As Passed by the House

129th General Assembly Regular Session 2011-2012

Am. Sub. H. B. No. 125

Representative Wachtmann 

Cosponsors: Representatives Henne, Buchy, Blessing, Rosenberger, Amstutz, McClain, Stautberg, Maag, Bubp, Adams, J., Snitchler, Sears, Roegner, Burke, Grossman, Hottinger, Johnson, Martin, Gardner, Combs, Beck, Schuring, Goodwin, Adams, R., Young, Brenner, Huffman, Hall, Mecklenborg, Slaby, Carey, Blair, Gonzales, Hackett, Kozlowski, Balderson, Hayes, Baker, Dovilla, Boose, Peterson, Derickson, Ruhl, Landis, Sprague, Newbold, Thompson, Uecker, Butler, Conditt, Hagan, C. Speaker Batchelder 

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A BILL

To amend section 4731.22 and to enact section 2919.19

1

of the Revised Code to generally prohibit an

2

abortion of an unborn human individual with a

3

detectable fetal heartbeat.

4

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

Section 1.  That section 4731.22 be amended and section	5
2919.19 of the Revised Code be enacted to read as follows:	6

Sec. 2919.19.  (A) The general assembly hereby declares that	7
it finds, according to contemporary medical research, all of the	8
following:	9

(1) As many as thirty per cent of natural pregnancies end in	10
spontaneous miscarriage;	11

(2) Less than five per cent of all natural pregnancies end in	12
spontaneous miscarriage after detection of fetal cardiac activity;	13

(3) Over ninety per cent of in vitro pregnancies survive the	14
first trimester if cardiac activity is detected in the gestational	15
sac;	16

(4) Nearly ninety per cent of in vitro pregnancies do not	17
survive the first trimester where cardiac activity is not detected	18
in the gestational sac;	19

(5) Fetal heartbeat, therefore, has become a key, medical	20
predictor that an unborn human individual will reach viability and	21
live birth;	22

(6) Cardiac activity begins at a biologically identifiable	23
moment in time, normally when the fetal heart is formed in the	24
gestational sac.	25

(B)(1) "Contraceptive" means a device, drug, or chemical that	26
prevents conception.	27

(2) "Fetal heartbeat" means cardiac activity or the steady	28
and repetitive rhythmic contraction of the fetal heart within the	29
gestational sac.	30

(3) "Fetus" means the human offspring developing during	31
pregnancy from the moment of conception and includes the embryonic	32
stage of development.	33

(4) "Gestational age" means the age of an unborn human	34
individual as calculated from the first day of the last menstrual	35
period of a pregnant woman.	36

(5) "Gestational sac" comprises the extra embryonic membranes	37
that envelop the fetus and that is typically visible by ultrasound	38
after the fourth week of pregnancy.	39

(6) "Medical emergency" means a condition that in the	40
physician's good faith medical judgment, based upon the facts	41
known to the physician at that time, so endangers the life of the	42
pregnant woman or a major bodily function of the pregnant woman as	43
to necessitate the immediate performance or inducement of an	44
abortion.	45

(7) "Physician" has the same meaning as in section 2305.113	46
of the Revised Code.	47

(8) "Pregnancy" means the human female reproductive condition	48
that begins with fertilization, when the woman is carrying the	49
developing human offspring, and that is calculated from the first	50
day of the last menstrual period of the woman.	51

(9) "Spontaneous miscarriage" means the natural or accidental	52
termination of a pregnancy and the expulsion of the fetus,	53
typically caused by genetic defects in the fetus or physical	54
abnormalities in the pregnant woman.	55

(10) "Unborn human individual" means an individual organism	56
of the species homo sapiens from fertilization until live birth.	57

(C)(1) Except when a medical emergency exists that prevents	58
compliance with this division, no person shall perform an abortion	59
on a pregnant woman prior to determining if the fetus the pregnant	60
woman is carrying has a detectable fetal heartbeat. Any person who	61
performs an abortion on a pregnant woman based on the exception in	62
this division shall note in the pregnant woman's medical records	63
that a medical emergency necessitating the abortion existed.	64

(2) A person who intends to perform an abortion on a pregnant	65
woman shall determine if there is the presence of a fetal	66
heartbeat of the unborn human individual that the pregnant woman	67
is carrying according to standard medical practice. A person shall	68
comply with division (C)(2) of this section regardless of whether	69
or not the director of health promulgated rules under division	70
(C)(3) of this section.	71

(3) The director of health may promulgate rules pursuant to	72
section 111.15 of the Revised Code for the appropriate methods of	73
performing an examination for the presence of a fetal heartbeat of	74
an unborn human individual based on standard medical practice.	75

(4) If a physician performs an abortion on a pregnant woman	76
prior to determining if the fetus the pregnant woman is carrying	77
has a detectable fetal heartbeat, that physician is subject to	78
disciplinary action under division (B)(41) of section 4731.22 of	79
the Revised Code.	80

(D)(1) Division (D) of this section applies to all abortions	81
that are not prohibited under sections 2919.12, 2919.121, and	82
2919.151 of the Revised Code, except when a medical emergency	83
exists that prevents compliance with this division.	84

(2) If the person who intends to perform an abortion on a	85
pregnant woman detects a fetal heartbeat in the unborn human	86
individual that the pregnant woman is carrying, no later than	87
twenty-four hours prior to the performance of the intended	88
abortion, both of the following apply:	89

