Legislative Update displays bills pending in the 2015-2016 state legislative sessions.  It is updated weekly.  To view bills from the 2013-2014 sessions and their results, see Legislative Archive.  

NEW FEATURE ADDED! Scroll to the end of the page to see "Vaccination Bills." 

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.


For more information on naturopathy and why naturopaths should not be licensed see the Oppose Naturopathic Licensing! website, former ND Britt Hermes blog, Naturopathic Diaries, and her posts on Science-Based Medicine (type "Hermes" in search box.)  She details the disturbing lack of education and training of naturopaths, as well as their appalling practices.

CALIFORNIA: Senate Bill 538. Passed in Senate; to Assembly; voted down in Assembly Appropriations Comm. but reconsideration granted. What would have been a major exapansion of naturopathic scope of practice was considerably trimmed as it moved through the Senate. Additional amendments in Assembly committees pulled back even further. As amended, the bill removes of MD/DO oversight of prescribing for Schedule V drugs only.  MD/DO oversight of naturopathic prescribing for Schedule III - VI drugs remains, although the original bill would have gotten rid of the required oversight for these drugs as well, including routes of administration and requiring patient-specific protocols in certain cases.   Pharmacist has right to see this standardized protocol when "there is uncertainty about the naturopathic doctor furnishing the order."  Right to use parenteral therapy and perform minor surgical procedures eliminated. The original bill would have removed requirement that non-ND licensed professional perform and interpret diagnostic studies by allowing naturopaths to perform, review and interpret results of diagnostic procedures, including venipuncture, lab tests, electrocardiograms, diagnostic imaging and biopsies, but amendments keep requirements that NDs leave performance and interpretation to properly trained professionals. The AARP is a major disappointment on this one, as it is one of the backers of the practice expansion. 

COLORADO: House Bill 1075. Passed House & Senate; signed by Governor. Committees considering this bill kept adding additional limitations on naturopathic practice as it moved through the House.  Colorado passed a naturopathic registration (but not licensing) act for naturopaths in 2013.  The bill contained provisions protecting children by placing restrictions on naturopathic treatment of pediatric "clients" including a complete ban on their seeing patients under 2 years of age. (Those who see naturopaths are not referred to as "patients" in the naturopathic registration law, but are called "clients.") They tried to get rid of these restrictions last year, but failed. This year, they are attempting a more modest amendment than in 2014. Instead of completely lifting the pediatric practice restrictions, they are asking the legislature to allow them to see clients younger than 2, but with the same restrictions that apply to clients between 2 and 8: providing the parent with the recommended vaccination schedule, 3 hours of yearly continuing education in pediatrics, informing the parent that the naturopath is not a licensed physician, recommending that the child have a relationship with a licensed health care provider and referring a child to such a provider for a wellness evaluation if the child has no such relationship. Bill amended in committee to add additional hours of training, including recognizing a sick infant and when to refer an infant for more intensive care and, in its latest version, requiring a collaborative agreement with a licensed pediatrician or family practice physician to "ensure safety" of clients under 2. Naturopathic registration law will undergo "sunset review" and could be repealed in its entirety on September 1, 2017.  The state must collect data from naturopaths who see clients under 2, including adverse reactions to naturopathic treatments. 

COLORADO: House Bill 1352. Passed House & Senate; signed by Governor. Expands scope of naturopathic practice to include broader prescription rights. Bill would allow naturopaths to inject vitamins and non-prescription drugs, and order these from wholesalers and other suppliers.

CONNECTICUT: House Bill 6797. Failed; Legislature adjourned.  Last year Connecticut "modernized" the naturopathic scope of practice by substantially expanding it. Naturopaths failed to get prescription privileges but are trying again this year. No bill allowing them to prescribe has been introduced, but this bill directs the Department of Health, in consultation with the state Board of Naturopathic Examiners, to submit a report to the legislature, by February, 2016, on the naturopathic scope of practice, including prescribing privileges.  

HAWAII: NEW! Senate Bill 1216. Failed deadline for further consideration in last session; reintroduced in current session.  This bill allows naturopaths to corner the market in colon hydrotherapy by specifically excluding others, except licensed physicians and nurse practitioners (who wouldn't use it on patients for "detoxification" anyway) from performing it.  The rationale is colon hydrotherapy can be dangerous when performed by untrained persons.  That is true, but allowing only trained persons to use it doesn't address a more basic issue with colonic hydrotherapy: it is based on the pseudoscientific notion that our bodies are full of "toxins" that can be eliminated via this method, thereby relieving us of all sorts of maladies. It is a waste of money. Also, it can be dangerous even when performed properly because it can deplete the body of electrolytes.   

HAWAII: Senate Bill 2332, House Bill 2256.  Would allow naturopaths to prescribe conrolled substances other than narcotics.  Bill preamble states that naturopaths are "experts in bio-identical hormone replacement therapy" as a rationale for allowing them to prescribe controlled substances like testosterone. Actually, there is no evidence that so-called "bio-identical hormones" (a marketing, not a medical term) are safe or effective and they are not recommended by responsible medical authorities, so the fact that naturopaths use them is hardly a reason to expand their prescription privileges.  

IDAHO: House Bill 181. Failed to pass. [see Senate Bill 1177, below.] This bill appears to be a new iteration of naturopathic licensing bills with a new and even broader scope of practice. Gone is the language defining naturopathy in terms of the "body's self-healing ability," i.e., vitalism.  Defines "naturopathic medicine" as "a distinct and comprehensive system of primary health care practiced by naturopathic physicians" and "natural health care services" as a "broad domain" including "diagnosis and treatment," but leaves the content of naturopathic practice largely up to a Board of Naturopathic "Physicians" using the vague standard that the practices permitted by the new law must be "consistent with naturopathic education and training." Could perform minor office procedures, prescribe prescription drugs and medical devices as determined by a formulary approved by the Board. The Board can approve "specialties," which are not defined in the bill but which presumably would include such things as "naturopathic oncology" and "naturopathic childbirth attendance."  "Gross negligence [but apparently not regular negligence], incompetence or misconduct" is prohibited, but not falling below a standard of care. No malpractice insurance is required. Naturopaths cannot be disciplined solely for using "unconventional"  practices unless a patient is actually harmed and the patient has signed a waiver acknowledging the practice is "unconventional."  Conviction of a crime is grounds for discipline but naturopath can request an "exemption review" so that his conviction doesn't count against him, if the Board establishes a rule allowing such reviews. 

IDAHO:  Senate 1177. Passed; signed by Governor. Repeals naturopathic licensing. All current licenses declared null and void. 

ILLINOIS: Senate Bill 1601; House Bill 3508. Naturopathic licensing bills. Like last year's unsuccessful bills, these bills would license naturopathic "physicians" but are vague on details.  Would be regulated by the state medical licensing board and state medical disciplinary board, each of which would have one naturopath member. No scope of practice defined, but they would be able to perform a number of tasks that medical doctors now perform, such as certify sick leave for certain state employees.

INDIANA: House Resolution 14. Urges legislative council to assign a study committee to look into licensure of naturopaths.

IOWA: Senate Study Bill 1067; House Study Bill 51. Bills failed legislative deadline for further consideration. Naturopathic licensing bills. These bills are identical and have the same provisions as study bills that failed to pass last year.  In Iowa, study bills are used to determine reception to an issue by the General Assembly and are developed under the auspices of a legislative committee. If a study bill is approved by the committee it can then be considered by the General Assembly. These study bills would give NDs an extremely broad scope of practice comparable to an MD or DO PCP and they could call themselves "physicians." NDs could diagnose and treat any patient with any disease or condition, order lab tests and diagnostic imaging, and prescribe drugs unless the drug is excluded by the naturopathic exclusionary formulary. They could administer drugs by numerous methods, including IV. NDs would be governed by the Medical Board acting on the advice of a naturopathic advisory committee, consisting of 4 NDs, one MD or DO, one pharmacist and one public member, giving the NDs an automatic majority.  This advisory committee would recommend which prescription drugs would be excluded from naturopathic practice. In other words, drugs are presumed included unless excluded. No malpractice insurance is required.

MASSACHUSETTS: House Bill 1992, Senate Bill 1205.  Heard before Joing Public Health Committee on Nov. 17; eligible for Executive SessionNaturopathic registration bills have been introduced in the previous 10 sessions and this makes the 11th. Gives naturopaths broad scope of practice to diagnose and treat any person, of any age, with any disease or condition, including those made up by naturopaths, such as "adrenal fatigue," "chronic yeast overgrowth" and "chronic Lyme disease." Could order diagnostic testing, which, again, would facilitate their bogus diagnoses and treatments and their practice using unproven "theories" of disease and treatment like "functional medicine."  Practice of naturopathy defined as having the goal of supporting or stimulating the body's own "self-healing processes," i.e., the long-discredited idea called "vitalism."  Could use homeopathy, vitamins, and other "natural" medicines, as well as colon hydrotherapy.  In what appears to be increased legislative recognition of naturopathic anti-vaccination ideology, the bill requires referral to a physician where it appears person under 18 has not been fully vaccinated.  Cannot call themselves physician or claim they practice primary care. Would be governed by 5 person naturopathic board, 2 of whom must be naturopaths; others are MD, pharmacist and public member. No malpractice insurance required. Another bill has been introduced to required insurance coverage for their services. (HB 1892).

