06 LC 33
1404S
The
Senate Health and Human Services Committee offered the following substitute to
SB 422:
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Chapter 9 of Title 43 of the Official Code of Georgia Annotated, relating
to chiropractors, so as to provide definitions; to provide for the scope of
practice; to increase the penalty for improper practice; to provide for related
matters; to repeal conflicting laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Chapter
9 of Title 43 of the Official Code of Georgia Annotated, relating to
chiropractors, is amended by striking Code Section 43-9-1, relating to
definitions, and inserting in lieu thereof a new Code Section 43-9-1 to read as
follows:
"43-9-1.
As
used in this chapter, the term:
(1)
'Board' means the Georgia Board of Chiropractic Examiners.
(2)
'Chiropractic' means the adjustment of the
articulation
articulations
of the human body, including ilium, sacrum, and coccyx, and the use of
electric
X-ray
photography,
provided that
the
X-ray shall not be used for therapeutical purposes. The term
'chiropractic'
shall also mean that separate and distinct branch of the healing arts whose
science and art utilize the inherent recuperative powers of the body and the
relationship between the musculoskeletal structures and functions of the body,
articularly of the spinal column and the nervous system, in the restoration and
maintenance of health. Chiropractic is a learned profession which teaches that
the relationship between structure and function in the human body is a
significant health factor and that such relationships between the spinal column
and the nervous system are most significant, since the normal transmission and
expression of nerve energy are essential to the restoration and maintenance of
health. However, the term
'chiropractic'
shall not include the use of drugs or surgery. The adjustment referred to in
this paragraph and subsection (b) of Code Section 43-9-16 may only be
administered by a doctor of chiropractic authorized to do so by the provisions
of this chapter; provided, however, that the provisions of this Code section
shall not prevent any other health care provider from administering techniques
authorized within their scope of practice.
(3)
'Health certificate' means a certification of physical examination in sickness,
health, or disability including reports for absence from employment or school or
from participation in sports activities.
(4)
'Practice of chiropractic' or 'to practice chiropractic' shall also include the
procedure by which chiropractors licensed in the State of Georgia evaluate the
quality and efficiency of services ordered or performed by other chiropractors,
including, but not limited to, practice analysis, audit, claims review,
underwriting assistance, utilization review, and compliance with applicable
laws, rules, and regulations.
(5)
'Subluxation' means a complex of functional or pathological articular changes
that may compromise neutral integrity and may influence organ system function
and general health. A subluxation is evaluated, diagnosed, and managed through
the use of chiropractic procedures based on the best available rational and
empirical
evidence."
SECTION
2.
Said
chapter is further amended by striking Code Section 43-9-16, relating to scope
of practice, and inserting in lieu thereof a new Code Section 43-9-16 to read as
follows:
"43-9-16.
(a)
Chiropractors who have complied with this chapter shall have the right to
practice chiropractic as defined in
paragraph
(2)
paragraphs (2)
and (4) of Code Section 43-9-1 and to
evaluate,
diagnose, and adjust patients according to
specific chiropractic methods
in order to
correct spinal subluxations or to adjust the articulations of the human
body. Chiropractors shall observe
all
applicable public health
regulations.
(b)
The chiropractic adjustment of the
spine
or articulations of the human body may
include manual adjustments and adjustments by means of electrical and mechanical
devices which produce traction or vibration. Chiropractors who have complied
with this chapter may also use
in
conjunction with adjustments of the spinal structures electrical
therapeutic
physical
modalities.
Modalities include any physical agent applied to produce therapeutic change to
biologic tissues including thermal, acoustic, light, mechanical, or electric
energy;
which
induce heat or electrical current beneath the skin, including
therapeutic
hot or cold
packs;
ultrasound,;
galvanism,;
microwave,;
diathermy,;
and
electromuscular
electrical
stimulation. Chiropractors who have complied with this chapter may utilize and
recommend
hot and
cold packs and nonprescription, over-the-counter structural supports for
the
therapeutic
procedures effecting change through the application of clinical skills or
services that attempt to improve function, including therapeutic exercise,
therapeutic activities, manual therapy techniques, massage, and structural
supports, as they relate to the
articulations of the human body
which are
commonly available through retail pharmacy
outlets; provided, however,
that
the same shall not be construed to allow chiropractors to treat patients outside
the scope of practice of chiropractic as set forth in this chapter.
(c)
Chiropractors who have complied with this chapter may utilize those
electric
therapeutic
physical
modalities and
procedures described in subsection (b) of
this Code section, provided
that
the chiropractor 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 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 who have complied with this chapter may use X-ray and refer for
diagnostic imaging, neurodiagnostic studies, and laboratory tests; provided,
however, that such referral shall not be construed to allow such chiropractor to
order, conduct, or perform such tests and the referral shall be to an entity
with whom the chiropractor has no direct or indirect pecuniary
interest.
(e)(f)
Chiropractors shall not prescribe or administer medicine to patients, perform
surgery, or practice obstetrics or osteopathy.
(f)(g)
Chiropractors 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;
provided, however, that this shall not prohibit the chiropractor from examining
the ears or mouth to determine the appropriateness of chiropractic
care. Nothing in this subsection shall be
construed to prohibit a chiropractor who is licensed to perform acupuncture
under Article 3 of Chapter 34 of this title from engaging in the practice of
acupuncture.
(g)(h)
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 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 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)(i)
A licensed practitioner of chiropractic may use only the title 'chiropractor,'
or 'doctor of chiropractic,' or 'D.C.'
(i)(j)
Chiropractors who have complied with this chapter may recommend the use of
vitamins,
minerals, or food
nutritional
and dietary supplements. Any such
recommendation of
vitamins,
minerals, or food
nutritional
and dietary supplements shall not be
construed to allow chiropractors 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 to sell at a profit any such
vitamins,
minerals, or food
nutritional
and dietary 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
3.
Said
chapter is further amended by striking Code Section 43-9-19, relating to
penalties, and inserting in lieu thereof a new Code Section 43-9-19 to read as
follows:
"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 '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
$5,000.00,
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
4.
All
laws and parts of laws in conflict with this Act are repealed.