(a) The person intending to perform the abortion shall inform	90
the pregnant woman in writing that the unborn human individual	91
that the pregnant woman is carrying has a fetal heartbeat and	92
shall inform the pregnant woman, to the best of the person's	93
knowledge, of the statistical probability of bringing the unborn	94
human individual to term based on the gestational age of the	95
unborn human individual possessing a detectable fetal heartbeat. A	96
person shall comply with division (D)(2)(a) of this section	97
regardless of whether or not the director of health promulgated	98
rules under division (D)(3) of this section.	99

(b) The pregnant woman shall sign a form acknowledging that	100
the pregnant woman has received information from the person	101
intending to perform the abortion that the unborn human individual	102
that the pregnant woman is carrying has a fetal heartbeat and that	103
the pregnant woman is aware of the statistical probability of	104
bringing the unborn human individual that the pregnant woman is	105
carrying to term.	106

(3) The director of health may define and promulgate by rules	107
adopted pursuant to section 111.15 of the Revised Code and based	108
upon available medical evidence the statistical probability of	109
bringing an unborn human individual to term based on the	110
gestational age of an unborn human individual who possesses a	111
detectable fetal heartbeat.	112

(4) Division (D) of this section does not repeal any other	113
provision of the Revised Code relating to informed consent for an	114
abortion.	115

(E)(1) Except as provided in division (E)(2) or (3) of this	116
section, no person shall knowingly perform an abortion on a	117
pregnant woman with the specific intent of causing or abetting the	118
termination of the life of the unborn human individual that the	119
pregnant woman is carrying and whose fetal heartbeat has been	120
detected according to the requirements of division (C) of this	121
section. Any person who acts based on the exception in division	122
(E)(2) or (3) of this section shall so note in the pregnant	123
woman's medical records and shall specify in the pregnant woman's	124
medical records which of the exceptions the person invoked.	125

(2)(a) A person is not in violation of division (E)(1) of	126
this section if that person performs a medical procedure designed	127
to or intended, in that person's reasonable medical judgment, to	128
prevent the death of a pregnant woman or to prevent a serious risk	129
of the substantial and irreversible impairment of a major bodily	130
function of the pregnant woman.	131

(b) Any person who performs a medical procedure as described	132
in division (E)(2)(a) of this section shall declare in writing,	133
under penalty of perjury, that the medical procedure is necessary,	134
to the best of that person's reasonable medical judgment, to	135
prevent the death of the pregnant woman or to prevent a serious	136
risk of the substantial and irreversible impairment of a major	137
bodily function of the pregnant woman. That person shall also	138
provide in that written document, under penalty of perjury, the	139
medical condition of that pregnant woman that the medical	140
procedure performed as described in division (E)(2)(a) of this	141
section will assertedly address, and the medical rationale for the	142
conclusion that the medical procedure is necessary to prevent the	143
death of the pregnant woman or to prevent a serious risk of the	144
substantial and irreversible impairment of a major bodily function	145
of the pregnant woman.	146

(c) The person who performs a medical procedure as described	147
in division (E)(2)(a) of this section shall place the written	148
documentation required under division (E)(2)(b) of this section in	149
the pregnant woman's medical records and shall maintain a copy of	150
the written documentation in the person's own records for at least	151
seven years.	152

(3) A person is not in violation of division (E)(1) of this	153
section if that person has performed an examination for the	154
presence of a fetal heartbeat in the fetus utilizing standard	155
medical practice and that examination does not reveal a fetal	156
heartbeat or the person has been informed by a physician who has	157
performed the examination for fetal heartbeat that the examination	158
did not reveal a fetal heartbeat.	159

(4) Division (E) of this section does not repeal any other	160
provision of the Revised Code that restricts or regulates the	161
performance of an abortion by a particular method or during a	162
particular stage of a pregnancy.	163

(5) Whoever violates division (E) of this section is guilty	164
of performing an abortion after the detection of a fetal	165
heartbeat, a felony of the fifth degree.	166

(F) Any person performing an abortion on a pregnant woman	167
carrying an unborn human individual whose heartbeat has been	168
detected pursuant to the requirements of division (C) of this	169
section to preserve the health of the pregnant woman shall set	170
forth in a separate document, under penalty of perjury, the	171
medical condition that the abortion will assertedly address and	172
the medical rationale for the conclusion that the abortion is	173
necessary to address that condition. The person shall place this	174
written documentation in the pregnant woman's medical records and	175
shall maintain a copy in the person's own records for at least	176
seven years. This documentation requirement is independent of the	177
provisions in divisions (E)(2)(a), (b), and (c) of this section.	178

(G) A pregnant woman on whom an abortion is performed in	179
violation of division (C) or (E) of this section is not guilty of	180
violating division (C) or (E) of this section or of attempting to	181
commit, conspiring to commit, or complicity in committing a	182
violation of division (C) or (E) of this section and is not	183
subject to a civil penalty based on that violation.	184

(H) Nothing in this section prohibits the sale, use,	185
prescription, or administration of a measure, drug, or chemical	186
designed for contraceptive purposes.	187

(I) If a state or federal court of competent jurisdiction	188
finds that a provision of this section is unconstitutional, the	189
effective date of that provision is tolled until either of the	190
following occur:	191

(1) An appellate tribunal finds that provision to be	192
constitutional.	193

(2) The attorney general certifies in an opinion to the	194
governor that, due to a subsequent decision or decisions by the	195
supreme court of the United States, it is reasonably probable that	196
the provision would be upheld as constitutional by a court of	197
competent jurisdiction.	198

