, but not limited to, physical	495
deterioration that adversely affects cognitive, motor, or	496
perceptive skills.	497

In enforcing this division, the board, upon a showing of a	498
possible violation, may compel any individual authorized to	499
practice by this chapter or who has submitted an application	500
pursuant to this chapter to submit to a mental examination,	501
physical examination, including an HIV test, or both a mental and	502
a physical examination. The expense of the examination is the	503
responsibility of the individual compelled to be examined. Failure	504
to submit to a mental or physical examination or consent to an HIV	505
test ordered by the board constitutes an admission of the	506
allegations against the individual unless the failure is due to	507
circumstances beyond the individual's control, and a default and	508
final order may be entered without the taking of testimony or	509
presentation of evidence. If the board finds an individual unable	510
to practice because of the reasons set forth in this division, the	511
board shall require the individual to submit to care, counseling,	512
or treatment by physicians approved or designated by the board, as	513
a condition for initial, continued, reinstated, or renewed	514
authority to practice. An individual affected under this division	515
shall be afforded an opportunity to demonstrate to the board the	516
ability to resume practice in compliance with acceptable and	517
prevailing standards under the provisions of the individual's	518
certificate. For the purpose of this division, any individual who	519
applies for or receives a certificate to practice under this	520
chapter accepts the privilege of practicing in this state and, by	521
so doing, shall be deemed to have given consent to submit to a	522
mental or physical examination when directed to do so in writing	523
by the board, and to have waived all objections to the	524
admissibility of testimony or examination reports that constitute	525
a privileged communication.	526

(20) Except when civil penalties are imposed under section	527
4731.225 or 4731.281 of the Revised Code, and subject to section	528
4731.226 of the Revised Code, violating or attempting to violate,	529
directly or indirectly, or assisting in or abetting the violation	530
of, or conspiring to violate, any provisions of this chapter or	531
any rule promulgated by the board.	532

This division does not apply to a violation or attempted	533
violation of, assisting in or abetting the violation of, or a	534
conspiracy to violate, any provision of this chapter or any rule	535
adopted by the board that would preclude the making of a report by	536
a physician of an employee's use of a drug of abuse, or of a	537
condition of an employee other than one involving the use of a	538
drug of abuse, to the employer of the employee as described in	539
division (B) of section 2305.33 of the Revised Code. Nothing in	540
this division affects the immunity from civil liability conferred	541
by that section upon a physician who makes either type of report	542
in accordance with division (B) of that section. As used in this	543
division, "employee," "employer," and "physician" have the same	544
meanings as in section 2305.33 of the Revised Code.	545

(21) The violation of section 3701.79 of the Revised Code or	546
of any abortion rule adopted by the public health council pursuant	547
to section 3701.341 of the Revised Code;	548

(22) Any of the following actions taken by an agency	549
responsible for authorizing, certifying, or regulating an	550
individual to practice a health care occupation or provide health	551
care services in this state or another jurisdiction, for any	552
reason other than the nonpayment of fees: the limitation,	553
revocation, or suspension of an individual's license to practice;	554
acceptance of an individual's license surrender; denial of a	555
license; refusal to renew or reinstate a license; imposition of	556
probation; or issuance of an order of censure or other reprimand;	557

(23) The violation of section 2919.12 of the Revised Code or	558
the performance or inducement of an abortion upon a pregnant woman	559
with actual knowledge that the conditions specified in division	560
(B) of section 2317.56 of the Revised Code have not been satisfied	561
or with a heedless indifference as to whether those conditions	562
have been satisfied, unless an affirmative defense as specified in	563
division (H)(2) of that section would apply in a civil action	564
authorized by division (H)(1) of that section;	565

(24) The revocation, suspension, restriction, reduction, or	566
termination of clinical privileges by the United States department	567
of defense or department of veterans affairs or the termination or	568
suspension of a certificate of registration to prescribe drugs by	569
the drug enforcement administration of the United States	570
department of justice;	571

(25) Termination or suspension from participation in the	572
medicare or medicaid programs by the department of health and	573
human services or other responsible agency for any act or acts	574
that also would constitute a violation of division (B)(2), (3),	575
(6), (8), or (19) of this section;	576

