PRIOR PRINTER'S NO. 674
PRINTER'S NO. 1959
THE GENERAL ASSEMBLY OF PENNSYLVANIA
INTRODUCED BY MUSTIO, CHRISTIANA, READSHAW, MAHER, KILLION, KORTZ, SONNEY, QUINN, GERGELY, GIBBONS, GINGRICH, KOTIK, MARSHALL, FLECK, AUMENT, ROAE, DENLINGER, COHEN, D. COSTA, NEUMAN, WHITE, V. BROWN, FREEMAN, SANTARSIERO, WHEATLEY, HELM, SNYDER, HARPER, SWANGER, COX, SCAVELLO, CUTLER AND GALLOWAY, FEBRUARY 8, 2013
AS REPORTED FROM COMMITTEE ON PROFESSIONAL LICENSURE, HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 5, 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.
<-6"Legend drug." A drug:
15"Naturopathic medicine." A system of primary health care
16practiced by doctors of naturopathic medicine for the
17prevention, diagnosis and treatment of human health conditions,
18injuries and diseases and that uses education, natural medicines
19and therapies to support and stimulate the individual's
20intrinsic self-healing processes.
21"Naturopathic musculoskeletal therapy." The treatment by
22manual and other mechanical means of all body tissues and
23structures, including, but not limited to, bones, fascia,
24muscles, tendons, ligaments, entheses, joint capsules, bursae,
25tendon sheaths, scar tissue and visceral organs by naturopathic
26doctors. These may be located anywhere in the human body,
27including, but not limited to, the spine, cranium,
28thoracoabdominal cavity and extremities. These manual and
29mechanical techniques involve the use of oscillation, <-thrust,
30pressure and sustained tension, including traction, mobilization
4"Naturopathic physical medicine." The methods of treating
5the body by means of electromagnetic energy, colon hydrotherapy,
6therapeutic exercise and therapeutic use by naturopathic doctors
7of the physical agents of air, water, heat, cold, sound, light
8and the physical modalities and procedures, including, but not
9limited to, hydrotherapy, electrotherapy, magnetic therapy,
10diathermy, ultrasound, ultraviolet, infrared and low-level laser
11light, therapeutic exercise, neural therapy and myofascial
12trigger point therapy.
13"Naturopathic therapies." Methods used in the treatment of
14an individual which include, but are not limited to,
15hydrotherapy, topical medicines, foods, food extracts, vitamins,
16amino acids, minerals, enzymes, dietary supplements, over-the-
17counter medications and nonprescription drugs as defined by the
18Federal Food, Drug, and Cosmetic Act (52 Stat. 1040, 21 U.S.C. §
19301 et seq.), homeopathic remedies and plant substances that are
20not designated as prescription drugs or controlled substances.
24STATE BOARD OF MEDICINE
25Section 201. Declaration of purpose.
29Section 202. Naturopathic medical education.
30The board shall approve a naturopathic medical education
1program accredited by the Council on Naturopathic Medical
2Education or an equivalent federally recognized accrediting body
3for the naturopathic medical profession that has the following
5(1) Admission requirements that include a minimum of
6three-quarters of the credits required for a bachelor's
7degree from a regionally accredited or preaccredited college
8or university or the equivalency, as determined by the
10(2) Program requirements for its degree or diploma of a
11minimum of 4,100 total hours in basic and clinical sciences,
12naturopathic philosophy, naturopathic modalities and
13naturopathic medicine. Of the total requisite hours, not less
14than 2,500 hours shall consist of academic instruction, and
15not less than 1,200 hours shall consist of supervised
16clinical training approved by the naturopathic medical
18(3) A naturopathic medical education program in the
19United States shall offer graduate-level, full-time studies
20and training leading to the degree of Doctor of Naturopathy
21or Doctor of Naturopathic Medicine. The program shall be an
22institution or part of an institution of higher education
23that is either accredited or is a candidate for accreditation
24by a regional institutional accrediting agency recognized by
25the United States Secretary of Education and the Council on
26Naturopathic Medical Education, or an equivalent federally
27recognized accrediting body for naturopathic doctor
1the United States shall offer a full-time, doctoral-level,
2naturopathic medical education program with its graduates
3being eligible to apply to the board for licensure and to the
4North American Board of Naturopathic Examiners that
5administers the <-national naturopathic licensing examination.
8Section 301. Qualifications for licensure.
12(1) The applicant is of good moral character.
13(2) The applicant has completed a doctorate-level
14naturopathic medical program <-which is accredited or from an
15accredited college recognized by the United States Department
16of Education. <-approved by the board.