(J) If a provision of this section is found constitutional by	199
an appellate tribunal or the attorney general issues an opinion as	200
described in division (H)(2) of this section, the provision shall	201
be prospective.	202

(K) If any provisions of this section or its application to	203
any person or circumstance is held invalid, the invalidity does	204
not affect other provisions or applications of this section that	205
can be given effect without the invalid provision or application,	206
and to this end the provisions of this section are severable.	207

Sec. 4731.22.  (A) The state medical board, by an affirmative	208
vote of not fewer than six of its members, may revoke or may	209
refuse to grant a certificate to a person found by the board to	210
have committed fraud during the administration of the examination	211
for a certificate to practice or to have committed fraud,	212
misrepresentation, or deception in applying for or securing any	213
certificate to practice or certificate of registration issued by	214
the board.	215

(B) The board, by an affirmative vote of not fewer than six	216
members, shall, to the extent permitted by law, limit, revoke, or	217
suspend an individual's certificate to practice, refuse to	218
register an individual, refuse to reinstate a certificate, or	219
reprimand or place on probation the holder of a certificate for	220
one or more of the following reasons:	221

(1) Permitting one's name or one's certificate to practice or	222
certificate of registration to be used by a person, group, or	223
corporation when the individual concerned is not actually	224
directing the treatment given;	225

(2) Failure to maintain minimal standards applicable to the	226
selection or administration of drugs, or failure to employ	227
acceptable scientific methods in the selection of drugs or other	228
modalities for treatment of disease;	229

(3) Selling, giving away, personally furnishing, prescribing,	230
or administering drugs for other than legal and legitimate	231
therapeutic purposes or a plea of guilty to, a judicial finding of	232
guilt of, or a judicial finding of eligibility for intervention in	233
lieu of conviction of, a violation of any federal or state law	234
regulating the possession, distribution, or use of any drug;	235

(4) Willfully betraying a professional confidence.

236

For purposes of this division, "willfully betraying a	237
professional confidence" does not include providing any	238
information, documents, or reports to a child fatality review	239
board under sections 307.621 to 307.629 of the Revised Code and	240
does not include the making of a report of an employee's use of a	241
drug of abuse, or a report of a condition of an employee other	242
than one involving the use of a drug of abuse, to the employer of	243
the employee as described in division (B) of section 2305.33 of	244
the Revised Code. Nothing in this division affects the immunity	245
from civil liability conferred by that section upon a physician	246
who makes either type of report in accordance with division (B) of	247
that section. As used in this division, "employee," "employer,"	248
and "physician" have the same meanings as in section 2305.33 of	249
the Revised Code.	250

(5) Making a false, fraudulent, deceptive, or misleading	251
statement in the solicitation of or advertising for patients; in	252
relation to the practice of medicine and surgery, osteopathic	253
medicine and surgery, podiatric medicine and surgery, or a limited	254
branch of medicine; or in securing or attempting to secure any	255
certificate to practice or certificate of registration issued by	256
the board.	257

As used in this division, "false, fraudulent, deceptive, or	258
misleading statement" means a statement that includes a	259
misrepresentation of fact, is likely to mislead or deceive because	260
of a failure to disclose material facts, is intended or is likely	261
to create false or unjustified expectations of favorable results,	262
or includes representations or implications that in reasonable	263
probability will cause an ordinarily prudent person to	264
misunderstand or be deceived.	265

(6) A departure from, or the failure to conform to, minimal	266
standards of care of similar practitioners under the same or	267
similar circumstances, whether or not actual injury to a patient	268
is established;	269

(7) Representing, with the purpose of obtaining compensation	270
or other advantage as personal gain or for any other person, that	271
an incurable disease or injury, or other incurable condition, can	272
be permanently cured;	273

(8) The obtaining of, or attempting to obtain, money or	274
anything of value by fraudulent misrepresentations in the course	275
of practice;	276

(9) A plea of guilty to, a judicial finding of guilt of, or a	277
judicial finding of eligibility for intervention in lieu of	278
conviction for, a felony;	279

(10) Commission of an act that constitutes a felony in this	280
state, regardless of the jurisdiction in which the act was	281
committed;	282

(11) A plea of guilty to, a judicial finding of guilt of, or	283
a judicial finding of eligibility for intervention in lieu of	284
conviction for, a misdemeanor committed in the course of practice;	285

(12) Commission of an act in the course of practice that	286
constitutes a misdemeanor in this state, regardless of the	287
jurisdiction in which the act was committed;	288

(13) A plea of guilty to, a judicial finding of guilt of, or	289
a judicial finding of eligibility for intervention in lieu of	290
conviction for, a misdemeanor involving moral turpitude;	291

(14) Commission of an act involving moral turpitude that	292
constitutes a misdemeanor in this state, regardless of the	293
jurisdiction in which the act was committed;	294

(15) Violation of the conditions of limitation placed by the	295
board upon a certificate to practice;	296

(16) Failure to pay license renewal fees specified in this	297
chapter;	298

(17) Except as authorized in section 4731.31 of the Revised	299
Code, engaging in the division of fees for referral of patients,	300
or the receiving of a thing of value in return for a specific	301
referral of a patient to utilize a particular service or business;	302

(18) Subject to section 4731.226 of the Revised Code,	303
violation of any provision of a code of ethics of the American	304
medical association, the American osteopathic association, the	305
American podiatric medical association, or any other national	306
professional organizations that the board specifies by rule. The	307
state medical board shall obtain and keep on file current copies	308
of the codes of ethics of the various national professional	309
organizations. The individual whose certificate is being suspended	310
or revoked shall not be found to have violated any provision of a	311
code of ethics of an organization not appropriate to the	312
individual's profession.	313

