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PRIOR PRINTER'S NO. 1231 PRINTER'S NO. 3278
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1106
Session of
2025
INTRODUCED BY BOROWSKI, BRENNAN, CERRATO, FREEMAN, GIRAL, HILL-
EVANS, JAMES, LAWRENCE, MADDEN, MALAGARI, MALONEY, MULLINS,
O'MARA, PIELLI, SANCHEZ, RADER, SCHMITT, STRUZZI, PICKETT,
BENNINGHOFF, KAUFFMAN, E. NELSON, GILLEN, WEBSTER, VENKAT,
MAJOR, COOK, TOMLINSON, PROKOPIAK, GUZMAN, PROBST, MUNROE,
KOSIEROWSKI, DALEY, MARKOSEK, M. MACKENZIE, CEPEDA-FREYTIZ
AND TAKAC, APRIL 3, 2025
AS REPORTED FROM COMMITTEE ON PROFESSIONAL LICENSURE, HOUSE OF
REPRESENTATIVES, AS AMENDED, APRIL 27, 2026
AN ACT
Amending the act of December 16, 1986 (P.L.1646, No.188),
entitled "An act providing for the licensing of chiropractors
and the regulation of the practice of chiropractic;
establishing the State Board of Chiropractic in the
Department of State and providing for its powers and duties;
providing for the supervision of colleges of chiropractic,
for the examination of applicants, for enforcement and for
disciplinary actions; providing penalties; and making
repeals," IN PRELIMINARY PROVISIONS, FURTHER PROVIDING FOR
DEFINITIONS; IN LICENSURE AND REGULATION, FURTHER PROVIDING
FOR REFUSAL, SUSPENSION OR REVOCATION OF LICENSE AND FOR
REPORTING OF MULTIPLE LICENSURE; providing for certified
chiropractic assistants; in supportive personnel, further
providing for supportive personnel; IN PENALTY PROVISIONS,
FURTHER PROVIDING FOR VIOLATION OF OTHER PROVISIONS AND FOR
CIVIL PENALTY; and making an editorial change.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of December 16, 1986 (P.L.1646, No.188),
known as the Chiropractic Practice Act, is amended by adding a
chapter to read:
SECTION 1. SECTION 102 OF THE ACT OF DECEMBER 16, 1986
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(P.L.1646, NO.188), KNOWN AS THE CHIROPRACTIC PRACTICE ACT, IS
AMENDED BY ADDING DEFINITIONS TO READ:
SECTION 102. DEFINITIONS.
THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS ACT SHALL
HAVE THE MEANINGS GIVEN TO THEM IN THIS SECTION UNLESS THE
CONTEXT CLEARLY INDICATES OTHERWISE:
* * *
"CERTIFIED CHIROPRACTIC ASSISTANT." AN INDIVIDUAL WHO HAS
MET ALL OF THE REQUIREMENTS OF THIS ACT AND IS CERTIFIED AS A
CHIROPRACTIC ASSISTANT IN ACCORDANCE WITH CHAPTER 5-A.
* * *
"DIRECT ON-PREMISES SUPERVISION." SUPERVISION CONDUCTED
WHILE BEING PHYSICALLY PRESENT IN AN OFFICE SUITE OR FACILITY,
BUT NOT NECESSARILY IN THE SAME ROOM, AND BEING IMMEDIATELY
AVAILABLE.
* * *
"THERAPEUTIC EXERCISE." A THERAPEUTIC PROCEDURE OF USING
EXERCISE TO DEVELOP STRENGTH, ENDURANCE, RANGE OF MOTION AND
FLEXIBILITY.
SECTION 2. SECTION 506 HEADING AND (A)(1), (3), (7), (8) AND
(13) OF THE ACT ARE AMENDED AND SUBSECTION (A) IS AMENDED BY
ADDING A PARAGRAPH TO READ:
SECTION 506. REFUSAL, SUSPENSION OR REVOCATION OF LICENSE OR
CERTIFICATE.