17(3) The applicant has passed a competency-based national
18naturopathic licensing examination administered by the North
19American Board of Naturopathic Examiners or successor agency
20that has been nationally recognized to administer a
21naturopathic examination that represents Federal standards of
22education and training, or has graduated prior to 1986 and
23has passed a state naturopathic licensing examination.
<-24(4) The applicant provides the board with a list of at
25least two physicians licensed to practice medicine in this
26State who have agreed to be available for consultation and
27accept referrals from the applicant. The applicant shall also
28provide the board with letters of verification from the
30(5) <-(4) The application is accompanied by the
1application fee as established by the board by regulation.
<-4(7) (6) (i) The applicant has not been convicted of a
5felony under the act of April 14, 1972 (P.L.233, No.64),
6known as The Controlled Substance, Drug, Device and
7Cosmetic Act, or of an offense under the laws of another
8jurisdiction which, if committed in this Commonwealth,
9would be a felony under The Controlled Substance, Drug,
10Device and Cosmetic Act, unless the following apply:
13(B) The applicant satisfactorily demonstrates to
14the board that the applicant has made significant
15progress in personal rehabilitation since the
16conviction and that licensure of the applicant should
17not be expected to create a substantial risk of harm
18to the public or a substantial risk of further
22(ii) As used in this paragraph, the term "convicted"
23includes a judgment, admission of guilt or a plea of nolo
24contendere or receiving probation without verdict,
25disposition in lieu of trial or an accelerated
26rehabilitative disposition of the disposition of felony
1this Commonwealth, would constitute a sexual offense or a
2felony. Compliance with this paragraph must be documented by
3a report of criminal history record information from the
4Pennsylvania State Police or by a statement from the
5Pennsylvania State Police that its central repository
6contains no information relating to the applicant. The costs
7associated with the report or statement shall be paid by the
11Section 302. License status and continuing education.
12(a) Duration of license.--A license shall be renewable on a
13biennial basis. The biennial expiration date shall be
14established by regulation of the board. Application for renewal
15of a license shall biennially be forwarded to an individual
16holding a current license prior to the expiration date of the
17current renewal biennium.
20(1) File a renewal application with the board.
26(i) At least ten hours shall be in pharmacology.
9(C) An accredited college or university.
13(E) Any other provider providing a program
14related to naturopathic education, if the provider
15has submitted an application to and received approval
16from the Pennsylvania Association of Naturopathic
17Physicians or American Association of Naturopathic
19(4) Pay a fee established by regulation of the board.
20(c) Inactive status.--A licensee may request an application
21for inactive status. The application form must be completed and
22returned to the board. Upon receipt of an application, the
23individual shall be maintained on inactive status without fee
24and shall be entitled to apply for licensure renewal at any
25time. An individual who requests the board to activate the
26individual's license and who has been on inactive status for a
27period of five consecutive years must, prior to receiving an
28active license, satisfy the requirements of the board's
29regulations for ensuring continued education, including holding
30current certification to administer cardiopulmonary
4(d) Reporting of multiple licensure.--A licensee who is also
5licensed to practice naturopathic medicine in another
6jurisdiction shall report this information to the board on the
7biennial registration application. Any disciplinary action taken
8in another jurisdiction shall be reported to the board on the
9biennial registration application or within 90 days of final
10disposition, whichever is sooner. Multiple licensures shall be
11noted by the board on the licensee's record, and the other
12licensing jurisdiction shall be notified by the board of any
13disciplinary actions taken against the licensee in this
15Section 303. Liability insurance.
16(a) General rule.--A licensed naturopathic doctor practicing
17in this Commonwealth shall maintain a level of medical
18professional liability insurance coverage in the minimum amount
19of $1,000,000 per occurrence or claim made. Failure to maintain
20insurance coverage as required shall subject the licensee to
21disciplinary proceedings. The board shall accept as satisfactory
22evidence of insurance coverage any of the following:
1in accordance with subsection (a). It is sufficient if the
2applicant files with the application a copy of a letter from the
3applicant's professional liability insurance carrier indicating
4that the applicant will be covered against professional
5liability in the required amounts effective upon the issuance of
6the applicant's license to practice in this Commonwealth. Upon
7issuance of the license, the licensee has 30 days to submit to
8the board the certificate of insurance or a copy of the policy
10Section 304. Reciprocity.
11The board has the power to grant a reciprocal license to an
12applicant who is licensed or certified as a naturopathic doctor
13or similar practice in another state and has demonstrated
14qualifications which equal or exceed those required under this
15act in the determination of the board. No license shall be
16granted under this section to an applicant unless the state in
17which the applicant is licensed affords reciprocal treatment to
18individuals who are residents of this Commonwealth and who are
19licensed under this act.
