Bill Text: FL H0633 | 2011 | Regular Session | Introduced

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Bill Title: Chiropractic Medicine

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2011-05-07 - Indefinitely postponed and withdrawn from consideration [H0633 Detail]

Download: Florida-2011-H0633-Introduced.html

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HB 633

1	A bill to be entitled
2	An act relating to chiropractic medicine; amending s.
3	460.4062, F.S.; revising the requirements for obtaining a
4	chiropractic medicine faculty certificate; amending s.
5	460.408, F.S.; prohibiting the Board of Chiropractic
6	Medicine from approving the use of certain courses in
7	continuing chiropractic education; amending s. 460.4165,
8	F.S.; providing that services rendered by a certified
9	chiropractic physician's assistant under indirect
10	supervision may occur only at the supervising chiropractic
11	physician's address of record; deleting the length of time
12	specified for the basic program of education and training
13	for certified chiropractic physician's assistants;
14	amending s. 460.4166, F.S.; requiring a person to register
15	as a chiropractic assistant if he or she renders
16	therapeutic services or administers therapeutic agents
17	related to a chiropractic physician's treatment of a
18	patient; providing registration requirements for such
19	persons; requiring a registered chiropractic assistant to
20	notify the board of his or her change of employment;
21	providing that a person who exclusively performs
22	nontherapeutic services is not required to register as a
23	chiropractic assistant; requiring the approval of certain
24	supervising chiropractic physicians by the board;
25	providing an effective date for the board's approval;
26	requiring a fee for approval of a supervising chiropractic
27	physician or group of chiropractic physicians; requiring
28	the board to adopt by rule an application form for the
29	initial registration of a registered chiropractic
30	assistant, a form for the approval of a supervising
31	chiropractic physician, and the notice of a change of
32	employment for a registered chiropractic assistant;
33	amending s. 460.4167, F.S.; authorizing certain sole
34	proprietorships, group practices, partnerships,
35	corporations, limited liability companies, limited
36	partnerships, professional associations, other entities,
37	health care clinics licensed under part X of ch. 400,
38	F.S., health maintenance organizations, or prepaid health
39	clinics to employ a chiropractic physician or engage a
40	chiropractic physician as an independent contractor to
41	provide services authorized by ch. 460, F.S.; authorizing
42	the spouse or adult children of a deceased chiropractic
43	physician to hold, operate, pledge, sell, mortgage,
44	assign, transfer, own, or control the deceased
45	chiropractic physician's ownership interests under certain
46	conditions; authorizing an employer that employs a
47	chiropractic physician to exercise control over the
48	patient records of the employed chiropractor, policies and
49	decisions relating to pricing, credit, refunds,
50	warranties, and advertising, and decisions relating to
51	office personnel and hours of practice; deleting an
52	obsolete provision; providing an effective date.
53
54	Be It Enacted by the Legislature of the State of Florida:
55
56	Section 1.  Paragraph (e) of subsection (1) of section
57	460.4062, Florida Statutes, is amended to read:
58	460.4062  Chiropractic medicine faculty certificate.-
59	(1)  The department may issue a chiropractic medicine
60	faculty certificate without examination to an individual who
61	remits a nonrefundable application fee, not to exceed $100 as
62	determined by rule of the board, and who demonstrates to the
63	board that he or she meets the following requirements:
64	(e)1.  Performs research or has been offered and has
65	accepted a full-time or part-time faculty appointment to teach
66	in a program of chiropractic medicine at a publicly funded state
67	university or college or at a college of chiropractic located in
68	the state and accredited by the Council on Chiropractic
69	Education; and
70	2.  Provides a certification from the dean of the
71	appointing college acknowledging the appointment.
72	Section 2.  Paragraph (b) of subsection (1) of section
73	460.408, Florida Statutes, is amended to read:
74	460.408  Continuing chiropractic education.-
75	(1)  The board shall require licensees to periodically
76	demonstrate their professional competence as a condition of
77	renewal of a license by completing up to 40 contact classroom
78	hours of continuing education.