MICHIGAN: House Bill 4531To House Comm. on Health Policy. Naturopathic licensing bill. Would give naturopathic "physicians" one of broadest scopes of practice in U.S. Would be governed by naturopathic board; prescription authority if on naturopathic formulary as determined by formulary council; can use all routes of administration including injection and IV. Could perform and order lab tests, including use of phlebotomy; order diagnostic imaging; perform minor office procedures, including obtaining specimens "to diagnose, assess and treat disease," presumably includes biopsy and treatment of malignant lesions. Board can expand scope to include other therapeutics if consistent with education and training, leaving the door wide open for just about anything. All the usual pseudoscience included in practice, such as dietary supplements, homeopathy, colonic irrigation, electromagnetic energy, vitalism. 

MISSISSIPPI: House Bill 725. Failed; Legislature adjourned.  Naturopathic licensing bill. Would give naturopaths, who would be allowed to call themselves "physicians," a scope of practice almost as broad as an MD or DO primary care physician. They would be  regulated by their own board, the Board of Naturopathic Medicine. They could prescribe drugs, if these drugs are on the naturopathic formulary approved by a formulary council consisting of 2 two naturopaths, two pharmacists and one MD or DO. The approved prescription drugs could be by all the usual routes, including IV. Naturopaths could practice "naturopathic childbirth attendance" as well, with some additional training and passing an approved exam.  One of these exams is that of the North American Registry of Midwives,  an organization of "direct-entry midwives," that is, midwives who have no formal medical training. All the usual naturopathic nostrums would be included in their practice act: dietary supplements, homeopathy, enzymes, vitamins, minerals, colonic hydrotherapy. They would be allowed to use a wide range of diagnostic procedures, including ordering and performing phlebotomy, clinical lab tests, orificial exams, and physiological function tests and ordering diagnostic imagining. These would presumably include such things as PET scans, MRIs, x-rays, spirometry and cardiac function testing. 

MONTANA: Senate Bill 133. Failed deadline; Legislature adjourned. Currently, naturopaths have a limited formulary that includes some prescription drugs. This bill would allow naturopaths to prescribe all prescription drugs, thereby giving the same prescriptive authority at medical doctors. 

NEVADA: Senate Bill 408. Failed; Legislature adjourned. Naturopathic licensing bill. Would give naturopaths scope of practice very close to an MD/DO primary care physician. Allows naturopaths to diagnose and treat any patient with any disease or condition. Can prescribe and dispense drugs, can do injections, can prescribe controlled substances and use IVs with permission of naturopathic board, can perform minor office procedures, use all diagnostic methods, including imagining. Does not define naturopathy as vitalism, but rather just like practice of medicine. No malpractice insurance required.  

NEW JERSEY: Failed; died in committee; legislature adjourned. Assembly Bill 814, Senate Bill 1190. Naturopathic licensing bill. Bill defines naturopathic doctors as practitioners of primary health care and gives them the authority to independently diagnose and treat any patient with any condition, injury or disease. Naturopaths could order diagnostic tests, including x-rays; use typical naturopathic remedies such as homeopathy, dietary supplements, colonic irrigation, and "neutraceuticals;" and prescribe durable medical equipment. They would be self-governed by a naturopathic board.  Establishes an advisory committee to look into "naturopathic childbirth attendance." 

NEW JERSEY: Naturopathic licensing bill. Assembly Bill 1937. This is the same bill that never got out of committee during the last N.J. legislative session, reintroduced with a new bill number for the new session. Bill defines naturopathic doctors as practitioners of primary health care and gives them the authority to independently diagnose and treat any patient with any condition, injury or disease. Naturopaths could order diagnostic tests, including x-rays; use typical naturopathic remedies such as homeopathy, dietary supplements, colonic irrigation, and "neutraceuticals;" and prescribe durable medical equipment. They would be self-governed by a naturopathic board.  Establishes an advisory committee to look into "naturopathic childbirth attendance." 

