SB 1330 — An Act amending the act of December 16, 1986 (P.L.1646, No.188), known as the Chiropractic Practice Act, 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 providing for fees.

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
 1   Amending the act of December 16, 1986 (P.L.1646, No.188),
 2      entitled "An act providing for the licensing of chiropractors
 3      and the regulation of the practice of chiropractic;
 4      establishing the State Board of Chiropractic in the
 5      Department of State and providing for its powers and duties;
 6      providing for the supervision of colleges of chiropractic,
 7      for the examination of applicants, for enforcement and for
 8      disciplinary actions; providing penalties; and making
 9      repeals," in preliminary provisions, providing for findings
10      and declarations and for applicability and construction and
11      further providing for definitions; in State Board of
12      Chiropractic, further providing for powers and duties and
13      providing for certification to perform dry needling, for
14      certification to practice animal chiropractic, for concussion
15      management and for student athletes; in licensure and
16      regulation, further providing for applications for license,
17      repealing provisions relating to examination and to failure
18      of examination, further providing for reciprocity, for
19      limited license, for refusal, suspension or revocation of
20      license, repealing provisions relating to continuing
21      chiropractic education, providing for continuing chiropractic
22      education requirements, for format and limits for continuing
23      chiropractic education, for course content and approval, for
24      calculation of continuing chiropractic education credits, for
25      sponsor approval and program administration, for renewal
26      certification, reporting and audits, for exemptions and
27      carryover and for extensions, waivers and enforcement,
28      further providing for professional liability insurance, for
29      license required, for Doctor of Chiropractic and abbreviation
30      and for relationship with other branches of the healing arts
31      and providing for opinions and testimony; in penalty
32      provisions, further providing for practice of chiropractic
33      without license prohibited and for violation of other
34      provisions; and, in miscellaneous provisions, further
 1      providing for fees.
 2      The General Assembly of the Commonwealth of Pennsylvania
 3   hereby enacts as follows:
 4      Section 1.    The act of December 16, 1986 (P.L.1646, No.188),
 5   known as the Chiropractic Practice Act, is amended by adding
 6   sections to read:
 7   Section 101.1.    Findings and declarations.
 8      The General Assembly finds and declares as follows:
 9            (1)   Chiropractic is a health profession in this
10      Commonwealth that is subject to regulation and oversight to
11      protect the public health, welfare and safety.
12            (2)   It is in the public interest that only a person who
13      meets the qualifications established under this act engage in
14      the practice of chiropractic to maintain public trust and
15      confidence in the profession.
16   Section 101.2.    Applicability and construction.
17      (a)   Applicability.--This act shall apply to a person who
18   practices chiropractic in this Commonwealth regardless of the
19   person's place of residence or whether a doctor-patient
20   relationship exists.
21      (b)   Construction.--This act shall be liberally construed to
22   implement the purposes of this act.
23      Section 2.    The definitions of "adjunctive procedures,"
24   "chiropractic," "chiropractor" and "manipulation/adjustment" in
25   section 102 are amended and the section is amended by adding
26   definitions to read:
27   Section 102.    Definitions.
28      The following words and phrases when used in this act shall
29   have the meanings given to them in this section unless the
30   context clearly indicates otherwise:


20260SB1330PN1719                    - 2 -
 1      "Adjunctive procedures."      [Physical measures such as
 2   mechanical stimulation, heat, cold, light, air, water,
 3   electricity, sound, massage and mobilization.] A physical
 4   measure, physiologic therapeutic program or rehabilitative or
 5   exercise program, including active and passive modalities,
 6   mechanical stimulation, heat, cold, light, air, water,
 7   electricity, sound, massage and mobilization, that a licensee
 8   uses to reduce pain or muscle spasm, increase function or
 9   mobility, reduce disability or otherwise provide chiropractic
10   care and treatment to a patient.
11      "Animal."    A living animal other than a human being.
12      "Animal chiropractic."      The evaluation and treatment of
13   vertebral or extremity joint dysfunction of an animal through
14   spinal, joint or neuromusculoskeletal manipulative therapy or
15   soft tissue therapy. The term does not include administering,
16   selling, distributing, recommending or providing advice
17   regarding a substance, product or device to restore or maintain
18   the health of an animal, including any of the following:
19          (1)     Vitamins.
20          (2)     Minerals.
21          (3)     Phytonutrients.
22          (4)     Antioxidants.
23          (5)     Enzymes.
24          (6)     Glandular extracts.
25          (7)     Botanical substances.
26          (8)     Herbal therapies.
27          (9)     Homeopathic remedies.
28          (10)     Drugs available without a prescription.
29          (11)     Durable or nondurable medical goods and devices.
30      "Artificial intelligence assisted chiropractic adjustment."

20260SB1330PN1719                       - 3 -
 1   The use of artificial intelligence, robotics or a mechatronic
 2   system to perform, guide or augment spinal manipulation or a
 3   related chiropractic procedure.
 4      * * *
 5      ["Chiropractic."   A branch of the healing arts dealing with
 6   the relationship between the articulations of the vertebral
 7   column, as well as other articulations, and the neuro-musculo-
 8   skeletal system and the role of these relationships in the
 9   restoration and maintenance of health. The term shall include
10   systems of locating misaligned or displaced vertebrae of the
11   human spine and other articulations; the examination preparatory
12   to the adjustment or manipulation of such misaligned or
13   displaced vertebrae and other articulations; the adjustment or
14   manipulation of such misaligned or displaced vertebrae and other
15   articulations; the furnishing of necessary patient care for the
16   restoration and maintenance of health; and the use of board-
17   approved scientific instruments of analysis, including X-ray.
18   The term shall also include diagnosis, provided that such
19   diagnosis is necessary to determine the nature and
20   appropriateness of chiropractic treatment; the use of adjunctive
21   procedures in treating misaligned or dislocated vertebrae or
22   articulations and related conditions of the nervous system,
23   provided that, after January 1, 1988, the licensee must be
24   certified in accordance with this act to use adjunctive
25   procedures; and nutritional counseling, provided that nothing
26   herein shall be construed to require licensure as a chiropractor
27   in order to engage in nutritional counseling. The term shall not
28   include the practice of obstetrics or gynecology, the reduction
29   of fractures or major dislocations, or the use of drugs or
30   surgery.]

