PRINTER'S NO. 674
THE GENERAL ASSEMBLY OF PENNSYLVANIA
INTRODUCED BY MUSTIO, CHRISTIANA, READSHAW, MAHER, KILLION, KORTZ, SONNEY, QUINN, GERGELY, GIBBONS, GINGRICH, KOTIK, MARSHALL, SWANGER, FLECK, AUMENT, ROAE, DENLINGER, COHEN, D. COSTA, NEUMAN, WHITE, V. BROWN, FREEMAN, SANTARSIERO AND WHEATLEY, FEBRUARY 8, 2013
REFERRED TO COMMITEE ON PROFESSIONAL LICENSURE, FEBRUARY 8, 2013
5TABLE OF CONTENTS
6Chapter 1. Preliminary Provisions
7Section 101. Short title.
8Section 102. Declaration of policy.
9Section 103. Definitions.
10Chapter 2. State Board of Medicine
11Section 201. Declaration of purpose.
12Section 202. Naturopathic medical education.
13Chapter 3. Licensure
14Section 301. Qualifications for licensure.
15Section 302. License status and continuing education.
16Section 303. Liability insurance.
17Section 304. Reciprocity.
1Chapter 4. Practice of Naturopathic Medicine
2Section 401. Scope of practice.
3Chapter 5. Administration and Enforcement
4Section 501. Refusal, suspension and revocation of licenses.
5Section 502. Reinstatement of license.
6Section 503. License renewal; records and fees.
7Section 504. Duty of licensee.
8Section 505. Other professions.
9Section 506. Unlawful practice.
10Section 507. Violation of act.
11Chapter 6. Miscellaneous Provisions
12Section 601. Regulations.
13Section 602. Effective date.
18Section 101. Short title.
21Section 102. Declaration of policy.
22The General Assembly finds and declares as follows:
27(2) It is a matter of public interest that naturopathic
28doctors and the practice of naturopathic medicine merit the
29confidence of the public, that only qualified persons be
30authorized to practice naturopathic medicine in this
4(3) The General Assembly recognizes that naturopathic
5doctors comprise a distinct health care profession that
6affects the public health, safety and welfare and increases
7freedom of choice in health care.
10Section 103. Definitions.
17"Board." The State Board of Medicine.
25"Common diagnostic procedures." The use of venipuncture and
26commonly used diagnostic imaging modalities consistent with
27naturopathic practice, health history taking, physical
28examination, radiography, laboratory medicine and examination of
29body orifices excluding endoscopy.
30"Department." The Department of State of the Commonwealth.
8"Naturopathic medicine." A system of primary health care
9practiced by doctors of naturopathic medicine for the
10prevention, diagnosis and treatment of human health conditions,
11injuries and diseases and that uses education, natural medicines
12and therapies to support and stimulate the individual's
13intrinsic self-healing processes.
14"Naturopathic musculoskeletal therapy." The treatment by
15manual and other mechanical means of all body tissues and
16structures, including, but not limited to, bones, fascia,
17muscles, tendons, ligaments, entheses, joint capsules, bursae,
18tendon sheaths, scar tissue and visceral organs by naturopathic
19doctors. These may be located anywhere in the human body,
20including, but not limited to, the spine, cranium,
21thoracoabdominal cavity and extremities. These manual and
22mechanical techniques involve the use of oscillation, thrust,
23pressure and sustained tension, including traction, mobilization
24through physiologic and extra-physiologic ranges of motion,
25including passive intrinsic mobility of all body joints, and
26repositioning of displaced body tissues and organs.
27"Naturopathic physical medicine." The methods of treating
28the body by means of electromagnetic energy, colon hydrotherapy,
29therapeutic exercise and therapeutic use by naturopathic doctors
30of the physical agents of air, water, heat, cold, sound, light
1and the physical modalities and procedures, including, but not
2limited to, hydrotherapy, electrotherapy, magnetic therapy,
3diathermy, ultrasound, ultraviolet, infrared and low-level laser
4light, therapeutic exercise, neural therapy and myofascial
5trigger point therapy.