(26) Impairment of ability to practice according to	577
acceptable and prevailing standards of care because of habitual or	578
excessive use or abuse of drugs, alcohol, or other substances that	579
impair ability to practice.	580

For the purposes of this division, any individual authorized	581
to practice by this chapter accepts the privilege of practicing in	582
this state subject to supervision by the board. By filing an	583
application for or holding a certificate to practice under this	584
chapter, an individual shall be deemed to have given consent to	585
submit to a mental or physical examination when ordered to do so	586
by the board in writing, and to have waived all objections to the	587
admissibility of testimony or examination reports that constitute	588
privileged communications.	589

If it has reason to believe that any individual authorized to	590
practice by this chapter or any applicant for certification to	591
practice suffers such impairment, the board may compel the	592
individual to submit to a mental or physical examination, or both.	593
The expense of the examination is the responsibility of the	594
individual compelled to be examined. Any mental or physical	595
examination required under this division shall be undertaken by a	596
treatment provider or physician who is qualified to conduct the	597
examination and who is chosen by the board.	598

Failure to submit to a mental or physical examination ordered	599
by the board constitutes an admission of the allegations against	600
the individual unless the failure is due to circumstances beyond	601
the individual's control, and a default and final order may be	602
entered without the taking of testimony or presentation of	603
evidence. If the board determines that the individual's ability to	604
practice is impaired, the board shall suspend the individual's	605
certificate or deny the individual's application and shall require	606
the individual, as a condition for initial, continued, reinstated,	607
or renewed certification to practice, to submit to treatment.	608

Before being eligible to apply for reinstatement of a	609
certificate suspended under this division, the impaired	610
practitioner shall demonstrate to the board the ability to resume	611
practice in compliance with acceptable and prevailing standards of	612
care under the provisions of the practitioner's certificate. The	613
demonstration shall include, but shall not be limited to, the	614
following:	615

(a) Certification from a treatment provider approved under	616
section 4731.25 of the Revised Code that the individual has	617
successfully completed any required inpatient treatment;	618

(b) Evidence of continuing full compliance with an aftercare	619
contract or consent agreement;	620

(c) Two written reports indicating that the individual's	621
ability to practice has been assessed and that the individual has	622
been found capable of practicing according to acceptable and	623
prevailing standards of care. The reports shall be made by	624
individuals or providers approved by the board for making the	625
assessments and shall describe the basis for their determination.	626

The board may reinstate a certificate suspended under this	627
division after that demonstration and after the individual has	628
entered into a written consent agreement.	629

When the impaired practitioner resumes practice, the board	630
shall require continued monitoring of the individual. The	631
monitoring shall include, but not be limited to, compliance with	632
the written consent agreement entered into before reinstatement or	633
with conditions imposed by board order after a hearing, and, upon	634
termination of the consent agreement, submission to the board for	635
at least two years of annual written progress reports made under	636
penalty of perjury stating whether the individual has maintained	637
sobriety.	638

(27) A second or subsequent violation of section 4731.66 or	639
4731.69 of the Revised Code;	640

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

641

(a) Waiving the payment of all or any part of a deductible or	642
copayment that a patient, pursuant to a health insurance or health	643
care policy, contract, or plan that covers the individual's	644
services, otherwise would be required to pay if the waiver is used	645
as an enticement to a patient or group of patients to receive	646
health care services from that individual;	647

(b) Advertising that the individual will waive the payment of	648
all or any part of a deductible or copayment that a patient,	649
pursuant to a health insurance or health care policy, contract, or	650
plan that covers the individual's services, otherwise would be	651
required to pay.	652

(29) Failure to use universal blood and body fluid	653
precautions established by rules adopted under section 4731.051 of	654
the Revised Code;	655

(30) Failure to provide notice to, and receive acknowledgment	656
of the notice from, a patient when required by section 4731.143 of	657
the Revised Code prior to providing nonemergency professional	658
services, or failure to maintain that notice in the patient's	659
file;	660

(31) Failure of a physician supervising a physician assistant	661
to maintain supervision in accordance with the requirements of	662
Chapter 4730. of the Revised Code and the rules adopted under that	663
chapter;	664

