Indiana: Ownership and Oversight
Reduced practice: prescribing-tethered collaboration, 5% chart sample. Indiana's collaboration requirement attaches to prescribing rather than practice, filed with the Board of Nursing, with a signature 5% chart-sampling rule and, unusually, no ratio, no geography, and no on-site requirement anywhere in the framework.
Who the statute actually covers
- The collaborative practice agreement (IC 25-23-1-19.4; 848 IAC 5-1-1): required for an APRN's prescriptive authority; sets out how the APRN and "licensed practitioner" cooperate, coordinate, and consult; submitted to the Board of Nursing with the prescriptive authority application and cover sheet; not valid until authority is granted; immediate written Board notice of changes or termination.
- The 5% rule: the agreement must provide for submission of documentation of prescribing practices to the collaborating practitioner within 7 days, including a minimum 5% random sample of charts and medications prescribed.
- What Indiana does NOT require: no NP-per-physician ratio, no geographic proximity, no on-site time, no same-specialty mandate (the collaborator is a "licensed practitioner"), and — almost uniquely — no national certification for NP licensure (though payers effectively require it).
- PA framework (IC 25-27.5): collaborative agreement filed with the PA Board; the collaborating physician or designee reviews patient encounters within 10 business days (14 for non-treatment in-home wellness evaluations); a statutory first-year review percentage applies, then a percentage the physician deems reasonable.
1. Who can own what
| Entity / Path | Who may own | Key limits |
|---|---|---|
| Medical professional entities | Licensee-owned professional corporations under IC 23-1.5; verify permitted health-profession combinations before mixing license types. | Indiana's corporate-practice posture is moderate; hospital and system employment is routine. |
| APRN-owned practice | Viable: NP owns the entity and maintains the filed collaborative agreement for prescribing; no geography or ratio constraints make Indiana collaborations comparatively easy to source. | The agreement lives at the Board of Nursing; keep filings current with every change of collaborator. |
| PA path | Collaborative agreements with signature review mechanics; no ownership lane into medical entities. | |
| Lay / MSO | Standard exclusion from professional entities; MSO at FMV. |
2. Collaborative and supervisory oversight
| Role | Agreement required | Oversight mechanics | Path to independence |
|---|---|---|---|
| PA | Written collaborative agreement filed per Board requirements; encounter review within 10 business days as set in the agreement. | First-year statutory review percentage, then physician-determined percentage stated in the agreement (IC 25-27.5-6-1); no ratio. | None. Indiana PAs have no independence pathway. |
| NP / APRN | Practice is broad, but prescribing requires the filed collaborative practice agreement; Schedules II–V per the agreement plus the Indiana CS registration. | 5% random chart/medication sample within 7 days; no ratio, no geography, no on-site requirement; renewal every odd-numbered year with 30 CE hours including 8 pharmacology. | None. FPA bills (SB 213/HB 1330, 2023 and successors) have not passed; collaboration is career-long for prescribing APRNs. |
3. Primary authorities
- IC 25-23-1-19.4; 848 IAC 5-1-1.
- IC 25-27.5-6-1; Indiana PLA checklists and sample agreements.
- IC 23-1.5 (professional corporations).
Practical read: Indiana is the easiest restricted state to operate in: no ratio, no geography, and a collaborator who just needs a license makes sourcing simple. The whole compliance load reduces to two numbers: 5% of prescribing charts within 7 days, and paperwork current at the Board. The mistake to avoid is treating Indiana's looseness as independence — the agreement is still the legal basis for every prescription, and a lapsed filing means a prescribing NP with no authority at all.
General education, not legal advice.