(A) REASONS ENUMERATED.--THE BOARD MAY REFUSE TO ISSUE A
LICENSE OR CERTIFICATE OR MAY SUSPEND OR REVOKE A LICENSE OR
CERTIFICATE FOR ANY OF THE FOLLOWING REASONS:
(1) FAILING TO DEMONSTRATE THE QUALIFICATIONS OR
STANDARDS FOR A LICENSE OR CERTIFICATE CONTAINED IN THIS ACT
OR REGULATIONS OF THE BOARD.
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(3) PRACTICING FRAUD OR DECEIT IN OBTAINING A LICENSE TO
PRACTICE CHIROPRACTIC OR A CERTIFICATE TO PRACTICE AS A
CHIROPRACTIC ASSISTANT.
* * *
(7) HAVING A LICENSE TO PRACTICE CHIROPRACTIC OR A
CERTIFICATE TO PRACTICE AS A CHIROPRACTIC ASSISTANT
SUSPENDED, REVOKED OR REFUSED OR RECEIVING OTHER DISCIPLINARY
ACTION BY THE PROPER CHIROPRACTIC LICENSING AUTHORITY OF
ANOTHER STATE, TERRITORY, POSSESSION OR COUNTRY.
(8) BEING UNABLE TO PRACTICE CHIROPRACTIC WITH
REASONABLE SKILL AND SAFETY TO PATIENTS BY REASON OF ILLNESS,
DRUNKENNESS, EXCESSIVE USE OF DRUGS, NARCOTICS, CHEMICALS OR
ANY OTHER TYPE OF MATERIAL, OR AS A RESULT OF ANY MENTAL OR
PHYSICAL CONDITION. IN ENFORCING THIS PARAGRAPH, THE BOARD
SHALL, UPON PROBABLE CAUSE, HAVE AUTHORITY TO COMPEL A
CHIROPRACTOR OR CERTIFIED CHIROPRACTIC ASSISTANT TO SUBMIT TO
A MENTAL OR PHYSICAL EXAMINATION BY PHYSICIANS APPROVED BY
THE BOARD. FAILURE OF A CHIROPRACTOR OR CERTIFIED
CHIROPRACTIC ASSISTANT TO SUBMIT TO SUCH EXAMINATION WHEN
DIRECTED BY THE BOARD, UNLESS SUCH FAILURE IS DUE TO
CIRCUMSTANCES BEYOND HIS CONTROL, SHALL CONSTITUTE AN
ADMISSION OF THE ALLEGATIONS AGAINST HIM, CONSEQUENT UPON
WHICH A DEFAULT AND FINAL ORDER MAY BE ENTERED WITHOUT THE
TAKING OF TESTIMONY OR PRESENTATION OF EVIDENCE. A
CHIROPRACTOR AFFECTED UNDER THIS PARAGRAPH SHALL AT
REASONABLE INTERVALS BE AFFORDED AN OPPORTUNITY TO
DEMONSTRATE THAT HE CAN RESUME A COMPETENT PRACTICE OF
CHIROPRACTIC WITH REASONABLE SKILL AND SAFETY TO PATIENTS. A
CERTIFIED CHIROPRACTIC ASSISTANT AFFECTED UNDER THIS
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PARAGRAPH SHALL, AT REASONABLE INTERVALS, BE AFFORDED AN
OPPORTUNITY TO DEMONSTRATE THAT HE CAN RESUME COMPETENT
PRACTICE AS A CERTIFIED CHIROPRACTIC ASSISTANT WITH
REASONABLE SKILL AND SAFETY TO PATIENTS.
* * *
(13) FAILING TO PERFORM ANY STATUTORY OBLIGATION PLACED
UPON A LICENSED CHIROPRACTOR OR CERTIFIED CHIROPRACTIC
ASSISTANT.
* * *
(20) IN THE CASE OF A LICENSED CHIROPRACTOR, FAILING TO
PROPERLY SUPERVISE A CERTIFIED CHIROPRACTIC ASSISTANT IN
ACCORDANCE WITH THIS ACT AND BOARD REGULATIONS.