(32) Failure of a physician or podiatrist to enter into a	665
standard care arrangement with a clinical nurse specialist,	666
certified nurse-midwife, or certified nurse practitioner with whom	667
the physician or podiatrist is in collaboration pursuant to	668
section 4731.27 of the Revised Code or failure to fulfill the	669
responsibilities of collaboration after entering into a standard	670
care arrangement;	671

(33) Failure to comply with the terms of a consult agreement	672
entered into with a pharmacist pursuant to section 4729.39 of the	673
Revised Code;	674

(34) Failure to cooperate in an investigation conducted by	675
the board under division (F) of this section, including failure to	676
comply with a subpoena or order issued by the board or failure to	677
answer truthfully a question presented by the board in an	678
investigative interview, an investigative office conference, at a	679
deposition, or in written interrogatories, except that failure to	680
cooperate with an investigation shall not constitute grounds for	681
discipline under this section if a court of competent jurisdiction	682
has issued an order that either quashes a subpoena or permits the	683
individual to withhold the testimony or evidence in issue;	684

(35) Failure to supervise an oriental medicine practitioner	685
or acupuncturist in accordance with Chapter 4762. of the Revised	686
Code and the board's rules for providing that supervision;	687

(36) Failure to supervise an anesthesiologist assistant in	688
accordance with Chapter 4760. of the Revised Code and the board's	689
rules for supervision of an anesthesiologist assistant;	690

(37) Assisting suicide as defined in section 3795.01 of the	691
Revised Code;	692

(38) Failure to comply with the requirements of section	693
2317.561 of the Revised Code;	694

(39) Failure to supervise a radiologist assistant in	695
accordance with Chapter 4774. of the Revised Code and the board's	696
rules for supervision of radiologist assistants;	697

(40)(39) Performing or inducing an abortion at an office or	698
facility with knowledge that the office or facility fails to post	699
the notice required under section 3701.791 of the Revised Code;	700

(41)(40) Failure to comply with the standards and procedures	701
established in rules under section 4731.054 of the Revised Code	702
for the operation of or the provision of care at a pain management	703
clinic;	704

(42)(41) Failure to comply with the standards and procedures	705
established in rules under section 4731.054 of the Revised Code	706
for providing supervision, direction, and control of individuals	707
at a pain management clinic;	708

(43)(42) Failure to comply with the requirements of section	709
4729.79 of the Revised Code, unless the state board of pharmacy no	710
longer maintains a drug database pursuant to section 4729.75 of	711
the Revised Code;	712

(44)(43) Failure to comply with the requirements of section	713
2919.171 of the Revised Code or failure to submit to the	714
department of health in accordance with a court order a complete	715
report as described in section 2919.171 of the Revised Code;	716

(45)(44) Failure to supervise a genetic counselor holding a	717
supervised practice license in accordance with Chapter 4778. of	718
the Revised Code and the board's rules for supervision of the	719
genetic counselor;	720

(46)(45) Failure to fulfill the responsibilities of	721
collaboration after entering into a collaborative agreement with a	722
genetic counselor under division (B) of section 4778.11 of the	723
Revised Code or failure to comply with the board's rules regarding	724
such agreements.	725

(47)(46) Practicing at a facility that is subject to	726
licensure as a category III terminal distributor of dangerous	727
drugs with a pain management clinic classification unless the	728
person operating the facility has obtained and maintains the	729
license with the classification;	730

(48)(47) Owning a facility that is subject to licensure as a	731
category III terminal distributor of dangerous drugs with a pain	732
management clinic classification unless the facility is licensed	733
with the classification.	734

(C) Disciplinary actions taken by the board under divisions	735
(A) and (B) of this section shall be taken pursuant to an	736
adjudication under Chapter 119. of the Revised Code, except that	737
in lieu of an adjudication, the board may enter into a consent	738
agreement with an individual to resolve an allegation of a	739
violation of this chapter or any rule adopted under it. A consent	740
agreement, when ratified by an affirmative vote of not fewer than	741
six members of the board, shall constitute the findings and order	742
of the board with respect to the matter addressed in the	743
agreement. If the board refuses to ratify a consent agreement, the	744
admissions and findings contained in the consent agreement shall	745
be of no force or effect.	746

