All Roll Calls
Yes: 181 • No: 2
IndianaSB 473First Regular Session 124th General Assembly (2025)SenateWALLET
Various health care matters.
Sponsored By: Liz Brown (Republican)
Signed by Governor
Summary
Specifies the process for a managed care organization to follow concerning home modification services. Requires a patient of an opioid treatment program (program) who has tested positive on a drug test to be given a random drug test monthly until the patient passes the test. (Current law requires the patient to be tested weekly.) Allows a program to close on Sundays and federal holidays. Prohibits the division of mental health and addiction from: (1) requiring a program's medical director to have admitting privileges at a hospital; and (2) establishing rules or guidelines concerning program admission and medication that are more stringent than federal regulations. Allows specified health care providers to perform the initial assessment, examination, and evaluation of a patient being admitted to a program. Allows the medical staff of an ambulatory outpatient surgical center to make recommendations on the granting of clinical privileges or the appointment or reappointment of an applicant to the governing board of the ambulatory outpatient surgical center for a period not to exceed 36 months. (Current law allows medical staff of hospitals to make recommendations.) Establishes the certified health care professions commission (commission). Sets forth the requirements for the: (1) certification of nurse aides and qualified medication aides; and (2) registration of home health aides. Specifies the duties of the Indiana department of health and the commission in regulating these professions. Relocates provisions concerning training for home health aides and requires the commission to approve the training. Sets forth requirements on facilities in employing nurse aides. Specifies the definition of "nurse aide" for purposes of an administrative rule. Makes changes to the release of medical information statute. Modifies the duties of the center for deaf and hard of hearing education. Adds provisions regarding "family navigators" and specifies the role of family navigators in the provisions of the bill regarding the center for deaf and hard of hearing education. Allows a prescriber to prescribe certain agonist opioids through telehealth services for the treatment or management of opioid dependence. (Current law allows only a partial agonist to be prescribed through telehealth.) Allows certain residential care administrators an exemption from taking continuing education during the initial licensing period. Allows for the provision of certain anesthesia in a physician's office or a podiatrist's office without the office being accredited. (Current law allows for this in dental offices.) Requires adverse events concerning anesthesia in an office based setting to be reported to the medical licensing board of Indiana (board). Requires the board to: (1) determine the types of adverse events to be reported; (2) establish a procedure for reporting; and (3) post the adverse events on the board's website. Creates a process for certain individuals who do not have a Social Security number and who are seeking licensure by examination as a registered nurse or practical nurse to obtain a provisional license. Requires a nursing program to offer a clinical experience for clinical hours in a hospital and a health facility setting.
health and provider servicesappropriationsthe housepublic health
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38 provisions identified: 16 benefits, 7 costs, 15 mixed.
Temporary licenses for nurses without Social Security numbers
Most Indiana professional license applicants and licensees must provide Social Security numbers beginning July 1, 2025. Licensing agencies may share numbers with testing services and licensing regulators for licensing and discipline. Eligible nursing applicants seeking a federally authorized work visa can instead get a provisional license lasting up to 180 days. It costs $10 and requires an alien identification number, a sworn statement, a qualifying Indiana job offer, and federal status verification. Applicants must meet nursing license requirements and provide their Social Security number once issued; otherwise, the provisional license lapses.
Addiction treatment prescriptions available through telehealth
Prescribers can issue telehealth prescriptions for an FDA-approved opioid addiction treatment without a prior in-person exam. The medicine must be used to treat or manage opioid dependence. Prescribers must meet care standards, stay within their license and certification, and follow the law’s other prescription requirements.
Deaf children and families get support
Beginning July 1, 2025, the state center must support deaf and hard-of-hearing children from birth through age 21. Services include family navigators, resource connections, and audiology assessments and management, without favoring a communication mode. The center follows children from birth through age 3 with state programs; support coordination for ages 3–21 covers children enrolled or preparing to enroll in early intervention or school. Direct therapy is barred except for deaf mentor, audiology, and interpreter services. The center can charge government entities only for audiologists, interpreters, family navigators, or deaf mentors; this provision creates no direct household charge.
