Bill Text: IN HB1298 | 2011 | Regular Session | Amended
Bill Title: Professional licensing issues.
Spectrum: Slight Partisan Bill (Republican 3-1)
Status: (Engrossed - Dead) 2011-03-31 - First reading: referred to Committee on Health and Provider Services [HB1298 Detail]
Download: Indiana-2011-HB1298-Amended.html
Citations Affected: IC 25-1; IC 25-2.1; IC 25-27.5; IC 34-30;
IC 34-46; IC 35-48.
Synopsis: Professional licensing issues. Creates a one (1) year
amnesty program for accountants who failed to renew their licenses and
meet certain requirements.Changes the phrase "quality review" to "peer
review" for purposes of the laws governing public accountancy
beginning July 1, 2012. Permits a peer review rating of fail to be used
in disciplining a certified public accountant or public accounting firm
after June 30, 2012. Indicates that a law requiring the state board of
accountancy to initiate a complaint with the office of the attorney
general to discipline a licensee does not prohibit the board from taking
other actions permitted by law. Specifies that certain client records
must be returned to a client within 45 days after a request for the
records is made. Provides civil immunity to a person engaged in a
quality review or peer review or administering a quality review or peer
review program. Removes geographical locations that a supervising
physician must be located within. Allows the medical licencing board
to deny supervisory agreements. (Current law requires the board to
approve supervisory agreements.) Removes certain limitations on
physician assistants (PA) prescribing and dispensing certain drugs and
controlled substances. Requires that the supervising physician or
physician designee review specified percentages of PA patient
encounters within 72 hours based on the PAs years of practice. Allows
for electronic prescriptions from a practitioner for certain drugs.
Effective: July 1, 2011.
January 12, 2011, read first time and referred to Committee on Public Health.
February 17, 2011, amended, reported _ Do Pass.
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in
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A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
(b) As used in this section, "fund" refers to the accountant investigative fund established by IC 25-2.1-8-4.
(c) The agency shall create an amnesty program for persons, including firms, required to be licensed under IC 25-2.1 who did not renew their licenses for one (1) or more renewal periods during the period beginning January 1, 2003, and ending June 30, 2011. The amnesty program begins July 1, 2011, and ends June 30, 2012.
(d) To be eligible for the program, the person must:
(1) have held a valid license under IC 25-2.1 on January 1, 2003;
(2) have met the requirements for each missed license period during each missed license period, except for the requirements of having submitted a renewal form and paid
the renewal fee; and
(3) provide a sworn statement that the person has not
committed any act during the missed renewal periods that
would constitute a violation of IC 25-1-11.
(e) When renewing a license under this section, the licensee shall
pay:
(1) all missed license renewal fees;
(2) the current license renewal fee; and
(3) an additional fee of one hundred dollars ($100) to be
deposited in the fund.
(f) The agency shall amend the renewal records of a person who
has successfully completed the requirements under this section to
reflect that the person has been properly renewed during the
missed renewal periods.
(g) This section expires July 1, 2012.
(1) Permanently revoke a practitioner's license.
(2) Suspend a practitioner's license.
(3) Censure a practitioner.
(4) Issue a letter of reprimand.
(5) Place a practitioner on probation status and require the practitioner to:
(A) report regularly to the board upon the matters that are the basis of probation;
(B) limit practice to those areas prescribed by the board;
(C) continue or renew professional education approved by the board until a satisfactory degree of skill has been attained in those areas that are the basis of the probation;
(D) perform or refrain from performing any acts, including community restitution or service without compensation, that the board considers appropriate to the public interest or to the rehabilitation or treatment of the practitioner; or
(E) satisfactorily complete a quality review (before July 1, 2012) or peer review (after June 30, 2012) specified by the board as a condition for termination of probationary status if the practitioner is a licensee (as defined in IC 25-2.1-1-8).
(6) Assess a civil penalty against the practitioner for not more than one thousand dollars ($1,000) for each violation listed in sections 5 through 9 of this chapter except for a finding of incompetency due to a physical or mental disability.
(7) Order a practitioner to pay consumer restitution to a person who suffered damages as a result of the conduct or omission that was the basis for the disciplinary sanctions under this chapter.
