842 IAC 1-6-2 Standards of professional conduct and competent practice

Sec. 2. (a) A practitioner when engaging in the practice of physical therapy shall abide by, and comply with, the standards of professional conduct in this section. (b) A practitioner shall maintain the confidentiality of all knowledge and information regarding a patient, including, but not limited to, the patient's: (1) diagnosis; (2) treatment; and (3) prognosis; of which the practitioner has knowledge during the course of the patient-practitioner relationship. Information about a patient shall be disclosed by a practitioner when required by law, including, but not limited to, the requirements of IC 34-30-15-1 et seq. and IC 16-39-1-1 et seq., and any amendments thereto, or when authorized by the patient or those responsible for the patient's care. (c) A practitioner shall give a truthful, candid, and reasonably complete account of the patient's condition to the patient or to those responsible for the patient's care, except where a practitioner reasonably determines that the information is detrimental to the physical or mental health of: (1) the patient; or (2) those persons responsible for the patient's care. (d) The practitioner shall give reasonable written notice to the patient and to any referring provider when the practitioner withdraws from a case so that another referral may be made by the referring provider. A practitioner shall not abandon a patient. A practitioner who withdraws from a case, except in emergency circumstances, shall, upon written request, comply with the provisions of IC 16-39-1-1 et seq., and of any subsequent amendment or revision thereof, when a patient requests health records. (e) A practitioner shall exercise reasonable care and diligence in the treatment of patients based upon generally accepted scientific principles, methods, treatments, and current professional theory and practice. (f) A practitioner shall not: (1) represent; (2) advertise; (3) state; or (4) indicate; the possession of any degree recognized as the basis for licensure to practice physical therapy unless the practitioner is actually licensed on the basis of such degree in the state or states in which he/she practices. (g) A physical therapist shall not delegate to supportive personnel any service that requires the skill, knowledge, and judgment of the licensed physical therapist. (h) A physical therapist assistant shall not accept a delegation of a service that exceeds the scope of practice of their certificate as defined in 842 IAC 1-1-1(g)(3). (i) A physical therapist must have the knowledge, skill, ability, and competence to perform dry needling. After June 30, 2024, to be deemed competent to perform dry needling, a physical therapist must successfully complete a minimum of fifty (50) hours of education specific to dry needling theory, practice, and technique of which forty (40) hours must be completed in person. (1) A physical therapist may apply dry needling specific education hours completed within the entry-level education program toward the fifty (50) hour requirement. The physical therapist must complete any remaining education hours to reach a total of fifty (50) hours prior to providing dry needling services. (2) The physical therapist bears the burden of proof of sufficient education and training to ensure competence with the treatment or intervention. Education courses that meet the requirements of 842 IAC 1-7-5 satisfy this requirement. (3) If requested by the board or a member of the public, the physical therapist providing dry needling services shall provide documentation of completion of the training required by this rule. (4) Failure to provide written documentation to the board in compliance with this requirement shall be deemed prima facie evidence that the physical therapist is not competent and shall not be permitted to perform dry needling. (5) Dry needling shall be performed directly by the physical therapist and shall not be delegated. (j) A practitioner who has personal knowledge based upon a reasonable belief that another practitioner holding the same license or certificate has engaged in illegal, unlawful, incompetent, or fraudulent conduct in the practice of physical therapy shall promptly report such conduct to a peer review or similar body, as defined in IC 34-6-2-99 and as provided in IC 34-30-15-1 et seq., having jurisdiction over the offending practitioner and the matter. This provision does not prohibit a practitioner from promptly reporting said conduct directly to the physical therapy board. Further, a practitioner who has personal knowledge of any person engaged in, or attempting to engage in, the unauthorized practice of medicine or physical therapy shall promptly report such conduct to the Indiana board of physical therapy. (k) A practitioner who voluntarily submits himself or herself to, or is otherwise undergoing a course of treatment for: (1) addiction; (2) severe dependency upon alcohol or other drugs or controlled substances; or (3) psychiatric impairment; where such treatment is sponsored or supervised by a committee for impaired practitioners of a state, regional, or local organization of professional health care providers, or where such treatment is sponsored or supervised by a committee for impaired practitioners of a hospital, shall be exempt from reporting to a peer review committee as set forth in subsection (j) or to the physical therapy board so long as the practitioner is complying with the course of treatment and making satisfactory progress. If the practitioner fails to comply with or is not benefited by the course of treatment, the practitioner-chief administrative officer, his or her designee, or any member of the committee for impaired practitioners shall promptly report such facts and circumstances to the physical therapy board. Subsection (j) and this subsection shall not, in any manner whatsoever, directly or indirectly, be deemed or construed to prohibit, restrict, limit, or otherwise preclude the physical therapy board from taking such action as it deems appropriate or as may otherwise be provided by law. (l) Fees charged by a practitioner for his or her professional services shall be reasonable and shall reasonably compensate the practitioner only for services actually rendered. (m) A practitioner shall not enter into agreement for, charge, or collect an illegal or clearly excessive fee. (n) Factors to be considered in determining the reasonableness of a fee include, but are not limited to, the following: (1) The difficulty or uniqueness, or both, of the services performed and the time, skill, and experience required. (2) The fee customarily charged in the locality