hb546_LC_9_1620_a

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05 LC 9 1620

House Bill 546

By: Representatives Maddox of the 172nd, May of the 111th, Reese of the 98th, and Mumford of the 95th

A BILL TO BE ENTITLED
AN ACT

To amend Code Section 9-11-9.1 of the Official Code of Georgia Annotated, relating to affidavits which must accompany charges of professional malpractice; Chapter 10 of Title 14 of the Official Code of Georgia Annotated, known as "The Georgia Professional Association Act"; Code Section 24-7-9 of the Official Code of Georgia Annotated, relating to identification of medical bills and authentication of writings; Code Section 30-5-4 of the Official Code of Georgia Annotated, relating to reporting of need for protective services for elder persons or disabled adults and immunity from liability; Title 31 of the Official Code of Georgia Annotated, relating to health; Title 33 of the Official Code of Georgia Annotated, relating to insurance; Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses; Code Section 45-16-27 of the Official Code of Georgia Annotated, relating to when a coroner shall hold an inquest and procedures connected with such inquest; and Code Section 48-13-9 of the Official Code of Georgia Annotated, relating to limitations on the authority of local governments to impose regulatory fees, so as to permit chiropractors to use the title "chiropractic physician"; to change statutory references throughout the Official Code of Georgia Annotated; to prohibit certain conduct and provide for penalties; to repeal conflicting laws; and for other purposes.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:

SECTION 1.

Code Section 9-11-9.1 of the Official Code of Georgia Annotated, relating to affidavits which must accompany charges of professional malpractice, is amended by striking subsection (f) and inserting in its place the following:

"(f) The professions to which this Code section applies are:

(1) Architects;

(2) Attorneys at law;

(3) Certified public accountants;

(4) Chiropractors Chiropractic physicians;

(5) Clinical social workers;

(6) Dentists;

(7) Dietitians;

(8) Land surveyors;

(9) Medical doctors;

(10) Marriage and family therapists;

(11) Nurses;

(12) Occupational therapists;

(13) Optometrists;

(14) Osteopathic physicians;

(15) Pharmacists;

(16) Physical therapists;

(17) Physicianś assistants;

(18) Professional counselors;

(19) Professional engineers;

(20) Podiatrists;

(21) Psychologists;

(22) Radiological technicians;

(23) Respiratory therapists; or

(24) Veterinarians."

SECTION 2.

Chapter 10 of Title 14 of the Official Code of Georgia Annotated, known as "The Georgia Professional Association Act," is amended by striking Code Section 14-10-2, relating to definitions, and inserting in its place the following:

"14-10-2.

As used in this chapter, the term:

(1) 'Professional association' means an unincorporated association, as distinguished from a partnership, organized under this chapter for the purpose of rendering one type of professional service.

(2) 'Professional service' means the personal services rendered by attorneys at law and any type of professional service which may be legally performed only pursuant to a license from a board pursuant to Title 43, for example, the personal services rendered by certified public accountants, chiropractors chiropractic physicians, dentists, osteopaths, physicians and surgeons, and podiatrists (chiropodists)."

SECTION 3.

Code Section 24-7-9 of the Official Code of Georgia Annotated, relating to identification of medical bills and authentication of writings, is amended by striking subsection (a) and inserting in its place the following:

"(a) Upon the trial of any civil case involving injury or disease, the patient or the member of his or her family or other person responsible for the care of the patient shall be a competent witness to identify bills for expenses incurred in the treatment of the patient upon a showing by such witness that the expenses were incurred in connection with the treatment of the injury, disease, or disability involved in the subject of litigation at trial and that the bills were received from:

(1) A hospital;

(2) An ambulance service;

(3) A pharmacy, drugstore, or supplier of therapeutic or orthopedic devices; or

(4) A licensed practicing physician, chiropractor chiropractic physician, dentist, orthotist, podiatrist, or psychologist."

SECTION 4.