For purposes of this division, a "provision of a code of	314
ethics of a national professional organization" does not include	315
any provision that would preclude the making of a report by a	316
physician of an employee's use of a drug of abuse, or of a	317
condition of an employee other than one involving the use of a	318
drug of abuse, to the employer of the employee as described in	319
division (B) of section 2305.33 of the Revised Code. Nothing in	320
this division affects the immunity from civil liability conferred	321
by that section upon a physician who makes either type of report	322
in accordance with division (B) of that section. As used in this	323
division, "employee," "employer," and "physician" have the same	324
meanings as in section 2305.33 of the Revised Code.	325

(19) Inability to practice according to acceptable and	326
prevailing standards of care by reason of mental illness or	327
physical illness, including, but not limited to, physical	328
deterioration that adversely affects cognitive, motor, or	329
perceptive skills.	330

In enforcing this division, the board, upon a showing of a	331
possible violation, may compel any individual authorized to	332
practice by this chapter or who has submitted an application	333
pursuant to this chapter to submit to a mental examination,	334
physical examination, including an HIV test, or both a mental and	335
a physical examination. The expense of the examination is the	336
responsibility of the individual compelled to be examined. Failure	337
to submit to a mental or physical examination or consent to an HIV	338
test ordered by the board constitutes an admission of the	339
allegations against the individual unless the failure is due to	340
circumstances beyond the individual's control, and a default and	341
final order may be entered without the taking of testimony or	342
presentation of evidence. If the board finds an individual unable	343
to practice because of the reasons set forth in this division, the	344
board shall require the individual to submit to care, counseling,	345
or treatment by physicians approved or designated by the board, as	346
a condition for initial, continued, reinstated, or renewed	347
authority to practice. An individual affected under this division	348
shall be afforded an opportunity to demonstrate to the board the	349
ability to resume practice in compliance with acceptable and	350
prevailing standards under the provisions of the individual's	351
certificate. For the purpose of this division, any individual who	352
applies for or receives a certificate to practice under this	353
chapter accepts the privilege of practicing in this state and, by	354
so doing, shall be deemed to have given consent to submit to a	355
mental or physical examination when directed to do so in writing	356
by the board, and to have waived all objections to the	357
admissibility of testimony or examination reports that constitute	358
a privileged communication.	359

(20) Except when civil penalties are imposed under section	360
4731.225 or 4731.281 of the Revised Code, and subject to section	361
4731.226 of the Revised Code, violating or attempting to violate,	362
directly or indirectly, or assisting in or abetting the violation	363
of, or conspiring to violate, any provisions of this chapter or	364
any rule promulgated by the board.	365

This division does not apply to a violation or attempted	366
violation of, assisting in or abetting the violation of, or a	367
conspiracy to violate, any provision of this chapter or any rule	368
adopted by the board that would preclude the making of a report by	369
a physician of an employee's use of a drug of abuse, or of a	370
condition of an employee other than one involving the use of a	371
drug of abuse, to the employer of the employee as described in	372
division (B) of section 2305.33 of the Revised Code. Nothing in	373
this division affects the immunity from civil liability conferred	374
by that section upon a physician who makes either type of report	375
in accordance with division (B) of that section. As used in this	376
division, "employee," "employer," and "physician" have the same	377
meanings as in section 2305.33 of the Revised Code.	378

(21) The violation of section 3701.79 of the Revised Code or	379
of any abortion rule adopted by the public health council pursuant	380
to section 3701.341 of the Revised Code;	381

(22) Any of the following actions taken by the agency	382
responsible for regulating the practice of medicine and surgery,	383
osteopathic medicine and surgery, podiatric medicine and surgery,	384
or the limited branches of medicine in another jurisdiction, for	385
any reason other than the nonpayment of fees: the limitation,	386
revocation, or suspension of an individual's license to practice;	387
acceptance of an individual's license surrender; denial of a	388
license; refusal to renew or reinstate a license; imposition of	389
probation; or issuance of an order of censure or other reprimand;	390

(23) The violation of section 2919.12 of the Revised Code or	391
the performance or inducement of an abortion upon a pregnant woman	392
with actual knowledge that the conditions specified in division	393
(B) of section 2317.56 of the Revised Code have not been satisfied	394
or with a heedless indifference as to whether those conditions	395
have been satisfied, unless an affirmative defense as specified in	396
division (H)(2) of that section would apply in a civil action	397
authorized by division (H)(1) of that section;	398

(24) The revocation, suspension, restriction, reduction, or	399
termination of clinical privileges by the United States department	400
of defense or department of veterans affairs or the termination or	401
suspension of a certificate of registration to prescribe drugs by	402
the drug enforcement administration of the United States	403
department of justice;	404

(25) Termination or suspension from participation in the	405
medicare or medicaid programs by the department of health and	406
human services or other responsible agency for any act or acts	407
that also would constitute a violation of division (B)(2), (3),	408
(6), (8), or (19) of this section;	409

(26) Impairment of ability to practice according to	410
acceptable and prevailing standards of care because of habitual or	411
excessive use or abuse of drugs, alcohol, or other substances that	412
impair ability to practice.	413