20260SB1330PN1719                  - 4 -
 1      "Chiropractor."   A [practitioner of chiropractic.] person
 2   licensed under this act to practice chiropractic. The term
 3   includes a person with the title "Doctor of Chiropractic,"
 4   "Chiropractic Physician," "Doctor of Chiropractic Medicine" or
 5   the abbreviation "DC."
 6      * * *
 7      "Dry needling."   A physical intervention that uses a filiform
 8   needle to stimulate trigger points to diagnose and treat
 9   neuromusculoskeletal pain and functional movement deficits. The
10   term does not include stimulation of auricular points or other
11   points based upon areas of oriental medicine or the practice of
12   acupuncture under the act of February 14, 1986 (P.L.2, No.2),
13   known as the Acupuncture Licensure Act.
14      "Licensee."   The term shall have the same meaning as
15   chiropractor.
16      "Manipulation/adjustment."    A passive manual maneuver, also
17   known as chiropractic manipulative treatment or spinal
18   manipulation adjustment, during which a joint complex is carried
19   beyond the normal [physiological] voluntary physiologic range of
20   motion [that are applied] without exceeding the boundaries of
21   anatomical integrity of the joint complex or other articulations
22   and that are intended to result in cavitation of the joint [or],
23   reduce subluxation[.], restore or correct nerve dysfunction or
24   restore or correct musculoskeletal dysfunction. The term
25   includes the following:
26          (1)   A grade five joint mobilization or passive manual
27      maneuver performed by hand or with the aid of a mechanical
28      instrument or an artificial intelligence assisted
29      chiropractic adjustment in which a joint complex may be
30      carried beyond the normal voluntary physiologic range of

20260SB1330PN1719                    - 5 -
 1    motion into the paraphysiologic space without exceeding the
 2    boundaries of anatomical integrity. For the purpose of this
 3    paragraph, the grade five joint mobilization or passive
 4    manual maneuver may, but need not, result in an audible
 5    release.
 6        (2)    A thrust, that is, a brief, sudden and carefully
 7    administered impulsion delivered at the end of the normal
 8    passive range of movement. For the purpose of this paragraph,
 9    the thrust technique may be low velocity or high velocity.
10    "Practice of chiropractic."         As follows:
11        (1)    The science, philosophy and art of examination,
12    diagnosis, manipulation/adjustment and treatment of a human
13    being of any age and an animal by methods and analyses
14    commonly taught in an accredited chiropractic college or
15    program or a chiropractic college or program approved by the
16    board. The term includes all of the following:
17               (i)    Utilization review, peer review, organization
18        review, impairment rating review and a review involving
19        the determination or assessment of the necessity of
20        chiropractic care and treatment.
21               (ii)    The authority to diagnose, order diagnostic and
22        laboratory testing, analyze test results and treat a
23        patient by any of the following:
24                      (A)   Manipulative, manual, neuromuscular,
25               mechanical, nutritional and dietary methods,
26               lifestyle modification, chiropractic physiotherapy,
27               therapeutic exercise and rehabilitative procedures.
28                      (B)   The use of supportive appliances and the
29               prescription and use of durable medical equipment,
30               prosthetics, orthotics and supplies.

20260SB1330PN1719                      - 6 -
 1                        (C)   Board-approved scientific instruments of
 2                 analysis, including diagnostic imaging.
 3                        (D)   Nutritional supplements and venipuncture.
 4                 (iii)    The use of adjunctive procedures, dry
 5          needling, a sports physical examination and animal
 6          chiropractic if the licensee is certified under this act
 7          to perform the service.
 8                 (iv)    Manipulation under anesthesia if the
 9          chiropractor has received formal training and is
10          certified by an accredited certification board and
11          performs the manipulation under anesthesia in the
12          presence of a medical doctor or doctor of osteopathic
13          medicine licensed in this Commonwealth.
14          (2)     The term does not include operative surgery, the
15      reduction of a fracture or major dislocation, obstetrics,
16      gynecology, osteopathy, podiatry or the administration or
17      prescription of a drug requiring a registration issued by the
18      United States Drug Enforcement Administration.
19      "Sports physical examination."           The initial physical
20   clearance examination of an athlete to determine whether the
21   athlete is physically capable of engaging in the athletic
22   activity for which the athlete seeks the examination.
23      Section 3.    Section 302 of the act is amended by adding
24   paragraphs to read:
25   Section 302.    Powers and duties.
26      The board shall have powers and duties as follows:
27          * * *
28          (14)     To establish standards of practice and codes of
29      conduct pertaining to the practice of chiropractic.
30          (15)     To establish health, safety and public protection

20260SB1330PN1719                        - 7 -
 1      standards for the ownership and operation of a chiropractic
 2      office, clinic or facility.
 3            (16)   To publicize qualifying disciplinary action and
 4      other pertinent action taken by the board.
 5      Section 4.     The act is amended by adding sections to read:
 6   Section 305.     Certification to perform dry needling.
 7      (a)     Certification required.--The board shall certify a
 8   qualified licensee to perform dry needling in accordance with
 9   this section. A licensee may not perform dry needling unless the
10   board has issued the licensee a certification under this
11   section.
12      (b)     Application.--To obtain a certification under this
13   section, a licensee must submit an application to the board on a
14   form provided by the board and must demonstrate to the
15   satisfaction of the board that the licensee has completed any of
16   the following:
17            (1)    Passage of an examination on the performance of dry
18      needling prepared and administered by a qualified and
19      approved professional testing organization in accordance with
20      section 812.1 of the act of April 9, 1929 (P.L.177, No.175),
21      known as The Administrative Code of 1929.
22            (2)    Completion of a minimum of 24 hours of study in the
23      performance of dry needling under a curriculum approved by
24      the board at a board approved chiropractic college or
25      postgraduate education program, including a minimum of 20
26      hours in an in-person, hands-on classroom setting.
27   Section 306.     Certification to practice animal chiropractic.
28      (a)     Certification required.--The board shall certify a
29   qualified licensee to practice animal chiropractic in accordance
30   with this section. A licensee may not practice animal