(b) When imposing a civil penalty under subsection (a)(6), the board shall consider a practitioner's ability to pay the amount assessed. If the practitioner fails to pay the civil penalty within the time specified by the board, the board may suspend the practitioner's license without additional proceedings. However, a suspension may not be imposed if the sole basis for the suspension is the practitioner's inability to pay a civil penalty.
(c) The board may withdraw or modify the probation under subsection (a)(5) if the board finds after a hearing that the deficiency that required disciplinary action has been remedied or that changed circumstances warrant a modification of the order.
(1) an individual who; or
(2) a firm in the practice of accountancy that;
attests or issues compilation reports, by at least one (1) individual who holds a certificate from any state and possesses qualifications that meet the applicable substantial equivalency standards and who is independent of the individual or firm being reviewed. The term includes any part of a quality review conducted before July 1, 2012, that becomes part of a peer review conducted or peer review report issued after June 30, 2012.
(b) After June 30, 2012, any reference in any law, rule, or other document to "quality review" as that term was applied under this article before July 1, 2012, shall be treated as a reference to peer review.
(1) an individual who; or
(2) a firm in the practice of accountancy that;
attests or issues compilation reports, by at least one (1) individual who holds a certificate from any state and possesses qualifications that meet the applicable substantial equivalency standards and who is independent of the individual or firm being reviewed.
(b) This section expires July 1, 2012.
(1) The board's meetings and conduct of business.
(2) The procedure of investigations and hearings.
(3) The educational and experience qualifications required for the issuance of certificates under this article and the continuing professional education required for renewal of certificates under IC 25-2.1-4.
(4) Rules of professional conduct directed to controlling the quality and probity of the practice of accountancy by licensees, including independence, integrity, and objectivity, competence and technical standards, and responsibilities to the public and clients.
(5) The actions and circumstances that constitute professing to be a licensee in connection with the practice of accountancy.
(6) The manner and circumstances of use of the title "certified public accountant" and the abbreviation "CPA".
(7) Quality reviews (before July 1, 2012) or peer reviews (after June 30, 2012) that may be required to be performed under this article.
(8) Methods of applying for and conducting the examinations, including methods for grading examinations and determining a passing grade required of an applicant for a certificate. However, the board shall to the extent possible provide that the examination, grading of the examination, and the passing grades are uniform with those applicable in other states.
(9) Substantial equivalency.
(10) Administration of the accountant investigative fund established by IC 25-2.1-8-4.
undergo, not more than once every three (3) years, a quality review
(before July 1, 2012) or peer review (after June 30, 2012) conducted
in a manner the board specifies.
(b) The rules adopted under subsection (a) must:
(1) be adopted reasonably in advance of the time when a quality
review (before July 1, 2012) or peer review (after June 30,
2012) first becomes effective;
(2) include reasonable provision for compliance by an applicant
showing that the applicant has in the preceding three (3) years
undergone a quality review (before July 1, 2012) or peer review
(after June 30, 2012) that is a satisfactory equivalent to the
quality review (before July 1, 2012) or peer review (after June
30, 2012) required under this section;
(3) require, with respect to quality reviews (before July 1, 2012)
or peer reviews (after June 30, 2012) under subdivision (2), that
the quality review (before July 1, 2012) or peer review (after
June 30, 2012) be subject to review by an oversight body
established or sanctioned by the board that shall:
(A) comply with IC 25-2.1-9-4; and
(B) periodically report to the board on the effectiveness of the
review program and provide to the board a listing of firms that
have participated in a quality review (before July 1, 2012) or
peer review (after June 30, 2012) program; and
(4) subject to section 9 of this chapter and IC 25-2.1-9-4,
require, with respect to quality reviews (before July 1, 2012) or
peer reviews (after June 30, 2012) under subdivision (2), that:
(A) the proceedings, records, and work papers of a review
committee are privileged and are not subject to discovery,
subpoena, or other means of legal process or introduction into
evidence in a civil action, arbitration, administrative
proceeding, or Indiana board of accountancy proceeding; and
(B) a member of the review committee or individual who was
involved in the quality review (before July 1, 2012) or peer
review (after June 30, 2012) process is not permitted or
required to testify in a civil action, arbitration, administrative
proceeding, or Indiana board of accountancy proceeding to
matters:
(i) produced, presented, disclosed or discussed during, or in
connection with, the quality review (before July 1, 2012) or
peer review (after June 30, 2012) process; or
(ii) that involve findings, recommendations, evaluations,
opinions, or other actions of the committee or a committee
member.
