Authority: IC 16-41-42.1-10

Affected: IC 16-41-42.1

Sec. 4. (a) To register, a health care entity shall submit a completed application to the department.

(b) A health care entity must disclose the following information on the department prescribed application:

1. (1) The types of health care services that the health care entity will provide in Indiana.

2. (2) The names of any employees, who are currently in good standing, licensed, certified, or registered in a health care profession in:

   1. (A) Indiana; or
   2. (B) any other state;
3. and a copy of the employee's license, certification, or registration.
4. (3) Any health care services that are to be provided under a contract between the health care entity and a person that is licensed, certified, or registered in Indiana to provide health care services.

5. (4) The types of:

   1. (A) health care services;
   2. (B) health care tests; and
   3. (C) equipment;
6. that the health care entity will perform or use.
7. (5) The manner in which test results and recommendations for health care based on the results are disclosed to the patient.

8. (6) The:

   1. (A) health care entity's:

      1. (i) name;
      2. (ii) address; and
      3. (iii) telephone number; and
   2. (B) name of any company that is affiliated with the health care entity.

9. (7) The name and address of the:

   1. (A) state agency;
   2. (B) foreign country agency; or
   3. (C) province agency of a foreign country agency;
10. where the health care entity is registered or licensed.

(c) A health care entity that submits a completed application and meets the requirements of IC 16-41-42 [IC 16-41- 42 was repealed by P.L.3-2008, SECTION 269, effective March 13, 2008. See IC 16-41-42.1.] and this rule will be issued a certificate of registration.

(Indiana Department of Health; 410 IAC 15.1-1-4; filed Jul 31, 2008, 4:16 p.m.: 20080827-IR-410070489FRA; readopted filed Sep 10, 2014, 2:08 p.m.: 20141008-IR-410140299RFA; readopted filed Sep 10, 2020, 2:11 p.m.: 20201007-IR-410200404RFA)