79	(b)  The board shall approve those courses that build upon
80	the basic courses required for the practice of chiropractic
81	medicine, and the board may also approve courses in adjunctive
82	modalities. Courses that consist of instruction in the use,
83	application, prescription, recommendation, or administration of
84	a specific company's brand of products or services are not
85	eligible for approval.
86	Section 3.  Subsections (2) and (5) of section 460.4165,
87	Florida Statutes, are amended to read:
88	460.4165  Certified chiropractic physician's assistants.-
89	(2)  PERFORMANCE BY CERTIFIED CHIROPRACTIC PHYSICIAN'S
90	ASSISTANT.-Notwithstanding any other provision of law, a
91	certified chiropractic physician's assistant may perform
92	chiropractic services in the specialty area or areas for which
93	the certified chiropractic physician's assistant is trained or
94	experienced when such services are rendered under the
95	supervision of a licensed chiropractic physician or group of
96	chiropractic physicians certified by the board. Any certified
97	chiropractic physician's assistant certified under this section
98	to perform services may perform those services only:
99	(a)  In the office of the chiropractic physician to whom
100	the certified chiropractic physician's assistant has been
101	assigned, in which office such physician maintains her or his
102	primary practice;
103	(b)  Under indirect supervision if the indirect supervision
104	occurs at the supervising chiropractic physician's address of
105	record or place of practice required by s. 456.035, other than
106	at a clinic licensed under part X of chapter 400, of the
107	chiropractic physician to whom she or he is assigned as defined
108	by rule of the board;
109	(c)  In a hospital in which the chiropractic physician to
110	whom she or he is assigned is a member of the staff; or
111	(d)  On calls outside of the office of the chiropractic
112	physician to whom she or he is assigned, on the direct order of
113	the chiropractic physician to whom she or he is assigned.
114	(5)  PROGRAM APPROVAL.-The department shall issue
115	certificates of approval for programs for the education and
116	training of certified chiropractic physician's assistants which
117	meet board standards. Any basic program curriculum certified by
118	the board shall cover a period of 24 months. The curriculum must
119	consist of a curriculum of at least 200 didactic classroom hours
120	during those 24 months.
121	(a)  In developing criteria for program approval, the board
122	shall give consideration to, and encourage, the use utilization
123	of equivalency and proficiency testing and other mechanisms
124	whereby full credit is given to trainees for past education and
125	experience in health fields.
126	(b)  The board shall create groups of specialty
127	classifications of training for certified chiropractic
128	physician's assistants. These classifications must shall reflect
129	the training and experience of the certified chiropractic
130	physician's assistant. The certified chiropractic physician's
131	assistant may receive training in one or more such
132	classifications, which shall be shown on the certificate issued.
133	(c)  The board shall adopt and publish standards to ensure
134	that such programs operate in a manner which does not endanger
135	the health and welfare of the patients who receive services
136	within the scope of the program. The board shall review the
137	quality of the curricula, faculties, and facilities of such
138	programs; issue certificates of approval; and take whatever
139	other action is necessary to determine that the purposes of this
140	section are being met.
141	Section 4.  Subsection (3) of section 460.4166, Florida
142	Statutes, is amended, and subsections (4) and (5) are added to
143	that section, to read:
144	460.4166  Registered chiropractic assistants.-
145	(3)  REGISTRATION.-
146	(a)  A registered chiropractic assistant assistants may
147	register with be registered by the board for a biennial fee not
148	to exceed $25. Effective April 1, 2012, a person must register
149	with the board as a chiropractic assistant if the person
150	performs therapeutic services or administers therapeutic agents
151	related to a chiropractic physician's treatment of a patient,
152	unless the person is otherwise certified or licensed to perform
153	those services or administer those agents.
154	(b)  A person employed as a registered chiropractic
155	assistant, if required to register under this section, must
156	submit to the board an initial application for registration
157	within 30 days after employment. Upon the board's approval of
158	the application, the effective date of the registration shall
159	apply retroactively to the date of employment.
