| 1 | A bill to be entitled |
| 2 | An act relating to chiropractic medicine; amending s. |
| 3 | 460.4062, F.S.; authorizing the Department of Health to |
| 4 | issue a chiropractic medicine faculty certificate to |
| 5 | faculty who perform research; amending s. 460.4165, F.S.; |
| 6 | limiting the locations where certified chiropractic |
| 7 | physician's assistants may perform chiropractic services; |
| 8 | deleting restrictions on the minimum time permitted for |
| 9 | completing the curriculum of a training program for |
| 10 | certified chiropractic physician's assistants; amending s. |
| 11 | 460.4166, F.S.; requiring chiropractic assistants who |
| 12 | perform certain services to register with the Board of |
| 13 | Chiropractic Medicine after a specified date; requiring a |
| 14 | registered chiropractic assistant to notify the board of a |
| 15 | change of employment; requiring the supervision of |
| 16 | registered chiropractic assistants by chiropractic |
| 17 | physicians approved by the board; providing that the |
| 18 | board's approval of supervising chiropractic physicians |
| 19 | and registration applications shall apply retroactively; |
| 20 | providing for a fee; requiring the board to prescribe |
| 21 | forms; amending s. 460.4167, F.S.; revising restrictions |
| 22 | on the ownership of entities that employ chiropractic |
| 23 | physicians; authorizing additional persons to possess |
| 24 | ownership interests in entities that employ chiropractic |
| 25 | physicians; authorizing the surviving spouse of a deceased |
| 26 | chiropractic physician to keep an ownership interest in |
| 27 | the chiropractic practice for a specified period after the |
| 28 | chiropractic physician's death; providing penalties for |
| 29 | violations of provisions prohibiting ownership of a |
| 30 | chiropractic practice by persons other than licensed |
| 31 | chiropractic physicians; voiding contracts entered into or |
| 32 | renewed before a specified date that violate provisions |
| 33 | prohibiting ownership of a chiropractic practice by |
| 34 | persons other than licensed chiropractic physicians; |
| 35 | providing effective dates. |
| 36 |
|
| 37 | Be It Enacted by the Legislature of the State of Florida: |
| 38 |
|
| 39 | Section 1. Paragraph (e) of subsection (1) of section |
| 40 | 460.4062, Florida Statutes, is amended to read: |
| 41 | 460.4062 Chiropractic medicine faculty certificate.-- |
| 42 | (1) The department may issue a chiropractic medicine |
| 43 | faculty certificate without examination to an individual who |
| 44 | remits a nonrefundable application fee, not to exceed $100 as |
| 45 | determined by rule of the board, and who demonstrates to the |
| 46 | board that he or she meets the following requirements: |
| 47 | (e)1. Has been offered and has accepted a full-time |
| 48 | faculty appointment to teach in a program of chiropractic |
| 49 | medicine or perform research at a publicly funded state |
| 50 | university or college or at a college of chiropractic located in |
| 51 | the state and accredited by the Council on Chiropractic |
| 52 | Education; and |
| 53 | 2. Provides a certification from the dean of the |
| 54 | appointing college acknowledging the appointment. |
| 55 | Section 2. Paragraph (b) of subsection (2) and subsection |
| 56 | (5) of section 460.4165, Florida Statutes, are amended to read: |
| 57 | 460.4165 Certified chiropractic physician's assistants.-- |
| 58 | (2) PERFORMANCE BY CERTIFIED CHIROPRACTIC PHYSICIAN'S |
| 59 | ASSISTANT.--Notwithstanding any other provision of law, a |
| 60 | certified chiropractic physician's assistant may perform |
| 61 | chiropractic services in the specialty area or areas for which |
| 62 | the certified chiropractic physician's assistant is trained or |
| 63 | experienced when such services are rendered under the |
| 64 | supervision of a licensed chiropractic physician or group of |
| 65 | chiropractic physicians certified by the board. Any certified |
| 66 | chiropractic physician's assistant certified under this section |
| 67 | to perform services may perform those services only: |
| 68 | (b) Under indirect supervision if the indirect supervision |
| 69 | occurs at the supervising chiropractic physician's address of |
| 70 | record or place of practice required by s. 456.035, other than |
| 71 | at a clinic licensed under part X of chapter 400, of the |
| 72 | chiropractic physician to whom she or he is assigned as defined |
| 73 | by rule of the board; |
| 74 | (5) PROGRAM APPROVAL.--The department shall issue |
| 75 | certificates of approval for programs for the education and |
| 76 | training of certified chiropractic physician's assistants which |
| 77 | meet board standards. Any basic program curriculum certified by |
| 78 | the board shall cover a period of 24 months. The curriculum must |