NEW YORK: Assembly Bill 7035, Senate Bill 4917.This will be the 8th consecutive session in which a naturopathic licensing bill has been introduced; passed in Senate but failed in Assembly in last session.. Permits broad scope of practice; could diagnose and treat any patient of any age with any disease or condition. Supervision by naturopathic licensing board. Can administer and prescribe dietary supplements, homeopathic remedies, vitamins, minerals, thyroid, estrogen, progesterone hormones, DHEA and may administer these substances by injection with additional training. Can administer immunizations, including homeopathic nosodes. Permits the use of CLIA-waived lab tests, venipuncture and "hair cutting."  Permits "colonic therapy." Must do one-year "residence," but this can be practicing under the supervision of another naturopath.

NORTH CAROLINA: House Bill 913. Failed legislative deadline for further consideration.  Naturopathic licensing bills have been introduced, and failed, in each of the last 6 2-year legislative sessions (plus 1993). This year marks the 7th attempt. Typical naturopathic licensing bill, giving naturopaths the right to diagnose and treat with no supervision; could order and interpret some lab tests and diagnostic imaging, but MRIs, electrocardiograms and the like requires physician interpretation. Can prescribe all manner of "natural" substances like dietary supplements, neutraceuticals and homeopathic remedies and can use transdermal routes of administration. Regulated by natuorpathic board; allows reciprocity, which will allow influx of under-employed naturopaths from other states to practice; replaces malpractice standard of care for discipline with "gross negligence, incompetency, or misconduct." 

NORTH DAKOTA: Senate Bill 2194. Failed to pass; Legislature adjourned. Expands naturopathic scope of practice to include prescription drugs if on a formulary established by a subcommittee of the Board of Integrative Medicine consisting of an MD or DO, naturopath, pharmacist and APRN. Formulary cannot include Schedule I-IV controlled substances except anabolic steroids. Naturopaths can currently prescribe homeopathic remedies, minerals, vitamins, enzymes, dietary supplements and "botanical medicines."  If on the formulary, this will mean they will be able to administer these substances by injection, including IV. Bill would also allow naturopaths to perform "minor office procedures," but not skin biopsies.  Permits naturopaths to perform "naturopathic childbirth attendance" after completing a 3-year certified professional midwifery curriculum approved by Board and passing a standardized Board-endorsed exam, such as that of the North American Registry of Midwives, the certifying agency for direct-entry midwives.  Direct-entry midwives do not need any prior medical education, such as a nursing degree, to be certified. 

OREGON: House Bill 3301. Passed House & Senate; signed by Governor. Would force insurers to allow naturopathic "physicians" to choose whether they want to be credentialed as a primary care provider or specialty care provider.  Redefines naturopathy as "primary care" in state law. 

OREGON: Senate Bill 1535. Oregon has a law requiring clearance by a health care professional before a student athlete who has suffered a concussion can return to play. This bill would add "chiropractic physicians" and "naturopathic physicians" to the defintion of "health care professional."  This implies that chiropractors and naturopaths are not only competent to clear students for return to play, but also that they are sufficiently educated and trained to diagnose and treat brain injuries, which they are not.  Because the deleterious effect of brain injuries due to concussions may take years to manifest themselves, lack of adequate diagnosis and treatment is especially dangerous. 

PENNSYLVANIA: House Bill 516, Senate Bill 621. Passed in House; in Senate Comm. on Consumer Protection & Prof. Licensure. Naturopathic licensing bill. Grants naturopaths a broad scope of practice, defining naturopathy as "a system of primary health care," allowing them to diagnose and treat any patient with any disease or condition. Cannot prescribe drugs but can use homeopathy (defined as substances "given in microdosage in the prevention and treatment of disease"), vitamins, minerals and enzymes, colon hydrotherapy and "electromagnetic energy," and visceral manipulation. Many routes of administration permitted: transdermal, subcutaneous, intramuscular, ocular. Can order and perform lab exams (including the use of venipuncture) but not diagnostic imagining. Requires malpractice insurance; would practice under jurisdiction of state medical board.

RHODE ISLAND: Senate Bills 94, 331, House Bills 5501,5380. Failed to pass; Legislature adjourned.  These bills are similar to a licensing bill that failed to pass last year. Gives naturopaths a broad scope of practice similar to MD/DO primary care physicians. Could diagnose any patient of any age with any disease or condition using all diagnostic methods "commonly used" by medical PCPs, a term that is undefined. Presumably, this would include the ability to order and interpret the reports of, for example, EKGs, MRIs, CT scans, PET scans, EEGs. Defines naturopathy as the practice of supporting and stimulating the body's self-healing ability, i.e., vitalism. Permits prescription of "natural medicines" and defines "natural" as "present in, produced by, or derived from nature," which could mean practically any substance.  Permits use of homeopathy. NDs would be overseen by Department of Health with two naturopaths as its sole advisors.

