HOUSE BILL 189
57th legislature - STATE OF NEW MEXICO - first session, 2025
INTRODUCED BY
Dayan Hochman-Vigil
AN ACT
RELATING TO LICENSING; AMENDING AND ENACTING SECTIONS OF THE CHIROPRACTIC PHYSICIAN PRACTICE ACT TO REQUIRE THAT THE CHIROPRACTIC BOARD INCLUDE A CERTIFIED ADVANCED PRACTICE CHIROPRACTIC PHYSICIAN MEMBER; REQUIRING APPLICANTS FOR LICENSURE TO PROVIDE EVIDENCE OF GRADUATION FROM AN ACCREDITED CHIROPRACTIC PROGRAM; EXPANDING THE CHIROPRACTIC BOARD'S AUTHORITY TO CREATE CLASSIFICATIONS FOR LEVEL ONE AND LEVEL TWO CERTIFIED ADVANCED PRACTICE CHIROPRACTIC PHYSICIANS IN THE ADVANCED PRACTICE CHIROPRACTIC CERTIFICATION REGISTRY, ESTABLISH REQUIREMENTS AND PROCEDURES FOR CERTIFICATION AND CERTIFY APPLICANTS; PROVIDING FOR THE EXPANSION OF AUTHORITY FOR LEVEL ONE CERTIFIED ADVANCED PRACTICE CHIROPRACTIC PHYSICIANS AND LEVEL TWO CERTIFIED ADVANCED PRACTICE CHIROPRACTIC PHYSICIANS TO INCORPORATE CERTAIN CLINICAL PROCEDURES AND PRESCRIBE DANGEROUS DRUGS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. Section 61-4-2 NMSA 1978 (being Laws 1968, Chapter 3, Section 2, as amended) is amended to read:
"61-4-2. DEFINITIONS.--As used in the Chiropractic Physician Practice Act:
A. "advanced practice chiropractic certification registry" means a compendium kept by the board that meets and maintains the board's established credentials for certified advanced practice chiropractic physicians;
B. "certified advanced practice chiropractic physician" means a chiropractic physician who has been included in the advanced practice chiropractic certification registry as a level one certified advanced practice chiropractic physician or a level two certified advanced practice chiropractic physician;
C. "chiropractic medicine" means the science, art and philosophy of things natural, the science of locating and removing interference with the transmissions or expression of nerve forces in the human body by the correction of misalignments or subluxations of the articulations and adjacent structures, more especially those of the vertebral column and pelvis, for the purpose of restoring and maintaining health for treatment of human disease [primarily] by, but not limited to, adjustment and manipulation of the human structure and diagnosis and treatment of a condition or disease process for which the chiropractic physician has been educated and trained. It shall include [but not be limited to] the prescribing and administering of all natural agents to assist in the healing act, such as food, water, heat, cold, light, oxygen, electricity, mechanical appliances and medical devices; the selling of herbs, nutritional supplements and homeopathic remedies; the [administering of a drug by injection] prescription, administration, injection or dispensing of dangerous drugs by a certified advanced practice chiropractic physician; and any necessary diagnostic procedure, excluding invasive procedures, except as provided by the board by rule and regulation. It shall exclude:
(1) the practice of operative surgery; provided that a level two advanced practice chiropractic physician may perform clinical procedures as taught for primary care practice, commensurate with physician level whole person primary care practice;
(2) the prescription, [or use of controlled or] administration, injection or dispensing of dangerous drugs; provided that a level one certified advanced practice chiropractic physician or a level two certified advanced practice chiropractic physician may prescribe, administer, inject or dispense dangerous drugs; and
(3) the practice of acupuncture;
D. "board" means the chiropractic board;
E. "chiropractic physician" includes doctor of chiropractic, chiropractor and chiropractic physician and means a person who practices chiropractic medicine as defined in the Chiropractic Physician Practice Act; and
F. "chiropractic assistant" means a person who practices under the on-premises supervision of a licensed chiropractic physician."