Code Section 30-5-4 of the Official Code of Georgia Annotated, relating to reporting of need for protective services for elder persons or disabled adults and immunity from liability, is amended by striking subparagraph (a)(1)(A) and inserting in its place the following:

"(a)(1)(A) Any physician, osteopath, intern, resident, other hospital or medical personnel, dentist, psychologist, chiropractor chiropractic physician, podiatrist, pharmacist, physical therapist, occupational therapist, licensed professional counselor, nursing personnel, social work personnel, day-care personnel, coroner, medical examiner, employee of a public or private agency engaged in professional health related services to elder persons or disabled adults, or law enforcement personnel having reasonable cause to believe that a disabled adult or elder person has had a physical injury or injuries inflicted upon such disabled adult or elder person, other than by accidental means, or has been neglected or exploited shall report or cause reports to be made in accordance with the provisions of this Code section."

SECTION 5.

Title 31 of the Official Code of Georgia Annotated, relating to health, is amended by striking paragraph (2) of Code Section 31-7-131, relating to definitions relative to peer review groups, and inserting in its place the following:

"(2) 'Professional health care provider' means an individual who is licensed, or an organization which is approved, to practice or operate in the health care field under the laws of Georgia, including, but not limited to, the following individuals or organizations:

(A) A physician;

(B) A dentist;

(D) A chiropractor chiropractic physician;

(E) An optometrist;

(F) A psychologist;

(G) A pharmacist;

(H) A registered or practical nurse;

(I) A physical therapist;

(J) An administrator of a hospital, a nursing or convalescent home, or other health care facility;

(K) A corporation or other organization operating a hospital, a nursing or convalescent home, or other health care facility, as well as the officers, directors, or employees of such corporation or organization or the members of such corporatiońs or organizatiońs governing board who are performing a peer review function;

(L) A rehabilitation supplier registered with the State Board of Workerś Compensation; and

(M) An occupational therapist."

SECTION 6.

Said title is further amended by striking subsection (a) of Code Section 31-8-82, relating to reporting of abuse or exploitation of residents in long-term care facilities, and inserting in its place the following:

"(a) Any:

(1) Administrator, manager, physician, nurse, nursés aide, orderly, or other employee in a hospital or facility;

(2) Medical examiner, dentist, osteopath, optometrist, chiropractor chiropractic physician, podiatrist, social worker, coroner, clergyman, police officer, pharmacist, physical therapist, or psychologist; or

(3) Employee of a public or private agency engaged in professional services to residents or responsible for inspection of long-term care facilities

who has knowledge that any resident or former resident has been abused or exploited while residing in a long-term care facility shall immediately make a report as described in subsection (c) of this Code section by telephone or in person to the department. In the event that an immediate report to the department is not possible, the person shall make the report to the appropriate law enforcement agency. Such person shall also make a written report to the Department of Human Resources within 24 hours after making the initial report."

SECTION 7.

Title 33 of the Official Code of Georgia Annotated, relating to insurance, is amended by striking paragraph (6) of Code Section 33-20A-3, relating to definitions relative to patient protection and managed health care plans, and inserting in its place the following:

"(6) 'Health care provider' or 'provider' means any physician, dentist, podiatrist, pharmacist, optometrist, psychologist, clinical social worker, advance practice nurse, registered optician, licensed professional counselor, physical therapist, marriage and family therapist, chiropractor chiropractic physician, athletic trainer qualified pursuant to paragraph (1) or (2) of subsection (a) of Code Section 43-5-8, occupational therapist, speech language pathologist, audiologist, dietitian, or physiciańs assistant."

SECTION 8.

Said title is further amended by striking subsection (b) of Code Section 33-24-27, relating to provision for reimbursement for services within the lawful scope of practice of psychologists or chiropractors, and inserting in its place the following:

"(b) Notwithstanding any provisions in policies or contracts which might be construed to the contrary, from and after July 1, 1980, all individual, group, or blanket policies of accident and sickness insurance and individual or group service or indemnity contracts issued by nonprofit corporations or by health care corporations which are issued, delivered, issued for delivery, amended, or renewed in this state and which provide coverage for services which are within the lawful scope of practice of a psychologist or chiropractor chiropractic physician duly licensed to practice in this state shall be deemed to provide that any person covered under the policies or contracts shall be entitled to receive reimbursement for services under the policies or contracts regardless of whether they are rendered by a duly licensed doctor of medicine or by a duly licensed psychologist or chiropractor chiropractic physician."