20260SB1330PN1719                     - 8 -
 1   chiropractic unless the board has issued the licensee a
 2   certification under this section.
 3      (b)   Application and requirements.--To obtain a certification
 4   under this section, a licensee must submit an application to the
 5   board on a form provided by the board and must demonstrate to
 6   the satisfaction of the board that the licensee has completed
 7   all of the following:
 8            (1)   Passed an examination on the practice of animal
 9      chiropractic prepared and administered by a qualified and
10      approved professional testing organization in accordance with
11      section 812.1 of the act of April 9, 1929 (P.L.177, No.175),
12      known as The Administrative Code of 1929.
13            (2)   Completed a minimum of 50 hours of study in the
14      practice of animal chiropractic under a curriculum approved
15      by the board at a board approved chiropractic college or
16      postgraduate education program, including a minimum of 20
17      hours in an in-person, hands-on classroom setting.
18      (c)   Scope of practice.--A licensee certified under this
19   section may practice chiropractic on an animal only for a type
20   of animal for which the certified licensee has received
21   training.
22      (d)   Supervision.--A licensee certified under this section
23   may practice chiropractic on an animal without supervision by a
24   licensed veterinarian.
25   Section 307.    Concussion management.
26      (a)   Standard of care.--A licensee who assesses, diagnoses or
27   treats a concussed patient, including a student athlete, shall
28   do so in accordance with nationally accepted standards and
29   guidelines on the effective date of this subsection.
30      (b)   Continuing education.--A licensee who assesses,

20260SB1330PN1719                    - 9 -
 1   diagnoses or treats a concussed patient shall complete
 2   continuing education that keeps pace with evolving standards and
 3   guidelines related to concussion management.
 4      (c)   Scope of services.--Within the scope of practice, a
 5   licensee who provides concussion management services may engage
 6   in any of the following:
 7            (1)   Assess a patient.
 8            (2)   Diagnose a patient.
 9            (3)   Treat a patient.
10            (4)   Determine whether a patient may return to activities
11      of daily living.
12            (5)   Consult with, refer to or collaborate with another
13      licensed health care provider.
14   Section 308.    Student athletes.
15      (a)   Sports physical examination.--A licensee may perform a
16   comprehensive initial preparticipation physical evaluation and
17   may complete the comprehensive initial preparticipation physical
18   evaluation form of the Pennsylvania Interscholastic Athletic
19   Association or may perform another similar evaluation to certify
20   that a student is physically fit to participate in an activity,
21   including practice, interschool practice, scrimmage or contest.
22      (b)   Continuing education.--A licensee who performs a sports
23   physical examination or who assesses, diagnoses or treats a
24   concussed student athlete shall maintain continuing education
25   that keeps pace with evolving standards and guidelines related
26   to concussion management.
27      (c)   Assessment and clearance.--A licensee may assess and
28   grant clearance to a student athlete to return to participation.
29   For concussion management, a licensee may make an assessment or
30   grant clearance under this subsection only in accordance with

20260SB1330PN1719                       - 10 -
 1   the following:
 2            (1)   In consultation with a medical doctor, a doctor of
 3      osteopathic medicine or a licensee acting within the scope of
 4      services under section 307(c).
 5            (2)   Under referral of a medical doctor, a doctor of
 6      osteopathic medicine or a licensee acting within the scope of
 7      services under section 307(c).
 8            (3)   In collaboration with a medical doctor, a doctor of
 9      osteopathic medicine or a licensee acting within the scope of
10      services under section 307(c).
11            (4)   Under the supervision of a medical doctor, a doctor
12      of osteopathic medicine or a licensee acting within the scope
13      of services under section 307(c).
14      (d)   Exception.--Subsection (c) shall not apply to a licensee
15   who holds any of the following current credentials:
16            (1)   Diplomate in chiropractic neurology recognized by
17      the American Chiropractic Neurology Board or the
18      International Board of Chiropractic Neurology.
19            (2)   Diplomate in chiropractic sports medicine recognized
20      by the American Chiropractic Board of Sports Physicians.
21            (3)   Certified chiropractic sports physician recognized
22      by the American Chiropractic Board of Sports Physicians and
23      listed on the national concussion registry maintained by that
24      organization.
25            (4)   Diplomate in orthopedic or neuromusculoskeletal
26      medicine recognized by the International Academy of
27      Neuromusculoskeletal Medicine, formerly the Academy of
28      Chiropractic Orthopedists, and the American Board of
29      Chiropractic Orthopedics.
30            (5)   Diplomate in chiropractic rehabilitation recognized

20260SB1330PN1719                    - 11 -
 1      by the American Chiropractic Rehabilitation Board.
 2            (6)   Another diplomate or certification approved by the
 3      board.
 4      Section 5.        Section 501(a) introductory paragraph and (b) of
 5   the act are amended and the section is amended by adding
 6   subsections to read:
 7   Section 501.     Applications for license.
 8      (a)   Requirement for licensure.--[An] Except as provided
 9   under subsection (a.1), an applicant for a license under this
10   act shall submit satisfactory proof to the board that the
11   applicant meets all of the following:
12            * * *
13      (a.1)    Requirements for licensure beginning January 1,
14   2030.--Beginning January 1, 2030, an applicant for a license
15   shall submit satisfactory proof to the board that the applicant
16   meets all of the following:
17            (1)   Is at least 18 years of age.
18            (2)   Has successfully completed all of the following
19      examinations, with a score approved by the board:
20                  (i)    The National Board of Chiropractic Examiners
21            certification examination, Parts I, II, III and IV.
22                  (ii)    The physiotherapy examination.
23                  (iii)    Another examination approved by the board. The
24            board may approve another testing organization that is a
25            qualified and approved professional testing organization
26            in accordance with section 812.1 of the act of April 9,
27            1929 (P.L.177, No.175), known as The Administrative Code
28            of 1929.
29            (3)   Has not been convicted of a felonious act prohibited
30      under the act of April 14, 1972 (P.L.233, No.64), known as

