CS/HB 1485

1
A bill to be entitled
2An act relating to chiropractic medicine; amending s.
3460.406, F.S.; providing requirements for students
4relating to licensure as a chiropractic physician by
5examination; amending s. 460.4062, F.S.; revising
6provisions relating to chiropractic medicine faculty
7certificates; amending s. 460.408, F.S.; revising
8requirements for continuing education; amending s.
9460.4165, F.S.; revising conditions under which a
10certified chiropractic physician's assistant may perform
11services; revising provisions relating to certified
12chiropractic physician's assistant licensure application;
13restricting the place of practice of certified
14chiropractic physician's assistants performing services
15under indirect supervision; creating s. 460.4167, F.S.;
16providing requirements for proprietorships owned by
17persons other than licensed chiropractic physicians;
18providing prohibitions; providing penalties; providing a
19purpose; providing an effective date.
20
21Be It Enacted by the Legislature of the State of Florida:
22
23     Section 1.  Subsection (1) of section 460.406, Florida
24Statutes, is amended, and subsections (5) and (6) are added to
25that section, to read:
26     460.406  Licensure by examination.--
27     (1)  Any person desiring to be licensed as a chiropractic
28physician shall apply to the department to take the licensure
29examination. There shall be an application fee set by the board
30not to exceed $100 which shall be nonrefundable. There shall
31also be an examination fee not to exceed $500 plus the actual
32per applicant cost to the department for purchase of portions of
33the examination from the National Board of Chiropractic
34Examiners or a similar national organization, which may be
35refundable if the applicant is found ineligible to take the
36examination. The department shall examine each applicant who the
37board certifies has:
38     (a)  Completed the application form and remitted the
39appropriate fee.
40     (b)  Submitted proof satisfactory to the department that he
41or she is not less than 18 years of age.
42     (c)  Submitted proof satisfactory to the department that he
43or she is a graduate of a chiropractic college which is
44accredited by or has status with the Council on Chiropractic
45Education or its predecessor agency. However, any applicant who
46is a graduate of a chiropractic college that was initially
47accredited by the Council on Chiropractic Education in 1995, who
48graduated from such college within the 4 years immediately
49preceding such accreditation, and who is otherwise qualified
50shall be eligible to take the examination. No application for a
51license to practice chiropractic medicine shall be denied solely
52because the applicant is a graduate of a chiropractic college
53that subscribes to one philosophy of chiropractic medicine as
54distinguished from another.
55     (d)1.  For an applicant who has matriculated in a
56chiropractic college prior to July 2, 1990, completed at least 2
57years of residence college work, consisting of a minimum of one-
58half the work acceptable for a bachelor's degree granted on the
59basis of a 4-year period of study, in a college or university
60accredited by an accrediting agency recognized and approved by
61the United States Department of Education. However, prior to
62being certified by the board to sit for the examination, each
63applicant who has matriculated in a chiropractic college after
64July 1, 1990, shall have been granted a bachelor's degree, based
65upon 4 academic years of study, by a college or university
66accredited by a regional accrediting agency which is a member of
67the Commission on Recognition of Postsecondary Accreditation.
68     2.  Effective July 1, 2000, completed, prior to
69matriculation in a chiropractic college, at least 3 years of
70residence college work, consisting of a minimum of 90 semester
71hours leading to a bachelor's degree in a liberal arts college
72or university accredited by an accrediting agency recognized and
73approved by the United States Department of Education. However,
74prior to being certified by the board to sit for the
75examination, each applicant who has matriculated in a
76chiropractic college after July 1, 2000, shall have been granted
77a bachelor's degree from an institution holding accreditation
78for that degree from a regional accrediting agency which is
79recognized by the United States Department of Education. The
80applicant's chiropractic degree must consist of credits earned
81in the chiropractic program and may not include academic credit
82for courses from the bachelor's degree.
83     (e)  Successfully completed the National Board of
84Chiropractic Examiners certification examination in parts I, II,
85and III and II and clinical competency, with a score approved by
86the board, within 10 years immediately preceding application to
87the department for licensure.
88     (f)  Submitted to the department a set of fingerprints on a
89form and under procedures specified by the department, along
90with payment in an amount equal to the costs incurred by the
91Department of Health for the criminal background check of the
92applicant.
93     (5)  A student in a school or college of chiropractic
94accredited by the Council on Chiropractic Education or its
95successor in the final year of the program may file an
96application pursuant to subsection (1), take all examinations
97required for licensure, submit a set of fingerprints, and pay
98all fees required for licensure. A chiropractic student who
99successfully completes the licensure examinations and who
100otherwise meets all requirements for licensure as a chiropractic
101physician during the student's final year must have graduated
102before being certified for licensure pursuant to this section.