(b) Any:
(1) materials prepared in connection with a particular engagement merely because they happen to subsequently be presented or considered as part of the quality review (before July 1, 2012) or peer review (after June 30, 3012) process; or
(2) dispute between review committees and individuals or firms subject to a quality review (before July 1, 2012) or peer review (after June 30, 2012) arising from the performance of the quality review (before July 1, 2012) or peer review (after June 30, 2012);
are not privileged.
(1) A violation of IC 25-1-11-5, including:
(A) a peer review rating of fail; or
(B) an act or omission that is the basis of a peer review rating of fail;
on any peer review report issued under this article after June 30, 2012.
(2) Revocation or suspension of the right to practice before a state or federal agency.
(3) Dishonesty, fraud, or gross negligence in the practice of accountancy or in the filing of or failure to file the licensee's own income tax returns.
(4) Any conduct reflecting adversely on the licensee's fitness to engage in the practice of accountancy.
(5) Failure to complete continuing education requirements satisfactorily.
(6) Failure to furnish evidence, when required, of satisfactory completion of continuing education requirements.
(b) A holder of a CPA certificate issued under this article is subject
to disciplinary action in this state if the CPA certificate holder:
(1) offers or renders services or uses the CPA title in another
state; and
(2) commits an act in that other state for which the CPA
certificate holder would be subject to discipline in the other state
if the CPA certificate holder were licensed in the other state.
The board shall investigate a complaint made by a board of
accountancy or the equivalent of a board of accountancy in another
state.
(1) To undergo a quality review
(2)
(1) the board shall direct that a complaint be issued under IC 25-1-7, if the subject of the investigation is a licensee; and
(2) the board shall take appropriate action under IC 25-1-7-14, if the subject of the investigation is not a licensee.
(b) Subsection (a) does not prohibit the board from taking an action permitted under IC 25-1 or IC 25-2.1-8-2, including an action under the following:
(1) IC 25-1-4-5 (conditional license and other actions related to continuing education or lapsed license).
(2) IC 25-1-6-4 (refusal to issue a license or placement on probationary status).
(b) The following definitions apply throughout this section:
(1) "Administering entity" refers to the oversight body established or sanctioned by the board to conduct a peer review program.
(2) "Director" refers to the director of the division of consumer protection in the office of the attorney general.
(3) "Oversight committee" refers to a committee of licensees who are not board members that is designated by the board to receive a report.
(4) "Report" refers to a peer review report described in subsection (a), including any description of the deficiencies on which the peer review rating of fail is based.
(c) The board shall provide the director with the name and contact information for the administering entity.
(d) Not more than thirty (30) days after the issuance of a report, the administering entity shall make the report available to the oversight committee. The oversight committee may forward the report to the director. Receipt of the report shall be treated under IC 25-1-7-4, IC 25-1-7-5, and IC 25-1-7-6 as a complaint submitted by the board. If, after conducting an investigation, the director believes that a licensee should be subjected to disciplinary sanctions by the board, the director shall report the director's determination to the attorney general. Upon receiving the director's report, the attorney general may prosecute the matter, on behalf of the state of Indiana, before the board. IC 25-1-7-7(b) does not apply to a determination related to a complaint filed under this section.
(e) The administering entity and the peer review committee issuing a report shall cooperate with an investigation under IC 25-1-7 of a complaint filed under this section and with any resulting proceeding, including compliance with any request for access to or production of the proceedings, records, and work papers of the review committee by the director, the office of the attorney general, or a party to any proceeding initiated as a result of the filing of a complaint under this section. However, all complaints and information pertaining to a complaint are confidential until the attorney general files notice with the board of the attorney general's intent to prosecute a licensee under IC 25-1-7-7. Any meeting of the board, the oversight committee, or a designee of the board or oversight committee that is required in an investigation conducted before the attorney general files notice of intent to prosecute shall be conducted as an executive session under IC 5-14-1.5-6.1.