Medication aides can perform more tasks
Certified medication aides can give specified prescribed medicines, including medicines through stomach or intestinal feeding tubes, and perform finger-stick blood sugar tests. They must have the required training and follow provider orders, nurse assessment or authorization requirements, and facility policies. Beginning September 1, 2025, the law repeals an older section restricting injectable medicines. That repeal does not authorize every aide to give every injection; the replacement practice limits still apply.
Inactive nurse aides can return
Nurse aides can regain registry status after passing the state nurse aide exam. They must have been removed within the past five years because they provided no nursing-related services for 24 consecutive months. They must also have no findings of abuse, neglect, or misuse of patient property while certified.
False aide titles carry criminal penalties
People without certification cannot claim to be certified nurse aides or work in that role. People without valid medication aide certification cannot claim that title or use words or symbols implying it. Knowingly or intentionally making either false title claim is a Class A misdemeanor.
Medication aides face job entry requirements
Qualified medication aide trainees must be at least 18 and have a high school diploma or equivalent. They must hold nurse aide certification in good standing. They also need 1,000 hours of nurse aide work unless the commission waives that requirement. Work generally requires completing approved training and competency evaluation and passing the exam, with exceptions for specified certification paths.
Positive drug tests limit take-home treatment
Beginning July 1, 2025, a prohibited positive drug test blocks take-home opioid treatment medication until assessment and a passing random test. The state division can authorize an exception. Patients must report daily, except during closures, until the evaluator and program staff determine daily treatment is no longer needed. An onsite physician or another authorized provider must evaluate the patient within 10 days and consult medical and behavioral staff. Follow-up random testing occurs monthly rather than weekly until the patient passes.
Home health aides face registration standards
Home health aides must apply for registration and complete a competency program meeting federal standards. Training must total at least 75 hours, including 16 classroom hours before supervised practice. Registration lasts two years; renewal requires the state's process and required in-service training. Out-of-state aides have a registration route requiring proof of good standing, no verified complaint in another state, and a national criminal history check.
More certification paths for medication aides
Medication aide certification paths cover nurse aides, nursing students and graduates, specified out-of-state workers and health practitioners, and military-trained applicants. Training, testing, background checks, and good-standing requirements depend on the applicant's background. Certification lasts two years; renewal requires six education hours, or seven for insulin-authorized aides, including one insulin hour. Certain applicants get four exam attempts in two years, then must appear before the commission before reapplying. Facilities must check qualifications and registry status, but can allow work before listing with proof of completed approved training and testing.
More certification paths for nurse aides
The law provides alternative nurse aide certification paths for specified nursing students, graduates, out-of-state aides, health practitioners, and military-trained applicants. Training, exams, and affidavits about disqualifying convictions depend on the path. Out-of-state aides must show good standing, with no verified complaints or criminal convictions since their other-state certification. Nursing graduates must document graduation within the past 24 months; specified student, graduate, and military paths allow four exam attempts in two years. After four failures, applicants must appear before the commission before reapplying; the commission can also require appearances to resolve application or renewal questions.
New oversight and deadlines for aides
A new state commission oversees nurse aide, medication aide, and home health aide credentials, training, and disciplinary findings. Applications expire after one year unless requirements are completed; the commission can grant up to 30 extra days for good cause. An application filed after that expiration counts as a new application. The health department must give renewal notice 90 days before expiration; late notice protects aides who renew within 45 days of receiving it. Missing a required commission hearing can lead to action against an aide's credential.
Nurse aides face training and screening
Beginning September 1, 2025, facilities generally must use certified nurse aides and check their registry status. Exceptions cover some trainees and aides awaiting registry listing; one allows up to four months after approved evaluation and a facility competency finding. Facilities must arrange approved evaluations for planned hires and confirm registry listing when required for continued work. Commission-approved training requires 75 hours, mostly supervised clinical experience, including at least 16 supervised practical hours; approval can be revoked for cause. Employers must obtain certification applicants’ limited criminal histories from the Indiana State Police.