103     (6)  The board may require an applicant who graduated from
104a Council on Chiropractic Education accredited institution more
105than 10 years prior to the date of application to the board to
106take the National Board of Chiropractic Examiners' Special
107Purposes Examination for Chiropractic or its equivalent, as
108determined by the board. The board shall establish by rule a
109passing score.
110     Section 2.  Paragraph (e) of subsection (1) and subsection
111(2) of section 460.4062, Florida Statutes, are amended to read:
112     460.4062  Chiropractic medicine faculty certificate.--
113     (1)  The department may issue a chiropractic medicine
114faculty certificate without examination to an individual who
115remits a nonrefundable application fee, not to exceed $100 as
116determined by rule of the board, and who demonstrates to the
117board that he or she meets the following requirements:
118     (e)1.  Has been offered and has accepted a full-time
119faculty appointment to teach in a program of chiropractic
120medicine at a publicly funded state university or college or at
121a college of chiropractic located in the state and accredited by
122the Council on Chiropractic Education; and
123     2.  Provides a certification from the dean of the
124appointing college acknowledging the appointment.
125     (2)  The certificate shall authorize the holder to practice
126only in conjunction with his or her faculty position at a
127publicly funded state university or college and its affiliated
128clinics that are registered with the board as sites at which
129holders of chiropractic medicine faculty certificates will be
130practicing. Except as provided in subsection (4), such
131certificate shall automatically expire upon termination of the
132holder's relationship with the university or college school or
133after a period of 2 years, whichever occurs first.
134     Section 3.  Subsection (1) of section 460.408, Florida
135Statutes, is amended to read:
136     460.408  Continuing chiropractic education.--
137     (1)  The board shall require licensees to periodically
138demonstrate their professional competence as a condition of
139renewal of a license by completing up to 40 contact classroom
140hours of continuing education.
141     (a)  Continuing education courses sponsored by chiropractic
142colleges whose graduates are eligible for examination under any
143provision of this chapter shall be approved by the board if all
144other requirements of board rules setting forth criteria for
145course approval are met.
146     (b)  The board shall approve those courses that build upon
147the basic courses required for the practice of chiropractic
148medicine, and the board may also approve courses in adjunctive
149modalities.
150     Section 4.  Paragraph (b) of subsection (2) and subsection
151(6) of section 460.4165, Florida Statutes, are amended, and
152subsection (14) is added to that section, to read:
153     460.4165  Certified chiropractic physician's assistants.--
154     (2)  PERFORMANCE BY CERTIFIED CHIROPRACTIC PHYSICIAN'S
155ASSISTANT.--Notwithstanding any other provision of law, a
156certified chiropractic physician's assistant may perform
157chiropractic services in the specialty area or areas for which
158the certified chiropractic physician's assistant is trained or
159experienced when such services are rendered under the
160supervision of a licensed chiropractic physician or group of
161chiropractic physicians certified by the board. Any certified
162chiropractic physician's assistant certified under this section
163to perform services may perform those services only:
164     (b)  Under indirect supervision if the indirect supervision
165occurs at the principal place of practice of the chiropractic
166physician to whom she or he is assigned as defined by rule of
167the board;
168     (6)  APPLICATION APPROVAL.--Any person desiring to be
169licensed as a certified chiropractic physician's assistant must
170apply to the department. The application shall include a work
171arrangement proposal and, as part of the application process,
172the board shall interview the proposed supervising chiropractic
173physician and the applicant about the work arrangement proposal.
174The department shall issue a certificate to any person certified
175by the board as having met the following requirements:
176     (a)  Is at least 18 years of age.
177     (b)  Is a graduate of an approved program or its equivalent
178and is fully certified by reason of experience and education, as
179defined by board rule, to perform chiropractic services under
180the responsible supervision of a licensed chiropractic physician
181and when the board is satisfied that the public will be
182adequately protected by the arrangement proposed in the
183application.
184     (c)  Has completed the application form and remitted an
185application fee set by the board pursuant to this section. An
186application for certification made by a chiropractic physician's
187assistant must include:
188     1.  A certificate of completion of a physician's assistant
189training program specified in subsection (5).
190     2.  A sworn statement of any prior felony conviction in any
191jurisdiction.
192     3.  A sworn statement of any previous revocation or denial
193of licensure or certification in any state or jurisdiction.