For the purposes of this division, any individual authorized	414
to practice by this chapter accepts the privilege of practicing in	415
this state subject to supervision by the board. By filing an	416
application for or holding a certificate to practice under this	417
chapter, an individual shall be deemed to have given consent to	418
submit to a mental or physical examination when ordered to do so	419
by the board in writing, and to have waived all objections to the	420
admissibility of testimony or examination reports that constitute	421
privileged communications.	422

If it has reason to believe that any individual authorized to	423
practice by this chapter or any applicant for certification to	424
practice suffers such impairment, the board may compel the	425
individual to submit to a mental or physical examination, or both.	426
The expense of the examination is the responsibility of the	427
individual compelled to be examined. Any mental or physical	428
examination required under this division shall be undertaken by a	429
treatment provider or physician who is qualified to conduct the	430
examination and who is chosen by the board.	431

Failure to submit to a mental or physical examination ordered	432
by the board constitutes an admission of the allegations against	433
the individual unless the failure is due to circumstances beyond	434
the individual's control, and a default and final order may be	435
entered without the taking of testimony or presentation of	436
evidence. If the board determines that the individual's ability to	437
practice is impaired, the board shall suspend the individual's	438
certificate or deny the individual's application and shall require	439
the individual, as a condition for initial, continued, reinstated,	440
or renewed certification to practice, to submit to treatment.	441

Before being eligible to apply for reinstatement of a	442
certificate suspended under this division, the impaired	443
practitioner shall demonstrate to the board the ability to resume	444
practice in compliance with acceptable and prevailing standards of	445
care under the provisions of the practitioner's certificate. The	446
demonstration shall include, but shall not be limited to, the	447
following:	448

(a) Certification from a treatment provider approved under	449
section 4731.25 of the Revised Code that the individual has	450
successfully completed any required inpatient treatment;	451

(b) Evidence of continuing full compliance with an aftercare	452
contract or consent agreement;	453

(c) Two written reports indicating that the individual's	454
ability to practice has been assessed and that the individual has	455
been found capable of practicing according to acceptable and	456
prevailing standards of care. The reports shall be made by	457
individuals or providers approved by the board for making the	458
assessments and shall describe the basis for their determination.	459

The board may reinstate a certificate suspended under this	460
division after that demonstration and after the individual has	461
entered into a written consent agreement.	462

When the impaired practitioner resumes practice, the board	463
shall require continued monitoring of the individual. The	464
monitoring shall include, but not be limited to, compliance with	465
the written consent agreement entered into before reinstatement or	466
with conditions imposed by board order after a hearing, and, upon	467
termination of the consent agreement, submission to the board for	468
at least two years of annual written progress reports made under	469
penalty of perjury stating whether the individual has maintained	470
sobriety.	471

(27) A second or subsequent violation of section 4731.66 or	472
4731.69 of the Revised Code;	473

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

474

(a) Waiving the payment of all or any part of a deductible or	475
copayment that a patient, pursuant to a health insurance or health	476
care policy, contract, or plan that covers the individual's	477
services, otherwise would be required to pay if the waiver is used	478
as an enticement to a patient or group of patients to receive	479
health care services from that individual;	480

(b) Advertising that the individual will waive the payment of	481
all or any part of a deductible or copayment that a patient,	482
pursuant to a health insurance or health care policy, contract, or	483
plan that covers the individual's services, otherwise would be	484
required to pay.	485

(29) Failure to use universal blood and body fluid	486
precautions established by rules adopted under section 4731.051 of	487
the Revised Code;	488

(30) Failure to provide notice to, and receive acknowledgment	489
of the notice from, a patient when required by section 4731.143 of	490
the Revised Code prior to providing nonemergency professional	491
services, or failure to maintain that notice in the patient's	492
file;	493

(31) Failure of a physician supervising a physician assistant	494
to maintain supervision in accordance with the requirements of	495
Chapter 4730. of the Revised Code and the rules adopted under that	496
chapter;	497

(32) Failure of a physician or podiatrist to enter into a	498
standard care arrangement with a clinical nurse specialist,	499
certified nurse-midwife, or certified nurse practitioner with whom	500
the physician or podiatrist is in collaboration pursuant to	501
section 4731.27 of the Revised Code or failure to fulfill the	502
responsibilities of collaboration after entering into a standard	503
care arrangement;	504

(33) Failure to comply with the terms of a consult agreement	505
entered into with a pharmacist pursuant to section 4729.39 of the	506
Revised Code;	507

(34) Failure to cooperate in an investigation conducted by	508
the board under division (F) of this section, including failure to	509
comply with a subpoena or order issued by the board or failure to	510
answer truthfully a question presented by the board at a	511
deposition or in written interrogatories, except that failure to	512
cooperate with an investigation shall not constitute grounds for	513
discipline under this section if a court of competent jurisdiction	514
has issued an order that either quashes a subpoena or permits the	515
individual to withhold the testimony or evidence in issue;	516

(35) Failure to supervise an acupuncturist in accordance with	517
Chapter 4762. of the Revised Code and the board's rules for	518
supervision of an acupuncturist;	519

(36) Failure to supervise an anesthesiologist assistant in	520
accordance with Chapter 4760. of the Revised Code and the board's	521
rules for supervision of an anesthesiologist assistant;	522

(37) Assisting suicide as defined in section 3795.01 of the	523
Revised Code;	524

(38) Failure to comply with the requirements of section	525
2317.561 of the Revised Code;	526

(39) Failure to supervise a radiologist assistant in	527
accordance with Chapter 4774. of the Revised Code and the board's	528
rules for supervision of radiologist assistants;	529

