Report Title:

Chiropractic; Scope of Practice; Workers' Compensation Reimbursement; Motor Vehicle Insurance

Description:

Limits workers compensation reimbursement for chiropractic treatment to treatment of the spinal column. Defines "chiropractic" as palpation and adjustment of articulations and adjacent tissue of human body, limited to spinal column, head, lower and upper extremities, and rib cage. Allows chiropractor to use titles of "doctor of chiropractic" and "chiropractic physician". Clarifies that the Act does not expand the scope of chiropractic practice or increase the limitation on chiropractic treatments under motor vehicle insurance law. (SD1)

HOUSE OF REPRESENTATIVES

H.B. NO.

1510

TWENTY-SECOND LEGISLATURE, 2003

H.D. 1

STATE OF HAWAII

S.D. 1


 

A BILL FOR AN ACT

 

RELATING TO CHIROPRACTIC.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. Chapter 386, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§386-   Reimbursement for chiropractic treatment. Reimbursement for chiropractic treatment under section 386-21 shall be limited to chiropractic treatment of only the human spinal column."

SECTION 2. Section 442-1, Hawaii Revised Statutes, is amended to read as follows:

"§442-1 Chiropractic defined. (a) Chiropractic is defined to be the science of palpating and adjusting the articulations and adjacent tissues of the human [spinal column by hand; provided that the] body, limited to:

(1) The spinal column, further defined as the five spinal regions: cervical region (includes atlanto-occipital joint); thoracic region (includes costovertebral and costotransverse joint); lumbar region; sacral region; and pelvic (sacroiliac joint) region;

(2) The head, including temporomandibular joint, excluding atlanto-occipital;

(3) The lower and upper extremities; and

(4) The rib cage, limited to the anterior region, but excluding the costotransverse and costovertebral joints.

(b) The practice of chiropractic as contemplated and set forth in this chapter, and rules adopted thereunder, may include [the]:

(1) The use of necessary patient evaluation and management procedures of the human spinal column, [hot] head, extremities, and rib cage;

(2) Hot or cold packs, whirlpool, therapeutic and rehabilitative exercise, traction, electrical and electromechanical stimulation, therapeutic ultrasound, myofascial release, diathermy, infrared, [and] chiropractic spinal and extraspinal manipulative treatment and [extraspinal] evaluations, as set forth in this section; and

(3) Referral to laboratory examination for a specimen for the diagnosis and treatment of neuromusculoskeletal conditions related to the human spinal column, head, extremities, and rib cage,

subject to the restrictions contained in this chapter[; and provided further that the].

The practice of chiropractic as contemplated and set forth in this chapter and rules adopted thereunder, shall not include the practice of lomilomi or massage[. For the purposes of this section, spinal refers to the five spinal regions: cervical region (includes atlanto-occipital joint); thoracic region (includes costovertebral and costotransverse joint); lumbar region; sacral region; and pelvic (sacroiliac joint) region.], or any chiropractic extraspinal manipulative treatment that is not based on generally accepted professional chiropractic standards and included in the curriculum of chiropractic educational programs accredited by an accrediting agency recognized by the U.S. Department of Education."

SECTION 3. Section 442-19, Hawaii Revised Statutes, is amended to read as follows:

"§442-19 Violations, penalty. Any person except a licensed chiropractor who practices or attempts to practice chiropractic, or any person who buys, sells, or fraudulently obtains a diploma or a license to practice chiropractic, whether recorded or not, or who uses the title "chiropractor", "doctor of chiropractic", "chiropractic physician", or "D.C.", or any word or title to induce, or tending to induce belief that the person is engaged in the practice of chiropractic, without first complying with this chapter; or any licensee under this chapter who uses the word "doctor" or the prefix "Dr." without the word "chiropractor" or "D.C." immediately following the licensee's name, or uses the letters "M.D." or the words "doctor of medicine", or the term "surgeon", or the term "physician", or the word "osteopath", or the letters "D.O.", or any other letters, prefixes, or suffixes, the use of which would indicate that the licensee is practicing a profession for which the licensee holds no license from the State, or any person who violates any of the provisions of this chapter, shall be fined not more than $1,000, or imprisoned not more than ninety days, or both."

SECTION 4. Nothing in this Act:

(1) Shall be construed to increase the scope of practice of licensees under chapter 442, Hawaii Revised Statutes, as of January 1, 2003; and

(2) Is intended to increase the limitation on the number of chiropractic visits allowed under section 431:10C-103.6, Hawaii Revised Statutes.

SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 6. This Act shall take effect on July 1, 2050.