RHODE ISLAND: Senate Bill 2050. Appears to be the same as bills that failed in previous years (see above), reintroduced with a new number. Gives naturopaths a broad scope of practice similar to MD/DO primary care physicians. Could diagnose any patient of any age with any disease or condition using all diagnostic methods "commonly used" by physicians, but does not otherwise specify these methods. Presumably, this would include the ability to order and interpret the reports of, for example, EKGs, MRIs, CT scans, PET scans, EEGs. Defines naturopathy as the practice of supporting and stimulating the body's self-healing ability, i.e., vitalism. Permits prescription of "natural medicines" and defines "natural" as "present in, produced by, or derived from nature," which could mean practically any substance.  Permits use of homeopathy. NDs would be overseen by Department of Health with two naturopaths as its sole advisors.

VERMONT: House Bill 791. Currently, naturopaths are under the regulatory jurisdiction of the Director of the Office of Professional Regulation, who is advised by two appointed naturopaths.  Bill would allow naturopaths to self-regulate under Board of Naturopathic Physicians. 

WASHINGTON: House Bill 2304, Senate Bill 5815.  Would substantially expand naturopathic prescribing privileges. Authorizes a naturopath to prescribe and administer legend drugs; hydrocodone products contained in Schedule II of the uniform controlled substances act; and controlled substances contained in Schedules III through V of the uniform controlled substances act.including right to prescribe all legend drugs and many controlled substances, among them hydrocodone. Naturopathy board is not required to establish additional education and training requirements for these privileges. As has been extensively documented, naturopathic education in pharmacology is woefully inadequate clinical education virtually non-existent.  (See this SFSBM post for further information.) 


ARIZONA: House Bill 2215. Failed; Legislature adjourned. Establishes certification for chiropractors to practice "animal chiropractic."  For veterinarians, establishes a "specialist certification" in animal chirorpactic.  Applicants must complete a "postgraduate course" in animal chiropractic and pass an exam.  These "postgraduate courses" are weekend programs at small animal chiropractic trade-type schools not affiliated with any accredited institution of higher education except one at Parker University, a straight chiropractic college.

ARIZONA: Senate Bill 1040. Failed; Legislature adjourned. Permits chiropractors "certified in pharmacology" to prescribe prescription-strength doses of ibuprofen, naproxen, methocarbomol and cyclobenzaphrine.  Certification requires an unspecified number of hours studying pharmacology at a chiropractic college and "postgraduate study," which appears to be a sort of self-study with an instructor from a chiropractic, medical or osteopathic school.  It also requires a "rotation" of an unspecified number of hours under the supervision of an MD or DO, and passing an exam approved by the state chiropractic board. 

HAWAII: House Bill 997. Failed deadline for further consideration. Expands chiropractic scope of practice and allows chiropractors to call themselves "physicians." Currently, chiropractors are limited to "adjustments" of the spine with limited permission to treat certain extra-spinal neuromusculoskeletal conditions. This bill would eliminate those restrictions and allow chiropractors to diagnose and treat any disease or abnormality (except for use of legend drugs and surgery), the only limitation being that diagnostic methods and treatments be taught by an accredited chiropractic college. They could also employ "clinical nutritional methods," which would give them the authority to perform bogus "nutritional" testing and sell dietary supplements to patients. They could use or order diagnostic and laboratory testing as well as  any other method of diagnostic examination as long as the latter are taught by chiropractic colleges and approved by the state chiropractic board. This is another of several recent attempts in the state legislatures  to default to the chiropractic colleges to determine a chiropractor's scope of practice

IDAHO: House Concurrent Resolution 20. Failed; Legislature adjournedIdaho law permits legislative review of agency administrative rules. The legislature can reject, via a concurrent resolution, those rules which violate the intent of the statute under which the rule was made. H.C.R. 20 appears to be a rare pushback by a state legislature against chiropractic overreach. The Resolution would eliminate a State Board of Chiropractic Physicians rule permitting chiropractors to prescribe, sell and compound vitamins, minerals, herbal medicines, homeopathic remedies and glandulars (dessicated animal organs), among other substances.

LOUISIANA:  House Bill 552, Senate Bill 56. Failed; Legislature adjourned. Expands scope of practice by removing restrictions on performing and ordering diagnostic imaging and changing definition of chiropractic practice from diagnosing and treating conditions "associated with the functional integrity of the spine" to diagnosing patients to determine "conditions related to the function of the neuromuscular or musculoskeletal system."  The bill was amended several times to reduce the scope of practice, although all definitions have been so broad and vague as to leave plenty of room for creative maneuvering. Adds that chiropractors can cousel patients regarding "health, wellness, diet and nutrition." Unfortunately, this can lead the way to chiropractors using bogus diagnostic tests to sell dietary supplements.