(40) Performing or inducing an abortion at an office or	530
facility with knowledge that the office or facility fails to post	531
the notice required under section 3701.791 of the Revised Code;	532

(41) Performing an abortion on a pregnant woman prior to	533
determining if the fetus the pregnant woman is carrying has a	534
detectable fetal heartbeat, as provided in division (C) of section	535
2919.19 of the Revised Code.	536

(C) Disciplinary actions taken by the board under divisions	537
(A) and (B) of this section shall be taken pursuant to an	538
adjudication under Chapter 119. of the Revised Code, except that	539
in lieu of an adjudication, the board may enter into a consent	540
agreement with an individual to resolve an allegation of a	541
violation of this chapter or any rule adopted under it. A consent	542
agreement, when ratified by an affirmative vote of not fewer than	543
six members of the board, shall constitute the findings and order	544
of the board with respect to the matter addressed in the	545
agreement. If the board refuses to ratify a consent agreement, the	546
admissions and findings contained in the consent agreement shall	547
be of no force or effect.	548

If the board takes disciplinary action against an individual	549
under division (B) of this section for a second or subsequent plea	550
of guilty to, or judicial finding of guilt of, a violation of	551
section 2919.123 of the Revised Code, the disciplinary action	552
shall consist of a suspension of the individual's certificate to	553
practice for a period of at least one year or, if determined	554
appropriate by the board, a more serious sanction involving the	555
individual's certificate to practice. Any consent agreement	556
entered into under this division with an individual that pertains	557
to a second or subsequent plea of guilty to, or judicial finding	558
of guilt of, a violation of that section shall provide for a	559
suspension of the individual's certificate to practice for a	560
period of at least one year or, if determined appropriate by the	561
board, a more serious sanction involving the individual's	562
certificate to practice.	563

(D) For purposes of divisions (B)(10), (12), and (14) of this	564
section, the commission of the act may be established by a finding	565
by the board, pursuant to an adjudication under Chapter 119. of	566
the Revised Code, that the individual committed the act. The board	567
does not have jurisdiction under those divisions if the trial	568
court renders a final judgment in the individual's favor and that	569
judgment is based upon an adjudication on the merits. The board	570
has jurisdiction under those divisions if the trial court issues	571
an order of dismissal upon technical or procedural grounds.	572

(E) The sealing of conviction records by any court shall have	573
no effect upon a prior board order entered under this section or	574
upon the board's jurisdiction to take action under this section	575
if, based upon a plea of guilty, a judicial finding of guilt, or a	576
judicial finding of eligibility for intervention in lieu of	577
conviction, the board issued a notice of opportunity for a hearing	578
prior to the court's order to seal the records. The board shall	579
not be required to seal, destroy, redact, or otherwise modify its	580
records to reflect the court's sealing of conviction records.	581

(F)(1) The board shall investigate evidence that appears to	582
show that a person has violated any provision of this chapter or	583
any rule adopted under it. Any person may report to the board in a	584
signed writing any information that the person may have that	585
appears to show a violation of any provision of this chapter or	586
any rule adopted under it. In the absence of bad faith, any person	587
who reports information of that nature or who testifies before the	588
board in any adjudication conducted under Chapter 119. of the	589
Revised Code shall not be liable in damages in a civil action as a	590
result of the report or testimony. Each complaint or allegation of	591
a violation received by the board shall be assigned a case number	592
and shall be recorded by the board.	593

(2) Investigations of alleged violations of this chapter or	594
any rule adopted under it shall be supervised by the supervising	595
member elected by the board in accordance with section 4731.02 of	596
the Revised Code and by the secretary as provided in section	597
4731.39 of the Revised Code. The president may designate another	598
member of the board to supervise the investigation in place of the	599
supervising member. No member of the board who supervises the	600
investigation of a case shall participate in further adjudication	601
of the case.	602

(3) In investigating a possible violation of this chapter or	603
any rule adopted under this chapter, the board may administer	604
oaths, order the taking of depositions, issue subpoenas, and	605
compel the attendance of witnesses and production of books,	606
accounts, papers, records, documents, and testimony, except that a	607
subpoena for patient record information shall not be issued	608
without consultation with the attorney general's office and	609
approval of the secretary and supervising member of the board.	610
Before issuance of a subpoena for patient record information, the	611
secretary and supervising member shall determine whether there is	612
probable cause to believe that the complaint filed alleges a	613
violation of this chapter or any rule adopted under it and that	614
the records sought are relevant to the alleged violation and	615
material to the investigation. The subpoena may apply only to	616
records that cover a reasonable period of time surrounding the	617
alleged violation.	618

On failure to comply with any subpoena issued by the board	619
and after reasonable notice to the person being subpoenaed, the	620
board may move for an order compelling the production of persons	621
or records pursuant to the Rules of Civil Procedure.	622

A subpoena issued by the board may be served by a sheriff,	623
the sheriff's deputy, or a board employee designated by the board.	624
Service of a subpoena issued by the board may be made by	625
delivering a copy of the subpoena to the person named therein,	626
reading it to the person, or leaving it at the person's usual	627
place of residence. When the person being served is a person whose	628
practice is authorized by this chapter, service of the subpoena	629
may be made by certified mail, restricted delivery, return receipt	630
requested, and the subpoena shall be deemed served on the date	631
delivery is made or the date the person refuses to accept	632
delivery.	633

A sheriff's deputy who serves a subpoena shall receive the	634
same fees as a sheriff. Each witness who appears before the board	635
in obedience to a subpoena shall receive the fees and mileage	636
provided for under section 119.094 of the Revised Code.	637