(1) entity administering a quality review program before July 1, 2012, or a peer review program after June 30, 2012;
(2) officer, member, or employee of an entity administering a quality review program before July 1, 2012, or a peer review program after June 30, 2012;
(3) employee or member of a quality review committee before July 1, 2012, or a peer review committee after June 30, 2012; and
(4) entity in which or for which a member of a quality review committee (before July 1, 2012) or peer review committee (after June 30, 2012) is a sole proprietor, a partner, a shareholder, a member, or an employee;
is immune from civil liability that would otherwise arise from communications, supervision, findings, recommendations, evaluations, reports, opinions, or other actions taken or omissions occurring in good faith in the course and scope of the duties of a quality review administering entity (before July 1, 2012) or peer review administering entity (after June 30, 2012) or a quality review committee (before July 1, 2012) or peer review committee (after June 30, 2012) that arise under this article, including the rules adopted by the board. The immunity granted under this section includes immunity for an act or omission related to any part of a quality review conducted under this article before July 1, 2012, that becomes part of a peer review conducted or peer review report issued after June 30, 2012.
profession:
(1) in rendering an opinion on the presentation of financial
statements;
(2) in ethical investigations conducted by private professional
organizations;
(3) in the course of quality reviews (before July 1, 2012) or peer
reviews (after June 30, 2012) or an investigation or
proceeding related to a quality review (before July 1, 2012) or
peer review (after June 30, 2012); or
(4) in making disclosure where the financial statements or the
professional services of an accountant are contested.
(1) "Client provided records" means accounting or other records belonging to the client that were provided to the licensee by or on behalf of the client.
(2) "Client records prepared by the licensee" means accounting or other records (for example, tax returns, general ledgers, subsidiary journals, and supporting schedules such as detailed employee payroll records and depreciation schedules) that the licensee was engaged to prepare for the client.
(3) "Supporting records" means information not reflected in the client's books and records that are otherwise not available to the client with the result that the client's financial information is incomplete.
(4) "Working papers" include, but are not limited to, audit programs, analytical review schedules, and statistical sampling results, analyses, and schedules prepared by the client at the request of the licensee.
(b) All statements, records, schedules, working papers, and memoranda made by a licensee or a partner, a member, a shareholder, an officer, a director, or an employee of a licensee, including information prepared by the client for the work and services rendered to a client in the practice of accountancy, except the reports submitted by the licensee to the client and records that are part of the client's records, must remain the property of the licensee except in an express agreement between the licensee and the client to the contrary.
(c) Upon a client's request, a licensee is required to provide the following to the client:
(1) Client provided records in the licensee's custody or control.
(2) Client records prepared by the licensee. However, client records prepared by the licensee may be withheld if the preparation of the records is not complete or there are fees due the licensee for the engagement to prepare those records.
(3) Supporting records related to a completed and issued work product of a licensee. However, supporting records prepared by the licensee may be withheld if there are fees due to the licensee for the specific work product.
(d) A licensee may make and retain a copy of any records returned to a client. Records may be provided in any format usable to the client. To the extent practicable, records shall be returned to a client not more than forty-five (45) days after a request is received.
(b) A licensee is not required to keep any work paper beyond the period prescribed in any applicable statute.
(1) The supervising physician or the physician designee is physically present at the location at which services are rendered or tasks are performed by the physician assistant.
(b) The term includes the use of protocols, guidelines, and standing orders developed or approved by the supervising physician.
(b) Three (3) members of the committee constitute a quorum. An affirmative vote of a majority of the members appointed to the committee is required for the committee to take action on any business.
(c) The committee shall do the following:
(1) Consider the qualifications of individuals who apply for an initial license under this article.
(2) Approve or reject license applications.
(3) Approve or reject renewal applications.
physician and that are within the supervising physician's scope of
practice, including prescribing and dispensing drugs and medical
devices. A patient may elect to be seen, examined, and treated by the
supervising physician.
(b) If a physician assistant determines that a patient needs to be
examined by a physician, the physician assistant shall immediately
notify the supervising physician or physician designee.