| 79 | consist of a curriculum of at least 200 didactic classroom hours |
| 80 | during those 24 months. |
| 81 | (a) In developing criteria for program approval, the board |
| 82 | shall give consideration to, and encourage, the utilization of |
| 83 | equivalency and proficiency testing and other mechanisms whereby |
| 84 | full credit is given to trainees for past education and |
| 85 | experience in health fields. |
| 86 | (b) The board shall create groups of specialty |
| 87 | classifications of training for certified chiropractic |
| 88 | physician's assistants. These classifications shall reflect the |
| 89 | training and experience of the certified chiropractic |
| 90 | physician's assistant. The certified chiropractic physician's |
| 91 | assistant may receive training in one or more such |
| 92 | classifications, which shall be shown on the certificate issued. |
| 93 | (c) The board shall adopt and publish standards to ensure |
| 94 | that such programs operate in a manner which does not endanger |
| 95 | the health and welfare of the patients who receive services |
| 96 | within the scope of the program. The board shall review the |
| 97 | quality of the curricula, faculties, and facilities of such |
| 98 | programs; issue certificates of approval; and take whatever |
| 99 | other action is necessary to determine that the purposes of this |
| 100 | section are being met. |
| 101 | Section 3. Subsection (3) of section 460.4166, Florida |
| 102 | Statutes, is amended, and subsections (4) and (5) are added to |
| 103 | that section, to read: |
| 104 | 460.4166 Registered chiropractic assistants.-- |
| 105 | (3) REGISTRATION.-- |
| 106 | (a) A registered chiropractic assistant assistants may |
| 107 | register with be registered by the board for a biennial fee not |
| 108 | to exceed $25. Effective April 1, 2010, a person must register |
| 109 | with the board as a chiropractic assistant if the person |
| 110 | performs therapeutic services or administers therapeutic agents |
| 111 | related to a chiropractic physician's treatment of a patient, |
| 112 | unless the person is otherwise certified or licensed to perform |
| 113 | those services or administer those agents. |
| 114 | (b) A person employed as a registered chiropractic |
| 115 | assistant, if required to register under this section, must |
| 116 | submit an initial application for registration to the board |
| 117 | within 30 days after employment. Upon the board's approval of |
| 118 | the application, the effective date of the registration shall |
| 119 | apply retroactively to the date of employment. |
| 120 | (c) A registered chiropractic assistant, within 30 days |
| 121 | after a change of employment, must notify the board of the new |
| 122 | place of employment and the name of the chiropractic physician |
| 123 | or group of chiropractic physicians under whose supervision the |
| 124 | registered chiropractic assistant performs the duties described |
| 125 | in subsection (2). |
| 126 | (d) A person who exclusively performs nontherapeutic |
| 127 | services is not required to register under this section. |
| 128 | (4) APPROVAL OF SUPERVISING CHIROPRACTIC PHYSICIANS.-- |
| 129 | (a) A chiropractic physician or group of chiropractic |
| 130 | physicians under whose supervision a registered chiropractic |
| 131 | assistant performs the duties described in subsection (2) must |
| 132 | be approved by the board. If a registered chiropractic assistant |
| 133 | performs those duties under the direct supervision of a |
| 134 | certified chiropractic physician's assistant, the chiropractic |
| 135 | physician or group of chiropractic physicians under whose |
| 136 | supervision the certified chiropractic physician's assistant |
| 137 | provides direct supervision for the registered chiropractic |
| 138 | assistant must be approved by the board. |
| 139 | (b) If a registered chiropractic assistant changes |
| 140 | employment, the supervising chiropractic physician or group of |
| 141 | chiropractic physicians at the new place of employment must be |
| 142 | approved by the board. |
| 143 | (c) Upon approval of a supervising chiropractic physician |
| 144 | or group of chiropractic physicians, the effective date of the |
| 145 | board's approval shall apply retroactively to the date of |
| 146 | employment. The board shall assess a fee for approval of a |
| 147 | supervising chiropractic physician or group of chiropractic |
| 148 | physicians not to exceed $75. |
| 149 | (5) APPLICATION FORMS.--The board shall prescribe by rule |
| 150 | application forms for the initial registration of a registered |
| 151 | chiropractic assistant, the board's approval of a supervising |
| 152 | chiropractic physician or group of chiropractic physicians, and |
| 153 | the registered chiropractic assistant's notice of a change of |
| 154 | employment. |