License holders gain contact information privacy
Beginning July 1, 2025, licensing agencies generally must keep home phone numbers and email addresses private. This covers current and former license holders, applicants, and board members. Exceptions allow specified government, legal, research, consent-based, and other legally authorized uses. Requesters using an exception must prove their identity and commit to using the information only for an authorized purpose.
Medicaid home changes get processing deadlines
Beginning July 1, 2025, Medicaid managed care plans contracted to provide home modifications must follow processing deadlines. Plans must request project specifications within 15 days after a patient care coordinator’s request. They must approve or deny the work, with an explanation, within 15 days after receiving completed specifications. After approval, they have five days to request bids and notify willing providers. Within 30 days after bid notification and receipt of bids, plans must notify winning and unsuccessful bidders and explain unsuccessful bids.
More clinicians can assess addiction patients
Beginning July 1, 2025, opioid treatment admission assessments can be performed by physicians, qualified advanced practice registered nurses, or qualified physician assistants. Nurses and physician assistants need the required license and a collaborative agreement with an onsite program physician. Assessments must stay within the clinician’s scope of practice and be recorded in the patient’s medical record. The state division cannot set admission or first-dose standards stricter than the cited federal standards.
Trained home aides can give tube feedings
The law repeals earlier tube-feeding provisions and authorizes registered home health aides to provide gastrointestinal or jejunostomy tube feedings under the new framework. Training requires 4–8 classroom hours, 2–4 practical hours, and written and practical exams. A registered nurse must supervise or delegate the task after assessing competency for the specific patient. Agencies must permit the practice, set patient-specific procedures, retain training records, and notify affected patients on admission. The commission can require up to one hour of annual in-service training.
Trained medication aides can give insulin
Medication aides can give insulin after completing an optional course and passing written and practical tests. The course requires 4–8 classroom hours and 2–4 practical hours. The facility must permit the task, and a registered nurse must supervise or delegate based on the aide’s competency. Facilities must set patient-specific instructions, reassess care, retain training records, and notify patients on admission. Aides cannot give concentrated insulin equal to or stronger than U-500.
Broader evaluations for deaf children
Beginning July 1, 2025, the state center must ensure comprehensive educational evaluations for deaf and hard-of-hearing children. Evaluations must consider the full range of communication options. The center must make professionals available based on each child's needs.
New care administrators skip education hours
New residential care administrators are exempt from 20 continuing education hours during the two-year period when their first Indiana license is issued. The exemption applies only to administrators who were not previously licensed as residential care administrators in another state.
Aide investigations and good-faith reporting protections
The health department must investigate aide abuse, neglect, and theft or misuse of patient property, plus medication aide misconduct. It must send supporting evidence and findings to the commission, which decides whether findings enter the registry. Beginning September 1, 2025, specified civil and criminal immunity covers qualifying good-faith reports to the commission. Covered reports also include those to the health department or nurse aide registry, plus participation in covered registry investigations or proceedings. The protection does not cover actions lacking good faith.
Fewer requirements for opioid treatment directors
Beginning July 1, 2025, the state mental health and addiction division cannot require opioid treatment medical directors to have hospital admitting privileges. This limits the division's requirements for directors, not patients' treatment duties.
Patients gain anesthesia incident reporting
Providers must report board-designated anesthesia adverse events within 24 hours in offices operating under the law’s accreditation exception. The board decides which events require reports and sets reporting procedures. It must post reported events on its website.
Patients gain medication aide safety safeguards
Beginning September 1, 2025, medication aide misconduct includes medication misuse, unsafe work, certification fraud, impairment, and false investigation statements. Improper patient relationships are also covered, with exceptions for specified family ties and arrangements predating certification. Licensed health facilities must report alleged abuse, neglect, misuse of patient property, or misconduct by medication aides. Before giving previously ordered as-needed medicine, aides must obtain a nurse’s approval each time symptoms occur and document the symptoms, contact, approval, and administration times. The nurse must cosign by shift end, or by the end of the next work period when on call.