(4) All hearings and investigations of the board shall be	638
considered civil actions for the purposes of section 2305.252 of	639
the Revised Code.	640

(5) Information received by the board pursuant to an	641
investigation is confidential and not subject to discovery in any	642
civil action.	643

The board shall conduct all investigations and proceedings in	644
a manner that protects the confidentiality of patients and persons	645
who file complaints with the board. The board shall not make	646
public the names or any other identifying information about	647
patients or complainants unless proper consent is given or, in the	648
case of a patient, a waiver of the patient privilege exists under	649
division (B) of section 2317.02 of the Revised Code, except that	650
consent or a waiver of that nature is not required if the board	651
possesses reliable and substantial evidence that no bona fide	652
physician-patient relationship exists.	653

The board may share any information it receives pursuant to	654
an investigation, including patient records and patient record	655
information, with law enforcement agencies, other licensing	656
boards, and other governmental agencies that are prosecuting,	657
adjudicating, or investigating alleged violations of statutes or	658
administrative rules. An agency or board that receives the	659
information shall comply with the same requirements regarding	660
confidentiality as those with which the state medical board must	661
comply, notwithstanding any conflicting provision of the Revised	662
Code or procedure of the agency or board that applies when it is	663
dealing with other information in its possession. In a judicial	664
proceeding, the information may be admitted into evidence only in	665
accordance with the Rules of Evidence, but the court shall require	666
that appropriate measures are taken to ensure that confidentiality	667
is maintained with respect to any part of the information that	668
contains names or other identifying information about patients or	669
complainants whose confidentiality was protected by the state	670
medical board when the information was in the board's possession.	671
Measures to ensure confidentiality that may be taken by the court	672
include sealing its records or deleting specific information from	673
its records.	674

(6) On a quarterly basis, the board shall prepare a report	675
that documents the disposition of all cases during the preceding	676
three months. The report shall contain the following information	677
for each case with which the board has completed its activities:	678

(a) The case number assigned to the complaint or alleged	679
violation;	680

(b) The type of certificate to practice, if any, held by the	681
individual against whom the complaint is directed;	682

(c) A description of the allegations contained in the	683
complaint;	684

(d) The disposition of the case.

685

The report shall state how many cases are still pending and	686
shall be prepared in a manner that protects the identity of each	687
person involved in each case. The report shall be a public record	688
under section 149.43 of the Revised Code.	689

(G) If the secretary and supervising member determine that	690
there is clear and convincing evidence that an individual has	691
violated division (B) of this section and that the individual's	692
continued practice presents a danger of immediate and serious harm	693
to the public, they may recommend that the board suspend the	694
individual's certificate to practice without a prior hearing.	695
Written allegations shall be prepared for consideration by the	696
board.	697

The board, upon review of those allegations and by an	698
affirmative vote of not fewer than six of its members, excluding	699
the secretary and supervising member, may suspend a certificate	700
without a prior hearing. A telephone conference call may be	701
utilized for reviewing the allegations and taking the vote on the	702
summary suspension.	703

The board shall issue a written order of suspension by	704
certified mail or in person in accordance with section 119.07 of	705
the Revised Code. The order shall not be subject to suspension by	706
the court during pendency of any appeal filed under section 119.12	707
of the Revised Code. If the individual subject to the summary	708
suspension requests an adjudicatory hearing by the board, the date	709
set for the hearing shall be within fifteen days, but not earlier	710
than seven days, after the individual requests the hearing, unless	711
otherwise agreed to by both the board and the individual.	712

Any summary suspension imposed under this division shall	713
remain in effect, unless reversed on appeal, until a final	714
adjudicative order issued by the board pursuant to this section	715
and Chapter 119. of the Revised Code becomes effective. The board	716
shall issue its final adjudicative order within seventy-five days	717
after completion of its hearing. A failure to issue the order	718
within seventy-five days shall result in dissolution of the	719
summary suspension order but shall not invalidate any subsequent,	720
final adjudicative order.	721

(H) If the board takes action under division (B)(9), (11), or	722
(13) of this section and the judicial finding of guilt, guilty	723
plea, or judicial finding of eligibility for intervention in lieu	724
of conviction is overturned on appeal, upon exhaustion of the	725
criminal appeal, a petition for reconsideration of the order may	726
be filed with the board along with appropriate court documents.	727
Upon receipt of a petition of that nature and supporting court	728
documents, the board shall reinstate the individual's certificate	729
to practice. The board may then hold an adjudication under Chapter	730
119. of the Revised Code to determine whether the individual	731
committed the act in question. Notice of an opportunity for a	732
hearing shall be given in accordance with Chapter 119. of the	733
Revised Code. If the board finds, pursuant to an adjudication held	734
under this division, that the individual committed the act or if	735
no hearing is requested, the board may order any of the sanctions	736
identified under division (B) of this section.	737

(I) The certificate to practice issued to an individual under	738
this chapter and the individual's practice in this state are	739
automatically suspended as of the date of the individual's second	740
or subsequent plea of guilty to, or judicial finding of guilt of,	741
a violation of section 2919.123 of the Revised Code, or the date	742
the individual pleads guilty to, is found by a judge or jury to be	743
guilty of, or is subject to a judicial finding of eligibility for	744
intervention in lieu of conviction in this state or treatment or	745
intervention in lieu of conviction in another jurisdiction for any	746
of the following criminal offenses in this state or a	747
substantially equivalent criminal offense in another jurisdiction:	748
aggravated murder, murder, voluntary manslaughter, felonious	749
assault, kidnapping, rape, sexual battery, gross sexual	750
imposition, aggravated arson, aggravated robbery, or aggravated	751
burglary. Continued practice after suspension shall be considered	752
practicing without a certificate.	753