A telephone conference call may be utilized for ratification	747
of a consent agreement that revokes or suspends an individual's	748
certificate to practice. The telephone conference call shall be	749
considered a special meeting under division (F) of section 121.22	750
of the Revised Code.	751

If the board takes disciplinary action against an individual	752
under division (B) of this section for a second or subsequent plea	753
of guilty to, or judicial finding of guilt of, a violation of	754
section 2919.123 of the Revised Code, the disciplinary action	755
shall consist of a suspension of the individual's certificate to	756
practice for a period of at least one year or, if determined	757
appropriate by the board, a more serious sanction involving the	758
individual's certificate to practice. Any consent agreement	759
entered into under this division with an individual that pertains	760
to a second or subsequent plea of guilty to, or judicial finding	761
of guilt of, a violation of that section shall provide for a	762
suspension of the individual's certificate to practice for a	763
period of at least one year or, if determined appropriate by the	764
board, a more serious sanction involving the individual's	765
certificate to practice.	766

(D) For purposes of divisions (B)(10), (12), and (14) of this	767
section, the commission of the act may be established by a finding	768
by the board, pursuant to an adjudication under Chapter 119. of	769
the Revised Code, that the individual committed the act. The board	770
does not have jurisdiction under those divisions if the trial	771
court renders a final judgment in the individual's favor and that	772
judgment is based upon an adjudication on the merits. The board	773
has jurisdiction under those divisions if the trial court issues	774
an order of dismissal upon technical or procedural grounds.	775

(E) The sealing of conviction records by any court shall have	776
no effect upon a prior board order entered under this section or	777
upon the board's jurisdiction to take action under this section	778
if, based upon a plea of guilty, a judicial finding of guilt, or a	779
judicial finding of eligibility for intervention in lieu of	780
conviction, the board issued a notice of opportunity for a hearing	781
prior to the court's order to seal the records. The board shall	782
not be required to seal, destroy, redact, or otherwise modify its	783
records to reflect the court's sealing of conviction records.	784

(F)(1) The board shall investigate evidence that appears to	785
show that a person has violated any provision of this chapter or	786
any rule adopted under it. Any person may report to the board in a	787
signed writing any information that the person may have that	788
appears to show a violation of any provision of this chapter or	789
any rule adopted under it. In the absence of bad faith, any person	790
who reports information of that nature or who testifies before the	791
board in any adjudication conducted under Chapter 119. of the	792
Revised Code shall not be liable in damages in a civil action as a	793
result of the report or testimony. Each complaint or allegation of	794
a violation received by the board shall be assigned a case number	795
and shall be recorded by the board.	796

(2) Investigations of alleged violations of this chapter or	797
any rule adopted under it shall be supervised by the supervising	798
member elected by the board in accordance with section 4731.02 of	799
the Revised Code and by the secretary as provided in section	800
4731.39 of the Revised Code. The president may designate another	801
member of the board to supervise the investigation in place of the	802
supervising member. No member of the board who supervises the	803
investigation of a case shall participate in further adjudication	804
of the case.	805

(3) In investigating a possible violation of this chapter or	806
any rule adopted under this chapter, or in conducting an	807
inspection under division (E) of section 4731.054 of the Revised	808
Code, the board may question witnesses, conduct interviews,	809
administer oaths, order the taking of depositions, inspect and	810
copy any books, accounts, papers, records, or documents, issue	811
subpoenas, and compel the attendance of witnesses and production	812
of books, accounts, papers, records, documents, and testimony,	813
except that a subpoena for patient record information shall not be	814
issued without consultation with the attorney general's office and	815
approval of the secretary and supervising member of the board.	816

(a) Before issuance of a subpoena for patient record	817
information, the secretary and supervising member shall determine	818
whether there is probable cause to believe that the complaint	819
filed alleges a violation of this chapter or any rule adopted	820
under it and that the records sought are relevant to the alleged	821
violation and material to the investigation. The subpoena may	822
apply only to records that cover a reasonable period of time	823
surrounding the alleged violation.	824

(b) On failure to comply with any subpoena issued by the	825
board and after reasonable notice to the person being subpoenaed,	826
the board may move for an order compelling the production of	827
persons or records pursuant to the Rules of Civil Procedure.	828