SECTION 2. Section 61-4-3 NMSA 1978 (being Laws 1968, Chapter 3, Section 3, as amended) is amended to read:
"61-4-3. BOARD CREATED--APPOINTMENT--OFFICERS--DUTIES--COMPENSATION.--
A. The "chiropractic board" is created and is administratively attached to the regulation and licensing department. The board shall consist of six persons, four of whom have been continuously engaged in the practice of chiropractic medicine in New Mexico for five years immediately prior to their appointment and of which at least one shall be a certified advanced practice chiropractic physician. Two persons shall represent the public and shall not have practiced chiropractic medicine in this state or any other jurisdiction. A person shall not be appointed to the board who is an officer or employee of or who is financially interested in any school or college of [chiropractic] medicine, surgery, [or] osteopathy or other allied health profession. The public members shall not have any significant financial interest in chiropractic medicine or be active in another health care profession.
B. Members of the board shall be appointed by the governor for staggered terms of five years or less and in a manner that the term of one board member expires on July 1 of each year. A list of five names for each professional member vacancy shall be submitted by the New Mexico chiropractic association to the governor for consideration in the appointment of board members. A vacancy shall be filled by appointment for the unexpired term. Board members shall serve until their successors have been appointed and qualified.
C. The board shall annually elect a chair and a secretary-treasurer. A majority of the board constitutes a quorum. The board shall meet quarterly. Special meetings may be called by the chair and shall be called upon the written request of two members of the board. Notification of special meetings shall be made by certified mail unless such notice is waived by the entire board and the action noted in the minutes. Notice of all regular meetings shall be made by regular mail at least ten days prior to the meeting, and copies of the minutes of all meetings shall be mailed to each board member within thirty days after a meeting.
D. A board member failing to attend three consecutive meetings, either regular or special, shall automatically be removed as a member of the board.
E. The board shall adopt a seal.
F. The board shall promulgate and file, in accordance with the State Rules Act, all rules necessary for the implementation and enforcement of the provisions of the Chiropractic Physician Practice Act, including educational requirements for a chiropractic assistant.
G. The board, for the purpose of protecting the health and well-being of the citizens of this state and maintaining and continuing informed professional knowledge and awareness, shall establish by rule mandatory continuing education requirements for chiropractic physicians and certified advanced practice chiropractic physicians licensed in this state.
H. Failure to comply with the rules adopted by the board shall be grounds for investigation, which may lead to revocation of license.
I. Members of the board shall be reimbursed as provided in the Per Diem and Mileage Act, but shall receive no other compensation, perquisite or allowance for each day necessarily spent in the discharge of their duties."
SECTION 3. A new section of the Chiropractic Physician Practice Act is enacted to read:
"[NEW MATERIAL] EVIDENCE OF GRADUATION--ACCREDITATION OF COLLEGE.--In addition to the requirements prescribed in Section 61-4-4 NMSA 1978, all applicants for licensure who have matriculated at a chiropractic college after October 1, 1975 shall present evidence of having graduated from a chiropractic college having status with the leading chiropractic education accreditation organization or the equivalent criterion thereof."
SECTION 4. Section 61-4-6 NMSA 1978 (being Laws 1968, Chapter 3, Section 6, as amended) is amended to read:
"61-4-6. EXAMINATION--SUBJECTS--METHOD OF TREATMENT--RECORDING LICENSE.--
A. The board shall recognize successful completion of all parts of the examination conducted by the national board of chiropractic examiners.
B. The board shall examine each applicant in the act of chiropractic adjusting, procedures and methods as shall reveal the applicant's qualifications; provided that the board may waive the requirement for the board-administered examination upon proof of satisfactory completion of the examination conducted by the national board of chiropractic examiners.
