2008 Legislation
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HOUSE BILL NO. 377<br /> – Chiropractic Medical Formulary Cncl


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Bill Status

H0377.................................................by HEALTH AND WELFARE
CHIROPRACTIC MEDICAL FORMULARY COUNCIL - Adds to and amends existing law to
clarify chiropractic practices that are not allowed; to establish the
Chiropractic Medical Formulary Council; and to provide additional
rulemaking authority for the State Board of Chiropractic Physicians.

01/21    House intro - 1st rdg - to printing
01/22    Rpt prt - to Health/Wel

Bill Text

  ]]]]              LEGISLATURE OF THE STATE OF IDAHO             ]]]]
 Fifty-ninth Legislature                   Second Regular Session - 2008


                              IN THE HOUSE OF REPRESENTATIVES

                                     HOUSE BILL NO. 377

                              BY HEALTH AND WELFARE COMMITTEE

  1                                        AN ACT

  8    Be It Enacted by the Legislature of the State of Idaho:

  9        SECTION  1.  That  Section  54-704, Idaho Code, be, and the same is hereby
 10    amended to read as follows:

 11        54-704.  CHIROPRACTIC PRACTICE. Chiropractic practice and procedures which
 12    may be employed by physicians are as follows:
 13        (1)  The  system  of  specific   adjustment   or   manipulation   of   the
 14    articulations  and  tissues  of  the  body; the investigation, examination and
 15    clinical diagnosis of conditions of the human body and the  treatment  of  the
 16    human   body   by   the   application  of  manipulative,  manual,  mechanical,
 17    physiotherapeutic or clinical nutritional methods and may include the  use  of
 18    diagnostic X-rays.
 19        (a)  "Adjustment"  means  the  application of a precisely controlled force
 20        applied by hand or by mechanical device to a specific focal point  on  the
 21        anatomy  for the express purpose of creating a desired angular movement in
 22        skeletal joint structures in order to eliminate or  decrease  interference
 23        with  neural  transmission  and  correct or attempt to correct subluxation
 24        complex; "chiropractic adjustment" utilizes, as appropriate,  short  lever
 25        force,  high  velocity  force, short amplitude force, or specific line-of-
 26        correction force to achieve the desired angular movement, as well  as  low
 27        force  neuromuscular, neurovascular, neuro-cranial neurocranial, or neuro-
 28        lymphatic neurolymphatic reflex technique procedures.
 29        (b)  "Manipulation" means an application of a resistive movement by apply-
 30        ing a nonspecific force without the use of a thrust, that is directed into
 31        a region and not into a focal point of the anatomy for the general purpose
 32        of restoring movement and reducing fixation.
 33        (c)  "Massage therapy," also called massology, means the systematic manual
 34        or mechanical mobilization of the soft tissue of the body  by  such  move-
 35        ments  as  rubbing, kneading, pressing, rolling, slapping and tapping, for
 36        the purpose of promoting circulation of the blood and lymph, relaxation of
 37        muscles, release from pain, restoration  of  metabolic  balance,  and  the
 38        other benefits both physical and mental.
 39        (2)  Nothing herein contained shall allow any physician to:
 40        (a)  Perform surgical operations or practice obstetrics;
 41        (b)  Except  as approved by the chiropractic medical formulary council for
 42        use by chiropractic physicians as a clinical nutritional method,  dDirect,
 43        or  suggest  or  administer to the a patient that such patient shall use a


  1        substance drug which, under federal law is required, prior to  being  dis-
  2        pensed  or  delivered,  to be labeled with either one (1) of the following
  3        statements: (i) "Caution: Federal Law Prohibits  Dispensing  Without  Pre-
  4        scription"; or (ii) "Caution: Federal Law Restricts This Drug To Use By or
  5        On  The  Order  Of A Licensed Veterinarian"; or (iii) "Rx Only"; or (iv) a
  6        product which is required by any applicable federal or state  law  regula-
  7        tion to be dispensed on prescription only or is restricted to use by prac-
  8        titioners only.
  9        (3)  Chiropractic  practice,  as herein defined, is hereby declared not to
 10    be the practice of medicine within the meaning of the laws  of  the  state  of
 11    Idaho  defining  the  same,  and  physicians licensed pursuant to this chapter
 12    shall not be subject to the provisions of chapter 18, title  54,  Idaho  Code,
 13    nor  liable  to  any  prosecution  thereunder, when acting within the scope of
 14    practice as defined in this chapter.