State centralizes care aide oversight
Beginning September 1, 2025, Indiana must maintain a registry of certified nurse aides, qualified medication aides, and registered home health aides. The new Certified Health Care Professions Commission oversees aide qualifications, training, and discipline. Members who are not state employees receive a daily payment under Indiana law; members receive reimbursement for actual work expenses. Beginning July 1, 2025, specified older rules for care facility personnel and nurse aides are void and must be removed.
Addiction clinics can close on holidays
Beginning July 1, 2025, Indiana opioid treatment programs can close on Sundays and federally recognized national legal holidays. Programs are allowed, but not required, to close on those days.
Medication aides face clear care limits
Medication aides cannot give injections except authorized insulin, or inhaled medicines except through a metered-dose inhaler. They cannot give medicine through a nose-to-stomach tube or use irrigation fluids except the specified disposable enema. They cannot take responsibility for written or telephone medication orders. They also cannot treat advanced skin conditions, including stage II through IV pressure sores. Aides cannot record medicines given by another person or medicines that were never given.
Nursing students need two clinical settings
Beginning July 1, 2025, covered nursing programs must include clinical hours at both a licensed hospital and a licensed health facility. The rule applies to practical nursing, associate degree, diploma, and bachelor's degree nursing programs.
Training and renewal rules for nurse aides
Nurse aides hired without approved training must enroll in the first available approved program starting within 60 days of employment. Certification lasts two years, and renewal requires federally required in-service training. Certified aides must report mailing or email address changes within 30 days. Training programs must use instructors who meet federal qualifications. Instructor certification also lasts two years and can be renewed.
Nursing programs must use multiple sites
Beginning July 1, 2025, nursing programs must arrange required instruction and clinical experience at more than one institution or agency. The nursing board must approve each site used.
Courts oversee disease-related medical record requests
In cases involving offenses that may spread disease, prosecutors can seek a charged defendant’s medical information. Defendants can seek another person’s medical information relevant to their defense. Requests require a verified petition, notice to specified people and providers, and a hearing within 20 days. Courts must find probable cause of possible relevance before obtaining records, then review them privately before deciding whether release is justified. Release to the requester requires probable cause of relevance and must be limited to essential information and authorized people.
Health records gain protections and exceptions
Beginning July 1, 2025, specified confidentiality rules cover health information held by state and local health departments, including the health and hospital corporation. The state health department can share medical or disease information with a qualifying Indiana nonprofit when necessary for a public health event. A data-use agreement must limit the nonprofit's use and disclosure. A separate exception permits disclosure of an alleged perpetrator's medical information when a provider or covered business believes in good faith that it provides evidence of a crime on its premises.
Aide credentials stay valid during reviews
A complaint about conduct covered by the law can delay aide credential renewal for up to 120 days after expiration. The health department must notify the worker and investigate; the commission must review evidence and hold a hearing before the delay ends. The credential remains valid until the commission decides the matter or denies renewal. The department must renew it if the commission does not make the required decision. Renewal does not prevent the commission from later deciding an unresolved allegation.
Home aides register without state fees
Only registered home health aides may provide home health aide services. The commission and health department cannot charge aides for registration or renewal. A health care professional must supervise the aide’s care within that professional’s scope of practice.
Home health aides need ongoing training
Home health aides need 12 training hours each calendar year, including eight on specified topics; first-year hours are prorated. A registered nurse must provide or supervise training, agencies must keep records, and agencies with probationary licenses cannot provide training. Aides caring for people with dementia or related symptoms need six approved training hours within 60 days of being hired for that care. After one year of employment, they need three hours before December 31 each year. Aides with 24 consecutive months of work and completed training do not repeat it when hired by a home health agency.