21PRACTICE OF NATUROPATHIC MEDICINE
22Section 401. Scope of practice.
4(i) Naturopathic therapies.
5(ii) Naturopathic physical medicine.
9(iv) Health education and health counseling.
10(v) Behavioral medicine.
11(vi) Botanical medicine.
12(vii) Naturopathic musculoskeletal therapy.
13(viii) Homeopathic medicine.
24(2) Perform surgical procedures.
28(4) Use general or spinal anesthetics.
<-6(8) Perform physical therapy, as defined in the act of
7October 10, 1975 (P.L.383, No.110), known as the Physical
8Therapy Practice Act, unless licensed as a physical therapist
9by the Commonwealth.
11ADMINISTRATION AND ENFORCEMENT
12Section 501. Refusal, suspension and revocation of licenses.
16(1) Being convicted under Federal law, under the law of
17any state or under the law of any foreign jurisdiction of an
18offense of moral turpitude or of an offense which, if
19committed in this Commonwealth, would constitute a sexual
20offense or a felony. As used in this paragraph, the term
21"convicted" includes a finding or verdict of guilt, an
22admission of guilt or a plea of nolo contendere or receiving
23probation without verdict, disposition in lieu of trial or an
24accelerated rehabilitative disposition in the disposition of
26(2) Being found to have engaged in immoral or
27unprofessional conduct. In proceedings based on this
28paragraph, actual injury to the patient need not be
29established. As used in this paragraph, the term
30"unprofessional conduct" includes:
3(ii) sexual exploitation of a patient.
27(12) Being unable to practice with reasonable skill and
28safety by reason of illness, drunkenness, excessive use of
29drugs, narcotics, chemicals or any other type of material, or
30as a result of any mental or physical condition. In enforcing
1this paragraph, the board, upon probable cause, has authority
2to compel a licensee to submit to a mental or physical
3examination by a physician approved by the board. Failure of
4a licensee to submit to an examination when directed by the
5board, unless the failure is due to circumstances beyond the
6licensee's control, shall constitute an admission of the
7allegations against the licensee, consequent upon which a
8default and final order may be entered without the taking of
9testimony or presentation of evidence. A licensee affected
10under this paragraph shall, at reasonable intervals as
11determined by the board, be afforded an opportunity to
12demonstrate that the licensee can resume competent practice
13with reasonable skill and safety.
14(b) Board action.--If the board finds that the license or
15application for license may be refused, revoked, restricted or
16suspended under the terms of subsection (a), the board may do
17any of the following:
18(1) Deny the application for license.
19(2) Administer a public reprimand.
27(c) Administrative Agency Law.--Actions of the board under
28subsections (a) and (b) are subject to 2 Pa.C.S. Chs. 5 Subch. A
29(relating to practice and procedure of Commonwealth agencies)
30and 7 Subch. A (relating to judicial review of Commonwealth
2(d) Temporary suspension.--The board shall temporarily
3suspend a license under circumstances as determined by the board
4to be an immediate and clear danger to the public health and
5safety. The board shall issue an order to that effect without a
6hearing, but upon notice to the licensee concerned at the
7licensee's last known address, which must include a written
8statement of all allegations against the licensee. Subsection
9(c) shall not apply to temporary suspension. Upon issuance of an
10order under this subsection, the board shall commence formal
11action to suspend, revoke or restrict the license as otherwise
12provided for in this act. All actions shall be taken promptly.
13Within 30 days following the issuance of an order temporarily
14suspending a license, the board shall conduct a preliminary
15hearing to determine that there is a prima facie case supporting
16the suspension. The licensee whose license has been temporarily
17suspended may be present at the preliminary hearing and may be
18represented by counsel, cross-examine witnesses, inspect
19physical evidence, call witnesses, offer evidence and testimony
20and make a record of the proceedings. If it is determined that
21there is not a prima facie case, the suspended license shall be
22immediately restored. The temporary suspension shall remain in
23effect until vacated by the board, but in no event longer than
25(e) Automatic suspension.--
26(1) A license shall automatically be suspended upon the
27legal commitment of a licensee to an institution because of
28mental incompetence from any cause upon filing with the board
29a certified copy of the commitment.
30(2) A license shall automatically be suspended upon
1conviction of a felony under the act of April 14, 1972 (P.L.
2233, No. 64), known as The Controlled Substance, Drug, Device
3and Cosmetic Act, or conviction of an offense under the laws
4of another jurisdiction, which, if committed in this
5Commonwealth, would be a felony under The Controlled
6Substance, Drug, Device and Cosmetic Act. As used in this
7paragraph, the term "conviction" includes a judgment, an
8admission of guilt or a plea of nolo contendere.