* * *
SECTION 3. SECTION 523 OF THE ACT IS AMENDED TO READ:
SECTION 523. REPORTING OF MULTIPLE LICENSURE OR CERTIFICATION.
ANY LICENSED CHIROPRACTOR OR CERTIFIED CHIROPRACTIC ASSISTANT
OF THIS COMMONWEALTH WHO IS ALSO LICENSED TO PRACTICE
CHIROPRACTIC OR CERTIFIED TO PRACTICE AS A CHIROPRACTIC
ASSISTANT IN ANY OTHER STATE, TERRITORY, POSSESSION OR COUNTRY
SHALL REPORT THIS INFORMATION TO THE BOARD ON THE BIENNIAL
REGISTRATION APPLICATION. ANY DISCIPLINARY ACTION TAKEN IN SUCH
OTHER JURISDICTION SHALL BE REPORTED TO THE BOARD ON THE
BIENNIAL REGISTRATION APPLICATION OR WITHIN [90] 30 DAYS OF
FINAL DISPOSITION, WHICHEVER IS SOONER. MULTIPLE LICENSURE OR
CERTIFICATION SHALL BE NOTED BY THE BOARD ON THE CHIROPRACTOR'S
OR CERTIFIED CHIROPRACTIC ASSISTANT'S RECORD AND SUCH STATE,
TERRITORY, POSSESSION OR COUNTRY SHALL BE NOTIFIED BY THE BOARD
OF ANY DISCIPLINARY ACTIONS TAKEN AGAINST SAID CHIROPRACTOR OR
CERTIFIED CHIROPRACTIC ASSISTANT IN THIS COMMONWEALTH.
SECTION 4. THE ACT IS AMENDED BY ADDING A CHAPTER TO READ:
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CHAPTER 5-A
CERTIFIED CHIROPRACTIC ASSISTANTS
Section 501-A. Chiropractic assistant certifications.
(a) Eligibility.--To be eligible for certification by the
board as a chiropractic assistant, an applicant shall:
(1) be at least 18 years of age unless otherwise
determined by the board;
(2) possess a high school diploma or its equivalent;
(3) prove to the satisfaction of the board that the
individual is of good moral character and is not unfit or
unable to practice as a chiropractic assistant by reason of
physical or mental impairment. In assessing the moral
character of an individual with a criminal conviction, the
board shall conduct an individualized assessment in
accordance with 63 Pa.C.S. § 3113 (relating to consideration
of criminal convictions);
(4) be a graduate of a nationally recognized
chiropractic assistant program approved by the board; and
(5) successfully pass an examination approved by the
board, subject to rules and regulations established by the
board and administered in accordance with section 812.1 of
the act of April 9, 1929 (P.L.177, No.175), known as The
Administrative Code of 1929. An applicant may not be
certified as a certified chiropractic assistant unless the
applicant has attained passing scores on the examination
under this paragraph as published prior to the administration
of the examination.
(b) Temporary certification.--Upon the submission of an
application for certification as a chiropractic assistant as
provided by the board, the board shall issue a temporary
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certificate to the applicant who meets the requirements under
subsection (a)(1) , (2), (3) and (4) and is eligible to take the
examination under subsection (a)(5) . The board shall issue only
one temporary certificate under this subsection to an applicant.
A temporary certificate under this subsection shall expire upon
the applicant's failure of the first examination under
subsection (a)(5), or six months after the date of issuance of
the temporary certificate, whichever occurs first. Issuance of a
temporary certificate under this subsection shall permit the
applicant to engage in the practice of chiropractic assistance
only while under the direct on-premises supervision of a
licensed chiropractor. Upon the expiration of a temporary
certificate under this subsection, the applicant shall promptly
return the temporary certificate to the board.
(c) Second examination.--If an applicant fails the first
examination under subsection (a)(5), the applicant for
certification, after the expiration of 60 days from the date of
the first examination and no later than one year after the first
examination, shall have the opportunity to take the examination
a second time. The board may adopt regulations governing the
eligibility of applicants who have failed to pass two
examinations under subsection (a)(5) in order to be admitted to
subsequent examinations.
(d) Use of title.--Only an individual who has been properly
certified as a chiropractic assistant with the board, in
accordance with this chapter and the rules and regulations
promulgated by the board, shall assist a licensed chiropractor
as a certified chiropractic assistant and use the title
"certified chiropractic assistant" and the abbreviation "CCA."
(e) Actions.--The board shall issue, renew, revoke or
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suspend the certification of a chiropractic assistant in
accordance with the rules and regulations promulgated by the
board. All actions of the board under this subsection shall be
taken subject to the right of notice, hearing and adjudication
and the right of appeal in accordance with 2 Pa.C.S. (relating
to administrative law and procedure).
(f) Reinstatement.--Unless ordered by a court of competent
jurisdiction, the board shall not reinstate the certification of
an individual to practice as a chiropractic assistant that has
been revoked under subsection (e). The individual may apply for
certification as a chiropractic assistant after five years have
elapsed since the date of revocation in accordance with this
chapter.
(g) Renewals.--For each certificate renewal, a CERTIFIED
chiropractic assistant shall complete within the preceding two-
year period at least 16 hours of continuing chiropractic
education, including eight hours of in-person learning, as
approved by the board in accordance with standards and criteria
established by the board by rules and regulations. A certified
chiropractic assistant shall provide the board with evidence of
the completion of the continuing chiropractic education under
this subsection. The board's rules and regulations shall remain
in effect until such time as the board establishes by
regulations, standards and criteria relating to continuing
chiropractic education for certified chiropractic assistants.
Section 502-A. Performance of chiropractic acts and services.
(a) Supervision.--While providing assistance to a licensed
chiropractor, a certified chiropractic assistant shall MAY only
perform patient-related chiropractic acts and services that are
assigned or delegated by and under the direct on-premises
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supervision of a licensed chiropractor.
(b) Scope DELEGATION .--A certified chiropractic assistant
may provide, demonstrate, administer or observe therapeutic
exercise under the direct on-premises supervision of a licensed
chiropractor AS DOCUMENTED IN THE PATIENT'S PLAN OF CARE
DEVELOPED BY THE LICENSED CHIROPRACTOR . A certified chiropractic
assistant may not perform evaluations, adjustments, test
interpretations, other therapeutic procedures or the planning or
modification of a plan of care for a patient.
(c) Responsibility.--A licensed chiropractor shall be
responsible for the performance of acts and services by a
certified chiropractic assistant. In all practice settings, the
initial patient contact shall be made by a licensed chiropractor
for evaluation of the patient and establishment of a plan of
care.
(d) Consultation.--A certified chiropractic assistant shall
consult with the supervising licensed chiropractor in the event
of a change in the patient's condition that may require the
assessment of a licensed chiropractor.
(e) Limitation.--A licensed chiropractor shall not supervise
more than three certified chiropractic assistants at any time.
If there is a change of the licensed chiropractor supervising a
certified chiropractic assistant, the succeeding licensed
chiropractor shall be responsible for the ongoing supervision of
the certified chiropractic assistant and shall be considered the
supervising licensed chiropractor for the purpose of this
section.
(f) Definitions.--As used in this section, the term
"therapeutic exercise" shall mean a therapeutic procedure of
using exercise to develop strength, endurance, range of motion
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and flexibility.
SECTION 503-A. ADDITIONAL DUTIES OF BOARD.
(A) REGULATIONS.--
(1) THE BOARD SHALL PROMULGATE BY REGULATIONS THE
QUALIFICATIONS AND REQUIREMENTS FOR THE CERTIFICATION AND
REGULATION OF CERTIFIED CHIROPRACTIC ASSISTANTS. THE
REGULATIONS SHALL PROVIDE FOR DISCIPLINARY ACTION AND THE
GROUNDS FOR DISCIPLINARY ACTION.
(2) THE BOARD MAY NOT ISSUE TEMPORARY CERTIFICATES UNTIL
THE REGULATIONS UNDER PARAGRAPH (1) ARE PROMULGATED.
(B) FEES.--THE BOARD MAY ESTABLISH REASONABLE FEES FOR
CERTIFICATION UNDER THIS CHAPTER.
Section 2 5. Chapter 6 heading and section 601 SECTIONS 601,
702(2), (6) AND (9) AND 703 of the act are amended to read:
CHAPTER 6
UNLICENSED OR UNCERTIFIED SUPPORTIVE PERSONNEL
Section 601. Supportive personnel.
(a) Construction.--Nothing in this act shall prohibit a
licensed chiropractor from utilizing the assistance of
unlicensed or uncertified supportive personnel performing under
the direct on-premises supervision of a licensed chiropractor,
provided that a chiropractor may not delegate any activity or
duty to such unlicensed or uncertified individuals which
requires formal education or training in the practice of
chiropractic or the knowledge and skill of a licensed
chiropractor.
(b) Definitions.--As used in this section, the term "d irect
on-premises supervision" shall mean supervision conducted while
being physically present in the office suite or facility, but
not necessarily in the same room and immediately available.
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Section 3. This act shall take effect in 60 days.
SECTION 702. VIOLATION OF OTHER PROVISIONS.
A PERSON COMMITS A MISDEMEANOR OF THE THIRD DEGREE AND, UPON
CONVICTION, SHALL BE SENTENCED TO PAY A FINE OF NOT MORE THAN
$500, OR TO IMPRISONMENT FOR NOT MORE THAN SIX MONTHS, OR BOTH,
IF HE COMMITS ANY ACT DECLARED UNLAWFUL BY ANY OTHER PROVISION
OF THIS ACT, OTHER THAN SECTION 701, OR IF HE:
* * *
(2) PRACTICES FRAUD OR DECEIT IN OBTAINING A LICENSE TO
PRACTICE CHIROPRACTIC OR A CERTIFICATE TO PRACTICE AS A
CHIROPRACTIC ASSISTANT.
* * *
(6) KNOWINGLY AIDS, ASSISTS, PROCURES OR ADVISES ANY
UNLICENSED OR UNCERTIFIED PERSON TO PRACTICE CHIROPRACTIC,
CONTRARY TO THIS ACT OR REGULATIONS OF THE BOARD.
* * *
(9) FAILS TO PERFORM ANY STATUTORY OBLIGATION PLACED
UPON A LICENSED CHIROPRACTOR OR CERTIFIED CHIROPRACTIC
ASSISTANT.
* * *
SECTION 703. CIVIL PENALTY.
IN ADDITION TO ANY OTHER CIVIL REMEDY OR CRIMINAL PENALTY
PROVIDED FOR IN THIS ACT, THE BOARD, BY A VOTE OF THE MAJORITY
OF THE MAXIMUM NUMBER OF THE AUTHORIZED MEMBERSHIP OF THE BOARD
AS PROVIDED BY LAW OR BY A VOTE OF THE MAJORITY OF THE DULY
QUALIFIED AND CONFIRMED MEMBERSHIP OR A MINIMUM OF FOUR MEMBERS,
WHICHEVER IS GREATER, MAY LEVY A CIVIL PENALTY OF UP TO $1,000
ON ANY CURRENT LICENSEE OR CERTIFICATE HOLDER WHO VIOLATES ANY
PROVISION OF THIS ACT OR ON ANY PERSON WHO PRACTICES
CHIROPRACTIC OR PRACTICES AS A CERTIFIED CHIROPRACTIC ASSISTANT
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WITHOUT BEING PROPERLY LICENSED OR CERTIFIED TO DO SO UNDER THIS
ACT. THE BOARD SHALL LEVY THIS PENALTY ONLY AFTER AFFORDING THE
ACCUSED PARTY THE OPPORTUNITY FOR A HEARING, AS PROVIDED IN
TITLE 2 OF THE PENNSYLVANIA CONSOLIDATED STATUTES (RELATING TO
ADMINISTRATIVE LAW AND PROCEDURE).
SECTION 6. THIS ACT SHALL TAKE EFFECT IN 60 DAYS.
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