MISSISSIPPI: House Bill 729. Failed; Died in committee; Legislature adjourned. Chiropractic is defined under current law as the analysis of "nerve interferences" and manipulation/adjustment to "restore and maintain health."  This is straight "subluxation" based chiropractic.  Chiropractors are permitted to use x-rays in their practices.  This bill would allow them to use any "radiologic technologies" necessary for their services.  Thus, the bill would allow the use of PET scans, CT scans, MRIs and other forms of radiation-emitting technologies to detect the non-existent chiropractic "subluxation," thereby exposing patients to radiation for no good reason. 

MICHIGAN: House Bill 4712. Chiropractors are pushing for the right to prescribe physical therapy, not via expansion of their practice act to add prescription privileges, which they currently do not enjoy, but by simply adding themselves to the list of practitioners who can prescribe.  Physical therapists, as well as MDs and insurance and business interests, oppose the bill. PTs say chiropractors can already refer patients to them and that, if an actual prescription is needed, the patient needs to see an MD, DO, DPM or DDS/DMD. Only these professionals are properly educated and trained to fully assess the patient's bio-medical issues and determine whether physical therapy, drugs, surgery or some other treatment is appropriate. Chiropractors have neither the scope of practice nor the ability to do this. 

NEBRASKA: Legislative Bill 211. First Regular Session adjourned; carried over to Second Regular Session, begins Jan. 2016. Under current law, school children must have a physical exam and eye exam at certain ages performed by a physician, physician's assistant or APRN. An optometrist can also perform the the exam. This bill would also allow chiropractors to perform physical and eye exams

NEW MEXICO: Senate Bill 376. Failed; Legislature adjourned. This is another effort in a continuing attempt to refashion chiropractors into primary care physicians.  The practice of chiropractic is renamed "chiropractic medicine." Would considerably expand the already liberal scope of practice for chiropractors in New Mexico. DCs would be allowed to diagnose and treat any condition for which they have been "educated and trained," essentially defaulting to the chiropractor the authority to make the decision regarding what he can and cannot do. The state's existing "advanced practice" chiropractors are divided into two tiers, "Level One" and "Level Two."  Both could administer certain substances, such as "nutritional medicine," bioidentical hormones, and glandulars, by injection. Both could prescribe any drugs approved by the chiropractic board. Level Ones currently have 90 additional hours of training after chiropractic school, and they would be grandfathered in, but requirements are changed to a "postgraduate degree in a clinical specialty" from a chiropractic school, with no minimum standards for such a course set.  "Advance practice" chiropractors can already prescribe such drugs as bioidentical hormones and live cell products. This bill would allow them to inject those and other substances. If the chiropractic board, in consultation with (but not necessarily the approval of) the pharmacy board, gives its ok, other drugs could be added.  Level Twos must have, in addition, 650 hours in a supervised "clinical rotation," which could take place at a chiropractic college. Level Twos prescribe, inject and dispense all dangerous drugs (as defined in by state law) except Schedule I and II controlled substances, that are used in standard primary care practice. Bill amendments require that instruction for Level Two be ok'd by state medical board and collaboration agreement with physician or certified nurse practitioner for first 5 years of practice for Level Two chiropractors who want to prescribe dangerous drugs, including chart review.

OHIO: House Bill 276. Permits chiropractors to recommend, distribute, administer and sell to patients vitamins, minerals, antioxidents, enzymes, glandulars, homeopathic remedies, non-prescription drugs and other supplements, as well as medical equipment, to "restore or maintain" health. This is a terrible conflict of interest and chiropractors are not adequately trained to use potentially dangerous substances like glandulars, which are substandard health care anyway. 

OREGON: Draft (no bill number assigned): Oregon has a law requiring clearance by a health care professional before a student athlete who has suffered a concussion can return to play. This bill would add "chiropractic physicians" and "naturopathic physicians" to the defintion of "health care professional."  This implies that chiropractors and naturopaths are not only competent to clear students for return to play, but also that they are sufficiently educated and trained to diagnose and treat brain injuries, which they are not.  Because the deleterious effect of brain injuries due to concussions may take years to manifest themselves, lack of adequate diagnosis and treatment is especially dangerous. 