 15        SECTION 2.  That Chapter 7, Title 54, Idaho Code,  be,  and  the  same  is
 16    hereby  amended by the addition thereto of a NEW SECTION, to be known and des-
 17    ignated as Section 54-704A, Idaho Code, and to read as follows:

 19    -- DUTIES. (1) There is hereby established a  chiropractic  medical  formulary
 20    council,  which is separate and distinct from the board of chiropractic physi-
 21    cians, to be composed of five (5) members appointed by the board of chiroprac-
 22    tic physicians as follows:
 23        (a)  Two (2) members shall be chiropractic physicians licensed under  this
 24        chapter;
 25        (b)  One (1) member shall be a pharmacist licensed under chapter 17, title
 26        54,  Idaho  Code,  appointed from a list of nominees provided by the Idaho
 27        state board of pharmacy;
 28        (c)  One (1) member shall be a physician licensed under chapter 18,  title
 29        54,  Idaho  Code,  appointed from a list of nominees provided by the Idaho
 30        state board of medicine;
 31        (d)  One (1) member shall be a public member appointed from a list of nom-
 32        inees from any source.
 33        (2)  The initial council shall be appointed as follows:
 34        (a)  One (1) chiropractic physician shall be appointed to a  term  of  one
 35        (1)  year  and one (1) chiropractic physician shall be appointed to a term
 36        of three (3) years;
 37        (b)  The  pharmacist  member  and  the  physician  member  shall  each  be
 38        appointed to a term of two (2) years; and
 39        (c)  The public member shall be appointed to a term of three (3) years.
 40    Thereafter, the term of office shall be three (3) years. A quorum  shall  con-
 41    sist of three (3) members and shall be required for any vote to be taken.
 42        (3)  It shall be the duty of the chiropractic medical formulary council to
 43    establish a formulary for use by chiropractic physicians, and immediately upon
 44    adoption or revision of the formulary, the council shall transmit the approved
 45    formulary to the board, which shall adopt the formulary by temporary rule. The
 46    formulary  shall  be  reviewed  annually by the council, or at any time at the
 47    request of the board. The formulary list shall not go beyond the scope of pre-
 48    scription medicines and medical devices covered by approved chiropractic  edu-
 49    cation  and  training  and  such  specialty  standards  and  certifications as
 50    required by board rule.
 51        (4)  Nothing herein shall allow  a  chiropractic  physician  to  dispense,
 52    administer   or   prescribe  any  prescription  drug  as  defined  in  section
 53    54-1705(28), Idaho Code, or medical device unless such  prescription  drug  or


  1    medical device is specifically included in the chiropractic medical formulary.