SECTION 9.

Said title is further amended by striking paragraph (17) of Code Section 33-39-3, relating to definitions relative to collection, use, and disclosure of information gathered by insurance institutions, and inserting in its place the following:

"(17) 'Medical professional' means any person licensed or certified to provide health care services to natural persons, including but not limited to, a chiropractor chiropractic physician, clinical dietitian, clinical psychologist, dentist, nurse, occupational therapist, optometrist, pharmacist, physical therapist, physician, podiatrist, psychiatric social worker, or speech therapist."

SECTION 10.

Said title is further amended by striking paragraph (7) of Code Section 33-46-2, relating to definitions relative to certification of private review agents, and inserting in its place the following:

"(7) 'Health care provider' means any person, corporation, facility, or institution licensed by this state or any other state to provide or otherwise lawfully providing health care services, including but not limited to a doctor of medicine, doctor of osteopathy, hospital or other health care facility, dentist, nurse, optometrist, podiatrist, physical therapist, psychologist, occupational therapist, professional counselor, pharmacist, chiropractor chiropractic physician, marriage and family therapist, or social worker."

SECTION 11.

Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses, is amended by striking subsection (b) of Code Section 43-1-28, relating to volunteers in health care specialties, and inserting in its place the following:

"(b) As used in this Code section, the term:

(1) 'Health care board' means that professional licensing board which licenses a health care practitioner under this title.

(2) 'Health care practitioner' means a chiropractor chiropractic physician, registered professional nurse, or podiatrist.

(3) 'Health care specialty' means the practice of chiropractic, nursing, or podiatry."

SECTION 12.

Said title is further amended by striking paragraph (6) of Code Section 43-1B-3, relating to definitions relative to patient self-referral, and inserting in its place the following:

"(6) 'Health care provider' means a physician, chiropractor chiropractic physician, podiatrist, optometrist, pharmacist, or physical therapist who is licensed or otherwise regulated under this title."

SECTION 13.

Said title is further amended by striking subsection (a) of Code Section 43-9-2, relating to creation of the Georgia Board of Chiropractic Examiners and the membership and qualifications of the board, and inserting in its place the following:

"(a) There is created and established a board to be known as the Georgia Board of Chiropractic Examiners. The board shall be composed of five practicing chiropractors chiropractic physicians who shall be appointed by the Governor with the approval of the Secretary of State and confirmation by the Senate. Such members shall be of good moral character, residents of the state, and graduates of chartered chiropractic schools or colleges requiring actual attendance in same and shall have practiced chiropractic continuously and resided in the state for a period of at least five years."

SECTION 14.

Said title is further amended by striking Code Section 43-9-6.1, relating to the scope of the authority of the Georgia Board of Chiropractic Examiners, and inserting in its place the following:

"43-9-6.1.

The board is authorized to:

(1) Adopt, amend, and repeal such rules and regulations not inconsistent with this chapter necessary for the proper administration and enforcement of said chapter;

(2) Examine, issue, renew, and reinstate the licenses of duly qualified applicants for licensure to practice chiropractic in this state;

(3) Deny, suspend, revoke, or otherwise sanction licenses to practice chiropractic in this state;

(4) Initiate investigations for the purpose of discovering violations of this chapter;

(5) Conduct hearings upon charges calling for the discipline of a licensee or on violations of this chapter; and

(6) Issue to chiropractors chiropractic physicians, licensed under this chapter, certificates under the seal of the board evidencing such licensure and signed, either by hand or facsimile signature, by the president of the board and the division director."

SECTION 15.

Said title is further amended by striking Code Section 43-9-7.2, relating to persons exempted from the application of Chapter 9 of Title 43, relating to chiropractors, and inserting in its place the following:

"43-9-7.2.

