Legislative Updates displays bills pending in the 2017 state legislative sessions. It is updated weekly. To view bills from the 2013-2014 and 2015-2016 sessions and their results, see Legislative Archive.
Bills are listed by state and subject, with a brief explanation of what's in the bill. Unless indicated otherwise, we believe the listed bills should not pass. Unfortunately, most CAM bills filed in the state legislatures are pro-CAM. Bills added to the list this week, or with updated information, are marked NEW!
To voice your opinion on these bills (and we hope you will) you need to find out where they are in the legislative process and how to contact state legislators in the states where they are pending. See FAQS for more information on how to do this. Each year there are many bills forcing public and private health insurance providers to cover CAM services (especially chiropractic). Because of the sheer volume of these bills we are unable to include them in our legislative updates at this time.
CALIFORNIA: NEW! Senate Bill 746.Practice expansion. Would allow chiropractors, naturopaths and nurse practitioners to perform school physicals required for interscholastic athletic play.
CALIFORNIA: NEW! Senate Bill 796. The naturopathic practice act is repealed and the Naturopathic Medicine Committee of the Osteopathic Medical Board is subject to review on Jan. 1, 2018. This bill moves the date for repeal and review to Jan. 1, 2022, thereby legalizing naturopathic practice and delaying further review for 5 more years.
COLORADO: Senate Bill 106. Before Senate. Colorado's naturopathic registration bill was to sunset in 2017. The original bill continued the registration law until 2022, but an amendment in Senate Comm. on Health & Human Services shortened time to sunset to 2020. Bill also requires reporting of malpractice settlements and judgments to the Department of Regulatory Affairs and makes naturopaths mandatory reporters of elder and child abuse. Anticipated amendments to expand naturopathic prescription authority did not happen in Senate Comm. but may be revived in House.
HAWAII: NEW!Senate Bill 223. Senate Comms. on Commerce, Consumer Protection, and Health (CPH) and Public Safety, Intergovernmental and Military Affairs (PSM) voted "do pass" as amended. Also referred to Judiciary and Labor; Ways and Means.Practice expansion bill. Would allow naturopaths to prescribe testosterone. Original bill would have allowed naturopaths to prescribe Schedule I-V controlled substances "consistent with naturopathic medical practice" but not narcotic drugs. (Hawaii naturopaths can already prescribe legend, i.e, prescription drugs, but not controlled substances.) Bill stated that "naturopathic physicians are known for their expertise in bio-identical hormone replacement therapy" and that their prescription, as well as prescription of codeine (which can have serious side effects) are "consistent with the practice of naturopathic medicine." Actually, the North American Board of Naturopathic Examiners has admitted that naturopathic education and training are not sufficient to allow naturopaths prescription privileges. "Bio-identical hormone" is a marketing, not a medical, term, and medical experts warn against their use.
ILLINOIS: Senate Bill 708; House Bill 2530. SB 708 postponed Senate Comms. on Assignments and Licensed Activities & Pensions; HB 2530 referred to House Comm. on Rules. Licensing bill. Similar to failed bills introduced in past legislative sessions, SB 708 and HB 2530 do not define the scope of practice for naturopathic "doctors," who must have graduated from a naturopathic "medical" school and passed the NPLEX. Would be regulated by state board of medicine, to which one naturopathic member would be added. Would be allowed to call themselves naturopathic "physicians."
INDIANA: Senate Bill 508; House Bill 1595. SB 508 Referred to Senate Comm. on Commerce & Technology; HB 1595 referred to House Comm. on Public Health.Licensing bill. Would give naturopathic "physicians" anextremely broad scope of practice, allowing them to diagnose and treat any patient of any age with any disease or condition using naturopathic therapies and substances "recognized by the Council on Naturopathic Medical Education" (even though the CNME doesn't officially "recognize" anything) and approved by a naturopathic board. The board, which would regulate all aspects of naturopathic practice, consists solely of naturopaths and two public members who must not be licensed health care professionals, virtually guaranteeing they are unlikely to be able to recognize naturopathic quackery for what it is or effectively protect the public. Would be able to prescribe certain medications, including controlled substances, approved by board; no formulary council or medical or pharmacist oversight of formulary required. Naturopaths would be able to order and perform physical and lab exams, including phlebotomy and electrocardiograms, giving them the authority to order quack tests to diagnose fake diseases (also here) and order and interpret the reports of diagnostic imaging studies. Could prescribe and sell to patients worthless and potentially dangerous herbs, other dietary supplements and homeopathic remedies, which they will be able to administer by all typical routes, including IV, as well as use the quack treatment colon hydrotherapy and perform minor office surgery.
MAINE: NEW! House Bill 393. Referred to Joint Comm. on Health & Human Services. Practice expansion. No bill language available yet, but bill proposes to expand the authority of naturopathic doctors to prescribe certain "naturally occurring medications."