C. The board shall issue a license to all applicants whose applications have been filed with and approved by the board and who have paid the required fees and passed either the board-administered examination with a general average of not less than seventy-five percent with no subject below sixty-five percent or the examination conducted by the national board of chiropractic examiners with a general average of not less than seventy-five percent with no subject below sixty-five percent. A license shall be refused to an applicant who fails to make application as provided in this section, fails the examination or fails to pay the required fees.
D. The license, when granted by the board, carries with it the title of doctor of chiropractic and entitles the holder to diagnose using any necessary diagnostic procedures, excluding invasive procedures, except as provided by the board by rule, and treat injuries, deformities or other physical or mental conditions [relating to the basic concepts of chiropractic] as taught in an accredited institution of higher education by the use of any methods as provided in this section, including but not limited to palpating, diagnosing, adjusting and treating injuries and defects of human beings by the application of manipulative, manual and mechanical means, including all natural agencies imbued with the healing act, such as food, water, heat, cold, light, oxygen, electricity and mechanical appliances, herbs, nutritional supplements and homeopathic remedies, but excluding operative surgery and prescription or use of controlled or dangerous drugs, except for level one certified advanced practice chiropractic physicians and level two certified advanced practice chiropractic physicians pursuant to this 2025 act. The holder may also supervise the use of any natural agencies imbued with the healing act, such as food, water, heat, cold, light, oxygen, electricity, mechanical appliances, herbs, nutritional supplements and homeopathic remedies administered by a chiropractic assistant.
E. Failure to display the license shall be grounds for the suspension of the license to practice chiropractic medicine until so displayed and shall subject the licensee to the penalties for practicing without a license.
F. The board shall certify a chiropractic physician as a level one certified advanced practice chiropractic physician or a level two certified advanced practice chiropractic physician when the chiropractic physician has demonstrated completion of advanced coursework and met other requirements established in the Chiropractic Physician Practice Act and by rule of the board."
SECTION 5. Section 61-4-8 NMSA 1978 (being Laws 1968, Chapter 3, Section 8, as amended) is amended to read:
"61-4-8. LICENSE WITHOUT EXAMINATION.--
A. The board shall issue a license without examination to a chiropractic physician who is a graduate of a [standard college of] chiropractic program accredited by an agency recognized by the leading higher education accreditation organization and has been licensed in another licensing jurisdiction if the applicant holds a valid and unrestricted license, is in good standing with the licensing board of the other licensing jurisdiction and has practiced as a chiropractor for at least two years immediately prior to application in New Mexico. The board shall, as soon as practicable but no later than thirty days after a person files an application for a license accompanied by any required fees, process the application and issue the expedited license in accordance with Section 61-1-31.1 NMSA 1978. If the board issues an expedited license to a person whose prior licensing jurisdiction did not require examination, the board may require that person to pass an examination before applying for license renewal.
B. The board by rule shall determine the states and territories of the United States and the District of Columbia from which it will not accept an applicant for expedited licensure and foreign countries from which it will accept an applicant for expedited licensure. The board shall post the lists of disapproved and approved licensing jurisdictions on its website. The list of disapproved licensing jurisdictions shall include the specific reasons for disapproval. The lists shall be reviewed annually to determine if amendments to the rule are warranted."
SECTION 6. A new section of the Chiropractic Physician Practice Act is enacted to read:
"[NEW MATERIAL] PRIVILEGES AND OBLIGATIONS.--
A. Licensed chiropractic physicians shall observe all health and hygiene laws and regulations of the state and its political subdivisions and shall report births and deaths to the proper authorities. Reports rendered by chiropractic physicians shall be accepted by officers of departments or agencies to which they are made.