(c) If a physician assistant notifies the supervising physician that the
physician should examine a patient, the supervising physician shall:
(1) schedule an examination of the patient in a timely manner
unless the patient declines; or
(2) arrange for another physician to examine the patient.
(d) If a patient is subsequently examined by the supervising
physician or another physician because of circumstances described in
subsection (b) or (c), the visit must be considered as part of the same
encounter except for in the instance of a medically appropriate referral.
(e) A supervising physician or physician assistant who does not
comply with subsections (b) through (d) is subject to discipline under
IC 25-1-9.
(f) A physician assistant's supervisory agreement with a supervising
physician must:
(1) be in writing;
(2) include all the tasks delegated to the physician assistant by the
supervising physician;
(3) set forth the supervisory plans for the physician assistant,
including the emergency procedures that the physician assistant
must follow; and
(4) specify the name of the drug or drug classification being
delegated to the physician assistant and the protocol the physician
assistant shall follow in prescribing a drug.
(g) The physician shall submit the supervisory agreement to the
board. for approval. The physician assistant may not prescribe a drug
under the supervisory agreement until unless the board approves
denies the supervisory agreement. Any amendment to the supervisory
agreement must be resubmitted to the board, for approval, and the
physician assistant may not operate under any new prescriptive
authority under the amended supervisory agreement until unless the
agreement has been approved denied by the board.
(h) A physician or a physician assistant who violates the supervisory
agreement described in this section may be disciplined under
IC 25-1-9.
SECTION 25, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]: Sec. 4. (a) Except as provided in this section, a
physician assistant may prescribe, dispense, and administer drugs and
medical devices or services to the extent delegated by the supervising
physician.
(b) A physician assistant may not prescribe, dispense, or administer
ophthalmic devices, including glasses, contact lenses, and low vision
devices.
(c) As permitted by the board, A physician assistant may use or
dispense only drugs prescribed or approved by the supervising
physician. A physician assistant may not prescribe or dispense the
following drugs:
(1) a schedule I substance listed in IC 35-48-2-4.
(2) A schedule II substance listed in IC 35-48-2-6.
(3) A schedule III, schedule IV, or schedule V drug if the drug
contains oxycodone.
However, a physician assistant may prescribe one (1) dose of a drug
listed in subdivision (2) or (3) for immediate administration if the
patient is in an inpatient hospital post-operative setting and the
physician is unavailable to make the prescription.
(d) A physician assistant may request, receive, and sign for
professional samples and may distribute professional samples to
patients if the samples are within the scope of the physician assistant's
prescribing privileges delegated by the supervising physician.
(e) A physician assistant may not prescribe drugs unless the
physician assistant has successfully completed at least thirty (30)
contact hours in pharmacology from an educational program that is
approved by the committee.
(f) A physician assistant may not prescribe, administer, or monitor
general anesthesia, regional anesthesia, or deep sedation as defined by
the board. A physician assistant may not administer moderate sedation:
(1) if the moderate sedation contains agents in which the
manufacturer's general warning advises that the drug should be
administered and monitored by an individual who is:
(A) experienced in the use of general anesthesia; and
(B) not involved in the conduct of the surgical or diagnostic
procedure; and
(2) during diagnostic tests, surgical procedures, or obstetric
procedures unless the following conditions are met:
(A) A physician is physically present in the area, is
immediately available to assist in the management of the
patient, and is qualified to rescue patients from deep sedation.
(B) The physician assistant is qualified to rescue patients from deep sedation and is competent to manage a compromised airway and provide adequate oxygenation and ventilation by reason of meeting the following conditions:
(i) The physician assistant is certified in advanced cardiopulmonary life support.
(ii) The physician assistant has knowledge of and training in the medications used in moderate sedation, including recommended doses, contraindications, and adverse reactions.
(g) Before a physician assistant may prescribe drugs, the physician assistant must have
(1) for
(2) at least one thousand eight hundred (1,800) hours.
(1) legend drugs except as provided in section 4(c) of this chapter; and
(2) medical devices (except ophthalmic devices, including glasses, contact lenses, and low vision devices).
(b) Any prescribing authority delegated to a physician assistant must be expressly delegated in writing by the physician assistant's supervising physician, including:
(1) the name of the drug or drug classification being delegated by the supervising physician; and
(2) the protocols the physician assistant shall use when prescribing the drug.