The board shall notify the individual subject to the	754
suspension by certified mail or in person in accordance with	755
section 119.07 of the Revised Code. If an individual whose	756
certificate is automatically suspended under this division fails	757
to make a timely request for an adjudication under Chapter 119. of	758
the Revised Code, the board shall do whichever of the following is	759
applicable:	760

(1) If the automatic suspension under this division is for a	761
second or subsequent plea of guilty to, or judicial finding of	762
guilt of, a violation of section 2919.123 of the Revised Code, the	763
board shall enter an order suspending the individual's certificate	764
to practice for a period of at least one year or, if determined	765
appropriate by the board, imposing a more serious sanction	766
involving the individual's certificate to practice.	767

(2) In all circumstances in which division (I)(1) of this	768
section does not apply, enter a final order permanently revoking	769
the individual's certificate to practice.	770

(J) If the board is required by Chapter 119. of the Revised	771
Code to give notice of an opportunity for a hearing and if the	772
individual subject to the notice does not timely request a hearing	773
in accordance with section 119.07 of the Revised Code, the board	774
is not required to hold a hearing, but may adopt, by an	775
affirmative vote of not fewer than six of its members, a final	776
order that contains the board's findings. In that final order, the	777
board may order any of the sanctions identified under division (A)	778
or (B) of this section.	779

(K) Any action taken by the board under division (B) of this	780
section resulting in a suspension from practice shall be	781
accompanied by a written statement of the conditions under which	782
the individual's certificate to practice may be reinstated. The	783
board shall adopt rules governing conditions to be imposed for	784
reinstatement. Reinstatement of a certificate suspended pursuant	785
to division (B) of this section requires an affirmative vote of	786
not fewer than six members of the board.	787

(L) When the board refuses to grant a certificate to an	788
applicant, revokes an individual's certificate to practice,	789
refuses to register an applicant, or refuses to reinstate an	790
individual's certificate to practice, the board may specify that	791
its action is permanent. An individual subject to a permanent	792
action taken by the board is forever thereafter ineligible to hold	793
a certificate to practice and the board shall not accept an	794
application for reinstatement of the certificate or for issuance	795
of a new certificate.	796

(M) Notwithstanding any other provision of the Revised Code,	797
all of the following apply:	798

(1) The surrender of a certificate issued under this chapter	799
shall not be effective unless or until accepted by the board.	800
Reinstatement of a certificate surrendered to the board requires	801
an affirmative vote of not fewer than six members of the board.	802

(2) An application for a certificate made under the	803
provisions of this chapter may not be withdrawn without approval	804
of the board.	805

(3) Failure by an individual to renew a certificate of	806
registration in accordance with this chapter shall not remove or	807
limit the board's jurisdiction to take any disciplinary action	808
under this section against the individual.	809

(N) Sanctions shall not be imposed under division (B)(28) of	810
this section against any person who waives deductibles and	811
copayments as follows:	812

(1) In compliance with the health benefit plan that expressly	813
allows such a practice. Waiver of the deductibles or copayments	814
shall be made only with the full knowledge and consent of the plan	815
purchaser, payer, and third-party administrator. Documentation of	816
the consent shall be made available to the board upon request.	817

(2) For professional services rendered to any other person	818
authorized to practice pursuant to this chapter, to the extent	819
allowed by this chapter and rules adopted by the board.	820

(O) Under the board's investigative duties described in this	821
section and subject to division (F) of this section, the board	822
shall develop and implement a quality intervention program	823
designed to improve through remedial education the clinical and	824
communication skills of individuals authorized under this chapter	825
to practice medicine and surgery, osteopathic medicine and	826
surgery, and podiatric medicine and surgery. In developing and	827
implementing the quality intervention program, the board may do	828
all of the following:	829

(1) Offer in appropriate cases as determined by the board an	830
educational and assessment program pursuant to an investigation	831
the board conducts under this section;	832

(2) Select providers of educational and assessment services,	833
including a quality intervention program panel of case reviewers;	834

(3) Make referrals to educational and assessment service	835
providers and approve individual educational programs recommended	836
by those providers. The board shall monitor the progress of each	837
individual undertaking a recommended individual educational	838
program.	839

(4) Determine what constitutes successful completion of an	840
individual educational program and require further monitoring of	841
the individual who completed the program or other action that the	842
board determines to be appropriate;	843

(5) Adopt rules in accordance with Chapter 119. of the	844
Revised Code to further implement the quality intervention	845
program.	846

An individual who participates in an individual educational	847
program pursuant to this division shall pay the financial	848
obligations arising from that educational program.	849

Section 2.  That existing section 4731.22 of the Revised Code	850
is hereby repealed.	851

Section 3.  Section 4731.22 of the Revised Code is presented	852
in this act as a composite of the section as amended by Am. Sub.	853
H.B. 280, Sub. H.B. 525, and Sub. S.B. 229 of the 127th General	854
Assembly. The General Assembly, applying the principle stated in	855
division (B) of section 1.52 of the Revised Code that amendments	856
are to be harmonized if reasonably capable of simultaneous	857
operation, finds that the composite is the resulting version of	858
the section in effect prior to the effective date of the section	859
as presented in this act.	860