160	(c)  A registered chiropractic assistant, within 30 days
161	after a change of employment, must notify the board of the new
162	place of employment and the name of the chiropractic physician
163	or group of chiropractic physicians under whose supervision the
164	registered chiropractic assistant performs the duties described
165	in subsection (2).
166	(d)  A person who exclusively performs nontherapeutic
167	services is not required to register under this section.
168	(4)  APPROVAL OF SUPERVISING CHIROPRACTIC PHYSICIANS.-
169	(a)  A chiropractic physician or group of chiropractic
170	physicians under whose supervision a registered chiropractic
171	assistant performs the duties described in subsection (2) must
172	be approved by the board. If a registered chiropractic assistant
173	performs those duties under the direct supervision of a
174	certified chiropractic physician's assistant, the chiropractic
175	physician or group of chiropractic physicians under whose
176	supervision the certified chiropractic physician's assistant
177	provides direct supervision for the registered chiropractic
178	assistant must be approved by the board.
179	(b)  If a registered chiropractic assistant changes
180	employment, the supervising chiropractic physician or group of
181	chiropractic physicians at the new place of employment must be
182	approved by the board.
183	(c)  Upon approval of a supervising chiropractic physician
184	or group of chiropractic physicians, the effective date of the
185	board's approval applies retroactively to the date of
186	employment. The board shall assess a fee for approval of a
187	supervising chiropractic physician or group of chiropractic
188	physicians, which may not exceed $75.
189	(5)  APPLICATION FORMS.-The board shall prescribe by rule
190	application forms for the initial registration of a registered
191	chiropractic assistant, the board's approval of a supervising
192	chiropractic physician or group of chiropractic physicians, and
193	the registered chiropractic assistant's notice of a change of
194	employment.
195	Section 5.  Section 460.4167, Florida Statutes, is amended
196	to read:
197	460.4167  Proprietorship by persons other than licensed
198	chiropractic physicians.-
199	(1)  A No person other than a sole proprietorship, group
200	practice, partnership, or corporation that is wholly owned by
201	one or more chiropractic physicians licensed under this chapter
202	or by a chiropractic physician licensed under this chapter and
203	the spouse, parent, child, or sibling of that chiropractic
204	physician may not employ a chiropractic physician licensed under
205	this chapter or engage a chiropractic physician licensed under
206	this chapter as an independent contractor to provide services
207	authorized by this chapter to be offered by a chiropractic
208	physician licensed under this chapter unless the person is any
209	of the following, except for:
210	(a)  A sole proprietorship, group practice, partnership,
211	corporation, limited liability company, limited partnership, any
212	person, professional association, or any other entity that is
213	wholly owned by:
214	1.  One or more chiropractic physicians licensed under this
215	chapter;
216	2.  A chiropractic physician licensed under this chapter
217	and the spouse or surviving spouse, parent, child, or sibling of
218	the chiropractic physician; or
219	3.  A trust whose trustees are chiropractic physicians
220	licensed under this chapter and the spouse, parent, child, or
221	sibling of a chiropractic physician.
222	(b)(a)  A sole proprietorship, group practice, partnership,
223	or corporation, limited liability company, limited partnership,
224	professional association, or any other entity that is wholly
225	owned by a physician or physicians licensed under this chapter,
226	chapter 458, chapter 459, or chapter 461.
227	(c)(b)  An entity Entities that is wholly are owned,
228	directly or indirectly, by an entity licensed or registered by
229	the state under chapter 395.
230	(d)(c)  A clinical facility that is facilities affiliated
231	with a college of chiropractic accredited by the Council on
232	Chiropractic Education at which training is provided for
233	chiropractic students.
234	(e)(d)  A public or private university or college.
235	(f)(e)  An entity wholly owned and operated by an
236	organization that is exempt from federal taxation under s.
237	501(c)(3) or (4) of the Internal Revenue Code, a any community
238	college or university clinic, and any entity owned or operated
239	by the Federal Government or by state government, including any
240	agency, county, municipality, or other political subdivision
241	thereof.