6"Naturopathic therapies." Methods used in the treatment of
7an individual which include, but are not limited to,
8hydrotherapy, topical medicines, foods, food extracts, vitamins,
9amino acids, minerals, enzymes, dietary supplements, over-the-
10counter medications and nonprescription drugs as defined by the
11Federal Food, Drug, and Cosmetic Act (52 Stat. 1040, 21 U.S.C. §
12301 et seq.), homeopathic remedies and plant substances that are
13not designated as prescription drugs or controlled substances.
17STATE BOARD OF MEDICINE
18Section 201. Declaration of purpose.
22Section 202. Naturopathic medical education.
23The board shall approve a naturopathic medical education
24program accredited by the Council on Naturopathic Medical
25Education or an equivalent federally recognized accrediting body
26for the naturopathic medical profession that has the following
3(2) Program requirements for its degree or diploma of a
4minimum of 4,100 total hours in basic and clinical sciences,
5naturopathic philosophy, naturopathic modalities and
6naturopathic medicine. Of the total requisite hours, not less
7than 2,500 hours shall consist of academic instruction, and
8not less than 1,200 hours shall consist of supervised
9clinical training approved by the naturopathic medical
11(3) A naturopathic medical education program in the
12United States shall offer graduate-level, full-time studies
13and training leading to the degree of Doctor of Naturopathy
14or Doctor of Naturopathic Medicine. The program shall be an
15institution or part of an institution of higher education
16that is either accredited or is a candidate for accreditation
17by a regional institutional accrediting agency recognized by
18the United States Secretary of Education and the Council on
19Naturopathic Medical Education, or an equivalent federally
20recognized accrediting body for naturopathic doctor
22(4) To qualify as an approved naturopathic medical
23school, a naturopathic medical program located in Canada or
24the United States shall offer a full-time, doctoral-level,
25naturopathic medical education program with its graduates
26being eligible to apply to the board for licensure and to the
27North American Board of Naturopathic Examiners that
28administers the naturopathic licensing examination.
1Section 301. Qualifications for licensure.
5(1) The applicant is of good moral character.
10(3) The applicant has passed a competency-based national
11naturopathic licensing examination administered by the North
12American Board of Naturopathic Examiners or successor agency
13that has been nationally recognized to administer a
14naturopathic examination that represents Federal standards of
15education and training, or has graduated prior to 1986 and
16has passed a state naturopathic licensing examination.
17(4) The applicant provides the board with a list of at
18least two physicians licensed to practice medicine in this
19State who have agreed to be available for consultation and
20accept referrals from the applicant. The applicant shall also
21provide the board with letters of verification from the
27(7) (i) The applicant has not been convicted of a
28felony under the act of April 14, 1972 (P.L.233, No.64),
29known as The Controlled Substance, Drug, Device and
30Cosmetic Act, or of an offense under the laws of another
6(B) The applicant satisfactorily demonstrates to
7the board that the applicant has made significant
8progress in personal rehabilitation since the
9conviction and that licensure of the applicant should
10not be expected to create a substantial risk of harm
11to the public or a substantial risk of further
15(ii) As used in this paragraph, the term "convicted"
16includes a judgment, admission of guilt or a plea of nolo
17contendere or receiving probation without verdict,
18disposition in lieu of trial or an accelerated
19rehabilitative disposition of the disposition of felony
21(8) The applicant has not been convicted of an offense
22under the laws of another jurisdiction which, if committed in
23this Commonwealth, would constitute a sexual offense or a
24felony. Compliance with this paragraph must be documented by
25a report of criminal history record information from the
26Pennsylvania State Police or by a statement from the
27Pennsylvania State Police that its central repository
28contains no information relating to the applicant. The costs
29associated with the report or statement shall be paid by the
3Section 302. License status and continuing education.