Nothing in this chapter shall be construed as preventing or prohibiting the practice, services, or activities of:

(1) Any person pursuing a course of study leading to a doctor of chiropractic degree, postgraduate training, or training as a chiropractic assistant, which is approved by the board as provided for in this chapter, if such person is designated by a title indicating student status, is fulfilling clinical training requirements for the attainment of a degree or certificate, and is under the supervision of a chiropractor chiropractic physician licensed under this chapter and approved by the board;

(2) Any person licensed to practice chiropractic in this or another state who is employed as a professor or instructor by a chiropractic school or college located in this state or who is enrolled in or teaching a course of study designed to develop chiropractic clinical skills when chiropractic activities are required as part of an educational program sponsored by a chiropractic school or college, as provided for in Code Section 43-9-7, or other educational program as may be approved by the board. Such practice shall be conducted under the supervision of a licensed chiropractor chiropractic physician approved by the board. No such person shall be authorized to provide chiropractic services outside of the scope of the educational program and setting, nor shall such a person perform, or supervise the performance of, any chiropractic service provided on a fee-for-service basis without having first obtained a license in accordance with this chapter. The board shall have the authority to promulgate rules relative to such practice;

(3) A chiropractor chiropractic physician licensed in good standing in any other state, territory, or other jurisdiction of the United States or of any other nation or foreign jurisdiction if that person is employed or designated in their professional capacity by a sports or performing arts entity visiting the state for a specific sports or performing arts event subject to the following restrictions:

(A) A chiropractoŕs chiropractic physiciańs practice under this paragraph is limited to the members, coaches, and staff of the team or event for which that chiropractor chiropractic physician is employed or designated, and such practice shall only occur at the designated venue of the event; and

(B) Any chiropractor chiropractic physician practicing under the authority of this paragraph may utilize only those practices and procedures authorized by this chapter and approved by board rule; and

(4) Nothing in this chapter shall prohibit any person from assisting a duly licensed chiropractor chiropractic physician in the practices and procedures so authorized by this chapter, excluding the adjustment of the articulations of the human body, provided such person is under the direct order and supervision of a duly licensed doctor of chiropractic who is physically present in the facility or office."

SECTION 16.

Said title is further amended by striking subsection (k) of Code Section 43-9-12, relating to grounds for refusal or revocation of licenses, and inserting in its place the following:

"(k) Notwithstanding the provisions of paragraph (2) of subsection (h) of Code Section 43-1-19, if a chiropractor chiropractic physician is the subject of a board investigation initiated as the result of a complaint or report to the board, a copy of a summary of the complaint or report shall be furnished to the chiropractor chiropractic physician as soon as practicable after the investigation is initiated but in any event prior to or at the same time as the delivery of a subpoena for the production of documents. If a chiropractor chiropractic physician is the subject of an investigation initiated by the board on its own initiative, a written statement of the acts or omissions being investigated shall be furnished to the chiropractor chiropractic physician as soon as practicable after the investigation is initiated but in any event prior to or at the same time as the delivery of a subpoena for the production of documents. The board may delay providing the chiropractor chiropractic physician with a copy of the summary or statement if the board determines that the nature of the investigation requires that its existence not be disclosed to the chiropractor chiropractic physician but in no event shall such summary or statement be provided later than the delivery of a subpoena for the production of documents to the chiropractor chiropractic physician. Nothing in this Code section shall be construed to limit the authority of the board to pursue violations of the board́s laws and rules and regulations discovered during the course of an investigation."

SECTION 17.

Said title is further amended by striking Code Section 43-9-12.1, relating to reasonable care and skills and referrals, and inserting in its place the following:

"43-9-12.1.

The doctor of chiropractic must bring to the exercise of that persońs profession a reasonable degree of care and skill, which shall include the determination of the need for chiropractic care, as defined in paragraph (2) of Code Section 43-9-1, and shall render treatment, referral to the appropriate health care provider, or both treatment and referral commensurate with that chiropractoŕs chiropractic physiciańs findings. Any failure to refer to the appropriate health care provider may subject the doctor of chiropractic to the provisions of Code Section 43-9-12. Nothing in this Code section shall be deemed to expand or limit the chiropractic scope of practice."

SECTION 18.

Said title is further amended by striking Code Section 43-9-16, relating to scope of practice and the tort of injury from want of a reasonable degree of care, and inserting in its place the following:

"43-9-16.

(a) Chiropractors Chiropractic physicians who have complied with this chapter shall have the right to practice chiropractic as defined in paragraph (2) of Code Section 43-9-1 and to adjust patients according to specific chiropractic methods. Chiropractors Chiropractic physicians shall observe public health regulations.

(b) The chiropractic adjustment of the articulations of the human body may include manual adjustments and adjustments by means of electrical and mechanical devices which produce traction or vibration. Chiropractors Chiropractic physicians who have complied with this chapter may also use in conjunction with adjustments of the spinal structures electrical therapeutic modalities which induce heat or electrical current beneath the skin, including therapeutic ultrasound, galvanism, microwave, diathermy, and electromuscular stimulation. Chiropractors Chiropractic physicians who have complied with this chapter may utilize and recommend hot and cold packs and nonprescription, over-the-counter structural supports for the articulations of the human body which are commonly available through retail pharmacy outlets; provided, however, the same shall not be construed to allow chiropractors chiropractic physicians to treat patients outside the scope of practice of chiropractic as set forth in this chapter.

(c) Chiropractors Chiropractic physicians who have complied with this chapter may utilize those electric therapeutic modalities described in subsection (b) of this Code section, provided the chiropractor chiropractic physician shall have completed a course of study containing a minimum of 120 hours of instruction in the proper utilization of those procedures in accordance with the guidelines set forth by the Council on Chiropractic Education or its successor and is qualified and so certified in that proper utilization.

(d) Chiropractors Chiropractic physicians who have complied with this chapter shall have the right to sign health certificates, reporting to the proper health officers the same as other practitioners.

(e) Chiropractors Chiropractic physicians shall not prescribe or administer medicine to patients, perform surgery, or practice obstetrics or osteopathy.

(f) Chiropractors Chiropractic physicians shall not use venipuncture, capillary puncture, acupuncture, or any other technique which is invasive of the human body either by penetrating the skin or through any of the orifices of the body or through the use of colonics. Nothing in this subsection shall be construed to prohibit a chiropractor chiropractic physician who is licensed to perform acupuncture under Article 3 of Chapter 34 of this title from engaging in the practice of acupuncture.

(g) A person professing to practice chiropractic for compensation must bring to the exercise of that persońs profession a reasonable degree of care and skill. Any injury resulting from a want of such care and skill shall be a tort for which a recovery may be had. If a chiropractor chiropractic physician performs upon a patient any act authorized to be so performed under this chapter but which act also constitutes a standard procedure of the practice of medicine, including but not limited to the use of modalities such as those described in subsection (b) of this Code section and X-rays, under similar circumstances the chiropractor chiropractic physician shall be held to the same standard of care as would licensed doctors of medicine who are qualified to and who actually perform those acts under similar conditions and like circumstances.

(h) A licensed practitioner of chiropractic may use only the title 'chiropractic physician,' 'chiropractor,' or 'doctor of chiropractic,' or 'D.C.'

(i) Chiropractors Chiropractic physicians who have complied with this chapter may recommend the use of vitamins, minerals, or food supplements. Any such recommendation of vitamins, minerals, or food supplements shall not be construed to allow chiropractors chiropractic physicians to treat patients outside the scope of the practice of chiropractic as set forth in this chapter nor shall this subsection be construed to allow chiropractors chiropractic physicians to sell at a profit any such vitamins, minerals, or food supplements without providing their generic name. Nothing in this subsection shall preclude compliance with Chapter 8 of Title 48, relating to the collection of sales and use taxes."

SECTION 19.

Said title is further amended by striking Code Section 43-9-19, relating to penalties related to the practice of chiropractic, and inserting in its place the following:

"43-9-19.