194     (14)  SUPERVISION OF CERTIFIED CHIROPRACTIC PHYSICIAN'S
195ASSISTANTS AT LICENSED CLINICS.--A certified chiropractic
196physician's assistant certified under this section to perform
197services at a clinic licensed under part X of chapter 400 may
198perform those services only under direct supervision of the
199chiropractic physician to whom she or he is assigned.
200     Section 5.  Section 460.4167, Florida Statutes, is created
201to read:
202     460.4167  Proprietorship by persons other than licensed
203chiropractic physicians.--
204     (1)  Effective July 1, 2008, no person other than a sole
205proprietorship, group practice, partnership, or corporation that
206is wholly owned by one or more chiropractic physicians licensed
207under this chapter or by a chiropractic physician licensed under
208this chapter and the spouse, parent, child, or sibling of that
209chiropractic physician may employ a chiropractic physician
210licensed under this chapter or engage a chiropractic physician
211licensed under this chapter as an independent contractor to
212provide services authorized by this chapter to be offered by a
213chiropractic physician licensed under this chapter, except for:
214     (a)  A sole proprietorship, group practice, partnership, or
215corporation that is wholly owned by a physician or physicians
216licensed under this chapter, chapter 458, chapter 459, or
217chapter 461.
218     (b)  Entities that are owned, directly or indirectly, by an
219entity licensed or registered by the state under chapter 395.
220     (c)  Clinical facilities affiliated with a college of
221chiropractic accredited by the Council on Chiropractic Education
222at which training is provided for chiropractic students.
223     (d)  A public or private university or college.
224     (e)  An entity that is exempt from federal taxation under
225s. 501(c)(3) or (4) of the Internal Revenue Code, any community
226college or university clinic, and any entity owned or operated
227by the Federal Government or by state government, including any
228agency, county, municipality, or other political subdivision
229thereof.
230     (f)  An entity owned by a corporation the stock of which is
231publicly traded.
232     (g)  A clinic licensed under part X of chapter 400 that
233provides health care services by physicians licensed under
234chapter 458, chapter 459, or chapter 460, the medical director
235of which is licensed under chapter 458 or chapter 459.
236     (h)  A state-licensed insurer.
237     (2)  No person other than a chiropractic physician licensed
238under this chapter shall direct, control, or interfere with a
239chiropractic physician's clinical judgment regarding medical
240necessity of chiropractic treatment. For purposes of this
241subsection, a chiropractic physician's clinical judgment does
242not apply to chiropractic services contractually excluded, the
243application of alternative services that may be appropriate
244given the chiropractic physician's prescribed course of
245treatment, or determinations comparing contractual provisions
246and scope of coverage with a chiropractic physician's prescribed
247treatment on behalf of a covered person by an insurer, health
248maintenance organization, or prepaid limited health service
249organization.
250     (3)  Any lease agreement, rental agreement, or other
251arrangement between a person other than a licensed chiropractic
252physician and a chiropractic physician whereby the person other
253than a licensed chiropractic physician provides the chiropractic
254physician with chiropractic equipment or chiropractic materials
255shall contain a provision whereby the chiropractic physician
256expressly maintains complete care, custody, and control of the
257equipment or practice.
258     (4)  The purpose of this section is to prevent a person
259other than a licensed chiropractic physician from influencing or
260otherwise interfering with the exercise of a chiropractic
261physician's independent professional judgment. In addition to
262the acts specified in subsection (1), a person other than a
263licensed chiropractic physician and any entity other than a sole
264proprietorship, group practice, partnership, or corporation that
265is wholly owned by one or more chiropractic physicians licensed
266under this chapter or by a chiropractic physician licensed under
267this chapter and the spouse, parent, child, or sibling of that
268physician, may not employ a chiropractic physician licensed
269under this chapter or enter into a contract or arrangement with
270a chiropractic physician pursuant to which such unlicensed
271person or such entity exercises control over the following:
272     (a)  The selection of a course of treatment for a patient,
273the procedures or materials to be used as part of such course of
274treatment, and the manner in which such course of treatment is
275carried out by the licensee;
276     (b)  The patient records of a chiropractor;
277     (c)  Policies and decisions relating to pricing, credit,
278refunds, warranties, and advertising; or
279     (d)  Decisions relating to office personnel and hours of
280practice.
281     (5)  Any person who violates this section commits a felony
282of the third degree, punishable as provided in s. 775.081, s.
283775.083, or s. 775.035.
284     (6)  Any contract or arrangement entered into or undertaken
285in violation of this section shall be void as contrary to public
286policy. This section applies to contracts entered into or
287renewed on or after October 1, 2010.
288     Section 6.  This act shall take effect July 1, 2007.


CODING: Words stricken are deletions; words underlined are additions.