| 155 | Section 4. Subsections (1) and (5) of section 460.4167, |
| 156 | Florida Statutes, are amended to read: |
| 157 | 460.4167 Proprietorship by persons other than licensed |
| 158 | chiropractic physicians.-- |
| 159 | (1) No person other than a sole proprietorship, group |
| 160 | practice, partnership, or corporation that is wholly owned by |
| 161 | one or more chiropractic physicians licensed under this chapter |
| 162 | or by a chiropractic physician licensed under this chapter and |
| 163 | the spouse, parent, child, or sibling of that chiropractic |
| 164 | physician may employ a chiropractic physician licensed under |
| 165 | this chapter, or engage a chiropractic physician licensed under |
| 166 | this chapter as an independent contractor, to provide services |
| 167 | authorized by this chapter to be offered by a chiropractic |
| 168 | physician licensed under this chapter, unless the person is any |
| 169 | of the following except for: |
| 170 | (a) A sole proprietorship, group practice, partnership, |
| 171 | corporation, limited liability company, limited partnership, |
| 172 | professional association, or any other entity that is wholly |
| 173 | owned by: |
| 174 | 1. One or more chiropractic physicians licensed under this |
| 175 | chapter; |
| 176 | 2. A chiropractic physician licensed under this chapter |
| 177 | and the spouse or surviving spouse, parent, child, or sibling of |
| 178 | the chiropractic physician; or |
| 179 | 3. A trust whose trustees are chiropractic physicians |
| 180 | licensed under this chapter and the spouse, parent, child, or |
| 181 | sibling of a chiropractic physician. |
| 182 | (b)(a) A sole proprietorship, group practice, partnership, |
| 183 | or corporation, limited liability company, limited partnership, |
| 184 | professional association, or any other entity that is wholly |
| 185 | owned by a physician or physicians licensed under this chapter, |
| 186 | chapter 458, chapter 459, or chapter 461. |
| 187 | (c)(b) An entity Entities that is wholly are owned, |
| 188 | directly or indirectly, by an entity licensed or registered by |
| 189 | the state under chapter 395. |
| 190 | (d)(c) A clinical facility facilities affiliated with a |
| 191 | college of chiropractic accredited by the Council on |
| 192 | Chiropractic Education at which training is provided for |
| 193 | chiropractic students. |
| 194 | (e)(d) A public or private university or college. |
| 195 | (f)(e) An entity wholly owned and operated by an |
| 196 | organization that is exempt from federal taxation under s. |
| 197 | 501(c)(3) or (4) of the Internal Revenue Code, a any community |
| 198 | college or university clinic, and any entity owned or operated |
| 199 | by the Federal Government, or by state government, including any |
| 200 | agency, county, municipality, or other political subdivision |
| 201 | thereof. |
| 202 | (g)(f) An entity owned by a corporation the stock of which |
| 203 | is publicly traded. |
| 204 | (h)(g) A clinic licensed under part X of chapter 400 that |
| 205 | provides chiropractic services by a chiropractic physician |
| 206 | licensed under chapter 460 and other health care services by |
| 207 | physicians licensed under chapter 458 or, chapter 459, or |
| 208 | chapter 460, the medical director of which must be is licensed |
| 209 | under chapter 458 or chapter 459. |
| 210 | (i)(h) A state-licensed insurer. |
| 211 | (j) A health maintenance organization or prepaid health |
| 212 | clinic regulated under chapter 641. |
| 213 |
|
| 214 | If a chiropractic physician described in subparagraph (a)2. |
| 215 | dies, notwithstanding part X of chapter 400, the deceased |
| 216 | chiropractic physician's surviving spouse may hold, operate, |
| 217 | pledge, sell, mortgage, assign, transfer, own, or control the |
| 218 | deceased chiropractic physician's ownership interests for 1 year |
| 219 | after the chiropractic physician's death. The chiropractic |
| 220 | practice must subsequently comply with this section and part X |
| 221 | of chapter 400. |
| 222 | (5) Any person who violates this section commits a felony |
| 223 | of the third degree, punishable as provided in s. 775.082 |
| 224 | 775.081, s. 775.083, or s. 775.084 s. 775.035. |
| 225 | Section 5. Effective July 1, 2010, subsection (6) of |
| 226 | section 460.4167, Florida Statutes, is amended to read: |
| 227 | 460.4167 Proprietorship by persons other than licensed |
| 228 | chiropractic physicians.-- |
| 229 | (6) Any contract or arrangement entered into or undertaken |
| 230 | in violation of this section is shall be void as contrary to |
| 231 | public policy. This section applies to contracts entered into or |
| 232 | renewed on or after July 1, 2008. |
| 233 | Section 6. Except as otherwise expressly provided in this |
| 234 | act, this act shall take effect July 1, 2009. |