AB513 - Revises provisions relating to chiropractic physicians and chiropractic assistants. (BDR 54-630)

- 83rd Session (2025) Assembly Bill No. 513–Committee on Commerce and Labor CHAPTER.......... AN ACT relating to chiropractic; enacting provisions relating to temporary certificates for chiropractic assistants; revising provisions relating to unprofessional conduct in the practice of chiropractic; revising the membership of the Chiropractic Physicians’ Board of Nevada; revising certain qualifications required to apply for a license as a chiropractic physician or a certificate as a chiropractic assistant; revising certain fees the Board may charge and collect; revising certain requirements for student participation in a preceptor program; revising certain requirements for certain cease and desist orders of the Board; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law regulates the practice of chiropractic in this State and provides for the licensure of chiropractic physicians and the certification of chiropractic assistants. (Chapter 634 of NRS) Section 1 of this bill authorizes the Chiropractic Physicians’ Board of Nevada, under certain circumstances, to issue a temporary certificate to practice as a chiropractic assistant to a person who holds an existing license, certificate or registration in good standing in another jurisdiction where the person resides. Section 1 provides that such a temporary certificate is: (1) valid for 15 business days or less; (2) valid only under the supervision and control of a chiropractic physician; and (3) not renewable, and the Board may grant not more than two temporary certificates to a person during any calendar year. Section 1 authorizes the Board to charge a reasonable fee, established by regulation of the Board, for each application for a temporary certificate. Existing law provides grounds for initiating disciplinary action against practitioners of chiropractic. (NRS 634.018, 634.140) Section 2 of this bill makes employing a person as a temporary chiropractic assistant if the person has not been issued a temporary certificate pursuant to section 1 grounds for disciplinary action. Existing law creates the Board, consisting of seven members, and requires the Governor to appoint members with certain qualifications. (NRS 634.020) Section 3 of this bill revises the membership of the Board by: (1) removing a requirement for the Governor to appoint one member who represents the interests of persons or agencies that regularly provide health care to patients who are indigent, uninsured or unable to afford health care; and (2) increasing from four to five the number of chiropractic physicians the Governor is required to appoint. Existing law requires: (1) the Board to hold certain examinations prescribed by the Board at least semiannually; and (2) examinations prescribed by the Board to include certain subjects. Existing law also authorizes the Board to: (1) determine the form of such examinations; and (2) include additional subjects on such examinations. (NRS 634.070) Section 4 of this bill removes the requirements that such examinations be held semiannually and contain certain subjects, and instead authorizes the Board to: (1) hold examinations semiannually or at other intervals prescribed by the Board; and (2) determine the content of such examinations. Section 5 of this bill requires an applicant for examination to submit to the Board a statement which attests that the applicant has read, understood and will abide by the provisions of existing law and regulations governing chiropractic physicians and – 2 – - 83rd Session (2025) providers of health care. Sections 7 and 10 of this bill remove provisions establishing the minimum score to pass the required examination. Section 7 additionally removes certain provisions governing applicants who fail to pass the examination. Sections 3, 5, 6 and 12 of this bill revise the educational requirements for licensure as a chiropractic physician and for being appointed to the Board to specify that the required education may be obtained through certain doctor of chiropractic degree programs. Existing law authorizes the Board to specify the formal training which an applicant for a certificate as a chiropractic assistant must complete, which must include at least 12 months of study or the equivalent. (NRS 634.123) Section 8 of this bill removes the requirement to include at least 12 months of training or the equivalent. Section 11 of this bill eliminates the authority of the Board to charge a fee for providing to a person who is not licensed to practice chiropractic: (1) a list of persons who were licensed to practice chiropractic following the most recent examination of the Board; (2) a copy of the statutes, regulations and other rules governing the practice of chiropractic in this State; and (3) a list of continuing education courses approved by the Board. Section 11 also expands the applicability of an existing fee for a review by the Board of certain courses offered for continuing education to include a review of a course offered to satisfy the requirements for the qualifications to perform dry needling. Section 12 revises certain requirements for a student to participate in a preceptor program. Section 13 of this bill revises certain contact information which is required to be included in certain cease and desist orders issued by the Board. EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 634 of NRS is hereby amended by adding thereto a new section to read as follows: 1. Except as otherwise provided in subsection 6, upon submission of the application and materials required by this section and payment of the required fee, the Board may issue a temporary certificate to practice as a chiropractic assistant in this State to a person who holds a corresponding license, certificate or registration which is in good standing to perform the functions of a chiropractic assistant in the District of Columbia or any other state or territory of the United States in which the person resides. 2. An applicant for a temporary certificate to practice as a chiropractic assistant must: (a) Hold a license, certificate or registration which is in good standing to perform the functions of a chiropractic assistant in the District of Columbia or any other state or territory of the United States in which the applicant is a resident; (b) Submit to the Board: – 3 – - 83rd Session (2025) (1) An application on a form prescribed by the Board; (2) An attestation on a form prescribed by the Board that the applicant has read, understood and will abide by the provisions of this chapter and the regulations adopted thereto; (3) An attestation on a form prescribed by the Board that the applicant understands he or she is not authorized to take and develop radiographs unless he or she is certified or licensed in this State to do so; and (4) The attestation required by subsection 3; and (c) Pay a reasonable application fee established by regulation of the Board. 3. A chiropractic physician who intends to use the services of a chiropractic assistant who will practice under a temporary certificate must attest on a form provided by the Board that: (a) The chiropractic physician has a need for the assistance of a chiropractic assistant on a temporary basis; (b) The person who will perform the functions of a chiropractic assistant on a temporary basis, if approved by the Board, will work under the supervision and control of the chiropractic physician, either as an employee or as an independent contractor; (c) The chiropractic physician will be responsible for the acts of the person performed in his or her capacity as a chiropractic assistant; and (d) The person will only perform the functions of a chiropractic assistant for the period specified by the chiropractic physician, which must be 15 business days or less. 4. An applicant for a temporary certificate as a chiropractic assistant shall not commence performing the functions of a chiropractic assistant until his or her application is approved and the applicant is issued the certificate. 5. A temporary certificate to practice as a chiropractic assistant is: (a) Valid for the period designated on the certificate, which must be 15 business days or less; (b) Valid only under the supervision and control of the chiropractic physician described in subsection 3; and (c) Not renewable. 6. The Board may not grant more than two temporary certificates to practice as a chiropractic assistant to a person during any calendar year. Sec. 2. NRS 634.018 is hereby amended to read as follows: 634.018 “Unprofessional conduct” means: – 4 – - 83rd Session (2025) 1. Obtaining a certificate upon fraudulent credentials or gross misrepresentation. 2. Procuring, or aiding or abetting in procuring, criminal abortion. 3. Assuring that a manifestly incurable disease can be permanently cured. 4. Advertising, by any form of public communication, a chiropractic practice: (a) Using grossly improbable statements; or (b) In any manner that will tend to deceive, defraud or mislead the public.  As used in this subsection, “public communication” includes, but is not limited to, communications by means of television, radio, motion pictures, Internet websites, electronic mail, social media accounts and newspapers, books, periodicals, handbills, letterhead and other printed matter. 5. Willful disobedience of the law, or of the regulations of the State Board of Health or of the Chiropractic Physicians’ Board of Nevada. 6. Conviction of any offense involving moral turpitude, or the conviction of a felony. The record of the conviction is conclusive evidence of unprofessional conduct. 7. Administering, dispensing or prescribing any controlled substance. 8. Conviction or violation of any federal or state law regulating the possession, distribution or use of any controlled substance. The record of conviction is conclusive evidence of unprofessional conduct. 9. Habitual intemperance or excessive use of alcohol or alcoholic beverages , cannabis or any controlled substance. 10. Conduct unbecoming a person licensed to practice chiropractic or detrimental to the best interests of the public. 11. Violating, or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision of this chapter or the regulations adopted by the Board, or any other statute or regulation pertaining to the practice of chiropractic. 12. Employing, directly or indirectly, any suspended or unlicensed practitioner in the practice of any system or mode of treating the sick or afflicted, or the aiding or abetting of any unlicensed person to practice chiropractic under this chapter. 13. Malpractice, which may be evidenced by claims of malpractice settled against a practitioner. – 5 – - 83rd Session (2025) 14. Solicitation by the licensee or the licensee’s designated agent of any person who, at the time of the solicitation, is vulnerable to undue influence, including, without limitation, any person known by the licensee to have recently been involved in a motor vehicle crash, involved in a work-related accident, or injured by, or as the result of the actions of, another person. As used in this subsection: (a) “Designated agent” means a person who renders service to a licensee on a contract basis and is not an employee of the licensee. (b) “Solicitation” means the attempt to acquire a new patient through information obtained from a law enforcement agency, medical facility or the report of any other party, which information indicates that the potential new patient may be vulnerable to undue influence, as described in this subsection. 15. Employing, directly or indirectly, any person as a chiropractic assistant unless the person [has] : (a) Has been issued a certificate by the Board pursuant to NRS 634.123, or has applied for such a certificate and is awaiting the determination of the Board concerning the application [.] ; or (b) Has been issued a temporary certificate by the Board pursuant to section 1 of this act. 16. Aiding, abetting, commanding, counseling, encouraging, inducing or soliciting an insurer or other third-party payor to reduce or deny payment or reimbursement for the care or treatment of a patient, unless such action is supported by: (a) The medical records of the patient; or (b) An examination of the patient by the chiropractic physician taking such action. 17. Violating a lawful order of the Board, a lawful agreement with the Board, or any of the provisions of this chapter or any regulation adopted pursuant thereto. 18. Practicing below the standard of care required from a chiropractic physician or chiropractic assistant under the circumstances. Sec. 3. NRS 634.020 is hereby amended to read as follows: 634.020 1. The Chiropractic Physicians’ Board of Nevada, consisting of seven members appointed by the Governor, is hereby created. 2. The Governor shall appoint: (a) [Four] Five members who are: (1) Graduates of chiropractic schools or colleges or of doctor of chiropractic degree programs giving a course of study embracing the following subjects: Anatomy, bacteriology, chiropractic theory and practice, diagnosis or analysis, elementary – 6 – - 83rd Session (2025) chemistry and toxicology, histology, hygiene and sanitation, obstetrics and gynecology, pathology, physiology and symptomatology; (2) Licensed under this chapter; and (3) Actually engaged in the practice of chiropractic in this State and who have been so engaged in this State for at least 3 years preceding their appointment. (b) [One member who represents the interests of persons or agencies that regularly provide health care to patients who are indigent, uninsured or unable to afford health care. This member may be licensed under the provisions of this chapter. (c)] Two members who are representatives of the general public. A member appointed pursuant to this paragraph must not be: (1) A chiropractic physician or a chiropractic assistant; or (2) The spouse or the parent or child, by blood, marriage or adoption, of a chiropractic physician or a chiropractic assistant. 3. At least two of the appointees must have had a course in physiotherapy in a school or college of chiropractic [.] or in a doctor of chiropractic degree program. Sec. 4. NRS 6 [Text truncated for display. Full text available on LegiScan.]