Licensed Complementary Modalities
There is legislation relating to some complementary alternative medicine (CAM) modalities in some states. These modalities include chiropractic, naturopathy, massage, and osteopathy. For links to information about current licensing, visit the virtual library and click on Regulations. If you are licensed as an allied healthcare provider, you may be able to adjunct complementary modalities, such as aromatherapy or herbal medicine, to your existing practice. You must check with your licensing board regarding your scope of practice and additional modalities.
At the time of writing (July 2010):
- Naturopaths (ND) are licensed in 12 states: Alaska, Arizona, California, Connecticut, Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, and Washington.
- Acupuncturists are licensed in 34 states (note that the scope of practice varies widely).
- Chiropractors (DC) are licensed in all 50 states and 11 of them mandate that health plans include chiropractic benefits.
Laws Relating to Otherwise Unlicensed Complementary and Alternative Healthcare Providers
The legislation varies from state to state and is not consistent. For this reason, it is always important to investigate the laws of the state in which you operate and to keep abreast of proposed changes. We recommend that you get involved in your state. The National Health Freedom Coalition has a listing of the state groups that can be accessed here:
California Senate Bill 577 2002 (SB 577) exempts complementary and alternative health practitioners from California’s Medical Practices’ Act. It allows CAM practitioners to offer their services provided they do not:
- Conduct surgery
- Administer X-rays
- Prescribe legend drugs
- Recommend the discontinuance of legend drugs
- Willfully cause or create risk of bodily harm or injury
- Set fractures
- Treat lacerations or abrasions through electrotherapy
- Hold themselves out as a licensed physician
All CAM practitioners must disclose to all clients in plain language so the client understands that:
- The CAM practitioner is not a licensed physician
- The nature of the services
- The practitioner’s educational and training experience
The CAM practitioner must obtain a written acknowledgement from the client that the client received the disclosure, and the acknowledgement must be kept on file for three years.
One of the most interesting parts of the legislation is the introduction, so please review that section regardless of the state you live in.THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature hereby finds and declares all of the following:
(a) Based upon a comprehensive report by the National Institute of Medicine and other studies, including a study published by the New England Journal of Medicine, it is evident that millions of Californians, perhaps more than five million, are presently receiving a substantial volume of health care services from complementary and alternative health care practitioners. Those studies further indicate that individuals utilizing complementary and alternative health care services cut across a wide variety of age, ethnic, socioeconomic, and other demographic categories.
(b) Notwithstanding the widespread utilization of complementary and alternative medical services by Californians, the provision of many of these services may be in technical violation of the Medical Practice Act (Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code). Complementary and alternative health care practitioners could therefore be subject to fines, penalties, and the restriction of their practice under the Medical Practice Act even though there is no demonstration that their practices are harmful to the public.
(c) The Legislature intends, by enactment of this act, to allow access by California residents to complementary and alternative health care practitioners who are not providing services that require medical training and credentials. The Legislature further finds that these nonmedical complementary and alternative services do not pose a known risk to the health and safety of California residents, and that restricting access to those services due to technical violations of the Medical Practice Act is not warranted.
Minnesota was the first state to provide legislation to cover unlicensed complementary and alternative healthcare providers. Minnesota provided a new model for other states concerned about protecting freedom of access to healthcare, while protecting public health and safety.
- Establishes Office of Unlicensed Complimentary and Alternative Health Care Practice.
- Registered CAM providers are exempt from prosecution for “practicing medicine without a license” if regulations are followed.
- Provides for disciplinary action if regulations are not followed.
Prohibited conduct under MN legislation:
- Conviction of certain crimes
- Failing to self-report
- Sexual contact with clients or former clients
- False, fraudulent, deceptive, or misleading advertising
- Deceptive, fraudulent, or harmful conduct
- Unnecessary danger to a client’s life, health, or safety
- Mental incompetence
- Lack of reasonable safety to clients
- Alcohol or drug abuse
- Breaching client confidentiality
- Ignoring a client’s request
- Kickbacks or fraudulent billing
- Failing to report as required
- Undue influence, harassment, duress, deception, or fraud
- Unprofessional relationship
- Failure to provide a client with a copy of the Client Bill of Rights
- Violating the Client Bill of Rights
- Not complying with disciplinary provisions or rules
- Use of the title “doctor”, “Dr.”, or “physician”
- Failure to provide a client with a referral to a licensed healthcare provider when necessary
The client must sign a written statement that they have received the Client Bill of Rights before any service is provided. The Client Bill of Rights must include (key terms only):
- Practitioners name and contact details
- Qualification details
- Information about fees
- Brief summary of the theoretical approach of the practitioner
It must also include notice of a client’s right:
- To file complaint with the Office of Unlicensed Complementary and Alternative Health Care Practice
- To complete info about a practitioner’s assessment and recommendation, including duration
- To courteous treatment—free from verbal, physical, or sexual abuse by the practitioner
- To confidentiality
- To access own records
- To a free choice of practitioners
- To coordinated transfer when provider changes
- To refuse services
There is a similar Health Freedom Bill proposed in Florida by Health Freedom Action.