TEXAS: House Bill 3925. Failed; Legislature adjourned. Expands chiropractic scope of practice in a way that may not be obvious to those unfamiliar with chiropractic code words.  Under current law, chiropractors can analyze and treat a "biomechanical condition of the spine and musculoskeletal system." Treatments include "adjustments" and other nonsurgical procedures "to improve the subluxation complex or biomechanics of the musculoskeletal system." The bill adds "or the condition of another system of the human body that is affected by the musculoskeketal system" to both the scope of diagnosis and treatment. Since chiropractic "theory" teaches that "nerve interference" caused by the non-existent chiropractic "subluxation" is the source of many diseases and other conditions, and that adjustments of these subluxations will remove this "nerve interference," the bill would essentially allow chiropractors to "adjust" the spine for all manner of patient complaints.  

VIRGINIA: House Bill 1098. Expands chiropractic scope of practice to include physical exams for commercial driver's licenses or commericial lerner's permit. Similar to a bill that failed last year. (See next entry.) 

VIRGINIA: Senate Bill 1244. Failed; Legislature adjourned.  Expands chiropractic scope of practice to include physical exams for commericial driver's licenses or instructors for such licenses. 

WYOMING: Senate Bills 61 and 79. SB 61 withdrawn; SB 70 Failed legislative deadline; Legislature adjourned. Permits chiropractors to use the term "chiropractic physician."

Acupuncture, Traditional Chinese Medicine and Oriental Medicine

COLORADO: House Bill 1360. Passed House & Senate; signed by Governor. Expands acupuncture scope of practice to include injection therapy: the injections of sterile herbs, vitamins, minerals, homeopathic substances, sarapin, saline, glucose, procaine and lidocaine into acupuncture points. 

IOWA: House Study Bill 101. Failed legislative deadline for further consideration Substantially expands acupuncturist's scope of practice to include "oriental medicine," which includes moxibustion, cupping, reflexology, magnets, herbal medicine, dietary supplements, mind-body techniques and stimulation by a device that doesn't pierce the skin. Defaults to the acupuncture accrediting organizations to determine what other clinical practices can be added. In addition, acupuncturists would be allowed to "promote, maintain, and restore health, improve bodily function and prevent disease."  Existing requirement that patients be notified that the acupuncturist's services must not be regarded as diagnosis, treatment, opinion or advice from a physician is eliminated. 

KANSAS: Senate Bill 351, Senate Bill 363. Hearing before Public Health Comm. on SB 363 scheduled for Wednesday, Feb. 3, at 1:30 pm.  Acupuncture and Oriental Medicine licensing act. Would give acupuncturists and Oriental Medicine practitioners a broad scope of practice, enabling them to diagnose and treat any patient of any age with any disease or condtion. In addition to traditional needle acupuncture, practitioners could employ a number of unproven methods, like "auricular detox," magnetic and electromagnetic treatments and cupping. Could dispense unproven and potentially dangerous herbal remedies and dietary supplements and presumably sell these to their patients, a terrible conflict of interest. Would be supervised by state board of healing arts; malpractice insurance required to practice. 

MASSACHUSETTS: House Bill 930; Senate Bill 1231. In addition to expanding health insurance coverage for acupuncture, would establish a commission to investigate "better integrated use of acupuncture services." 

MAINE: House Bill 751. Vetoed by Governor; House failed to override veto.  Establishes a pilot project for treatment of substance abuse disorders with auricular acupuncture. Directs state Department of Health and Human Services to apply to its federal counterpart for a waiver necessary to establish the project. 

MISSISSIPPI: NEW! House Bills 82 & 83, Senate Bill 2022. Further attempts, after failure in previous years (see below), to remove some physician oversight from acupuncture practice. HB 82 deletes referral requirement if patient has a previous evaluaction by physician or dentist. If patient being treated for chronic pain, alcoholism or substance abuse, must be referred to physician or dentist if no substantial improvement after 20 treatments.  Oddly, patients being treated by a chiropractor must still get referral, but acupncturist must refer to physician or dentist if no substantial improvement. HB 83 removes referral requirement if only patient being treated for pain and only if patient has a current prescription for an analgestic drug. SB 2022 simply removes the referral requirement altoghether. 

MISSISSIPPI: Senate Bill 2319; House Bill 898. Failed; Died in committee; Legislature adjourned. Acupuncturists are again trying to repeal a requirement that a physician examine a patient and give the patient a referral to an acupuncturist before the acupuncturist can treat the patient. Similar bills were defeated last year. 

NEBRASKA: Legislative Bill 962. Current law requires a referral from a physician for an acupuncturist to treat a patient. Bill would remove that requirement, adding that the acupuncturist must refer patient to appropriate practitioner when problem is beyond his training or competence.

NEW YORK: Assembly Bill 2558, Senate Bill 3911. Before House & Senate Higher Educ. Comms.  Expands acupuncture scope of practice to include recommendation of diet, herbs and "natural products." These include custom-made remedies and herbal products, but only with passage of "herbal competency exam." Adds continuing education requirements for acupuncturists and makes changes to their regulatory board, one of which is to include 3 physicians who practice acupuncture.

NORTH DAKOTA: Senate Bill 2191. Signed into law by Governor. Acupuncture licensing act. Defines scope of practice fairly narrowly as including botanical medicine and needle acupuncture, but without "electronic stimulation." Provides that hospitals may employ acupuncturists. Would be regulated by State Board of Integrative Health Care. 

OKLAHOMA:  Senate Bill 489. Failed legislative deadline for further consideration.  Acupuncture licensing act giving acupuncturists an extremely broad scope of practice. Acupuncture is defined as a form of "primary heatlh care" that "employs acupuncture diagosis and treatment" and "adjunctive therapies and diagnostic techniques" for "promotion, maintenance and restoration of health and the prevention of disease." There is absolutely no evidence that acupuncture does any of these things. They may, among other methods, employ needle acupuncture and moxibustion, prescribe herbs, and give dietary advice.    Puts acupuncturists under the jurisdiciton of the State Board of Medical Licensure and Supervision, but the Board's authority to enact regulations is limited to subjects like continuing education and certain other matters regarding licensing.  Advisory Committee consisting of acupuncturists and public members advises Board. No malpractice insurance required. 

RHODE ISLAND: House Bill 5381; Senate Bill 234. HB 5381 signed into law by Governor. Adds the practice of "Oriental medicine" to acupuncture practice act. Defined very broadly as a form of "primary health care" using Chinese medical and acupuncture diagnostics, including those based on "newer scientific models" for "assessment, treatment, preventaion and cure of any disease." May use acupuncture, moxibustion, gwa/sha, thermography, herbs, homeopathy and "supplement therapy." 

RHODE ISLAND: House Bill 7130. Would allow chemical dependency professionals to use "auricular acudetox," a treatment with no good evidence of effectiveness or biological plausibility, in their practices. 

VERMONT: House Bill 520. Would allow physicians to treat patients with acupuncture under rules established by the medical board. 

WYOMING: House Bill 246. Failed; died in committee. Acupuncture and oriental medicine licensing bill. Defines acupuncture and oriental medicine broadly as a "form of primary health care" based on oriental medicine concepts for diagnosis and treatment of disease and health promotion. Could "stimulate points on the body" with lancets, needles, magnets, electricity and suction, among other methods.  Could prescribe and sell, among others, herbal remedies to patients, as well as homeopathic treatments, glandulars and dietary supplements. Would be regulated by a board consisting of 4 acupuncturists and one public member. 

Other CAM Practitioners

NEVADA: Assembly Bill 295. Passed in Assembly & Senate; signed by Governor. This is a form of "health freedom" bill that gives a safe harbor to people who don't have a health care practitioner license, such as a license to practice chiropractic or massage. Under state law, such people are subject to allegations of practicing without the appropriate license. The bill permits "CAM" providers who do not have health care practitioner licenses to offer specified services, such as nondiagnostic iridology" reflexology, and holistic kinesiology. Unfortunately, it also includes treatments that can be dangerous, such as Gerson therapy, detoxification practices, herbalism, and use of dietary supplements and "nutrients." No education or training is needed to perform any of these practices. 

Other Bills of Interest

MASSACHUSETTS:  Senate Bill 1136. A "health freedom" bill that would protect unlicensed "complementary and alternative health care" practitioners from liability under state consumer protection laws.  Under its terms, neither the Attorney General nor the medical or other licensed practitioner regulatory agencies could not take action against CAM providers, nor could consumers sue for unfair and deceptive trade practices.  These practitioners need not have any education or training and few limitations are put on the services they can sell to the public. 

WASHINGTON: House Bill 1476, Senate Bill 5408. Failed legislative deadline for further consideration. Under current law, failure to provide medical care to a child or dependent person can constitute criminal mistreatment and can be punished as a misdemeanor or felony.  However, the statute provides an exemption: Christian Science treatment by a Christian Science practiitoner in lieu of medical care is not considered deprivation of medically necessary health care. A civil statute governing protection of childen from abuse and neglect states that Christian Science treatment in lieu of medical care is not by itself neglect. The bills would repeal both the criminal and civil provisions. 

Vaccination Bills

ALL STATES: Vax Advocacy website tracks state vaccination exemption legislation.