Some anesthesia offices avoid accreditation requirements
Some physician, podiatry, and dental offices are exempt from board accreditation when qualifying practitioners provide moderate sedation, deep sedation, or general anesthesia. Eligible practitioners include licensed anesthesiologists, nurse anesthetists under a physician's direction and immediate presence, and qualifying anesthesiologist assistants. Board practice standards still apply. The anesthesiologist or supervising doctor must report the office address and confirm compliance every two years.
Updated legal coverage for health services
For one legal provision, health care services include noninvasive care, routine dental care, injections, minor wound stitching, and draining boils or superficial abscesses. That definition excludes abortions, including those using abortion-inducing drugs, and prescribing controlled or scheduled drugs for abortion. A separate definition covers services by certified health professionals registered with both the health department and the new commission. Related references to nurse aides, medication aides, and home health aides are updated.
New standards for aide training programs
Medication aide programs are capped at 100 classroom and supervised practice hours, with facility practice, skills checklists, and documented lab substitutes. Instructors must be licensed nurses with one year of experience, an approved instructor course, and a state application. State-approved testers must give multiple-choice exams that stay valid and current; deficient programs can lose approval through required proceedings. Beginning September 1, 2025, previously approved medication aide programs, curricula, and instructor courses receive commission approval without another application. Qualifying home health aide tube-feeding curricula also receive transition approval; these transition rules expire December 31, 2025.
Sponsors & Cosponsors
Sponsor
Liz Brown
Republican • Senate
Cosponsors
Brad Barrett
Republican • House
Cindy Ledbetter
Republican • House
Ed Charbonneau
Republican • Senate
Gregory Porter
Democratic • House
Joanna King
Republican • House
Lonnie Randolph
Democratic • Senate
Mike Bohacek
Republican • Senate
Tyler Johnson
Republican • Senate
Vaneta Becker
Republican • Senate
Roll Call Votes
Senate vote • 4/16/2025
Senate concurred with House amendments
Yes: 41 • No: 0
House vote • 4/9/2025
Third reading: passed
Yes: 93 • No: 0
Senate vote • 2/20/2025
Third reading: passed
Yes: 47 • No: 2
Actions Timeline
Public Law 143
5/1/2025SenateSigned by the Governor
5/1/2025SenateSigned by the President of the Senate
4/23/2025SenateSigned by the Speaker
4/22/2025HouseSigned by the President Pro Tempore
4/17/2025SenateSenate concurred with House amendments; Roll Call 465: yeas 41, nays 0
4/16/2025SenateReturned to the Senate with amendments
4/10/2025HouseMotion to concur filed
4/10/2025SenateThird reading: passed; Roll Call 411: yeas 93, nays 0
4/9/2025HouseAmendment #3 (Barrett) prevailed; voice vote
4/8/2025HouseAmendment #1 (Barrett) prevailed; voice vote
4/8/2025HouseAmendment #4 (Barrett) prevailed; voice vote
4/8/2025HouseSecond reading: amended, ordered engrossed
4/8/2025HouseCommittee report: amend do pass, adopted
4/1/2025HouseRepresentatives Ledbetter and Porter added as cosponsors
4/1/2025HouseFirst reading: referred to Committee on Public Health
3/3/2025HouseReferred to the House
2/21/2025SenateThird reading: passed; Roll Call 201: yeas 47, nays 2
2/20/2025SenateHouse sponsor: Representative Barrett
2/20/2025SenateCosponsor: Representative King
2/20/2025SenateSecond reading: amended, ordered engrossed
2/17/2025SenateAmendment #1 (Brown L) prevailed; voice vote
2/17/2025SenateSenator Randolph added as coauthor
2/13/2025SenateCommittee report: amend do pass, adopted
2/13/2025SenateSenator Bohacek added as coauthor
1/30/2025Senate
Bill Text
Engrossed Senate Bill (H)
Engrossed Senate Bill (S)
Enrolled Senate Bill (S)
Introduced Senate Bill (S)
Senate Bill (H)
Senate Bill (S)
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