20260SB1330PN1719                       - 12 -
 1      The Controlled Substance, Drug, Device and Cosmetic Act, or
 2      of an offense under the laws of another jurisdiction that
 3      would constitute a felony under The Controlled Substance,
 4      Drug, Device and Cosmetic Act if committed in this
 5      Commonwealth. This paragraph shall not apply if the applicant
 6      demonstrates all of the following to the satisfaction of the
 7      board:
 8                (i)    At least 10 years have elapsed since the date of
 9          conviction.
10                (ii)    The applicant has made significant progress in
11          personal rehabilitation since the conviction so that
12          licensure of the applicant would not be expected to
13          create a substantial risk of harm to the health and
14          safety of the applicant's patients or the public or a
15          substantial risk of further criminal violations.
16                (iii)   The applicant meets the qualifications
17          required under this act. An applicant's statement in the
18          application declaring the absence of a conviction shall
19          constitute satisfactory evidence of the absence of a
20          conviction unless the board has evidence to the contrary.
21          As used in this subparagraph, the term "conviction"
22          includes a judgment, an admission of guilt or a plea of
23          nolo contendere.
24      (a.2)    Eligibility to sit for certification examination.--
25   Beginning January 1, 2030, in order to qualify to sit for the
26   National Board of Chiropractic Examiners certification
27   examination, an applicant must meet all of the following:
28          (1)    Has graduated from a chiropractic college that is
29      accredited by, or has status with, the Council on
30      Chiropractic Education.

20260SB1330PN1719                     - 13 -
 1            (2)   Has met the prechiropractic education requirement by
 2      satisfying any of the following:
 3                  (i)    Has been granted a bachelor's degree, based upon
 4            four academic years of study or through an accelerated
 5            bachelor's degree program, by a college or university
 6            accredited by the United States Department of Education.
 7                  (ii)    Has successfully completed a minimum of 90
 8            semester hours of undergraduate study at a college or
 9            university accredited by the United States Department of
10            Education.
11                  (iii)    Has successfully completed not less than three
12            academic years of undergraduate study at a college or
13            university accredited by the United States Department of
14            Education prior to enrollment in a chiropractic college.
15            The undergraduate study specified under this paragraph
16            shall meet the entrance requirements of a chiropractic
17            program accredited by the Council on Chiropractic
18            Education.
19            (3)   The applicant's chiropractic degree consists of
20      credits earned in the chiropractic program and does not
21      include academic credit for courses from the bachelor's
22      degree.
23      (b)   Renewal of licenses.--A license shall be renewed
24   biennially for a period of two years upon payment of the
25   biennial fee, provided that the licensee satisfies the other
26   requirements of this act. Upon receipt of a complete renewal
27   application, the board shall promptly review, process and
28   approve the application. The board shall complete the review,
29   processing and approval no later than 20 days after receipt of
30   the complete renewal application. The board may approve the

20260SB1330PN1719                       - 14 -
 1   renewal despite a minor administrative error or omission on the
 2   application if the board determines that the error or omission
 3   does not impact patient health or safety. Any person who has
 4   failed to renew his license for a period of longer than five
 5   years shall be required to apply for a license in accordance
 6   with subsection (a) if he desires to resume practicing
 7   chiropractic.
 8      Section 6.   Sections 502 and 503 of the act are repealed:
 9   [Section 502.   Examination.
10      (a)   Admission.--The board shall admit to a standard
11   examination any applicant who has satisfied all of the
12   requirements of section 501 except for the requirement to have
13   passed the examination. The board may, in its discretion, permit
14   a student in good standing in his final semester in an approved
15   chiropractic college to be admitted to the standard examination,
16   provided he meets all the other requirements of this act, but he
17   must have certification of graduation from said college before a
18   license may be granted.
19      (b)   Nature and content of examination.--The examination
20   shall be oral, practical and written, upon the principles and
21   technique of chiropractic and shall include the following
22   subjects: anatomy, physiology, histology, chemistry, pathology,
23   physics, bacteriology, diagnosis, hygiene and sanitation,
24   symptomatology, chiropractic analysis, X-ray, chiropractic
25   principles and a practical demonstration of chiropractic
26   technique.
27      (c)   When conducted.--Examinations shall be conducted at
28   least twice each year.
29      (d)   Testing organization.--All written, oral and practical
30   examinations required under this section shall be prepared and

20260SB1330PN1719                   - 15 -
 1   administered by a qualified and approved professional testing
 2   organization in accordance with section 812.1 of the act of
 3   April 9, 1929 (P.L.177, No.175), known as The Administrative
 4   Code of 1929, except that the oral and practical examinations
 5   shall not be subject to section 812.1 until such examinations
 6   are available from a testing organization.
 7      (e)   Score.--A license shall be granted to an applicant who
 8   meets the requirements of this act and who achieves:
 9            (1)   an overall score of at least 75% on the entire
10      examination; or
11            (2)   an average score of at least 75% on the oral and
12      practical examination and a passing score on the written
13      examination administered by the National Board of
14      Chiropractic Examiners as such passing score is determined by
15      the national board.
16   Section 503.    Failure of examination.
17      (a)   Second examination.--Any applicant who shall fail any
18   examination shall, after the expiration of six months and within
19   two years, have the privilege of taking a second examination.
20      (b)   Subsequent examinations.--The board may adopt
21   regulations governing the eligibility of applicants who have
22   failed to pass two examinations to be admitted to subsequent
23   examinations.]
24      Section 7.    Sections 504, 505(a)(4), 506(a)(4), (7), (8) and
25   (19) of the act are amended to read:
26   Section 504.    Reciprocity.
27      (a)   License without examination.--The board may grant
28   licenses without further examination to individuals from other
29   states and provinces of Canada if all of the following
30   conditions are met:

20260SB1330PN1719                    - 16 -
 1            (1)   The standards for licensing in such states or
 2      provinces are substantially the same as those provided in
 3      this act.
 4            (2)   Similar privileges are accorded persons licensed in
 5      this Commonwealth.
 6            (3)   The applicants hold valid licenses.
 7            (4)   The applicable rules and regulations prescribed by
 8      the board are complied with.
 9      (b)   Military and spouse licensure.--Within 30 days after
10   receipt of a completed application for licensure, the board
11   shall grant a license without further examination to an
12   applicant who meets all of the following:
13            (1)   Is an active duty member of the United States Armed
14      Forces or the spouse of an active duty member of the United
15      States Armed Forces.
16            (2)   Holds a current unrestricted license to practice
17      chiropractic issued by another state.
18            (3)   Has not committed an act that constitutes grounds
19      for refusal, suspension or revocation of a license unless the
20      board determines that the act should not preclude issuance of
21      a license under this subsection.
22   Section 505.     Limited license.
23      (a)   Requirements.--The following educational and
24   professional requirements must be met in order to secure a
25   limited license which may be issued to an out-of-State or
26   foreign chiropractic school or college graduate for a period not
27   to exceed one year for the purpose of teaching in an approved
28   graduate chiropractic education program:
29            * * *
30            (4)   The applicant must submit [to an oral examination in

20260SB1330PN1719                    - 17 -
 1      his specialty conducted by a board member or the board's
 2      designated representative] a curriculum vitae to the board.
 3      * * *
 4   Section 506.     Refusal, suspension or revocation of license.
 5      (a)   Reasons enumerated.--The board may refuse to issue a
 6   license or may suspend or revoke a license for any of the
 7   following reasons:
 8            * * *
 9            (4)   Displaying gross incompetence, negligence or
10      misconduct in carrying on the practice of chiropractic or
11      engaging in an unsafe or harmful technique in the practice of
12      chiropractic.
13            * * *
14            (7)   Having a license to practice chiropractic suspended,
15      revoked or refused or receiving other disciplinary action by
16      the proper chiropractic licensing authority of another state,
17      territory, possession or country. The board shall not be
18      required to impose reciprocal discipline under this paragraph
19      if the board or its designee determines that the disciplining
20      licensing authority imposed sufficient discipline or
21      sanctions.
22            (8)   Being unable to practice chiropractic with
23      reasonable skill and safety to patients by reason of illness,
24      drunkenness, excessive use of drugs, narcotics, chemicals or
25      any other type of material, or as a result of any mental or
26      physical condition. In enforcing this paragraph, the board
27      shall, upon probable cause, have authority to compel a
28      chiropractor to submit to a mental or physical examination by
29      physicians approved by the board. A chiropractor may appeal
30      the probable cause determination within 30 days after

20260SB1330PN1719                    - 18 -
 1      receiving notice of the board's determination. If a
 2      chiropractor appeals under this paragraph, the chiropractor
 3      shall have the right to a hearing before the board or its
 4      designee to contest the determination. Failure of a
 5      chiropractor to submit to such examination when directed by
 6      the board, unless such failure is due to circumstances beyond
 7      his control, or to appeal the probable cause determination
 8      within the time period required under this paragraph, shall
 9      constitute an admission of the allegations against him,
10      consequent upon which a default and final order may be
11      entered without the taking of testimony or presentation of
12      evidence. A chiropractor affected under this paragraph shall
13      at reasonable intervals be afforded an opportunity to
14      demonstrate that he can resume a competent practice of
15      chiropractic with reasonable skill and safety to patients.
16            * * *
17            (19)    Failing to refer a patient to a licensed
18      practitioner of another branch of the healing arts for
19      consultation or treatment when a diagnosis of such patient
20      indicates that such a referral is appropriate. If a
21      chiropractor makes an appropriate referral, a patient's
22      refusal to present the referral to the licensed practitioner
23      or the licensed practitioner's refusal to accept the referral
24      shall not constitute grounds for discipline of the
25      chiropractor or create liability for the chiropractor.
26      * * *
27      Section 8.     Section 507 of the act is repealed:
28   [Section 507.     Continuing chiropractic education.
29      (a)   Requirement for license renewal.--As a condition for the
30   biennial renewal of a license to practice chiropractic, a

20260SB1330PN1719                     - 19 -
 1   licensee shall submit to the board evidence that he has
 2   completed at least 24 hours of continuing chiropractic education
 3   within the immediately preceding two-year period, provided that
 4   this requirement for continuing chiropractic education shall
 5   apply for the first time to the renewal of licenses in 1988.
 6      (b)   Qualifying education.--A licensee may receive credit for
 7   only those hours of continuing chiropractic education in a
 8   program approved by the board and for only those hours directed
 9   toward keeping the licensee apprised of advancements and new
10   developments in chiropractic which build upon the basic courses
11   required to practice chiropractic and which are in the following
12   areas:
13            (1)    Anatomy.
14            (2)    Physiology.
15            (3)    Histology.
16            (4)    Chemistry.
17            (5)    Pathology.
18            (6)    Physics.
19            (7)    Bacteriology.
20            (8)    Diagnosis.
21            (9)    Hygiene and sanitation.
22            (10)    Symptomatology.
23            (11)    Chiropractic analysis.
24            (12)    X-ray.
25            (13)    Chiropractic principles.
26            (14)    Chiropractic technique.
27            (15)    Adjunctive procedures.
28   No credit shall be given for any course in office management or
29   practice building.
30      (c)   Application by sponsors.--Prior to receiving board