(c) A subpoena issued by the board may be served by a	829
sheriff, the sheriff's deputy, or a board employee designated by	830
the board. Service of a subpoena issued by the board may be made	831
by delivering a copy of the subpoena to the person named therein,	832
reading it to the person, or leaving it at the person's usual	833
place of residence, usual place of business, or address on file	834
with the board. When serving a subpoena to an applicant for or the	835
holder of a certificate issued under this chapter, service of the	836
subpoena may be made by certified mail, return receipt requested,	837
and the subpoena shall be deemed served on the date delivery is	838
made or the date the person refuses to accept delivery. If the	839
person being served refuses to accept the subpoena or is not	840
located, service may be made to an attorney who notifies the board	841
that the attorney is representing the person.	842

(d) A sheriff's deputy who serves a subpoena shall receive	843
the same fees as a sheriff. Each witness who appears before the	844
board in obedience to a subpoena shall receive the fees and	845
mileage provided for under section 119.094 of the Revised Code.	846

(4) All hearings, investigations, and inspections of the	847
board shall be considered civil actions for the purposes of	848
section 2305.252 of the Revised Code.	849

(5) A report required to be submitted to the board under this	850
chapter, a complaint, or information received by the board	851
pursuant to an investigation or pursuant to an inspection under	852
division (E) of section 4731.054 of the Revised Code is	853
confidential and not subject to discovery in any civil action.	854

The board shall conduct all investigations or inspections and	855
proceedings in a manner that protects the confidentiality of	856
patients and persons who file complaints with the board. The board	857
shall not make public the names or any other identifying	858
information about patients or complainants unless proper consent	859
is given or, in the case of a patient, a waiver of the patient	860
privilege exists under division (B) of section 2317.02 of the	861
Revised Code, except that consent or a waiver of that nature is	862
not required if the board possesses reliable and substantial	863
evidence that no bona fide physician-patient relationship exists.	864

The board may share any information it receives pursuant to	865
an investigation or inspection, including patient records and	866
patient record information, with law enforcement agencies, other	867
licensing boards, and other governmental agencies that are	868
prosecuting, adjudicating, or investigating alleged violations of	869
statutes or administrative rules. An agency or board that receives	870
the information shall comply with the same requirements regarding	871
confidentiality as those with which the state medical board must	872
comply, notwithstanding any conflicting provision of the Revised	873
Code or procedure of the agency or board that applies when it is	874
dealing with other information in its possession. In a judicial	875
proceeding, the information may be admitted into evidence only in	876
accordance with the Rules of Evidence, but the court shall require	877
that appropriate measures are taken to ensure that confidentiality	878
is maintained with respect to any part of the information that	879
contains names or other identifying information about patients or	880
complainants whose confidentiality was protected by the state	881
medical board when the information was in the board's possession.	882
Measures to ensure confidentiality that may be taken by the court	883
include sealing its records or deleting specific information from	884
its records.	885

(6) On a quarterly basis, the board shall prepare a report	886
that documents the disposition of all cases during the preceding	887
three months. The report shall contain the following information	888
for each case with which the board has completed its activities:	889

(a) The case number assigned to the complaint or alleged	890
violation;	891

(b) The type of certificate to practice, if any, held by the	892
individual against whom the complaint is directed;	893

(c) A description of the allegations contained in the	894
complaint;	895

(d) The disposition of the case.

896

The report shall state how many cases are still pending and	897
shall be prepared in a manner that protects the identity of each	898
person involved in each case. The report shall be a public record	899
under section 149.43 of the Revised Code.	900

(G) If the secretary and supervising member determine both of	901
the following, they may recommend that the board suspend an	902
individual's certificate to practice without a prior hearing:	903

(1) That there is clear and convincing evidence that an	904
individual has violated division (B) of this section;	905

(2) That the individual's continued practice presents a	906
danger of immediate and serious harm to the public.	907

Written allegations shall be prepared for consideration by	908
the board. The board, upon review of those allegations and by an	909
affirmative vote of not fewer than six of its members, excluding	910
the secretary and supervising member, may suspend a certificate	911
without a prior hearing. A telephone conference call may be	912
utilized for reviewing the allegations and taking the vote on the	913
summary suspension.	914