B. It is the purpose of the Chiropractic Physician Practice Act to grant to chiropractic physicians the right to practice chiropractic medicine as taught and practiced in accredited chiropractic programs and to entitle the holder of a license the right to diagnose, palpate and treat injuries, deformities and other physical or mental conditions for which the chiropractic physician has been educated and trained in an accredited institution of higher education by use of any methods provided in the Chiropractic Physician Practice Act, as provided in rules established and monitored by the board, but excluding:
(1) the practice of operative surgery; provided that a level two certified advanced practice chiropractic physician may perform clinical procedures as taught for primary care commensurate with the physician level of whole person primary care;
(2) the prescription, administration, injection or dispensing of dangerous drugs; provided that a level one certified advanced practice chiropractic physician or a level two certified advance practice chiropractic physician may prescribe, administer, inject or dispense dangerous drugs; and
(3) the practice of acupuncture."
SECTION 7. Section 61-4-9.1 NMSA 1978 (being Laws 2008, Chapter 44, Section 1) is amended to read:
"61-4-9.1. ADVANCED PRACTICE CHIROPRACTIC CERTIFICATION REGISTRY ESTABLISHED--INCLUSION OF LEVEL ONE AND LEVEL TWO CERTIFIED ADVANCED PRACTICE CHIROPRACTIC PHYSICIANS.--The board shall establish by rule the advanced practice chiropractic certification registry. A chiropractic physician authorized by the board to use the title "level one certified advanced practice chiropractic physician" or "level two certified advanced practice chiropractic physician" shall have prescriptive authority for therapeutic and diagnostic purposes as authorized by statute. Only a chiropractic physician included in the advanced practice chiropractic certification registry may use the title "level one certified advanced practice chiropractic physician" or "level two certified advanced practice chiropractic physician", and it is unlawful for a person to use the level one certified advanced practice chiropractic physician title or the level two certified advanced practice chiropractic physician title unless the person is included in the advanced practice chiropractic certification registry. [The advanced practice chiropractic certification registry shall include a chiropractic physician who applies for the designation and:
A. holds a chiropractic license in good standing;
B. has completed three years of post-graduate clinical chiropractic practice or equivalent clinical experience as established by the board;
C. has an advanced practice chiropractic certification by a nationally recognized credentialing agency providing credentialing and demonstrated competency by examination and additionally, after December 31, 2012, successful completion of a graduate degree in a chiropractic clinical practice specialty;
D. has completed a minimum of ninety clinical and didactic contact course hours in pharmacology, pharmacognosy, medication administration and toxicology certified by an examination from an institution of higher education approved by the board and the New Mexico medical board; and
E. has completed annual continuing education for advanced practice chiropractic physicians as set by the board.]"
SECTION 8. A new section of the Chiropractic Physician Practice Act is enacted to read:
"[NEW MATERIAL] ADVANCED PRACTICE CHIROPRACTIC CERTIFICATION--LEVEL ONE.--
A. The board shall certify a chiropractic physician as a level one certified advanced practice chiropractic physician if a chiropractic physician submits an application and documentation that the chiropractic physician:
(1) has successfully completed a minimum of ninety clinical and didactic contact hours or competency equivalent in pharmacology, pharmacognosy, medication administration and management and toxicology certified by an examination from an accredited institution of higher education; and
(2) holds a license in good standing to practice chiropractic medicine.
B. The board shall promulgate rules related to practice as a level one certified advanced practice chiropractic physician that provide for:
(1) the issuance, renewal, denial, suspension or revocation of certification; and
(2) continuing education requirements that shall include at least ten hours of continuing education per year."
SECTION 9. A new section of the Chiropractic Physician Practice Act is enacted to read:
"[NEW MATERIAL] ADVANCED PRACTICE CHIROPRACTIC CERTIFICATION--LEVEL TWO.--
A. The board shall certify a chiropractic physician as a level two certified advanced practice chiropractic physician if a chiropractic physician submits an application and documentation that the chiropractic physician:
(1) has successfully completed a program of supervised clinical rotation sponsored by a recognized accredited institution of higher education that consists of clinical and hands-on instruction of no fewer than five hundred hours; and
(2) holds a license in good standing to practice chiropractic medicine.