20260SB1330PN1719                       - 20 -
 1   approval for a program of continuing chiropractic education, a
 2   sponsor shall submit to the board, in writing, the following
 3   information at least 90 days prior to the date on which the
 4   program is scheduled to be presented:
 5            (1)   Evidence that the sponsor's program would be
 6      directed toward keeping the licensee apprised of advancements
 7      and new developments in chiropractic which build upon the
 8      basic courses required to practice chiropractic and which are
 9      in the areas specified in subsection (b).
10            (2)   A detailed course outline or syllabus, including
11      such items as methods of instruction and testing materials,
12      if any.
13            (3)   A current curriculum vitae of each instructor,
14      speaker or lecturer appearing in the program.
15      (d)   Action on application.--The board shall notify each
16   sponsor, in writing, of approval or disapproval of the
17   application within 45 days of the receipt of the application. If
18   an application is disapproved, the board shall detail the
19   reasons for disapproval in order that the sponsor may cure any
20   defect and submit an amended application in a timely manner.
21      (e)   Evidence of completion.--Each licensee, in order to
22   qualify for biennial renewal of his license, shall complete a
23   form provided by the sponsor and supplied by the board which
24   contains the name of the licensee, business address, name of the
25   sponsor and instructor, course taken, hours completed, date and
26   place of the continuing education program offered, and a signed
27   statement sworn and attested to by the licensee that the
28   licensee was fully in attendance at the program offered and that
29   the information in such form is true and correct. The licensee
30   shall be responsible for sending this form to the board.

20260SB1330PN1719                    - 21 -
 1      (f)   Notification.--The board, within 30 days after the
 2   effective date of this act, shall notify all licensees subject
 3   to this section that they will be required to complete 24 hours
 4   of continuing education within the two-year period before the
 5   renewal period commencing in 1988 and shall notify such
 6   licensees of continuing education required when renewal
 7   applications are issued for 1988 and every renewal period
 8   thereafter.
 9      (g)   Approved programs.--A continuing education program
10   offered by a chiropractic college approved in accordance with
11   this act and attended by a licensee must be accepted by the
12   board so long as the course requirements of this section are
13   met.
14      (h)   Exceptions.--The board may make exceptions to the
15   continuing education program requirements in emergency or
16   hardship cases on the basis of evidence submitted in proof of an
17   emergency or hardship.]
18      Section 9.    The act is amended by adding sections to read:
19   Section 507.1.   Continuing chiropractic education requirements.
20      (a)   Continuing education required for renewal.--As a
21   condition of biennial renewal of a license, a licensee shall
22   complete 24 continuing chiropractic education credits during the
23   immediately preceding biennial period.
24      (b)   Credit hour.--One continuing chiropractic education
25   credit shall equal 50 minutes of instruction.
26      (c)   Professional ethics.--A licensee may apply at least two
27   credits toward the requirement under subsection (a) in the study
28   of professional ethics. As used in this subsection, the term
29   "study of professional ethics" includes patient care services,
30   ethical patient management, advertising, marketing,

20260SB1330PN1719                   - 22 -
 1   recordkeeping, documentation, coding, billing practices and
 2   privacy requirements under 42 U.S.C. Ch. 7 Subch. XI Pt. C
 3   (relating to administrative simplification).
 4   Section 507.2.   Format and limits for continuing chiropractic
 5               education.
 6      (a)   Distance learning limit.--A licensee may complete not
 7   more than 12 of the credits required under section 507.1(a)
 8   through distance learning approved by the board. The remaining
 9   credits required under section 507.1(a) shall be completed
10   through an in-person live didactic learning experience.
11      (b)   Hands-on training requirement.--A licensee shall
12   complete at least four credits of in-person training in
13   manipulation techniques, physical rehabilitation or
14   physiotherapeutics to comply with section 507.1(a).
15      (c)   Waiver during emergency.--During a declaration of
16   disaster emergency under 35 Pa.C.S. § 7301(c) (relating to
17   general authority of Governor), the board may waive the in-
18   person requirements under this section.
19      (d)   Maximum credit per day.--The board may not award more
20   than 12 credits for a continuing chiropractic education program
21   that occurs during one calendar day.
22   Section 507.3.   Course content and approval.
23      (a)   Subject matter.--Continuing chiropractic education may
24   include subject matter taught by an accredited chiropractic
25   school or a college or university accredited by the United
26   States Department of Education or a subject matter tested for
27   licensure and approved by the board.
28      (b)   Providers of Approved Continuing Education.--The board
29   may accept a continuing chiropractic education program approved
30   by Providers of Approved Continuing Education. The board may

20260SB1330PN1719                  - 23 -
 1   reject a program approved by Providers of Approved Continuing
 2   Education if the board determines that the program meets any of
 3   the following:
 4            (1)   The program focuses on practice building, practice
 5      management or practice marketing.
 6            (2)   The program lacks significant intellectual or
 7      practical content that relates primarily to the practice of
 8      chiropractic or to the professional responsibilities or
 9      ethical obligations of a licensee.
10      (c)   Basic coursework excluded.--The board may not grant
11   continuing chiropractic education credit for coursework required
12   for graduation from a chiropractic college or for initial
13   licensure. The board shall grant credit only for postdoctoral
14   coursework designed to build upon basic knowledge or to bring a
15   licensee current on new developments relating to the practice of
16   chiropractic.
17      (d)   Other educational programs.--The board may approve an
18   educational program offered by a professional organization or
19   society, a health care profession, a school, a college or
20   university accredited by the United States Department of
21   Education or health care facility for continuing chiropractic
22   education credit if the board determines that the program has
23   significant intellectual or practical content that relates
24   primarily to the practice of chiropractic, chiropractic
25   philosophy or to the professional responsibilities or ethical
26   obligations of a licensee and does not focus on practice
27   building, practice management or practice marketing.
28      (e)   Equivalent educational programs.--The board may approve
29   an equivalent educational program for continuing chiropractic
30   education credit, including an examination, a scientific paper,

20260SB1330PN1719                    - 24 -
 1   a professional publication, a scientific presentation, a
 2   residency program, a teaching appointment, a research
 3   appointment, an advanced degree program, a certification program
 4   in a related field, a scientific exhibit, independent study,
 5   research or distance learning, if the board determines that the
 6   program has significant intellectual or practical content that
 7   relates primarily to the practice of chiropractic or to the
 8   professional responsibilities or ethical obligations of a
 9   licensee and does not focus on practice building, practice
10   management or practice marketing.
11   Section 507.4.   Calculation of continuing chiropractic education
12                credits.
13      The board shall calculate continuing chiropractic education
14   credits as follows:
15          (1)   For a continuing professional education program of a
16      national or State professional organization, one credit for
17      each 50 minutes of in-class participation.
18          (2)   For a course from a college or university accredited
19      by the United States Department of Education, 15 credits for
20      each semester or trimester credit hour earned and 10 credits
21      for each quarter credit hour earned.
22          (3)   For a noncredit course, one credit for each 50
23      minutes of in-class participation.
24          (4)   For a distance learning program or other independent
25      study program, one credit for each 50 minutes of
26      participation.
27          (5)   For teaching or instructing a course for the first
28      time or teaching a previously taught course if the licensee
29      spent substantial time updating course material, one credit
30      for each hour of instruction or preparation time. The board

20260SB1330PN1719                  - 25 -
 1      may not award more than 12 credits per biennial period under
 2      this paragraph. A licensee employed as a full-time teacher or
 3      instructor is not eligible for credit under this paragraph.
 4            (6)   For a scientific paper or professional publication,
 5      one credit for each 50 minutes of preparation time up to 12
 6      credits per biennial period. A licensee seeking credit under
 7      this paragraph shall submit a copy of the publication to the
 8      board with a request for credit. A licensee may request
 9      additional credit by submitting the publication to the board
10      with an explanation of exceptional circumstances that the
11      licensee believes justify additional credit. The board shall
12      determine whether to award additional credit on a case-by-
13      case basis and may consider subject matter complexity, length
14      of publication and preparation time.
15            (7)   For research and preparation of an examination or
16      service as an examiner for a clinical examination, one credit
17      for each hour of research or examination time up to six
18      credits per biennial period.
19            (8)   For a scientific presentation or exhibit, one credit
20      for each hour of preparation or presentation time up to six
21      credits per biennial period.
22   Section 507.5.    Sponsor approval and program administration.
23      (a)   Sponsor approval.--A program provider seeking approval
24   to sponsor a continuing chiropractic education program shall
25   apply to the board in the manner specified by the board at least
26   60 days before the date of the program. The application shall
27   include course and program descriptions, instructor
28   qualifications, locations, dates, times and other information
29   required by the board. The board shall issue its determination
30   not later than 30 days after receipt of the application.

20260SB1330PN1719                    - 26 -
 1      (b)   Sponsor criteria.--A sponsor approved under subsection
 2   (a) shall offer a course that meets all of the following:
 3            (1)   The course is a formal course of learning that
 4      contributes directly to the maintenance of professional
 5      competence of a licensee.
 6            (2)   The course is at least one credit in length and the
 7      board may award additional credit in increments of one half
 8      of a credit.
 9            (3)   The course is conducted by a qualified instructor or
10      discussion leader.
11            (4)   The course content satisfies the requirements under
12      section 507.3.
13      (c)   Sponsor records and attendance.--A sponsor approved
14   under subsection (a) shall maintain accurate records of
15   attendance for five years and shall comply with additional
16   requirements specified by the board, including requirements
17   related to verification of attendance.
18      (d)   Sponsor disclosures and facilities.--A sponsor approved
19   under subsection (a) shall disclose the objective,
20   prerequisites, experience level, content, required preparation,
21   teaching method and number of credits to prospective
22   participants. A sponsor approved under subsection (a) shall
23   ensure that class size and physical facilities are consistent
24   with the teaching methods used.
25      (e)   Instructors.--A sponsor approved under subsection (a)
26   shall select and assign qualified instructors. A sponsor
27   approved under subsection (a) shall provide the curriculum vitae
28   of each instructor to the board and shall certify that the
29   sponsor has verified the credentials of each instructor. A
30   sponsor approved under subsection (a) shall notify the board of

20260SB1330PN1719                    - 27 -
 1   an instructor change not later than 20 days after the change.
 2      (f)   Program evaluation.--A sponsor approved under subsection
 3   (a) shall evaluate instructor performance at the conclusion of
 4   each program and shall provide a means of program evaluation
 5   that includes participant and instructor feedback. The
 6   evaluation may include pretests, posttests, questionnaires or
 7   oral feedback and shall address whether objectives were met,
 8   prerequisites were necessary or desirable, facilities were
 9   satisfactory, the instructor was effective, preparation
10   materials were satisfactory and content was timely and
11   effective.
12      (g)   Certificates.--A sponsor approved under subsection (a)
13   shall provide a certificate of completion or comparable
14   documentation to each participant that includes dates attended,
15   credits earned, course title, description of content, method of
16   delivery, subject area, sponsor name, instructor name and course
17   location.
18      (h)   Sponsor list.--The board shall publish on its publicly
19   accessible Internet website a list of sponsors approved under
20   subsection (a).
21      (i)   Material changes.--A sponsor approved under subsection
22   (a) may not alter, amend, update or reconfigure an approved
23   course without permission of the board. If a sponsor approved
24   under subsection (a) alters, amends, updates or reconfigures an
25   approved course, the sponsor shall resubmit the course to the
26   board for approval.
27      (j)   Licensee submission for approval.--A licensee may submit
28   a program for approval for continuing chiropractic education
29   credit in the manner specified by the board if the program has
30   not been approved under this section. The board shall notify the

20260SB1330PN1719                  - 28 -
 1   licensee in writing of the board's determination.
 2      (k)   Specialized coursework preapproval.--Coursework required
 3   for certification to perform specialized examinations or
 4   electrodiagnostic tests shall be preapproved by the board at
 5   least 90 days before the course begins. A program provider
 6   seeking preapproval shall adhere to the approval process under
 7   subsection (a). A licensee seeking preapproval shall apply to
 8   the board in the manner specified by the board.
 9   Section 507.6.   Renewal certification, reporting and audits.
10      (a)   Certification on renewal.--A licensee shall certify on
11   the application for biennial license renewal that the licensee
12   has completed the continuing chiropractic education required
13   under section 507.1(a).
14      (b)   Documentation and retention.--A licensee shall maintain
15   evidence of completion of continuing chiropractic education
16   requirements for five years after completion of the credits and
17   shall submit documentation to the board upon request.
18      (c)   Random audits.--The board may conduct random audits to
19   determine compliance with sections 507.1, 507.2, 507.3, 507.4
20   and 507.5.
21   Section 507.7.   Exemptions and carryover.
22      (a)   New licensee exemption.--A new licensee who completed an
23   accredited graduate chiropractic education program within 12
24   months before the commencement of the biennial registration
25   period shall not be required to complete the continuing
26   chiropractic education requirements for that biennial period.
27      (b)   Carryover of excess credits.--A licensee who completes
28   more than 24 continuing chiropractic education credits during a
29   biennial period may apply not more than eight of the excess
30   credits to the continuing chiropractic education requirement for

20260SB1330PN1719                  - 29 -
 1   the immediately following biennial period only.
 2      (c)   Inactive or retired status.--A licensee holding an
 3   inactive license or a retired license shall be exempt from the
 4   continuing chiropractic education requirements. A licensee
 5   holding an inactive license or a retired license, or whose
 6   license is suspended or revoked, who applies to resume practice
 7   shall provide proof of completion of continuing chiropractic
 8   education for each biennial period for which the licensee was
 9   inactive, retired, suspended or revoked. If the total credits
10   required to become current exceeds 30, the maximum number
11   required shall be 30 credits.
12      (d)   Deficiency remediation.--An applicant seeking to resume
13   practice under subsection (c) shall submit to the board a
14   detailed list of all continuing chiropractic education completed
15   to become current. If the board determines that a deficiency
16   exists in a particular area of study, the board may require
17   completion of additional continuing chiropractic education in
18   the area of deficiency before the board reinstates the license
19   to active status.
20   Section 507.8.   Extensions, waivers and enforcement.
21      (a)   Hardship extensions and waivers.--The board may extend
22   the time for completion of continuing chiropractic education
23   requirements or may waive continuing chiropractic education
24   requirements on an individual basis for hardship, including
25   severe illness, disability or military service.
26      (b)   Application for extension or waiver.--A licensee seeking
27   an extension or waiver under subsection (a) shall apply to the
28   board in writing and shall include the specific reasons for the
29   request and supporting documentation. A licensee must apply
30   before expiration of the biennial renewal period and shall

20260SB1330PN1719                    - 30 -
 1   submit the request to the board office by certified mail with
 2   return receipt requested.
 3      (c)    Effective period and renewal.--An extension or waiver
 4   granted under this section shall apply to the biennial period
 5   for which it is granted. If the condition requiring an extension
 6   or waiver continues into the next biennial period, the licensee
 7   shall apply to the board for renewal of the extension or waiver
 8   for the next biennial period.
 9      (d)    Verification and proof.--A licensee shall provide
10   verification and proof of compliance with sections 507.1, 507.2,
11   507.3, 507.4, 507.5, 507.6 and 507.7 upon request of the board.
12      (e)    Noncompliance.--Noncompliance with continuing
13   chiropractic education requirements shall constitute cause for
14   civil penalties imposed under Chapter 7.
15      (f)    Repeat noncompliance.--A second or subsequent failure to
16   comply with continuing chiropractic education requirements may
17   constitute professional misconduct and constitutes grounds for
18   discipline, including suspension or revocation of a license.
19      Section 10.   Section 508(a) of the act is amended and the
20   section is amended by adding subsections to read:
21   Section 508.   Professional liability insurance.
22      [(a)    Insurance required.--As a condition for obtaining or
23   renewing a license to practice chiropractic in this Commonwealth
24   beginning with the 1988 license renewal period, an applicant
25   shall submit to the board satisfactory evidence that he has
26   obtained professional liability insurance, or that he has
27   established self-insurance for professional liability, in the
28   minimum amount of $100,000 per occurrence and $300,000 per
29   annual aggregate.]
30      (a.1)   Insurance required.--A chiropractor licensed under

20260SB1330PN1719                    - 31 -
 1   this act and maintaining a professional practice or having
 2   responsibility for patient care shall be covered.
 3      * * *
 4      (e)   Definitions.--As used in this section, the following
 5   words and phrases shall have the meanings given to them in this
 6   subsection unless the context clearly indicates otherwise:
 7      "Authorized."     Authorized by a government agency to offer
 8   chiropractic professional liability insurance products.
 9      "Covered."    The ongoing maintenance of insurance in an amount
10   of at least $500,000 per occurrence and $1,500,000 per policy
11   year, including extended reporting endorsement coverage for a
12   claims made policy, also known as tail coverage, issued by a
13   carrier or other entity authorized to write chiropractic
14   professional liability insurance in this Commonwealth.
15      "Maintaining a professional practice or having responsibility
16   for patient care."    The furnishing of professional services to a
17   patient in this Commonwealth, including testing for, diagnosing,
18   offering or furnishing treatment, preventive chiropractic care
19   or consultation relating to chiropractic care, at a location,
20   including an office, even if located in a home or clinic, or
21   through a business entity regardless of ownership of the
22   practice.
23      Section 11.    Section 521 of the act is amended by adding
24   paragraphs to read:
25   Section 521.    License required.
26      It shall be unlawful after the effective date of this act for
27   any person in this Commonwealth to engage in the practice of
28   chiropractic or indicate in any manner whatsoever the ability to
29   practice chiropractic unless licensed under the provisions of
30   this act, except that:

20260SB1330PN1719                    - 32 -
 1        * * *
 2        (3)   Nothing in this act shall be construed to prohibit a
 3    chiropractor in the service of the United States Armed
 4    Forces, the United States Public Health Service or the
 5    Veterans Administration, or a Federal employee, from
 6    discharging official duties.
 7        (4)   A chiropractor licensed in good standing to practice
 8    chiropractic in

…  [truncated — open the source document for the complete text]