4(a) Duration of license.--A license shall be renewable on a
5biennial basis. The biennial expiration date shall be
6established by regulation of the board. Application for renewal
7of a license shall biennially be forwarded to an individual
8holding a current license prior to the expiration date of the
9current renewal biennium.
12(1) File a renewal application with the board.
18(i) At least ten hours shall be in pharmacology.
1(C) An accredited college or university.
5(E) Any other provider providing a program
6related to naturopathic education, if the provider
7has submitted an application to and received approval
8from the Pennsylvania Association of Naturopathic
9Physicians or American Association of Naturopathic
11(4) Pay a fee established by regulation of the board.
12(c) Inactive status.--A licensee may request an application
13for inactive status. The application form must be completed and
14returned to the board. Upon receipt of an application, the
15individual shall be maintained on inactive status without fee
16and shall be entitled to apply for licensure renewal at any
17time. An individual who requests the board to activate the
18individual's license and who has been on inactive status for a
19period of five consecutive years must, prior to receiving an
20active license, satisfy the requirements of the board's
21regulations for ensuring continued education, including holding
22current certification to administer cardiopulmonary
23resuscitation and remitting the required fee. The board shall
24promulgate regulations to carry into effect the provisions of
26(d) Reporting of multiple licensure.--A licensee who is also
27licensed to practice naturopathic medicine in another
28jurisdiction shall report this information to the board on the
29biennial registration application. Any disciplinary action taken
30in another jurisdiction shall be reported to the board on the
1biennial registration application or within 90 days of final
2disposition, whichever is sooner. Multiple licensures shall be
3noted by the board on the licensee's record, and the other
4licensing jurisdiction shall be notified by the board of any
5disciplinary actions taken against the licensee in this
7Section 303. Liability insurance.
8(a) General rule.--A licensed naturopathic doctor practicing
9in this Commonwealth shall maintain a level of medical
10professional liability insurance coverage in the minimum amount
11of $1,000,000 per occurrence or claim made. Failure to maintain
12insurance coverage as required shall subject the licensee to
13disciplinary proceedings. The board shall accept as satisfactory
14evidence of insurance coverage any of the following:
21(b) Proof.--A license applicant shall provide proof that the
22applicant has obtained medical professional liability insurance
23in accordance with subsection (a). It is sufficient if the
24applicant files with the application a copy of a letter from the
25applicant's professional liability insurance carrier indicating
26that the applicant will be covered against professional
27liability in the required amounts effective upon the issuance of
28the applicant's license to practice in this Commonwealth. Upon
29issuance of the license, the licensee has 30 days to submit to
30the board the certificate of insurance or a copy of the policy
2Section 304. Reciprocity.
3The board has the power to grant a reciprocal license to an
4applicant who is licensed or certified as a naturopathic doctor
5or similar practice in another state and has demonstrated
6qualifications which equal or exceed those required under this
7act in the determination of the board. No license shall be
8granted under this section to an applicant unless the state in
9which the applicant is licensed affords reciprocal treatment to
10individuals who are residents of this Commonwealth and who are
11licensed under this act.
13PRACTICE OF NATUROPATHIC MEDICINE
14Section 401. Scope of practice.
25(i) Naturopathic therapies.
26(ii) Naturopathic physical medicine.
30(iv) Health education and health counseling.
1(v) Behavioral medicine.
2(vi) Botanical medicine.
3(vii) Naturopathic musculoskeletal therapy.
4(viii) Homeopathic medicine.
15(2) Perform surgical procedures.
19(4) Use general or spinal anesthetics.
27ADMINISTRATION AND ENFORCEMENT
28Section 501. Refusal, suspension and revocation of licenses.
2(1) Being convicted under Federal law, under the law of
3any state or under the law of any foreign jurisdiction of an
4offense of moral turpitude or of an offense which, if
5committed in this Commonwealth, would constitute a sexual
6offense or a felony. As used in this paragraph, the term
7"convicted" includes a finding or verdict of guilt, an
8admission of guilt or a plea of nolo contendere or receiving
9probation without verdict, disposition in lieu of trial or an
10accelerated rehabilitative disposition in the disposition of
12(2) Being found to have engaged in immoral or
13unprofessional conduct. In proceedings based on this
14paragraph, actual injury to the patient need not be
15established. As used in this paragraph, the term
16"unprofessional conduct" includes:
19(ii) sexual exploitation of a patient.