The board shall issue a written order of suspension by	915
certified mail or in person in accordance with section 119.07 of	916
the Revised Code. The order shall not be subject to suspension by	917
the court during pendency of any appeal filed under section 119.12	918
of the Revised Code. If the individual subject to the summary	919
suspension requests an adjudicatory hearing by the board, the date	920
set for the hearing shall be within fifteen days, but not earlier	921
than seven days, after the individual requests the hearing, unless	922
otherwise agreed to by both the board and the individual.	923

Any summary suspension imposed under this division shall	924
remain in effect, unless reversed on appeal, until a final	925
adjudicative order issued by the board pursuant to this section	926
and Chapter 119. of the Revised Code becomes effective. The board	927
shall issue its final adjudicative order within seventy-five days	928
after completion of its hearing. A failure to issue the order	929
within seventy-five days shall result in dissolution of the	930
summary suspension order but shall not invalidate any subsequent,	931
final adjudicative order.	932

(H) If the board takes action under division (B)(9), (11), or	933
(13) of this section and the judicial finding of guilt, guilty	934
plea, or judicial finding of eligibility for intervention in lieu	935
of conviction is overturned on appeal, upon exhaustion of the	936
criminal appeal, a petition for reconsideration of the order may	937
be filed with the board along with appropriate court documents.	938
Upon receipt of a petition of that nature and supporting court	939
documents, the board shall reinstate the individual's certificate	940
to practice. The board may then hold an adjudication under Chapter	941
119. of the Revised Code to determine whether the individual	942
committed the act in question. Notice of an opportunity for a	943
hearing shall be given in accordance with Chapter 119. of the	944
Revised Code. If the board finds, pursuant to an adjudication held	945
under this division, that the individual committed the act or if	946
no hearing is requested, the board may order any of the sanctions	947
identified under division (B) of this section.	948

(I) The certificate to practice issued to an individual under	949
this chapter and the individual's practice in this state are	950
automatically suspended as of the date of the individual's second	951
or subsequent plea of guilty to, or judicial finding of guilt of,	952
a violation of section 2919.123 of the Revised Code, or the date	953
the individual pleads guilty to, is found by a judge or jury to be	954
guilty of, or is subject to a judicial finding of eligibility for	955
intervention in lieu of conviction in this state or treatment or	956
intervention in lieu of conviction in another jurisdiction for any	957
of the following criminal offenses in this state or a	958
substantially equivalent criminal offense in another jurisdiction:	959
aggravated murder, murder, voluntary manslaughter, felonious	960
assault, kidnapping, rape, sexual battery, gross sexual	961
imposition, aggravated arson, aggravated robbery, or aggravated	962
burglary. Continued practice after suspension shall be considered	963
practicing without a certificate.	964

The board shall notify the individual subject to the	965
suspension by certified mail or in person in accordance with	966
section 119.07 of the Revised Code. If an individual whose	967
certificate is automatically suspended under this division fails	968
to make a timely request for an adjudication under Chapter 119. of	969
the Revised Code, the board shall do whichever of the following is	970
applicable:	971

(1) If the automatic suspension under this division is for a	972
second or subsequent plea of guilty to, or judicial finding of	973
guilt of, a violation of section 2919.123 of the Revised Code, the	974
board shall enter an order suspending the individual's certificate	975
to practice for a period of at least one year or, if determined	976
appropriate by the board, imposing a more serious sanction	977
involving the individual's certificate to practice.	978

(2) In all circumstances in which division (I)(1) of this	979
section does not apply, enter a final order permanently revoking	980
the individual's certificate to practice.	981

(J) If the board is required by Chapter 119. of the Revised	982
Code to give notice of an opportunity for a hearing and if the	983
individual subject to the notice does not timely request a hearing	984
in accordance with section 119.07 of the Revised Code, the board	985
is not required to hold a hearing, but may adopt, by an	986
affirmative vote of not fewer than six of its members, a final	987
order that contains the board's findings. In that final order, the	988
board may order any of the sanctions identified under division (A)	989
or (B) of this section.	990

(K) Any action taken by the board under division (B) of this	991
section resulting in a suspension from practice shall be	992
accompanied by a written statement of the conditions under which	993
the individual's certificate to practice may be reinstated. The	994
board shall adopt rules governing conditions to be imposed for	995
reinstatement. Reinstatement of a certificate suspended pursuant	996
to division (B) of this section requires an affirmative vote of	997
not fewer than six members of the board.	998