15Section 502. Reinstatement of license.
16Unless ordered to do so by a court of competent jurisdiction,
17the board shall not reinstate the license of an individual which
18has been revoked. An individual whose license has been revoked
19may reapply for a license after a period of at least five years
20but must meet all of the licensing requirements of this act.
21Section 503. License renewal, records and fees.
26(1) All fees required under this act shall be fixed by
27the board by regulation. If the revenue raised by fees, fines
28and civil penalties imposed under this act are not sufficient
29to meet expenditures over a two-year period, the board shall
30increase those fees by regulation so that the projected
1revenues will meet or exceed projected expenditures.
2(2) If the bureau determines that the fees established
3by the board under paragraph (1) are inadequate to meet the
4minimum enforcement efforts required by this act, the bureau,
5after consultation with the board, shall increase the fees by
6regulation in an amount so that adequate revenues are raised
7to meet the required enforcement effort.
8Section 504. Duty of licensee.
12Section 505. Other professions.
16(1) The practice of a profession by an individual who is
17licensed, certified or registered by a Commonwealth agency
18under other law and who is performing services or advertising
19within the authorized scope of practice.
24(3) The practice of naturopathic medicine by an
25individual licensed, registered or certified in another
26jurisdiction when incidentally called into this Commonwealth
27to teach a course related to the practice of naturopathic
28medicine or to consult with a licensee.
1traditional naturopathy, naturopathic therapies, naturopathic
2health care, naturopathic services, natural remedies,
3ayurvedic medicine, herbal remedies, food and dietary
4supplements, nutritional advice, homeopathy and homeopathic
5remedies, hydrotherapy and therapeutic exercises or any other
6complementary and alternative healing methods and treatments
7that may be components of naturopathic medicine, provided the
8individual does not hold himself out as a naturopathic doctor
9or as a provider of naturopathic medicine.
10Section 506. Unlawful practice.
11(a) General rule.--An individual may not practice
12naturopathic medicine or hold himself out as a naturopathic
13doctor unless licensed by the board. An individual represents
14himself as a naturopathic doctor when that person adopts or uses
15any title or any description of services that incorporates one
16or more of the following terms or designations:
17(1) naturopathic doctor or N.D.; or
20(b) Title.--An individual who holds a license or is
21maintained on inactive status may use the title "Naturopathic
22Doctor" and the abbreviation "N.D." or "N.M.D." No other
23individual may use the title "Naturopathic Doctor" or hold
24himself out to others as a naturopathic doctor. This subsection
25includes advertising as a naturopathic doctor and adopting or
26using any title or description, including naturopathic doctor,
27doctor of naturopathic medicine, naturopathic medicine or a
28derivative of those terms and their related abbreviations.
3(d) Terminology.--A business entity may not utilize in
4connection with a business name or activity the words
5naturopathic doctor, doctor of naturopathic medicine,
6naturopathic medicine or a derivative of those terms and their
7related abbreviations unless the services of the business are
8provided by licensees.
9(e) Injunction.--Unlawful practice may be enjoined by the
10courts upon petition of the commissioner or the board. In a
11proceeding under this section, it shall not be necessary to show
12that an individual has been injured. If the court finds that the
13respondent has violated this section, it shall enjoin the
14respondent from practicing until the respondent has been
15licensed. Procedure in such cases shall be the same as in any
16other injunction suit.
20Section 507. Violation of act.
21(a) General rule.--A person that violates a provision of
22this act or a regulation of the board commits a misdemeanor of
23the third degree and shall, upon conviction, be sentenced to pay
24a fine of not more than $1,000 or to imprisonment for not more
25than six months for the first violation and to pay a fine of not
26more than $2,000 or to imprisonment for not less than six months
27or more than one year, or both, for each subsequent violation.
1membership of the board or by a vote of the majority of the
2qualified and confirmed membership or a minimum of five members,
3whichever is greater, may levy a civil penalty of up to $1,000
4on any of the following:
14(c) Administrative Agency Law.--Action of the board under
15subsection (b) is subject to 2 Pa.C.S. Chs. 5 Subch. A (relating
16to practice and procedure of Commonwealth agencies) and 7 Subch.
17A (relating to judicial review of Commonwealth agency action).
20Section 601. Regulations.
21The board shall promulgate regulations to carry out this act.
22Publication of the final-form regulations under this section
23shall take place within 18 months of the effective date of this
24section. The board shall report, within 60 days of the effective
25date of this section, and every 30 days thereafter, on the
26status of the regulations to the Consumer Protection and
27Professional Licensure Committee of the Senate and the
28Professional Licensure Committee of the House of
30Section 602. Effective date.
1This act shall take effect as follows: