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PRINTER'S NO. 1719
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No. 1330
Session of
2026
INTRODUCED BY KEEFER, MAY 20, 2026
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE,
MAY 20, 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, providing for findings
and declarations and for applicability and construction and
further providing for definitions; in State Board of
Chiropractic, further providing for powers and duties and
providing for certification to perform dry needling, for
certification to practice animal chiropractic, for concussion
management and for student athletes; in licensure and
regulation, further providing for applications for license,
repealing provisions relating to examination and to failure
of examination, further providing for reciprocity, for
limited license, for refusal, suspension or revocation of
license, repealing provisions relating to continuing
chiropractic education, providing for continuing chiropractic
education requirements, for format and limits for continuing
chiropractic education, for course content and approval, for
calculation of continuing chiropractic education credits, for
sponsor approval and program administration, for renewal
certification, reporting and audits, for exemptions and
carryover and for extensions, waivers and enforcement,
further providing for professional liability insurance, for
license required, for Doctor of Chiropractic and abbreviation
and for relationship with other branches of the healing arts
and providing for opinions and testimony; in penalty
provisions, further providing for practice of chiropractic
without license prohibited and for violation of other
provisions; and, in miscellaneous provisions, further
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providing for fees.
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
sections to read:
Section 101.1. Findings and declarations.
The General Assembly finds and declares as follows:
(1) Chiropractic is a health profession in this
Commonwealth that is subject to regulation and oversight to
protect the public health, welfare and safety.
(2) It is in the public interest that only a person who
meets the qualifications established under this act engage in
the practice of chiropractic to maintain public trust and
confidence in the profession.
Section 101.2. Applicability and construction.
(a) Applicability.--This act shall apply to a person who
practices chiropractic in this Commonwealth regardless of the
person's place of residence or whether a doctor-patient
relationship exists.
(b) Construction.--This act shall be liberally construed to
implement the purposes of this act.
Section 2. The definitions of "adjunctive procedures,"
"chiropractic," "chiropractor" and "manipulation/adjustment" in
section 102 are amended and the section 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:
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"Adjunctive procedures." [Physical measures such as
mechanical stimulation, heat, cold, light, air, water,
electricity, sound, massage and mobilization.] A physical
measure, physiologic therapeutic program or rehabilitative or
exercise program, including active and passive modalities,
mechanical stimulation, heat, cold, light, air, water,
electricity, sound, massage and mobilization, that a licensee
uses to reduce pain or muscle spasm, increase function or
mobility, reduce disability or otherwise provide chiropractic
care and treatment to a patient.
"Animal." A living animal other than a human being.
"Animal chiropractic." The evaluation and treatment of
vertebral or extremity joint dysfunction of an animal through
spinal, joint or neuromusculoskeletal manipulative therapy or
soft tissue therapy. The term does not include administering,
selling, distributing, recommending or providing advice
regarding a substance, product or device to restore or maintain
the health of an animal, including any of the following:
(1) Vitamins.
(2) Minerals.
(3) Phytonutrients.
(4) Antioxidants.
(5) Enzymes.
(6) Glandular extracts.
(7) Botanical substances.
(8) Herbal therapies.
(9) Homeopathic remedies.
(10) Drugs available without a prescription.
(11) Durable or nondurable medical goods and devices.
"Artificial intelligence assisted chiropractic adjustment."
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Th e use of artificial intelligence, robotics or a mechatronic
system to perform, guide or augment spinal manipulation or a
related chiropractic procedure.
* * *
["Chiropractic." A branch of the healing arts dealing with
the relationship between the articulations of the vertebral
column, as well as other articulations, and the neuro-musculo-
skeletal system and the role of these relationships in the
restoration and maintenance of health. The term shall include
systems of locating misaligned or displaced vertebrae of the
human spine and other articulations; the examination preparatory
to the adjustment or manipulation of such misaligned or
displaced vertebrae and other articulations; the adjustment or
manipulation of such misaligned or displaced vertebrae and other
articulations; the furnishing of necessary patient care for the
restoration and maintenance of health; and the use of board-
approved scientific instruments of analysis, including X-ray.
The term shall also include diagnosis, provided that such
diagnosis is necessary to determine the nature and
appropriateness of chiropractic treatment; the use of adjunctive
procedures in treating misaligned or dislocated vertebrae or
articulations and related conditions of the nervous system,
provided that, after January 1, 1988, the licensee must be
certified in accordance with this act to use adjunctive
procedures; and nutritional counseling, provided that nothing
herein shall be construed to require licensure as a chiropractor
in order to engage in nutritional counseling. The term shall not
include the practice of obstetrics or gynecology, the reduction
of fractures or major dislocations, or the use of drugs or
surgery.]
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"Chiropractor." A [practitioner of chiropractic.] person
licensed under this act to practice chiropractic. The term
includes a person with the title "Doctor of Chiropractic,"
"Chiropractic Physician," "Doctor of Chiropractic Medicine" or
the abbreviation "DC."
* * *
"Dry needling." A physical intervention that uses a filiform
needle to stimulate trigger points to diagnose and treat
neuromusculoskeletal pain and functional movement deficits. The
term does not include stimulation of auricular points or other
points based upon areas of oriental medicine or the practice of
acupuncture under the act of February 14, 1986 (P.L.2, No.2),
known as the Acupuncture Licensure Act.
"Licensee." The term shall have the same meaning as
chiropractor.
"Manipulation/adjustment." A passive manual maneuver, also
known as chiropractic manipulative treatment or spinal
manipulation adjustment, during which a joint complex is carried
beyond the normal [physiological] voluntary physiologic range of
motion [that are applied] without exceeding the boundaries of
anatomical integrity of the joint complex or other articulations
and that are intended to result in cavitation of the joint [or],
reduce subluxation[.], restore or correct nerve dysfunction or
restore or correct musculoskeletal dysfunction. The term
includes the following:
(1) A grade five joint mobilization or passive manual
m aneuver performed by hand or with the aid of a mechanical
instrument or an artificial intelligence assisted
chiropractic adjustment in which a joint complex may be
carried beyond the normal voluntary physiologic range of
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motion into the paraphysiologic space without exceeding the
boundaries of anatomical integrity. For the purpose of this
paragraph, the grade five joint mobilization or passive
manual maneuver may, but need not, result in an audible
release.
(2) A thrust, that is, a brief, sudden and carefully
administered impulsion delivered at the end of the normal
passive range of movement. For the purpose of this paragraph,
the thrust technique may be low velocity or high velocit y.
"Practice of chiropractic." As follows:
(1) The science, philosophy and art of examination,
diagnosis, manipulation/adjustment and treatment of a human
being of any age and an animal by methods and analyses
commonly taught in an accredited chiropractic college or
program or a chiropractic college or program approved by the
board. The term includes all of the following:
(i) Utilization review, peer review, organization
review, impairment rating review and a review involving
the determination or assessment of the necessity of
chiropractic care and treatment.
(ii) The authority to diagnose, order diagnostic and
laboratory testing, analyze test results and treat a
patient by any of the following:
(A) Manipulative, manual, neuromuscular,
mechanical, nutritional and dietary methods,
lifestyle modification, chiropractic physiotherapy,
therapeutic exercise and rehabilitative procedures.
(B) The use of supportive appliances and the
prescription and use of durable medical equipment,
prosthetics, orthotics and supplies.
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(C) Board-approved scientific instruments of
analysis, including diagnostic imaging.
(D) Nutritional supplements and venipuncture.
(iii) The use of adjunctive procedures, dry
needling, a sports physical examination and animal
chiropractic if the licensee is certified under this act
to perform the service.
(iv) Manipulation under anesthesia if the
chiropractor has received formal training and is
certified by an accredited certification board and
performs the manipulation under anesthesia in the
presence of a medical doctor or doctor of osteopathic
medicine licensed in this Commonwealth.
(2) The term does not include operative surgery, the
reduction of a fracture or major dislocation, obstetrics,
gynecology, osteopathy, podiatry or the administration or
prescription of a drug requiring a registration issued by the
United States Drug Enforcement Administration.
"Sports physical examination." The initial physical
clearance examination of an athlete to determine whether the
athlete is physically capable of engaging in the athletic
activity for which the athlete seeks the examination .
Section 3. Section 302 of the act is amended by adding
paragraphs to read:
Section 302. Powers and duties.
The board shall have powers and duties as follows:
* * *
(14) To establish standards of practice and codes of
conduct pertaining to the practice of chiropractic.
(15) To establish health, safety and public protection
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standards for the ownership and operation of a chiropractic
office, clinic or facility.
(16) To publicize qualifying disciplinary action and
other pertinent action taken by the board.
Section 4. The act is amended by adding sections to read:
Section 305. Certification to perform dry needling.
(a) Certification required.--The board shall certify a
qualified licensee to perform dry needling in accordance with
this section. A licensee may not perform dry needling unless the
board has issued the licensee a certification under this
section.
(b) Application.--To obtain a certification under this
section, a licensee must submit an application to the board on a
form provided by the board and must demonstrate to the
satisfaction of the board that the licensee has completed any of
the following:
(1) Passage of an examination on the performance of dry
needling prepared and administered by a qualified and
approved professional testing organization 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.
(2) Completion of a minimum of 24 hours of study in the
performance of dry needling under a curriculum approved by
the board at a board approved chiropractic college or
postgraduate education program, including a minimum of 20
hours in an in-person, hands-on classroom setting.
Section 306. Certification to practice animal chiropractic.
(a) Certification required.--The board shall certify a
qualified licensee to practice animal chiropractic in accordance
with this section. A licensee may not practice animal
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chiropractic unless the board has issued the licensee a
certification under this section.
(b) Application and requirements.--To obtain a certification
under this section, a licensee must submit an application to the
board on a form provided by the board and must demonstrate to
the satisfaction of the board that the licensee has completed
all of the following:
(1) Passed an examination on the practice of animal
chiropractic prepared and administered by a qualified and
approved professional testing organization 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.
(2) Completed a minimum of 50 hours of study in the
practice of animal chiropractic under a curriculum approved
by the board at a board approved chiropractic college or
postgraduate education program, including a minimum of 20
hours in an in-person, hands-on classroom setting.
(c) Scope of practice.--A licensee certified under this
section may practice chiropractic on an animal only for a type
of animal for which the certified licensee has received
training.
(d) Supervision.--A licensee certified under this section
may practice chiropractic on an animal without supervision by a
licensed veterinarian.
Section 307. Concussion management.
(a) Standard of care.--A licensee who assesses, diagnoses or
treats a concussed patient, including a student athlete, shall
do so in accordance with nationally accepted standards and
guidelines on the effective date of this subsection.
(b) Continuing education.--A licensee who assesses,
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diagnoses or treats a concussed patient shall complete
continuing education that keeps pace with evolving standards and
guidelines related to concussion management.
(c) Scope of services.--Within the scope of practice, a
licensee who provides concussion management services may engage
in any of the following:
(1) Assess a patient.
(2) Diagnose a patient.
(3) Treat a patient.
(4) Determine whether a patient may return to activities
of daily living.
(5) Consult with, refer to or collaborate with another
licensed health care provider.
Section 308. Student athletes.
(a) Sports physical examination.--A licensee may perform a
comprehensive initial preparticipation physical evaluation and
may complete the comprehensive initial preparticipation physical
evaluation form of the Pennsylvania Interscholastic Athletic
Association or may perform another similar evaluation to certify
that a student is physically fit to participate in an activity,
including practice, interschool practice, scrimmage or contest.
(b) Continuing education.--A licensee who performs a sports
physical examination or who assesses, diagnoses or treats a
concussed student athlete shall maintain continuing education
that keeps pace with evolving standards and guidelines related
to concussion management.
(c) Assessment and clearance.--A licensee may assess and
grant clearance to a student athlete to return to participation.
For concussion management, a licensee may make an assessment or
grant clearance under this subsection only in accordance with
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the following:
(1) In consultation with a medical doctor, a doctor of
osteopathic medicine or a licensee acting within the scope of
services under section 307(c).
(2) Under referral of a medical doctor, a doctor of
osteopathic medicine or a licensee acting within the scope of
services under section 307(c).
(3) In collaboration with a medical doctor, a doctor of
osteopathic medicine or a licensee acting within the scope o f
services under section 307(c).
(4) Under the supervision of a medical doctor, a doctor
of osteopathic medicine or a licensee acting within the scope
of services under section 307(c).
(d) Exception.--Subsection (c) shall not apply to a licensee
who holds any of the following current credentials:
(1) Diplomate in chiropractic neurology recognized by
the American Chiropractic Neurology Board or the
International Board of Chiropractic Neurology.
(2) Diplomate in chiropractic sports medicine recognized
by the American Chiropractic Board of Sports Physicians.
(3) Certified chiropractic sports physician recognized
by the American Chiropractic Board of Sports Physicians and
listed on the national concussion registry maintained by that
organization.
(4) Diplomate in orthopedic or neuromusculoskeletal
medicine recognized by the International Academy of
Neuromusculoskeletal Medicine, formerly the Academy of
Chiropractic Orthopedists, and the American Board of
Chiropractic Orthopedics.
(5) Diplomate in chiropractic rehabilitation recognized
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by the American Chiropractic Rehabilitation Board.
(6) Another diplomate or certification approved by the
board.
Section 5. Section 501(a) introductory paragraph and (b) of
the act are amended and the section is amended by adding
subsections to read:
Section 501. Applications for license.
(a) Requirement for licensure.--[An] Except as provided
under subsection (a.1), an applicant for a license under this
act shall submit satisfactory proof to the board that the
applicant meets all of the following:
* * *
(a.1) Requirements for licensure beginning January 1,
2030.--Beginning January 1, 2030, an applicant for a license
shall submit satisfactory proof to the board that the applicant
meets all of the following:
(1) Is at least 18 years of age.
(2) Has successfully completed all of the following
examinations, with a score approved by the board:
(i) The National Board of Chiropractic Examiners
certification examination, Parts I, II, III and IV.
(ii) The physiotherapy examination.
(iii) Another examination approved by the board. The
board may approve another testing organization that is a
qualified and approved professional testing organization
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.
(3) Has not been convicted of a felonious act prohibited
under the act of April 14, 1972 (P.L.233, No.64), known as
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The Controlled Substance, Drug, Device and Cosmetic Act, or
of an offense under the laws of another jurisdiction that
would constitute a felony under The Controlled Substance,
Drug, Device and Cosmetic Act if committed in this
Commonwealth. This paragraph shall not apply if the applicant
demonstrates all of the following to the satisfaction of the
board:
(i) At least 10 years have elapsed since the date of
conviction.
(ii) The applicant has made significant progress in
personal rehabilitation since the conviction so that
licensure of the applicant would not be expected to
create a substantial risk of harm to the health and
safety of the applicant's patients or the public or a
substantial risk of further criminal violations.
(iii) The applicant meets the qualifications
required under this act. An applicant's statement in the
application declaring the absence of a conviction shall
constitute satisfactory evidence of the absence of a
conviction unless the board has evidence to the contrary.
As used in this subparagraph, the term "conviction"
includes a judgment, an admission of guilt or a plea of
nolo contendere.
(a.2) Eligibility to sit for certification examination.--
Beginning January 1, 2030 , in order to qualify to sit for the
National Board of Chiropractic Examiners certification
examination, an applicant must meet all of the following:
(1) Has graduated from a chiropractic college that is
accredited by, or has status with, the Council on
Chiropractic Education.
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(2) Has met the prechiropractic education requirement by
satisfying any of the following:
(i) Has been granted a bachelor's degree, based upon
four academic years of study or through an accelerated
bachelor's degree program, by a college or university
accredited by the United States Department of Education.
(ii) Has successfully completed a minimum of 90
semester hours of undergraduate study at a college or
university accredited by the United States Department of
Education.
(iii) Has successfully completed not less than three
academic years of undergraduate study at a college or
university accredited by the United States Department of
Education prior to enrollment in a chiropractic college.
The undergraduate study specified under this paragraph
shall meet the entrance requirements of a chiropractic
program accredited by the Council on Chiropractic
Education.
(3) The applicant's chiropractic degree consists of
credits earned in the chiropractic program and does not
include academic credit for courses from the bachelor's
degree.
(b) Renewal of licenses.--A license shall be renewed
biennially for a period of two years upon payment of the
biennial fee, provided that the licensee satisfies the other
requirements of this act. Upon receipt of a complete renewal
application, the board shall promptly review, process and
approve the application. The board shall complete the review,
processing and approval no later than 20 days after receipt of
the complete renewal application. The board may approve the
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renewal despite a minor administrative error or omission on the
application if the board determines that the error or omission
does not impact patient health or safety. Any person who has
failed to renew his license for a period of longer than five
years shall be required to apply for a license in accordance
with subsection (a) if he desires to resume practicing
chiropractic.
Section 6. Sections 502 and 503 of the act are repealed:
[Section 502. Examination.
(a) Admission.--The board shall admit to a standard
examination any applicant who has satisfied all of the
requirements of section 501 except for the requirement to have
passed the examination. The board may, in its discretion, permit
a student in good standing in his final semester in an approved
chiropractic college to be admitted to the standard examination,
provided he meets all the other requirements of this act, but he
must have certification of graduation from said college before a
license may be granted.
(b) Nature and content of examination.--The examination
shall be oral, practical and written, upon the principles and
technique of chiropractic and shall include the following
subjects: anatomy, physiology, histology, chemistry, pathology,
physics, bacteriology, diagnosis, hygiene and sanitation,
symptomatology, chiropractic analysis, X-ray, chiropractic
principles and a practical demonstration of chiropractic
technique.
(c) When conducted.--Examinations shall be conducted at
least twice each year.
(d) Testing organization.--All written, oral and practical
examinations required under this section shall be prepared and
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administered by a qualified and approved professional testing
organization 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, except that the oral and practical examinations
shall not be subject to section 812.1 until such examinations
are available from a testing organization.
(e) Score.--A license shall be granted to an applicant who
meets the requirements of this act and who achieves:
(1) an overall score of at least 75% on the entire
examination; or
(2) an average score of at least 75% on the oral and
practical examination and a passing score on the written
examination administered by the National Board of
Chiropractic Examiners as such passing score is determined by
the national board.
Section 503. Failure of examination.
(a) Second examination.--Any applicant who shall fail any
examination shall, after the expiration of six months and within
two years, have the privilege of taking a second examination.
(b) Subsequent examinations.--The board may adopt
regulations governing the eligibility of applicants who have
failed to pass two examinations to be admitted to subsequent
examinations.]
Section 7. Sections 504, 505(a)(4), 506(a)(4), (7), (8) and
(19) of the act are amended to read:
Section 504. Reciprocity.
(a) License without examination.--The board may grant
licenses without further examination to individuals from other
states and provinces of Canada if all of the following
conditions are met:
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(1) The standards for licensing in such states or
provinces are substantially the same as those provided in
this act.
(2) Similar privileges are accorded persons licensed in
this Commonwealth.
(3) The applicants hold valid licenses.
(4) The applicable rules and regulations prescribed by
the board are complied with.
(b) Military and spouse licensure.--Within 30 days after
receipt of a completed application for licensure, the board
shall grant a license without further examination to an
applicant who meets all of the following:
(1) Is an active duty member of the United States Armed
Forces or the spouse of an active duty member of the United
States Armed Forces.
(2) Holds a current unrestricted license to practice
chiropractic issued by another state.
(3) Has not committed an act that constitutes grounds
for refusal, suspension or revocation of a license unless the
board determines that the act should not preclude issuance of
a license under this subsection.
Section 505. Limited license.
(a) Requirements.--The following educational and
professional requirements must be met in order to secure a
limited license which may be issued to an out-of-State or
foreign chiropractic school or college graduate for a period not
to exceed one year for the purpose of teaching in an approved
graduate chiropractic education program:
* * *
(4) The applicant must submit [to an oral examination in
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his specialty conducted by a board member or the board's
designated representative] a curriculum vitae to the board.
* * *
Section 506. Refusal, suspension or revocation of license.
(a) Reasons enumerated.--The board may refuse to issue a
license or may suspend or revoke a license for any of the
following reasons:
* * *
(4) Displaying gross incompetence, negligence or
misconduct in carrying on the practice of chiropractic or
engaging in an unsafe or harmful technique in the practice of
chiropractic.
* * *
(7) Having a license to practice chiropractic suspended,
revoked or refused or receiving other disciplinary action by
the proper chiropractic licensing authority of another state,
territory, possession or country. The board shall not be
required to impose reciprocal discipline under this paragraph
if the board or its designee determines that the disciplining
licensing authority imposed sufficient discipline or
sanctions.
(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 to submit to a mental or physical examination by
physicians approved by the board. A chiropractor may appeal
the probable cause determination within 30 days after
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receiving notice of the board's determination. If a
chiropractor appeals under this paragraph, the chiropractor
shall have the right to a hearing before the board or its
designee to contest the determination. Failure of a
chiropractor to submit to such examination when directed by
the board, unless such failure is due to circumstances beyond
his control, or to appeal the probable cause determination
within the time period required under this paragraph, 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.
* * *
(19) Failing to refer a patient to a licensed
practitioner of another branch of the healing arts for
consultation or treatment when a diagnosis of such patient
indicates that such a referral is appropriate. If a
chiropractor makes an appropriate referral, a patient's
refusal to present the referral to the licensed practitioner
or the licensed practitioner's refusal to accept the referral
shall not constitute grounds for discipline of the
chiropractor or create liability for the chiropractor.
* * *
Section 8. Section 507 of the act is repealed:
[Section 507. Continuing chiropractic education.
(a) Requirement for license renewal.--As a condition for the
biennial renewal of a license to practice chiropractic, a
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licensee shall submit to the board evidence that he has
completed at least 24 hours of continuing chiropractic education
within the immediately preceding two-year period, provided that
this requirement for continuing chiropractic education shall
apply for the first time to the renewal of licenses in 1988.
(b) Qualifying education.--A licensee may receive credit for
only those hours of continuing chiropractic education in a
program approved by the board and for only those hours directed
toward keeping the licensee apprised of advancements and new
developments in chiropractic which build upon the basic courses
required to practice chiropractic and which are in the following
areas:
(1) Anatomy.
(2) Physiology.
(3) Histology.
(4) Chemistry.
(5) Pathology.
(6) Physics.
(7) Bacteriology.
(8) Diagnosis.
(9) Hygiene and sanitation.
(10) Symptomatology.
(11) Chiropractic analysis.
(12) X-ray.
(13) Chiropractic principles.
(14) Chiropractic technique.
(15) Adjunctive procedures.
No credit shall be given for any course in office management or
practice building.
(c) Application by sponsors.--Prior to receiving board
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approval for a program of continuing chiropractic education, a
sponsor shall submit to the board, in writing, the following
information at least 90 days prior to the date on which the
program is scheduled to be presented:
(1) Evidence that the sponsor's program would be
directed toward keeping the licensee apprised of advancements
and new developments in chiropractic which build upon the
basic courses required to practice chiropractic and which are
in the areas specified in subsection (b).
(2) A detailed course outline or syllabus, including
such items as methods of instruction and testing materials,
if any.
(3) A current curriculum vitae of each instructor,
speaker or lecturer appearing in the program.
(d) Action on application.--The board shall notify each
sponsor, in writing, of approval or disapproval of the
application within 45 days of the receipt of the application. If
an application is disapproved, the board shall detail the
reasons for disapproval in order that the sponsor may cure any
defect and submit an amended application in a timely manner.
(e) Evidence of completion.--Each licensee, in order to
qualify for biennial renewal of his license, shall complete a
form provided by the sponsor and supplied by the board which
contains the name of the licensee, business address, name of the
sponsor and instructor, course taken, hours completed, date and
place of the continuing education program offered, and a signed
statement sworn and attested to by the licensee that the
licensee was fully in attendance at the program offered and that
the information in such form is true and correct. The licensee
shall be responsible for sending this form to the board.
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(f) Notification.--The board, within 30 days after the
effective date of this act, shall notify all licensees subject
to this section that they will be required to complete 24 hours
of continuing education within the two-year period before the
renewal period commencing in 1988 and shall notify such
licensees of continuing education required when renewal
applications are issued for 1988 and every renewal period
thereafter.
(g) Approved programs.--A continuing education program
offered by a chiropractic college approved in accordance with
this act and attended by a licensee must be accepted by the
board so long as the course requirements of this section are
met.
(h) Exceptions.--The board may make exceptions to the
continuing education program requirements in emergency or
hardship cases on the basis of evidence submitted in proof of an
emergency or hardship.]
Section 9. The act is amended by adding sections to read:
Section 507.1. Continuing chiropractic education requirements.
(a) Continuing education required for renewal.--As a
condition of biennial renewal of a license, a licensee shall
complete 24 continuing chiropractic education credits during the
immediately preceding biennial period.
(b) Credit hour.--One continuing chiropractic education
credit shall equal 50 minutes of instruction.
(c) Professional ethics.--A licensee may apply at least two
credits toward the requirement under subsection (a) in the study
of professional ethics. As used in this subsection, the term
"study of professional ethics" includes patient care services,
ethical patient management, advertising, marketing,
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recordkeeping, documentation, coding, billing practices and
privacy requirements under 42 U.S.C. Ch. 7 Subch. XI Pt. C
(relating to administrative simplification) .
Section 507.2. Format and limits for continuing chiropractic
education.
(a) Distance learning limit.--A licensee may complete not
more than 12 of the credits required under section 507.1(a)
through distance learning approved by the board. The remaining
credits required under section 507.1(a) shall be completed
through an in-person live didactic learning experience.
(b) Hands-on training requirement.--A licensee shall
complete at least four credits of in-person training in
manipulation techniques, physical rehabilitation or
physiotherapeutics to comply with section 507.1(a).
(c) Waiver during emergency.--During a declaration of
disaster emergency under 35 Pa.C.S. § 7301(c) (relating to
ge neral authority of Governor) , the board may waive the in-
person requirements under this section.
(d) Maximum credit per day.--The board may not award more
than 12 credits for a continuing chiropractic education program
that occurs during one calendar day.
Section 507.3. Course content and approval.
(a) Subject matter.--Continuing chiropractic education may
include subject matter taught by an accredited chiropractic
school or a college or university accredited by the United
States Department of Education or a subject matter tested for
licensure and approved by the board.
(b) Providers of Approved Continuing Education.--The board
may accept a continuing chiropractic education program approved
by Providers of Approved Continuing Education. The board may
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reject a program approved by Providers of Approved Continuing
Education if the board determines that the program meets any of
the following:
(1) The program focuses on practice building, practice
management or practice marketing.
(2) The program lacks significant intellectual or
practical content that relates primarily to the practice of
chiropractic or to the professional responsibilities or
ethical obligations of a licensee.
(c) Basic coursework excluded.--The board may not grant
continuing chiropractic education credit for coursework required
for graduation from a chiropractic college or for initial
licensure. The board shall grant credit only for postdoctoral
coursework designed to build upon basic knowledge or to bring a
licensee current on new developments relating to the practice of
chiropractic.