*This is general information only. You should always seek legal advice from an attorney in your state.Idaho
TITLE 54 PROFESSIONS, VOCATIONS, AND BUSINESSES CHAPTER 18 PHYSICIANS AND SURGEONS 54-1804. UNLICENSED PRACTICE—PENALTIES AND REMEDIES RELATING TO UNLICENSED PRACTICE. (1) Under the circumstances described and subject in each case to limitations stated, the following persons, though not holding a license to practice medicine in this state, may engage in activities included in the practice of medicine: (a) A medical officer of the armed forces of the United States, of the United States public health service, or of the veteran's administration, while engaged in the performance of his official duties; (b) A person residing in another state or country and authorized to practice medicine there, who is called in consultation by a person licensed in this state to practice medicine, or who for the purpose of furthering medical education is invited into this state to conduct a lecture, clinic, or demonstration, while engaged in activities in connection with the consultation, lecture, clinic, or demonstration, so long as he does not open an office or appoint a place to meet patients or receive calls in this state; (c) A person authorized to practice medicine in another state or country while rendering medical care in a time of disaster or while caring for an ill or injured person at the scene of an emergency and while continuing to care for such person; (d) An extern, intern or resident who is registered with the board as provided in this chapter and while engaged in programs authorized pursuant to rules of the board or a physician assistant licensed by the board; (e) A person authorized or licensed by this state to engage in activities, which may involve the practice of medicine; (f) A person engaged in good faith in the practice of the religious tenets of any church or religious beliefs; (g) A person administering a remedy, diagnostic procedure, or advice as specifically directed by a physician; (h) A person rendering aid in an emergency, where no fee for the service is contemplated, charged or received; (i) A person administering a family remedy to a member of the family; (j) A person who administers treatment or provides advice regarding the human body and its functions that: (i) Does not use legend drugs or prescription drugs in such practice; (ii) Uses natural elements such as air, heat, water and light; (iii) Only uses class I or class II nonprescription, approved, medical devices as defined in section 513 of the federal food, drug, and cosmetic act; (iv) Only uses vitamins, minerals, herbs, natural food products and their extracts, and nutritional supplements; and who (v) Does not perform surgery; (vi) Requires each person receiving services to sign a declaration of informed consent which includes an overview of the health care provider's education which states that the health care provider is not an "M.D." or "D.O." and is not licensed under the provisions of this chapter.
There was a similar bill being proposed in Georgia in 2002 that does not appear to have progressed. The Complementary and Alternative Health Care Freedom of Access and Consumer Protection Bill, HB - 749, which is modeled on the Minnesota Act, was heard in the House General Health Subcommittee on February 17, 2000. Although it did not pass out of committee, the subcommittee members chose to send it to a study committee.
Five legislators from the general subcommittee of the house health and ecology committee were assigned to work with CAMA (Complementary and Alternative Medicine Association) over the summer to develop the Bill for re-introduction next session.
Click here to read up on the latest legislation for Georgia (and Oklahoma)
The Unlicensed Health Care Practices Act passed in Rhode Island on June 15, 2002. Modeled after the Minnesota Health Freedom Act, the law makes freedom of access to healthcare a fundamental right for the citizens of Rhode Island.
Rhode Island’s legislation allows unlicensed complementary healthcare practitioners to operate and receive compensation for their services provided they abide by the statute.
Consumers must approve, in writing, all services to be performed. Practitioners must disclose all items in the Bill of Rights, and the State of Rhode Island has oversight authority.
The law defines “Unlicensed Health Care Practices” as:
- 20 therapies commonly used to complement allopathic interventions; and
- As not including diagnosing and treating disease, performing surgery, or prescribing, administering or dispensing legend drugs.
The law requires:
- Practitioners to provide each client with a Bill of Rights disclosing education and training, services to be provided, fees to be charged, name, address, and info about filing complaints.
- The Department of Health to handle client complaints and to invoke disciplinary measures on practitioners who fail to follow the law.
- The client to sign a disclosure statement that all parts of the Bill of Rights have been provided to the client before any services begin.