It shall be unlawful for any person to practice chiropractic unless that person shall have first obtained a license as provided in this chapter and possesses all the qualifications prescribed by the terms of this chapter. Any person who practices or attempts to practice chiropractic without a license, or who buys or fraudulently obtains a license to practice chiropractic, or who violates any of the terms of this chapter, or who uses the title 'chiropractic physician,' 'doctor of chiropractic,' 'chiropractor,' 'chiropractic,' 'D.C.,' or any word or title to induce the belief that such a person is engaged in the practice of chiropractic, without first complying with this chapter, shall be guilty of a felony and, upon conviction thereof, shall be punished by a fine of not less than $500.00 nor more than $1,000.00, or by imprisonment for not less than two nor more than five years, or both, at the discretion of the court. All subsequent offenses shall be separate and distinct offenses, and punishable in like manner."

SECTION 20.

Code Section 45-16-27 of the Official Code of Georgia Annotated, relating to when a coroner shall hold an inquest and procedures connected with such inquest, is amended by striking subsection (c) and inserting in its place the following:

"(c) When a coroner or a medical examiner or a medical examiner from the office of chief medical examiner, as established in Code Section 35-3-153, conducts an investigation into the death of an individual, the coroner, medical examiner, or medical examiner from the office of chief medical examiner shall be authorized to issue subpoenas to compel the production of any books, records, including but not limited to medical records from hospitals, medical clinics, psychiatric hospitals, physicianś offices, chiropractorś chiropractic physicianś offices, and any other health care delivery facility, or papers relevant to the cause of death including without limitation AIDS confidential information as defined by Code Section 31-22-9.1. Any books, records, or papers received by the coroner, medical examiner, or medical examiner from the office of chief medical examiner pursuant to the subpoena must be regarded as confidential information and privileged and not subject to disclosure under Article 4 of Chapter 18 of Title 50. The actual costs of copying any books, records, or papers for the purposes of responding to a subpoena under this subsection shall be paid out of county funds to the person or entity required to respond to that subpoena, and the governing authority of the county of which that coroner or county medical examiner is a public officer shall pay those costs within 30 days after a bill therefor is submitted to the county. A medical examiner from the office of chief medical examiner shall pay the costs of copying from state funds within 30 days after a bill therefor is submitted to the state."

SECTION 21.

Code Section 48-13-9 of the Official Code of Georgia Annotated, relating to limitations on the authority of local governments to impose regulatory fees, is amended by striking subsection (c) and inserting in its place the following:

"(c) Examples of businesses and practitioners of professions and occupations which local governments are not authorized to subject to regulatory fees include, but are expressly not limited to, the following:

(1) Lawyers;

(2) Physicians licensed under Chapter 34 of Title 43;

(3) Osteopaths licensed under Chapter 34 of Title 43;

(4) Chiropractors Chiropractic physicians;

(5) Podiatrists;

(6) Dentists;

(7) Optometrists;

(8) Psychologists;

(9) Veterinarians;

(10) Landscape architects;

(11) Land surveyors;

(12) Practitioners of physiotherapy;

(13) Public accountants;

(14) Embalmers;

(15) Funeral directors;

(16) Civil, mechanical, hydraulic, or electrical engineers;

(17) Architects;

(18) Marriage and family therapists, social workers, and professional counselors;

(19) Dealers of motor vehicles, as defined in paragraph (1) of Code Section 10-1-622;

(20) Owners or operators of bona fide coin operated amusement machines, as defined in Code Section 48-17-1, and owners or operators of businesses where bona fide coin operated amusement machines are available for commercial use and play by the public, provided that such amusement machines have affixed current stickers showing payment of annual permit fees, in accordance with Code Section 48-17-9;

(21) Merchants or dealers as defined in Code Section 48-5-354 as to their deliveries to businesses and practitioners of professions and occupations in areas zoned for commercial use; and

(22) Any other business, profession, or occupation for which state licensure or registration is required by state law, unless the state law regulating such business, profession, or occupation specifically allows for regulation by local governments."

SECTION 22.

All laws and parts of laws in conflict with this Act are repealed.