(L) When the board refuses to grant a certificate to an	999
applicant, revokes an individual's certificate to practice,	1000
refuses to register an applicant, or refuses to reinstate an	1001
individual's certificate to practice, the board may specify that	1002
its action is permanent. An individual subject to a permanent	1003
action taken by the board is forever thereafter ineligible to hold	1004
a certificate to practice and the board shall not accept an	1005
application for reinstatement of the certificate or for issuance	1006
of a new certificate.	1007

(M) Notwithstanding any other provision of the Revised Code,	1008
all of the following apply:	1009

(1) The surrender of a certificate issued under this chapter	1010
shall not be effective unless or until accepted by the board. A	1011
telephone conference call may be utilized for acceptance of the	1012
surrender of an individual's certificate to practice. The	1013
telephone conference call shall be considered a special meeting	1014
under division (F) of section 121.22 of the Revised Code.	1015
Reinstatement of a certificate surrendered to the board requires	1016
an affirmative vote of not fewer than six members of the board.	1017

(2) An application for a certificate made under the	1018
provisions of this chapter may not be withdrawn without approval	1019
of the board.	1020

(3) Failure by an individual to renew a certificate of	1021
registration in accordance with this chapter shall not remove or	1022
limit the board's jurisdiction to take any disciplinary action	1023
under this section against the individual.	1024

(4) At the request of the board, a certificate holder shall	1025
immediately surrender to the board a certificate that the board	1026
has suspended, revoked, or permanently revoked.	1027

(N) Sanctions shall not be imposed under division (B)(28) of	1028
this section against any person who waives deductibles and	1029
copayments as follows:	1030

(1) In compliance with the health benefit plan that expressly	1031
allows such a practice. Waiver of the deductibles or copayments	1032
shall be made only with the full knowledge and consent of the plan	1033
purchaser, payer, and third-party administrator. Documentation of	1034
the consent shall be made available to the board upon request.	1035

(2) For professional services rendered to any other person	1036
authorized to practice pursuant to this chapter, to the extent	1037
allowed by this chapter and rules adopted by the board.	1038

(O) Under the board's investigative duties described in this	1039
section and subject to division (F) of this section, the board	1040
shall develop and implement a quality intervention program	1041
designed to improve through remedial education the clinical and	1042
communication skills of individuals authorized under this chapter	1043
to practice medicine and surgery, osteopathic medicine and	1044
surgery, and podiatric medicine and surgery. In developing and	1045
implementing the quality intervention program, the board may do	1046
all of the following:	1047

(1) Offer in appropriate cases as determined by the board an	1048
educational and assessment program pursuant to an investigation	1049
the board conducts under this section;	1050

(2) Select providers of educational and assessment services,	1051
including a quality intervention program panel of case reviewers;	1052

(3) Make referrals to educational and assessment service	1053
providers and approve individual educational programs recommended	1054
by those providers. The board shall monitor the progress of each	1055
individual undertaking a recommended individual educational	1056
program.	1057

(4) Determine what constitutes successful completion of an	1058
individual educational program and require further monitoring of	1059
the individual who completed the program or other action that the	1060
board determines to be appropriate;	1061

(5) Adopt rules in accordance with Chapter 119. of the	1062
Revised Code to further implement the quality intervention	1063
program.	1064

An individual who participates in an individual educational	1065
program pursuant to this division shall pay the financial	1066
obligations arising from that educational program.	1067

Section 2. That existing sections 2305.11, 2317.56, 2919.171,	1068
and 4731.22 and section 2317.561 of the Revised Code are hereby	1069
repealed.	1070

Section 3.  Section 4731.22 of the Revised Code is presented	1071
in this act as a composite of the section as amended by both Sub.	1072
H.B. 251 and Sub. S.B. 301 of the 129th General Assembly. The	1073
General Assembly, applying the principle stated in division (B) of	1074
section 1.52 of the Revised Code that amendments are to be	1075
harmonized if reasonably capable of simultaneous operation, finds	1076
that the composite is the resulting version of the section in	1077
effect prior to the effective date of the section as presented in	1078
this act.	1079