  2        SECTION  3.  That  Section  54-707, Idaho Code, be, and the same is hereby
  3    amended to read as follows:

  4        54-707.  POWERS AND DUTIES. The board shall have the authority to:
  5        (1)  Hire or appoint employees, including an executive director,  investi-
  6    gators, attorneys, consultants and independent hearing examiners;
  7        (2)  Establish,  pursuant to the provisions of chapter 52, title 67, Idaho
  8    Code, rules for the administration of the provisions of this chapter;
  9        (3)  Conduct investigations and examinations and hold hearings;
 10        (4)  Revoke or suspend licenses to practice chiropractic  after  providing
 11    the  licensee  with an opportunity for an appropriate contested case in accor-
 12    dance with the provisions of chapter 52, title 67, Idaho Code;
 13        (5)  In any disciplinary proceeding pursuant to this chapter to administer
 14    oaths, take depositions of witnesses within or without the state in the manner
 15    provided by law in civil cases, and shall have the power throughout the  state
 16    of  Idaho  to  require  the attendance of such witnesses and the production of
 17    such books, records, and papers as it may desire at any hearing and, for  that
 18    purpose,  the  board  may issue a subpoena for any witnesses or subpoena duces
 19    tecum to compel the production of any books, records or  papers,  directed  to
 20    the sheriff of any county in the state of Idaho, where such witness resides or
 21    may  be found, which shall be served and returned in the same manner as a sub-
 22    poena in a criminal case is served and returned. The fees and mileage  of  the
 23    witnesses shall be the same as that allowed in the district courts in criminal
 24    cases,  which fees and mileage shall be paid from any funds in the state trea-
 25    sury in the same manner as other expenses of the board are paid. The  licensee
 26    accused  in such proceedings shall have the same right of subpoena upon making
 27    application to the board therefor. In any case of disobedience to, or  neglect
 28    of,  any  subpoena  or  subpoena  duces  tecum, served upon any person, or the
 29    refusal of any witness to testify to any matter regarding which  he  may  law-
 30    fully  be  interrogated,  it  shall  be  the duty of the district court of any
 31    county in this state in which this disobedience, neglect or refusal occurs, on
 32    application by the board to compel compliance with the subpoena, to issue  its
 33    order directing compliance with such subpoena, and in the event of a violation
 34    of  such  order,  to compel compliance with such order by proceedings for con-
 35    tempt as in the case of disobedience of the requirement of a  subpoena  issued
 36    from such court or for refusal to testify therein;
 37        (6)  Seek  injunctive  relief  prohibiting the unlawful practice of chiro-
 38    practic;
 39        (7)  Make and enter into contracts in the  necessary  performance  of  its
 40    duties pursuant to this chapter;
 41        (8)  Develop  and submit a proposed budget setting forth the amount neces-
 42    sary to perform its functions;
 43        (9)  Perform such other duties as set forth in the laws of this state;
 44        (10) Provide such other services and perform such other functions  as  are
 45    necessary to fulfill its responsibilities;
 46        (11) Adopt  rules  to  provide  for reasonable fees and for administrative
 47    costs and to assess costs reasonably and necessarily incurred in the  enforce-
 48    ment  of  this  chapter  when  a  licensee  has  been found to be in violation
 49    thereof;
 50        (12) Adopt a rule requiring continuing education as a condition of contin-
 51    ued licensure; and
 52        (13) Adopt rules pursuant to chapter 52, title 67, Idaho Code,  to  estab-
 53    lish  and  operate  a  system of peer review for chiropractic physicians which


  1    shall include, but not be limited to, the appropriateness,  quality,  utiliza-
  2    tion,  and cost of chiropractic services and the ethical performance of chiro-
  3    practic care;
  4        (14) Adopt rules to create and establish standards and specialty  certifi-
  5    cations  for  the  use of intravenous and injectable substances as approved by
  6    the chiropractic medical formulary council; and
  7        (15) Adopt rules to create and establish standards and specialty  certifi-
  8    cations for chiropractic adjustments provided under anesthesia.

Statement of Purpose / Fiscal Impact

                   STATEMENT OF PURPOSE

                         RS 17440

This bill will create a chiropractic formulary council that will 
consist of five members; two licensed chiropractic physicians, 
one licensed pharmacist, one licensed physician, and one public 
member.  The purpose of this council is to establish a formulary 
for use by chiropractic physicians, but shall not go beyond the 
scope of prescription medicines and medical devices covered by 
chiropractic education, training, and such specialty standards 
and certifications as required by board rule.  This bill will 
give the board the authority to adopt rules to create standards 
and specialty certifications for intravenous, injectable 
substances, and adjustments provided under anesthesia.

                        FISCAL NOTE

There is no fiscal impact on the General Fund.  There would be 
an impact on dedicated funds.  The formulary council would need 
to meet two or three times at the onset which would require 
reimbursement of expenses for the council members.  This cost 
could be absorbed in their current budget.

Agency:	Occupational License, Bureau
Phone:	(208) 334-3233