for similar practitioner services. (3) The amount of the charges involved. (4) The quality of performance. (5) The nature and length of the professional relationship with the patient. (6) The experience, reputation, and ability of the practitioner in performing the kind of services involved. (o) A practitioner shall not pay, demand, or receive compensation for referral of a patient except for a patient referral program operated by a professional society or association. (p) A practitioner shall be responsible for the conduct of each and every person employed by the practitioner for every action or failure to act by said employee or employees in the course of the employment relationship. (q) A practitioner shall not, on behalf of: (1) himself or herself; (2) a partner; (3) an associate; (4) a shareholder in a professional corporation; or (5) any other practitioner or specific health care provider affiliated with the practitioner; use, or participate in the use of, any form of public communication containing a false, fraudulent, misleading, deceptive, or unfair statement or claim. (r) Subject to the requirements of subsection (q), and in order to facilitate the process of informed selection of a practitioner by the public, a practitioner may advertise services through the public media, provided that the advertisement is dignified and confines itself to the existence, scope, nature, and field of practice of physical therapy. (s) If the advertisement in subsection (r) is communicated to the public by audio or video format, it shall be prerecorded and approved for broadcast by the practitioner, and a recording and transcript of the actual transmission shall be retained by the practitioner for a period of five (5) years from the last date of broadcast. (t) If a practitioner advertises a fee for: (1) a service; (2) a treatment; (3) a consultation; (4) an examination; or (5) any other procedure; the practitioner must render that service or procedure for no more than the fee advertised. (u) Except as otherwise provided in these rules, a practitioner shall not contact or solicit individual members of the public personally or through an agent in order to offer services to such person or persons unless that individual initiated contact with the practitioner for the purpose of engaging that practitioner's professional services. (v) A practitioner may, whenever the practitioner believes it to be beneficial to the patient, and upon approval of the referring provider, send or refer a patient to a qualified specific professional health care provider for treatment or health care that falls within the specific professional health care provider's scope of practice. Prior to any such referral, however, the practitioner shall examine or consult with, or both, the patient and the referring provider to ensure that a condition exists in the patient that would be within the scope of practice of the specific professional health care provider to whom the patient is referred or sent. (w) The practitioner shall give reasonable written notice to an active patient or those responsible for the patient's care when the practitioner withdraws from a case so that another practitioner may be employed by the patient or by those responsible for the patient's care. A practitioner shall not abandon a patent [sic, patient]. As used in this section, "active patient" means a person whom the practitioner has examined, cared for, or otherwise consulted with, during the two (2) year period prior to retirement, discontinuation of practice, or leaving or moving from the community. (x) A practitioner who withdraws from a case, except in emergency circumstances, shall, upon written request, make available to the license holder's patient all records, test results, histories, diagnoses, files, and information relating to said patient which are in the practitioner's custody, possession, or control, or copies of such documents herein before described. (y) A practitioner shall not base his fee upon the uncertain outcome of a contingency, whether such contingency be the outcome of litigation or any other occurrence or condition that may or may not develop, occur, or happen. (z) A practitioner shall not attempt to exonerate himself or herself from or limit his or her liability to a patient for his or her personal malpractice except that a practitioner may enter into agreements that contain informed, voluntary releases or waivers of liability, or both, in settlement of a claim made by a patient or by those responsible for a patient's care. (aa) A practitioner shall not attempt to preclude, prohibit, or otherwise prevent the filing of a complaint against him or her by a patient or other practitioner for any alleged violation of this title, IC 25-27-1 et seq., or any other law. (bb) A practitioner shall maintain adequate patient records. (cc) A practitioner shall not interfere with, or refuse to cooperate in, an investigation or disciplinary proceeding by willful misrepresentation of facts or the use of threats or harassment against any patient or witness to prevent them from providing evidence in a disciplinary proceeding or any legal action. (dd) A practitioner shall not aid or abet a person not licensed or certified in this state who directly or indirectly performs activities requiring a license or certificate. (ee) A practitioner shall not practice as a physical therapist or work as a physical therapist assistant when physical or mental abilities are impaired by the use of: (1) controlled substances; (2) other habit-forming drugs; (3) chemicals; or (4) alcohol. (ff) A practitioner shall not engage in the performance of substandard care due to a deliberate or negligent act or failure to act regardless of whether there was actual injury to the patient. (gg) A practitioner shall not engage in sexual misconduct, including the following: (1) Making sexual advances. (2) Requesting sexual favors. (3) Engaging in verbal conduct or physical contact of a sexual nature with patients or clients. (hh) A practitioner who has been convicted of a felony, or who has pled no contest or any other finding of guilt as to such felony, in this or any other state, territory, or country, which demonstrates impaired judgment or risk to the public in the practitioner's future provision of physical therapy service, may be deemed to be in violation of this section. (ii) Failure to comply with the above standards of professional conduct and competent practice of physical therapy may result in disciplinary proceedings against the offending practitioners. Further, all practitioners licensed in Indiana shall be responsible for having knowledge of these standards of conduct and practice.