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CS/CS/HB 439 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to the practice of chiropractic 2
medicine; amending s. 460.403, F.S.; revising the 3
definition of the term "practice of chiropractic 4
medicine"; authorizing chiropractic physicians to 5
possess, for emergency purposes only at the 6
chiropractic physician's office or place of business, 7
prescription medical oxygen; authorizing chiropractic 8
physicians to possess specified solutions in aerosol 9
form; authorizing chiropractic physicians to order, 10
store, possess, prescribe, and administer, only by 11
means of injection at the chiropractic physician's 12
office, certain sterile substances, including 13
vitamins, minerals, and nutritional supplements; 14
prohibiting chiropractic physicians from administering 15
certain sterile substances by means of injection 16
unless he or she has been certified by the board; 17
prohibiting chiropractic physicians from administering 18
certain any substance through intravenous therapy; 19
creating s. 460.4086, F.S.; requiring a chiropractic 20
physician to be certified before administering sterile 21
substances in a specified manner; requiring the Board 22
of Chiropractic Medicine to establish minimum 23
standards of practice for the administration of 24
certain sterile substances by means of injection by 25
CS/CS/HB 439 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
chiropractic physicians; providing requirements for 26
such standards; requiring the board to issue a 27
chiropractic physician a letter certifying that he or 28
she is authorized to administer specified sterile 29
substances by means of injection under certain 30
conditions; providing rulemaking authority; providing 31
an effective date. 32
33
Be It Enacted by the Legislature of the State of Florida: 34
35
Section 1. Paragraph (c) of subsection (9) of section 36
460.403, Florida Statutes, is amended to read: 37
460.403 Definitions.—As used in this chapter, the term: 38
(9) 39
(c)1. Chiropractic physicians may adjust, manipulate, or 40
treat the human body by manual, mechanical, electrical, or 41
natural methods; by the use of physical means or physiotherapy, 42
including light, heat, water, or exercise; by the use of 43
acupuncture; by the use of monofilament intramuscular 44
stimulation treatment, also known as dry needling, for trigger 45
points or myofascial pain; or by the administration of foods, 46
food concentrates, food extracts, and items for which a 47
prescription is not required and may apply first aid and 48
hygiene, but chiropractic physicians are expressly prohibited 49
from prescribing or administering to any person any legend drug 50
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
except as authorized under subparagraph 2., from performing any 51
surgery except as stated herein, or from practicing obstetrics. 52
2. Notwithstanding the prohibition against prescribing and 53
administering legend drugs under subparagraph 1. or s. 54
499.83(2)(c), pursuant to board rule chiropractic physicians 55
may: 56
a. Order, store, possess and administer, for emergency 57
purposes only at the chiropractic physician's office or place of 58
business, prescription medical oxygen. and may also 59
b. Order, store, possess, and administer any solution the 60
following topical anesthetics in aerosol form: 61
(I)a. Any solution Consisting of 25 percent ethyl 62
chloride ethylchloride and 75 percent dichlorodifluoromethane; 63
or. 64
(II)b. Any solution Consisting of 15 percent 65
dichlorodifluoromethane and 85 percent 66
trichloromonofluoromethane. 67
c. Order, store, possess, prescribe, and administer by 68
means of injection, vitamins, minerals, and nutritional 69
supplements in sterile form that are proprietary or over-the-70
counter drugs as defined in s. 499.003; however, the 71
administration of such sterile substances may only take place at 72
the chiropractic physician's office or place of business. 73
74
However, this paragraph does not authorize a chiropractic 75
CS/CS/HB 439 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
physician to prescribe medical oxygen as defined in s. 76
499.82(10) or to administer any substance through intravenous 77
therapy. 78
Section 2. Section 460.4086, Florida Statutes, is created 79
to read: 80
460.4086 Administration of sterile substances by 81
chiropractic physicians.— 82
(1) A chiropractic physician must be certified before 83
administering sterile substances by means of injection to a 84
patient. 85
(2) The board shall establish minimum standards of 86
practice for the administration of sterile substances by means 87
of injection by chiropractic physicians, including, at a 88
minimum, all of the following: 89
(a) Completion of 36 hours of continuing education 90
consisting of didactic lectures and laboratory training on the 91
safe and effective administration of vitamins, minerals, and 92
nutritional supplements, including, but not limited to, 93
protocols, indications, and contraindications. 94
(b) Passage of a written and practical examination. 95
(c) A requirement that the administration of sterile 96
substances by means of injection may not be performed without 97
patient consent and education on the risks and adverse events 98
that could occur. Such patient consent and education must be 99
included as part of the patient's documented plan of care. 100
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(d) A requirement that the administration of sterile 101
substances by means of injection may not be delegated to any 102
person other than a chiropractic physician who is authorized to 103
administer sterile substances by means of injection under this 104
chapter. 105
(3) When a chiropractic physician submits documentation to 106
the board verifying completion of the continuing education 107
requirements and passage of examination under this section, the 108
board must issue the chiropractic physician a letter certifying 109
that the chiropractic physician is authorized to administer the 110
sterile substances. 111
(4) The board shall adopt rules to implement this section. 112
Section 3. This act shall take effect July 1, 2026. 113