B. The board shall promulgate rules related to practice as a level two certified advanced practice chiropractic physician that provide for:
(1) continuing education requirements that shall include at least twenty hours of continuing education per year; and
(2) the issuance, renewal, denial, suspension or revocation of certification.
C. A level one certified advanced practice chiropractic physician may apply to the board for certification as a level two certified advanced practice chiropractic physician on a form prescribed by the board that contains evidence satisfactory to the board that the applicant:
(1) holds a current license to practice chiropractic medicine;
(2) holds certification by the board as a level one certified advanced practice chiropractic physician;
(3) has successfully completed a program of supervised clinical rotation sponsored by a recognized accredited institution of higher education that consists of clinical and hands-on instruction of no fewer than five hundred hours in the following core areas of instruction:
(a) clinical pharmacology;
(b) evidence-based clinical assessment;
(c) clinical pharmacotherapeutics;
(d) primary care case management; and
(e) patient safety and standards of primary care;
(4) has professional liability insurance in place during the clinical education that is sufficient to satisfy the requirements established by rules of the board; and
(5) has obtained a declaration that the applicant has the prescribed clinical experience from:
(a) a supervising physician, a certified nurse practitioner or a level two certified advanced practice chiropractic physician; and
(b) the accredited institution of higher education where the applicant has successfully completed a supervised clinical rotation pursuant to Paragraph (1) of Subsection A of this section."
SECTION 10. Section 61-4-9.2 NMSA 1978 (being Laws 2008, Chapter 44, Section 2, as amended) is amended to read:
"61-4-9.2. CERTIFIED ADVANCED PRACTICE CHIROPRACTIC PHYSICIAN AUTHORITY [DEFINED]--CLINICAL PROCEDURES AND DANGEROUS DRUGS.--
A. A level one certified advanced practice chiropractic physician may prescribe, administer, inject and dispense herbal medicines, homeopathic medicines, over-the-counter drugs, vitamins, carbohydrates, sugars, alcohols, minerals, enzymes, glandular products, protomorphogens, live cell products, [gerovital] amino acids, dietary supplements, foods for special dietary use, bioidentical hormones, sterile water, sterile saline, sarapin or its generic, caffeine, [procaine] all dangerous drugs under the drug classes of antispastics and antispasmodics, steroids, prescription- strength nonsteroidal anti-inflammatory drugs, desiccated thyroid extract, oxygen, epinephrine and vapocoolants and local anesthetics, including procaine, lidocaine, carbocaine and bupivacaine.
B. A [formulary that includes all substances listed in Subsection A of this section, including compounded preparations for topical and oral administration, shall be developed and approved by the board. A formulary for injection that includes the substances in Subsection A of this section that are within the scope of practice of the certified advanced practice chiropractic physician shall be developed and approved by the board. Dangerous drugs or controlled substances, drugs for administration by injection and substances not listed in Subsection A of this section shall be submitted to the board of pharmacy and the New Mexico medical board for approval.] level two certified advanced practice chiropractic physician may prescribe, administer, inject and dispense dangerous drugs that are used in a primary care practice commensurate with physician level whole person primary care."
SECTION 11. Section 61-4-15 NMSA 1978 (being Laws 1968, Chapter 3, Section 14, as amended) is amended to read:
"61-4-15. EXEMPTIONS.--The Chiropractic Physician Practice Act does not apply to:
A. any commissioned officer of the armed forces of the United States in the discharge of [his] official duties;
B. a [chiropractor] chiropractic physician who is legally qualified to practice in the state or territory in which [he] the chiropractic physician resides, when in actual consultation with a licensed [chiropractor] chiropractic physician of this state; or
C. any bona fide student of any [standard] accredited chiropractic [college chiropractically analyzing and adjusting the human body] program who can diagnose and treat a condition or disease process for which a chiropractic physician has been educated and trained while under supervision of a licensed [chiropractor] chiropractic physician."
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