(c) A physician assistant who is delegated the authority to prescribe legend drugs or medical devices must do the following:
(1) Enter the following on each prescription form that the physician assistant uses to prescribe a legend drug or medical device:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the physician assistant by the NCCPA.
(C) The physician assistant's state license number.
(2) Comply with all applicable state and federal laws concerning prescriptions for legend drugs and medical devices.
(d) A supervising physician may delegate to a physician assistant the authority to prescribe only legend drugs and medical devices that are within the scope of practice of the licensed supervising physician or the physician designee.
(e) A physician assistant who is delegated the authority to prescribe controlled substances under subsection (a)
(1) Obtain an Indiana controlled substance registration and a federal Drug Enforcement Administration registration.
(2) Enter the following on each prescription form that the physician assistant uses to prescribe a controlled substance:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the physician assistant by the NCCPA.
(C) The physician assistant's state license number.
(D) The physician assistant's federal Drug Enforcement Administration (DEA) number.
(3) Comply with all applicable state and federal laws concerning prescriptions for controlled substances.
(f) A supervising physician may only delegate to a physician assistant the authority to prescribe controlled substances:
(1) that may be prescribed within the scope of practice of the licensed supervising physician or the physician designee;
(2) in an amount that does not exceed
(3) in accordance with the limitations set forth in section 4(c) of this chapter.
(b) A supervising physician or physician designee shall review all patient encounters not later than
(c) The supervising physician or physician designee shall review within seventy-two (72) hours of the patient encounter not less than the following percentages of the patient charts:
(1) For the first year of employment of the physician assistant, one hundred percent (100%).
(2) For the second year of employment of the physician assistant, fifty percent (50%).
(3) For the third year of employment of the physician assistant, twenty-five percent (25%).
However, if the physician assistant has had less than one thousand eight hundred (1,800) hours of practice, the supervising physician or physician designee shall review one hundred percent (100%) of the charts within seventy-two (72) hours of the patient encounter.
(1) Be licensed under IC 25-22.5.
(2) Register with the board the physician's intent to supervise a physician assistant.
(3) Submit a statement to the board that the physician will exercise supervision over the physician assistant in accordance with rules adopted by the board and retain professional and legal responsibility for the care rendered by the physician assistant.
(4) Not have a disciplinary action restriction that limits the physician's ability to supervise a physician assistant.
(5) Maintain a written agreement with the physician assistant that states the physician will:
(A) exercise supervision over the physician assistant in accordance with any rules adopted by the board; and
(B) retain responsibility for the care rendered by the physician assistant.
The agreement must be signed by the physician and physician assistant, updated annually, and made available to the board upon request.
(b) Except as provided in this section, this chapter may not be construed to limit the employment arrangement with a supervising physician under this chapter.
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 158. IC 25-2.1-9-5 (Concerning
immunity of an entity administering a quality review (before July
1, 2012) or peer review (after June 30, 2012) program and
members of a quality review committee (before July 1, 2012) or
peer review committee (after June 30, 2012)).
(b) In emergency situations, as defined by rule of the board, schedule II drugs may be dispensed upon oral prescription of a practitioner, reduced promptly to writing and filed by the pharmacy. Prescriptions shall be retained in conformity with the requirements of section 7 of this chapter. No prescription for a schedule II substance may be refilled.
(c) Except for dosages medically required for a period of not more than forty-eight (48) hours that are dispensed by or on the direction of a practitioner, or medication dispensed directly by a practitioner, other than a pharmacy, to an ultimate user, a controlled substance included in schedule III or IV, which is a prescription drug as determined under IC 16-42-19, shall not be dispensed without a written, electronic, or oral prescription of a practitioner. The prescription shall not be filled or refilled more than six (6) months after the date thereof or be refilled more than five (5) times, unless renewed by the practitioner. Prescriptions for schedule III, IV, and V controlled substances may be transmitted by facsimile from the practitioner or the agent of the practitioner to a pharmacy. The facsimile prescription is equivalent to an original prescription to the extent permitted under federal law.
(d) A controlled substance included in schedule V shall not be distributed or dispensed other than for a medical purpose.