(d) Other educational programs.--The board may approve an
educational program offered by a professional organization or
society, a health care profession, a school, a college or
university accredited by the United States Department of
Education or health care facility for continuing chiropractic
education credit if the board determines that the program has
significant intellectual or practical content that relates
primarily to the practice of chiropractic, chiropractic
philosophy or to the professional responsibilities or ethical
obligations of a licensee and does not focus on practice
building, practice management or practice marketing.
(e) Equivalent educational programs.--The board may approve
an equivalent educational program for continuing chiropractic
education credit, including an examination, a scientific paper,
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a professional publication, a scientific presentation, a
residency program, a teaching appointment, a research
appointment, an advanced degree program, a certification program
in a related field, a scientific exhibit, independent study,
research or distance learning, if the board determines that the
program has significant intellectual or practical content that
relates primarily to the practice of chiropractic or to the
professional responsibilities or ethical obligations of a
licensee and does not focus on practice building, practice
management or practice marketing.
Section 507.4. Calculation of continuing chiropractic education
credits.
The board shall calculate continuing chiropractic education
credits as follows:
(1) For a continuing professional education program of a
national or State professional organization, one credit for
each 50 minutes of in-class participation.
(2) For a course from a college or university accredited
by the United States Department of Education, 15 credits for
each semester or trimester credit hour earned and 10 credits
for each quarter credit hour earned.
(3) For a noncredit course, one credit for each 50
minutes of in-class participation.
(4) For a distance learning program or other independent
study program, one credit for each 50 minutes of
participation.
(5) For teaching or instructing a course for the first
time or teaching a previously taught course if the licensee
spent substantial time updating course material, one credit
for each hour of instruction or preparation time. The board
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may not award more than 12 credits per biennial period under
this paragraph. A licensee employed as a full-time teacher or
instructor is not eligible for credit under this paragraph.
(6) For a scientific paper or professional publication,
one credit for each 50 minutes of preparation time up to 12
credits per biennial period. A licensee seeking credit under
this paragraph shall submit a copy of the publication to the
board with a request for credit. A licensee may request
additional credit by submitting the publication to the board
with an explanation of exceptional circumstances that the
licensee believes justify additional credit. The board shall
determine whether to award additional credit on a case-by-
case basis and may consider subject matter complexity, length
of publication and preparation time.
(7) For research and preparation of an examination or
service as an examiner for a clinical examination, one credit
for each hour of research or examination time up to six
credits per biennial period.
(8) For a scientific presentation or exhibit, one credit
for each hour of preparation or presentation time up to six
credits per biennial period.
Section 507.5. Sponsor approval and program administration.
(a) Sponsor approval.--A program provider seeking approval
to sponsor a continuing chiropractic education program shall
apply to the board in the manner specified by the board at least
60 days before the date of the program. The application shall
include course and program descriptions, instructor
qualifications, locations, dates, times and other information
required by the board. The board shall issue its determination
not later than 30 days after receipt of the application.
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(b) Sponsor criteria.--A sponsor approved under subsection
(a) shall offer a course that meets all of the following:
(1) The course is a formal course of learning that
contributes directly to the maintenance of professional
competence of a licensee.
(2) The course is at least one credit in length and the
board may award additional credit in increments of one half
of a credit.
(3) The course is conducted by a qualified instructor or
discussion leader.
(4) The course content satisfies the requirements under
section 507.3.
(c) Sponsor records and attendance.--A sponsor approved
under subsection (a) shall maintain accurate records of
attendance for five years and shall comply with additional
requirements specified by the board, including requirements
related to verification of attendance.
(d) Sponsor disclosures and facilities.--A sponsor approved
under subsection (a) shall disclose the objective,
prerequisites, experience level, content, required preparation,
teaching method and number of credits to prospective
participants. A sponsor approved under subsection (a) shall
ensure that class s ize and physical facilities are consistent
with the teaching methods used.
(e) Instructors.--A sponsor approved under subsection (a)
shall select and assign qualified instructors. A sponsor
approved under subsection (a) shall provide the curriculum vitae
of each instructor to the board and shall certify that the
sponsor has verified the credentials of each instructor. A
sponsor approved under subsection (a) shall notify the board of
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an instructor change not later than 20 days after the change.
(f) Program evaluation.--A sponsor approved under subsection
(a) shall evaluate instructor performance at the conclusion of
each program and shall provide a means of program evaluation
that includes participant and instructor feedback. The
evaluation may include pretests, posttests, questionnaires or
oral feedback and shall address whether objectives were met,
prerequisites were necessary or desirable, facilities were
satisfactory, the instructor was effective, preparation
materials were satisfactory and content was timely and
effective.
(g) Certificates.--A sponsor approved under subsection (a)
shall provide a certificate of completion or comparable
documentation to each participant that includes dates attended,
credits earned, course title, description of content, method of
delivery, subject area, sponsor name, instructor name and course
location.
(h) Sponsor list.--The board shall publish on its publicly
accessible Internet website a list of sponsors approved under
subsection (a).
(i) Material changes.--A sponsor approved under subsection
(a) may not alter, amend, update or reconfigure an approved
course without permission of the board. If a sponsor approved
under subsection (a) alters, amends, updates or reconfigures an
approved course, the sponsor shall resubmit the course to the
board for approval.
(j) Licensee submission for approval.--A licensee may submit
a program for approval for continuing chiropractic education
credit in the manner specified by the board if the program has
not been approved under this section. The board shall notify the
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licensee in writing of the board's determination.
(k) Specialized coursework preapproval.--Coursework required
for certification to perform specialized examinations or
electrodiagnostic tests shall be preapproved by the board at
least 90 days before the course begins. A program provider
seeking preapproval shall adhere to the approval process under
subsection (a). A licensee seeking preapproval shall apply to
the board in the manner specified by the board.
Section 507.6. Renewal certification, reporting and audit s.
(a) Certification on renewal.--A licensee shall certify on
the application for biennial license renewal that the licensee
has completed the continuing chiropractic education required
under section 507.1(a).
(b) Documentation and retention.--A licensee shall maintain
evidence of completion of continuing chiropractic education
requirements for five years after completion of the credits and
shall submit documentation to the board upon request.
(c) Random audits.--The board may conduct random audits to
determine compliance with sections 507.1, 507.2, 507.3, 507.4
and 507.5.
Section 507.7. Exemptions and carryover.
(a) New licensee exemption.--A new licensee who completed an
accredited graduate chiropractic education program within 12
months before the commencement of the biennial registration
period shall not be required to complete the continuing
chiropractic education requirements for that biennial period.
(b) Carryover of excess credits.--A licensee who completes
more than 24 continuing chiropractic education credits during a
biennial period may apply not more than eight of the excess
credits to the continuing chiropractic education requirement for
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the immediately following biennial period only.
(c) Inactive or retired status.--A licensee holding an
inactive license or a retired license shall be exempt from the
continuing chiropractic education requirements. A licensee
holding an inactive license or a retired license, or whose
license is suspended or revoked, who applies to resume practice
shall provide proof of completion of continuing chiropractic
education for each biennial period for which the licensee was
inactive, retired, suspended or revoked. If the total credits
required to become current exceeds 30, the maximum number
required shall be 30 credits.
(d) Deficiency remediation.--An applicant seeking to resume
practice under subsection (c) shall submit to the board a
detailed list of all continuing chiropractic education completed
to become current. If the board determines that a deficiency
exists in a particular area of study, the board may require
completion of additional continuing chiropractic education in
the area of deficiency before the board reinstates the license
to active status.
Section 507.8. Extensions, waivers and enforcement.
(a) Hardship extensions and waivers.--The board may extend
the time for completion of continuing chiropractic education
requirements or may waive continuing chiropractic education
requirements on an individual basis for hardship, including
severe illness, disability or military service.
(b) Application for extension or waiver.--A licensee seeking
an extension or waiver under subsection (a) shall apply to the
board in writing and shall include the specific reasons for the
request and supporting documentation. A licensee must apply
before expiration of the biennial renewal period and shall
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submit the request to the board office by certified mail with
return receipt requested.
(c) Effective period and renewal.--An extension or waiver
granted under this section shall apply to the biennial period
for which it is granted. If the condition requiring an extension
or waiver continues into the next biennial period, the licensee
shall apply to the board for renewal of the extension or waiver
for the next biennial period.
(d) Verification and proof.--A licensee shall provide
verification and proof of compliance with sections 507.1, 507.2,
507.3, 507.4, 507.5, 507.6 and 507.7 upon request of the board.
(e) Noncompliance.--Noncompliance with continuing
chiropractic education requirements shall constitute cause for
civil penalties imposed under Chapter 7.
(f) Repeat noncompliance.--A second or subsequent failure to
comply with continuing chiropractic education requirements may
constitute professional misconduct and constitutes grounds for
discipline, including suspension or revocation of a license.
Section 10. Section 508(a) of the act is amended and the
section is amended by adding subsections to read:
Section 508. Professional liability insurance.
[(a) Insurance required.--As a condition for obtaining or
renewing a license to practice chiropractic in this Commonwealth
beginning with the 1988 license renewal period, an applicant
shall submit to the board satisfactory evidence that he has
obtained professional liability insurance, or that he has
established self-insurance for professional liability, in the
minimum amount of $100,000 per occurrence and $300,000 per
annual aggregate.]
(a.1) Insurance required.--A chiropractor licensed under
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this act and m aintaining a professional practice or having
responsibility for patient care shall be covered.
* * *
(e) Definitions.--As used in this section, the following
words and phrases shall have the meanings given to them in this
subsection unless the context clearly indicates otherwise:
"Authorized." Authorized by a government agency to offer
chiropractic professional liability insurance products.
"Covered." T he ongoing maintenance of insurance in an amount
of at least $500,000 per occurrence and $1,500,000 per policy
year, including extended reporting endorsement coverage for a
claims made policy, also known as tail coverage, issued by a
carrier or other entity authorized to write chiropractic
professional liability insurance in this Commonwealth.
"Maintaining a professional practice or having responsibility
for patient care." The furnishing of professional services to a
patient in this Commonwealth, including testing for, diagnosing,
offering or furnishing treatment, preventive chiropractic care
or consultation relating to chiropractic care, at a location,
including an office, even if located in a home or clinic, or
through a business entity regardless of ownership of the
practice.
Section 11. Section 521 of the act is amended by adding
paragraphs to read:
Section 521. License required.
It shall be unlawful after the effective date of this act for
any person in this Commonwealth to engage in the practice of
chiropractic or indicate in any manner whatsoever the ability to
practice chiropractic unless licensed under the provisions of
this act, except that:
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* * *
(3) Nothing in this act shall be construed to prohibit a
chiropractor in the service of the United States Armed
Forces, the United States Public Health Service or the
Veterans Administration, or a Federal employee, from
discharging official duties.
(4) A chiropractor licensed in good standing to practice
chiropractic in another state is exempt from the licensure
requirements of this act while practicing in this
Commonwealth if any of the following applies:
(i) The chiropractor has a written or oral agreement
with a sports team to provide care to team members and
coaching staff traveling with the team for a specific
sporting event to take place in this Commonwealth.
(ii) The chiropractor has been invited by a national
sport governing body to provide services to team members
and coaching staff at a national sport training center in
this Commonwealth or to provide services at an event or
competition in this Commonwealth sanctioned by the
national sport governing body and both of the following
apply:
(A) The chiropractor's practice is limited to
that required by the national sport governing body.
(B) The services provided by the chiropractor
are within the area of the chiropractor's competence
and within the scope of chiropractic as defined in
this act.
(5) A chiropractor exempt under paragraph (4) shall be
subject to all of the following:
(i) The chiropractor may not provide care or
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consultation to a person residing in this Commonwealth
other than a person described in paragraph (4)(i) or (ii)
or as otherwise provided by State law.
(ii) The exemption shall be valid as follows:
(A) For an exemption under paragraph (4)(i), the
exemption shall remain in force while the
chiropractor is traveling with the sports team but
may not exceed 10 days per sporting event. The board
may grant up to 20 additional days per sporting event
upon prior request by the chiropractor but the
exemption may not exceed 30 days in total.
(B) For an exemption under paragraph (4)(ii),
the exemption shall remain in force for the period
certified by the national sport governing body but
may not exceed 30 days.
Section 12. Section 525 of the act is amended to read:
Section 525. Doctor of Chiropractic and abbreviation.
(a) Title.--Any person who has a valid license in accordance
with this act may practice chiropractic and use the title
["Doctor of Chiropractic" and the abbreviation "DC."] "Doctor of
Chiropractic," "Chiropractic Physician," "Doctor of Chiropractic
Medicine" and the abbreviation "DC."
(b) Specialty certification.--A licensee may hold oneself
out as board certified in a specialty only if the licensee has
completed a specialty certification program approved by the
American Chiropractic Association, the International
Chiropractors Association, the American Chiropractic Board of
Sports Physicians, the Federation of Chiropractic Licensing
Boards or a similar organization approved by the board. A
licensee who has completed an approved specialty certification
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program but has not taken the examination may hold oneself out
as board eligible.
Section 13. Section 526 of the act is amended by adding a
subsection to read:
Section 526. Relationship with other branches of the healing
arts.
* * *
(c) Professional entity.--A licensee may form a professional
corporation or limited liability company with other licensees or
other health care practitioners licensed to provide health care
services in this Commonwealth if all of the following apply:
(1) The licensing boards that regulate the other health
care practitioners do not expressly prohibit the arrangement.
(2) The other health care practitioners or another
individual with an ownership interest does not hold a
controlling interest in the entity that permits the other
health care practitioner or individual to direct or interfere
with the licensee's independent professional judgment
regarding the practice of chiropractic.
Section 14. The act is amended by adding a section to read:
Section 528. Opinions and testimony.
(a) Causation and standard of care.--A chiropractor who
holds current license under this act shall be deemed competent
to offer an opinion in a court, administrative agency or other
tribunal of this Commonwealth on causation or the standard of
care within the scope of chiropractic practice if the testimony
is offered to a reasonable degree of chiropractic certainty and
an adequate foundation otherwise exists for admission of the
testimony.
(b) Permanent impairment and disability.--A chiropractor who
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holds a current license under this act shall be deemed competent
to offer an opinion in a court, administrative agency or other
tribunal of this Commonwealth on permanent impairment or
disability if the testimony is within the scope of chiropractic
practice, is offered to a reasonable degree of chiropractic
certainty and an adequate foundation otherwise exists for
admission of the testimony.
Section 15. Section 701(a)(2) and (b) of the act are amended
and subsection (a) is amended by adding a paragraph to read:
Section 701. Practice of chiropractic without license
prohibited.
(a) Offense defined.--It shall be unlawful for any person
to:
* * *
(2) Practice or hold himself out as a practitioner of
spinal or extraspinal adjustment or manipulation, spinal
mobilization or manipulation and mobilization and
manipulation of articulations of the [human] body for
therapeutic benefit unless he has first fulfilled the
requirements of this act and has been licensed by the board
or unless he has been licensed or certified in accordance
with another act of this Commonwealth.
(3) Offer chiropractic opinions in this Commonwealth for
the purpose of determining eligibility for health insurance
policy benefits relating to chiropractic care, including a
workers' compensation utilization review, peer review
organization review, third party administrator review,
impairment rating review or insurance payment related review,
unless the person is duly licensed as a chiropractor and
actively practicing in this Commonwealth.
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(b) Penalty.--A person who violates this section commits a
misdemeanor of the third degree. [and shall, upon conviction,
for a first offense, be sentenced to a fine not to exceed
$1,000, or to imprisonment for not more than six months, or
both. A second offense shall be subject to a fine not to exceed
$2,000, or imprisonment for a term of six months to one year, or
both.]
Section 16. Sections 702 introductory paragraph and (3) and
1101(a) of the act are amended to read:
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:
* * *
(3) Displays gross incompetence, negligence or
misconduct in carrying on the practice of chiropractic or
engages in an unsafe or harmful technique in the practice of
chiropractic.
* * *
Section 1101. Fees.
(a) Adoption.--The board shall, by regulation, fix the fees
required for examination, licensure, renewal of licenses and
limited licenses. The board shall waive the initial application
fee for an active duty member of the United States Armed Forces
and the spouse of an active duty member of the United States
Armed Forces.
* * *
Section 17. This act shall take effect in 60 days.
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