30(7) Violating a regulation promulgated by the board,
13(12) Being unable to practice with reasonable skill and
14safety by reason of illness, drunkenness, excessive use of
15drugs, narcotics, chemicals or any other type of material, or
16as a result of any mental or physical condition. In enforcing
17this paragraph, the board, upon probable cause, has authority
18to compel a licensee to submit to a mental or physical
19examination by a physician approved by the board. Failure of
20a licensee to submit to an examination when directed by the
21board, unless the failure is due to circumstances beyond the
22licensee's control, shall constitute an admission of the
23allegations against the licensee, consequent upon which a
24default and final order may be entered without the taking of
25testimony or presentation of evidence. A licensee affected
26under this paragraph shall, at reasonable intervals as
27determined by the board, be afforded an opportunity to
28demonstrate that the licensee can resume competent practice
29with reasonable skill and safety.
30(b) Board action.--If the board finds that the license or
4(1) Deny the application for license.
5(2) Administer a public reprimand.
13(c) Administrative Agency Law.--Actions of the board under
14subsections (a) and (b) are subject to 2 Pa.C.S. Chs. 5 Subch. A
15(relating to practice and procedure of Commonwealth agencies)
16and 7 Subch. A (relating to judicial review of Commonwealth
18(d) Temporary suspension.--The board shall temporarily
19suspend a license under circumstances as determined by the board
20to be an immediate and clear danger to the public health and
21safety. The board shall issue an order to that effect without a
22hearing, but upon notice to the licensee concerned at the
23licensee's last known address, which must include a written
24statement of all allegations against the licensee. Subsection
25(c) shall not apply to temporary suspension. Upon issuance of an
26order under this subsection, the board shall commence formal
27action to suspend, revoke or restrict the license as otherwise
28provided for in this act. All actions shall be taken promptly.
29Within 30 days following the issuance of an order temporarily
30suspending a license, the board shall conduct a preliminary
1hearing to determine that there is a prima facie case supporting
2the suspension. The licensee whose license has been temporarily
3suspended may be present at the preliminary hearing and may be
4represented by counsel, cross-examine witnesses, inspect
5physical evidence, call witnesses, offer evidence and testimony
6and make a record of the proceedings. If it is determined that
7there is not a prima facie case, the suspended license shall be
8immediately restored. The temporary suspension shall remain in
9effect until vacated by the board, but in no event longer than
11(e) Automatic suspension.--
12(1) A license shall automatically be suspended upon the
13legal commitment of a licensee to an institution because of
14mental incompetence from any cause upon filing with the board
15a certified copy of the commitment.
16(2) A license shall automatically be suspended upon
17conviction of a felony under the act of April 14, 1972 (P.L.
18233, No. 64), known as The Controlled Substance, Drug, Device
19and Cosmetic Act, or conviction of an offense under the laws
20of another jurisdiction, which, if committed in this
21Commonwealth, would be a felony under The Controlled
22Substance, Drug, Device and Cosmetic Act. As used in this
23paragraph, the term "conviction" includes a judgment, an
24admission of guilt or a plea of nolo contendere.
1Section 502. Reinstatement of license.
2Unless ordered to do so by a court of competent jurisdiction,
3the board shall not reinstate the license of an individual which
4has been revoked. An individual whose license has been revoked
5may reapply for a license after a period of at least five years
6but must meet all of the licensing requirements of this act.
7Section 503. License renewal, records and fees.
12(1) All fees required under this act shall be fixed by
13the board by regulation. If the revenue raised by fees, fines
14and civil penalties imposed under this act are not sufficient
15to meet expenditures over a two-year period, the board shall
16increase those fees by regulation so that the projected
17revenues will meet or exceed projected expenditures.