MINNESOTA: NEW! House Bill 1138. Referred to health & Human Services Reform. Major practice expansion.Changes naturopathy from a registered to a licensed health care profession. Adds authority to prescribe drugs, do minor office surgery, perform biopsies, and do speculum & orificial exams and phlebotomy. Can use the term "naturopathic physician."
NEW YORK: NEW!Senate Bill 4297, Assembly Bill 5913. SB 4297 referred to Senate Comm. on Higher Education; AB 5913 referred to Assembly Comm. on Higher Education. This will be the ninth consecutive legislative session a licensing bill has been introduced.Gives naturopaths a broad scope of practice "to address the shortage of primary care physicians." Is based on the fiction that naturopaths can stimulate the "inherent property in a living organism to heal itself," i.e., vitalism. Would allow naturopaths to diagnose and treat any patient of any age with any disease or condition. Allows the use of bogus "CLIA-waived" tests, including diagnostic tests that have never been validated, which they use to diagnose fake diseases. Naturopaths would be able to prescribe worthless homeopathic remedies, dietary supplements, herbs, thyroid hormones, estrogen, progesterone and DHEA, which they would be able to administer by all the usual routes (vaginal, rectal, oral) and, if registered with the state, by injection, including IV administration. This would permit them to concoct dubious remedies like Myers cocktails, high dose vitamin C and other substances and administer them intravenously. Could order diagnostic imaging, including MRIs and thermography, and perform cryotherapy, ligation, fulguration, other minor office procedures and colonics. Would be regulated by a naturopathic board consisting of six naturopaths, two public members and one MD or DO. If bill passes, after two years naturopaths would have to have completed a one-year "residency" to become licensed.
NORTH DAKOTA: Senate Bill 2256. Referred to Human Services Comm.Practice expansion bill. Would allow naturopaths to prescribe, dispense or administer prescription drugs listed on a naturopathic formulary established by a committee consisting of a physician, naturopath, pharmacists and advanced practice nurse. Formulary cannot include Schedule I - IV drugs except endogenous anabolic androgenic steroids. Would also permit naturopaths to perform minor office surgery and if "certified" practice "naturopathic childbirth attendance."
OREGON: Senate Bill 217; House Bill 2390; Hearing on SB 217 held Feb. 9 before Senate Comm. on Health Care. HB 2390 assigned to House Comm. on Health Care. Allows chiropractic "physicians" and naturopathic "physicians" to return student athletes who've suffered a concussion to play. Similar bills failed last year. Oregonian Mark Crislip, MD, explains how inadequate chiropractic and naturopathic education and training, plus their pseudoscience-filled practices, makes them ill-qualified to the task and puts patients at risk.
OREGON: Senate Bill 23. Before Senate Comm. on Health Care. Practice expansion bill. Current law allows naturopaths to surgically repair and care for superficial lacerations and abrasions and benign superficial lesions and to remove foreign bodies located in superficial structures. Bill would allow any surgery "that poses little risk to the life of the patient and can be safely performed in an office setting, as further defined by rule." Whether these vague criteria are met would be determined by the Oregon Board of Naturopathic Medicine, which requested the bill.
OREGON: Senate Bill 22. Before Senate Comm. on Health Care. Repeals provision establishing peer review committee for purpose of evaluating complaints against naturopathic "physicians" and making recommendations to Oregon Board of Naturopathic Medicine about those complaints. The reason for this is unclear, but the bill was introduced at the request of Governor Kate Brown on behalf of the Board, indicating that concern for public safety, as opposed to protection of naturopaths, is not a rationale.
RHODE ISLAND: NEW!Senate Bill 327; House Bill 5474. SB 327 referred to Senate Comm. on Health & Human Services; HB 5474 referred to House Comm. on Health, Education & Welfare. Licensing bills. Similar to bills rejected by the state legislature in past sessions, these bills would license naturopathic "physicians," give them the authority to diagnose and treat any patient of any age with any disease or condition. Could prescribe and sell patients dietary supplements and homeopathic remedies, order and perform lab tests; order diagnostic imaging. Could prescribe drugs on a formulary established by a formulary council, although bill does not say who would be on the council or how formulary would be composed. Could use all usual routes of administration, including injections and IVs. Would be regulated by the state Department of Health with the assistance of naturopathic "advisors." State would default to the National Board of Naturopathic Examiners, which is completely controlled by naturopaths, to determine what therapies naturopaths could use. In other words, these bills would subject the citizens of Rhode Island the substantial, and growing, hodgepodge of quackery typically employed by naturopaths.
WASHINGTON: Senate Bill 5369. Referred to Senate Comm. on Health Care. Practice expansion bill. Would expand authority to prescribe controlled substances to include all Schedule III, IV, and V controlled substances with additional education requirements determined by the naturopathic board. Currently, the board permits limited controlled substances prescribing with only 4 hours of additional education. Board would also be given exclusive authority to determine what minor office surgery naturopaths could perform and what are cryptically described as "other nutrients, compounds, and natural substances" naturopaths could prescribe and sell to patients.
CALIFORNIA: NEW! Senate Bill 746.Practice expansion. Would allow chiropractors, naturopaths and nurse practitioners to perform school physicals required for interscholastic athletic play.
COLORADO: NEW!Senate Bill 135. Reported favorably from Senate Agriculture, Natural Resources & Energy Comm.; in Senate. Colorado law permits the practice of animal chiropractic, defined as "diagnosing and treating animal vertebral subluxation," including the use of x-rays for diagnosis. Subluxations do not exist in humansor other mammals and obviously you cannot see them on an x-ray, although a favorite chiropractic scam is to point out the non-existent subluxation on an x-ray film. Chiropractors are required to get clearance from a DVM before "detecting" and "correcting" subluxations in animals. This bill removes the clearance requirement for chiropractors who are registered in animal chiropractic with the state. (For more on animal chiropractic and other forms of pseudoscience inflicted on animals, see the SkeptVet blog.)
FLORIDA: Senate Bill 240; House Bill 161. Would permit chiropractors (along with MDs, DOs and nurses) to enter into "direct primary care agreements" with patients. “Primary care service” is defined in these bills as "the screening, assessment, diagnosis, and treatment of a patient for the purpose of promoting health or detecting and managing disease or injury within the competency and training of the primary care provider." Chiropractic scope of practice is defined by state law as essentially the detection and correction of (non-existent) subluxations. Chiropractors are not educated and trained in primary care and are incompetent to provide this level of care. It is misleading to the public to imply that they are by allowing chiropractors to enter into direct primary care agreements with patients. It is important to remember that these agreements are not bound by the usual limitations imposed by health insurers based on the lack of evidence of safety or effectiveness. (See, for example, Aetna’s discussion of coverage of chiropractic services.)
INDIANA: Senate Bill 437.Before Senate Comm. on Health and Provider Services. Although not obvious at first glance, this is a major practice expansion bill in the vein of the American Chiropractic Association's position that chiropractors are competent primary care physicians. (Actually, they aren't.) Allows chiropractors to call themselves "physicians" and to order, perform and interpret "laboratory, radiological, electrodiagnostic or any other diagnostic studies" if taught in a chiropractic college, "including ordering of advanced imaging of all parts of the human body." Allows chiropractors to "evaluate and examine individuals" for "diagnosis of physical or physiologic injuries, conditions, or disorders of the body" and treat "injuries, conditions and disorders" by "administering or dispensing of supportive procedure therapies" including "nutrition" and "risk factor screening." This means chiropractors could diagnose and treat virtually any disease or condition (with the exception of infectious diseases, endocrine disorders, or atypical or abnormal histology, which are specifically prohibited by the bill) and use virtually all forms of diagnostic testing, no matter what organ or body system it involves, including dubious tests like MTHFR genetic testing for unvalidated purposes ("risk factor screening") using dietary supplements ("nutrition"). The bill also buys into the pretension that DCs are PCPs by stating that chiropractors can "manage, coordinate or delegate patient care functions including initiating referrals to specialists," which are basic functions of a real primary care doctor.
NEW MEXICO:Senate Bill 150. Referred to Senate Judiciary and Public Affairs Comms. New Mexico is unique in allowing "advance practice" chiropractors, who have 90 hours of education and training in pharmacology, to prescribe drugs. This bill would bifurcate the "advance practice" chiropractor into two levels. Level One, with the 90 hours of education, would have an expanded formulary, increasing the drugs they could inject and doing away with pharmacy and medical board approval. Level Twos could, with 650 hours of additional training at chiropractic schools, prescribe and administer all drugs used in primary care practice, except Schedule I controlled substances. The bill removes the statutory definition of chiropractic scope of practice, leaving it solely up to the chiropractic board to decide what chiropractors can and cannot do.
TENNESSEE: Senate Bill 313; House Bill 387; Senate Bill 1280 (same language as SB 313). SB 313 referred to Senate Health & Welfare Comm; HB 387 referred to House Health Comm. Subcomm. on Health. Practice expansion bills. Chiropractic is currently defined under state law as "locating and removing nerve interference," i.e., traditional subluxation-based chiropractic, and diagnosing and treating "neuromuscular and musculoskeletal conditions." This bill vastly expands chiropractic scope of practice to include performing a "differential diagnosis" for any physical condition to establish "an appropriate plan of care for the patient" using diagnostic testing "for which the chiropractic physician has received training." Thus, the state will default to chiropractic colleges and the chiropractic board to determine whether chiropractors have the necessary education and training to use a particular diagnostic procedure. Chiropractors are given the right to collect bodily fluids and specimens for analysis. Pursuant to Senate Bill 224 and House Bill 334, chiropractors could enter into direct primary care agreements with their patients. "Primary care" is defined under state law as "includes the screening, assessment, diagnosis, and treatment for the purpose of promotion of health or the detection and management of disease or injury within the competency and training of the direct primary care physician."
TEXAS: NEW! House Bill 2011. Practice expansion. Current law allows chiropractors to "analyze, examine, or evaluate the biomechanical condition of the spine and musculoskeletal system." Bill would add "diagnose."
Acupuncture, Traditional Chinese Medicine and Oriental Medicine
ILLINOIS: House Bill 2630, Senate Bill 1350. Passed House; Senate Comm. on Corporations, Elections & Political Subdivisions and Comm on Appropriations recommend "do pass" as amended. Adds the practice of "East Asian medicine" to acupuncture practice act, defined to include acupuncture, moxibustion, herbal medicine, dietary supplements, and diet, among others, to "normalize physiological functions, or for the treatment of diseases or dysfunctions of the body." Expands scope of practice of acupuncture to include far-infrared, electro and magnetic stimulation, cold laser, cupping, dry needling, and gua sha. Practitioners limited to determination of differential diagnosis via principles and techniques taught at acupuncture schools. Must refer patient to physician or dentist if patient's condition is beyond the scope of the practice of acupuncturist or East Asian medicine practitioner. Extends sunset of practice act from 2018 to 2028.
MISSISSIPPI: Senate Bill 2214; House Bill 495. SB 2214 passed in Senate; to House for consideration. HB 495 died in committee. Current law requires that an acupuncturists have a written prescription or referral from a physician to perform acupuncture and that the physician perform a medical diagnostic examination prior to the referral or prescription. SB 2214, as amended, repeals these requirements for acupuncturists who have been in practice for 5 years. HB 495 repeals this requirement altogether. Similar bills have failed in recent sessions.
MAINE:House Bill 141. Referred to Joint Comm. on Health & Human Services. Requires state Department of Health and Human Services to apply to for federal authorization to develop a pilot project to treat alcohol abuse disorders, substance abuse disorders using the National Acupuncture Detoxification Association ("NADA") auricular acupuncture protocol. NADA auricular acupuncture is highly implausible and has not been proven effective for substance abuse. As is typical of acupuncture studies in general, higher quality studies show that it is no more effective than placebo.
NEW MEXICO:House Bill 232. Referred to House Health and Business & Industry Comms. Would expand scope of practice of Doctors of Oriental Medicine, who are defined by state law as "primary care" practitioners, to include "substances used for detoxification and chelation," among other things. Adds certification in "holistic integrative medicine" to injection, intravenous and bioidentical hormone therapy certifications Board of Acupuncture and Oriental Medicine can issue.
NEBRASKA: Passed in Comm. on Health & Human Services. L.B. 19 Practice expansion bill. Would remove requirement that patient have a referral from, or an evaluation and medical diagnosis by, a physician. Add requirement that acupuncturist refer patient to "appropriate practitioner" when patient's problem is beyond training, experience, or competence of the acupuncturist; how acupuncturist is supposed to make this call is not explained.
NEW HAMPSHIRE: House Bill 575. Referred to House Comm. on Executive Depts. & Administration; Public Hearing scheduled for Feb. 14 at 2:30 pm. Creates "Certified Acupuncture Detoxification Specialist" who has been trained in the NADA protocol to practice. NADA auricular acupuncture is highly implausible and has not been proven effective for substance abuse. As is typical of acupuncture studies in general, higher quality studies show that it is no more effective than placebo.
UTAH: NEW! Senate Bill 73. Different versions passed in House and Senate; resolved in Conference Comm. Acupuncture practice act sunsets on July 1, 2017. Senate version of bill repeals the sunset date without adding a new sunset date, presumably allowing practice of acupuncture in perpetuity. House version extends sunset date to 2022. House version adopted in Conference Committee.
WYOMING: NEW!House Bill 165. Passed House; Senate Comm. on Corporations, Elections & Political Subdivisions and Comm on Appropriations recommend "do pass" as amended. As originally introduced, would license acupuncturists and practitioners of Oriental medicine, but Oriental medicine has been eliminated from the bill. Acupuncture is defined as insertion of needles, with or without electric current, for 'therapeutic purpose of promoting, maintaining and restoring health." Also permits practice of "auricular acupuncture" for "treating mental and emotional health, post and acute trauma, substance abuse and chemical dependency," even though it has not been proven effective for those conditions. Creates Board of Acupuncture, consisting of three acupuncturists, one public member and one licensed health care professional who is not an acupuncturist, to regulate acupuncture practice.
Written by Mark A Crislip
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