242	(g)(f)  An entity owned by a corporation the stock of which
243	is publicly traded.
244	(h)(g)  A clinic licensed under part X of chapter 400 which
245	that provides chiropractic services by a chiropractic physician
246	licensed under chapter 460 and other health care services by
247	physicians licensed under chapter 458 or, chapter 459, or
248	chapter 460, the medical director of which is licensed under
249	chapter 458 or chapter 459.
250	(i)(h)  A state-licensed insurer.
251	(j)  A health maintenance organization or prepaid health
252	clinic regulated under chapter 641.
253
254	If a chiropractic physician described in subparagraph (a)2.
255	dies, notwithstanding part X of chapter 400, the deceased
256	chiropractic physician's surviving spouse or adult children may
257	hold, operate, pledge, sell, mortgage, assign, transfer, own, or
258	control the deceased chiropractic physician's ownership
259	interests for so long as the surviving spouse or adult children
260	remain the sole proprietor of the chiropractic practice.
261	(2)  A No person other than a chiropractic physician
262	licensed under this chapter may not shall direct, control, or
263	interfere with a chiropractic physician's clinical judgment
264	regarding the medical necessity of chiropractic treatment. For
265	purposes of this subsection, a chiropractic physician's clinical
266	judgment does not apply to chiropractic services contractually
267	excluded, the application of alternative services that may be
268	appropriate given the chiropractic physician's prescribed course
269	of treatment, or determinations comparing contractual provisions
270	and scope of coverage with a chiropractic physician's prescribed
271	treatment on behalf of a covered person by an insurer, health
272	maintenance organization, or prepaid limited health service
273	organization.
274	(3)  Any lease agreement, rental agreement, or other
275	arrangement between a person other than a licensed chiropractic
276	physician and a chiropractic physician whereby the person other
277	than a licensed chiropractic physician provides the chiropractic
278	physician with chiropractic equipment or chiropractic materials
279	must shall contain a provision whereby the chiropractic
280	physician expressly maintains complete care, custody, and
281	control of the equipment or practice.
282	(4)  The purpose of this section is to prevent a person
283	other than the a licensed chiropractic physician from
284	influencing or otherwise interfering with the exercise of the a
285	chiropractic physician's independent professional judgment. In
286	addition to the acts specified in subsection (2) (1), a person
287	or entity other than an employer or entity authorized in
288	subsection (1) a licensed chiropractic physician and any entity
289	other than a sole proprietorship, group practice, partnership,
290	or corporation that is wholly owned by one or more chiropractic
291	physicians licensed under this chapter or by a chiropractic
292	physician licensed under this chapter and the spouse, parent,
293	child, or sibling of that physician, may not employ or engage a
294	chiropractic physician licensed under this chapter. A person or
295	entity may not or enter into a contract or arrangement with a
296	chiropractic physician pursuant to which such unlicensed person
297	or such entity exercises control over the following:
298	(a)  The selection of a course of treatment for a patient,
299	the procedures or materials to be used as part of such course of
300	treatment, and the manner in which such course of treatment is
301	carried out by the licensee;
302	(b)  The patient records of a chiropractor;
303	(c)  Policies and decisions relating to pricing, credit,
304	refunds, warranties, and advertising; or
305	(d)  Decisions relating to office personnel and hours of
306	practice. However, an employer authorized to employ a
307	chiropractic physician under subsection (1) may exercise control
308	over the patient records of the employed chiropractor; policies
309	and decisions relating to pricing, credit, refunds, warranties,
310	and advertising; and decisions relating to office personnel and
311	hours of practice.
312	(5)  Any person who violates this section commits a felony
313	of the third degree, punishable as provided in s. 775.082 s.
314	775.081, s. 775.083, or s. 775.084 s. 775.035.
315	(6)  Any contract or arrangement entered into or undertaken
316	in violation of this section is shall be void as contrary to
317	public policy. This section applies to contracts entered into or
318	renewed on or after July 1, 2008.
319	Section 6.  This act shall take effect July 1, 2011.

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