18(2) If the bureau determines that the fees established
19by the board under paragraph (1) are inadequate to meet the
20minimum enforcement efforts required by this act, the bureau,
21after consultation with the board, shall increase the fees by
22regulation in an amount so that adequate revenues are raised
23to meet the required enforcement effort.
24Section 504. Duty of licensee.
28Section 505. Other professions.
2(1) The practice of a profession by an individual who is
3licensed, certified or registered by a Commonwealth agency
4under other law and who is performing services or advertising
5within the authorized scope of practice.
10(3) The practice of naturopathic medicine by an
11individual licensed, registered or certified in another
12jurisdiction when incidentally called into this Commonwealth
13to teach a course related to the practice of naturopathic
14medicine or to consult with a licensee.
15(4) The use, recommendation or practice by an individual
16not licensed by the board as a naturopathic doctor, of
17traditional naturopathy, naturopathic therapies, naturopathic
18health care, naturopathic services, natural remedies,
19ayurvedic medicine, herbal remedies, food and dietary
20supplements, nutritional advice, homeopathy and homeopathic
21remedies, hydrotherapy and therapeutic exercises or any other
22complementary and alternative healing methods and treatments
23that may be components of naturopathic medicine, provided the
24individual does not hold himself out as a naturopathic doctor
25or as a provider of naturopathic medicine.
26Section 506. Unlawful practice.
27(a) General rule.--An individual may not practice
28naturopathic medicine or hold himself out as a naturopathic
29doctor unless licensed by the board. An individual represents
30himself as a naturopathic doctor when that person adopts or uses
3(1) naturopathic doctor or N.D.; or
6(b) Title.--An individual who holds a license or is
7maintained on inactive status may use the title "Naturopathic
8Doctor" and the abbreviation "N.D." or "N.M.D." No other
9individual may use the title "Naturopathic Doctor" or hold
10himself out to others as a naturopathic doctor. This subsection
11includes advertising as a naturopathic doctor and adopting or
12using any title or description, including naturopathic doctor,
13doctor of naturopathic medicine, naturopathic medicine or a
14derivative of those terms and their related abbreviations.
19(d) Terminology.--A business entity may not utilize in
20connection with a business name or activity the words
21naturopathic doctor, doctor of naturopathic medicine,
22naturopathic medicine or a derivative of those terms and their
23related abbreviations unless the services of the business are
24provided by licensees.
25(e) Injunction.--Unlawful practice may be enjoined by the
26courts upon petition of the commissioner or the board. In a
27proceeding under this section, it shall not be necessary to show
28that an individual has been injured. If the court finds that the
29respondent has violated this section, it shall enjoin the
30respondent from practicing until the respondent has been
6Section 507. Violation of act.
7(a) General rule.--A person that violates a provision of
8this act or a regulation of the board commits a misdemeanor of
9the third degree and shall, upon conviction, be sentenced to pay
10a fine of not more than $1,000 or to imprisonment for not more
11than six months for the first violation and to pay a fine of not
12more than $2,000 or to imprisonment for not less than six months
13or more than one year, or both, for each subsequent violation.
14(b) Civil penalty.--In addition to any other civil remedy or
15criminal penalty provided for in this act, the board, by a vote
16of the majority of the maximum number of the authorized
17membership of the board or by a vote of the majority of the
18qualified and confirmed membership or a minimum of five members,
19whichever is greater, may levy a civil penalty of up to $1,000
20on any of the following:
30(c) Administrative Agency Law.--Action of the board under
6Section 601. Regulations.
7The board shall promulgate regulations to carry out this act.
8Publication of the final-form regulations under this section
9shall take place within 18 months of the effective date of this
10section. The board shall report, within 60 days of the effective
11date of this section, and every 30 days thereafter, on the
12status of the regulations to the Consumer Protection and
13Professional Licensure Committee of the Senate and the
14Professional Licensure Committee of the House of
16Section 602. Effective date.
17This act shall take effect as follows: