HB2227 - Chiropractic board; complaints; training; authority.

REFERENCE TITLE: chiropractic board; complaints; training; authority. State of Arizona House of Representatives Fifty-seventh Legislature Second Regular Session 2026 HB 2227 Introduced by Representative Blackman AN ACT amending section 32-900, Arizona Revised Statutes; amending title 32, chapter 8, article 1, Arizona Revised Statutes, by adding section 32-900.01; amending section 32-904, Arizona Revised Statutes; amending title 32, chapter 8, article 1, Arizona Revised Statutes, by adding section 32-904.01; amending sections 32-905, 32-921, 32-923 and 32-924, Arizona Revised Statutes; amending title 32, chapter 8, article 2, Arizona Revised Statutes, by adding section 32-924.01; amending sections 32-929 and 32-934, Arizona Revised Statutes; relating to the state board of chiropractic examiners. (TEXT OF BILL BEGINS ON NEXT PAGE) Be it enacted by the Legislature of the State of Arizona: Section 1. Section 32-900, Arizona Revised Statutes, is amended to read: START_STATUTE 32-900. Definitions In this chapter, unless the context otherwise requires: 1. "Advisory letter" means a nondisciplinary letter to notify a licensee that either: (a) While there is insufficient evidence to support disciplinary action, the board believes that continuation of the activities that led to the investigation may result in further board action against the licensee. (b) The violation is a minor or technical violation that is not of sufficient merit to warrant disciplinary action. (c) The violation is a minor or technical violation, and while the licensee has demonstrated substantial compliance through rehabilitation or remediation that has mitigated the need for disciplinary action, the board believes that repetition of the activities that led to the investigation may result in further board action against the licensee. 2. "Board" means the state board of chiropractic examiners. 3. "Certification" means that a doctor of chiropractic has been certified by the board in a specialty of chiropractic as provided by law. 4. "Chiropractic assistant" means an unlicensed person who has completed an educational training program approved by the board, who assists in basic health care duties in the practice of chiropractic under the supervision of a doctor of chiropractic and who performs delegated duties commensurate with the chiropractic assistant's education and training but who does not evaluate, interpret, design or modify established treatment programs of chiropractic care or violate any statute. 5. "Doctor of chiropractic" or "chiropractic physician" means a natural person who holds a license to practice chiropractic pursuant to this chapter. 6. "License" means a license to practice chiropractic. 7. "Member" includes a doctor of chiropractic who is employed with, contracted with or otherwise affiliated with another licensee. 8. "Patient safety" means actions associated with chiropractic care that are taken to prevent errors and adverse effects to patients. 7. 9. "Physical medicine modalities" means any physical agent applied to produce therapeutic change to biologic tissues, including thermal, acoustic, noninvasive light, mechanical or electric energy, hot or cold packs, ultrasound, galvanism, microwave, diathermy and electrical stimulation. 8. 10. "Therapeutic procedures" means the application of clinical skills and services, including therapeutic exercise, therapeutic activities, manual therapy techniques, massage and structural supports, to improve a patient's neuromusculoskeletal condition. END_STATUTE Sec. 2. Title 32, chapter 8, article 1, Arizona Revised Statutes, is amended by adding section 32-900.01, to read: START_STATUTE 32-900.01. Unprofessional conduct; board prohibition A. In this chapter, for the PURPOSES of disciplining a doctor of chiropractic, any of the following whether occurring in this state or elsewhere constitutes Unprofessional conduct: 1. Failing to disclose, in writing, to a patient or a third-party payor that the licensee has a financial interest in a diagnostic or treatment facility, test, good or service when referring a patient for a prescribed diagnostic test, treatment, good or service and that the diagnostic test, treatment, good or service is available on a competitive basis from another health care provider. This paragraph does not apply to a referral by one licensee to another within a group of licensees who practice together. This paragraph applies regardless of whether the referred service is provided at the licensee's place of practice or at another location. 2. Knowingly making a false or misleading statement to a patient or a third-party payor. 3. Knowingly making a false or misleading statement, providing false or misleading information or omitting material information in any oral or written communication, including attachments, to the board, board staff or a board representative or on any form required by the board. 4. Knowingly filing with the board an application or other document that contains false or misleading information. 5. Failing to create an adequate patient record that includes the patient's health history, clinical impressions, examination findings, diagnostic results, x-ray films or digital imaging if taken, x-ray or digital imaging reports, a treatment plan, notes for each patient visit and a billing record. The notes for each patient visit must include the patient's name, the date of service, the doctor of chiropractic's findings, a description of any service rendered and the name or initials of the doctor of chiropractic who provided services to the patient. 6. Failing to maintain the information required by paragraph 5 of this subsection for a patient for at least six years after the last treatment date or, for a minor, six years after the minor's eighteenth birthday. 7. Failing to provide written notice to the board about how to access the patient records of a chiropractic practice that is closed by providing, at a minimum, the physical address, telephone number and full name of a person who can be contacted regarding where the records are maintained for at least six years after each patient's last treatment date or a minor patient's eighteenth birthday. 8. Failing to do any of the following: ( a ) Release a copy of all requested patient records as prescribed in paragraph 5 of this subsection, including the original or a diagnostic quality radiographic copy of x-rays or digital imaging, to another licensed physician, the patient or the patient's authorized agent within ten business days after receiving a written request to do so. This subdivision does not require the release of a patient's billing record to another licensed physician. ( b ) Release a copy of any specified portion or all of a patient's billing record to the patient or the patient's authorized agent within ten business days after receiving a written request to do so. ( c ) In the case of a patient or a patient's authorized agent who has verbally requested the patient record, provide the patient record. ( d ) Return original x-rays or digital imaging to a licensed physician within ten business days after receiving a written request to do so. ( e ) Provide copies of patient records to another licensed physician, the patient or the patient's authorized agent free of charge in violation of title 12, chapter 13, article 7.1. 9. Representing that the licensee has certification in a specialty area in which the licensee does not have certification or has academic or professional credentials that the licensee does not have. 10. Failing to provide to a patient on request documentation of the licensee's certification by the board in a specialty area or the licensee's academic certification, degree or professional credentials. 11. Practicing or billing for services under any name other than the name by which the doctor of chiropractic is licensed by the board, including a corporate, business or other licensed health care provider's name, without first notifying the board in writing. 12. Suggesting or having sexual contact, as defined in section 13-1401, in the course of patient treatment or within three months after the last chiropractic examination, treatment or consultation with an individual with whom a consensual sexual relationship did not exist before the doctor of chiropractic-patient relationship was established. 13. Intentionally viewing a completely or partially disrobed patient in the course of an examination or treatment if the viewing is not related to the patient's complaint, diagnosis or treatment under current practice standards. 14. Intentionally misrepresenting the effectiveness of a treatment, diagnostic test or device. 15. Penetrating a patient's rectum by a rectal probe or device to administer an ultrasound, diathermy or other modality. 16. Using ionizing radiation in violation of section 32-2811. 17. Promoting or using diagnostic testing or treatment for research or experimental purposes without doing both of the following: ( a ) Obtaining written informed consent from the patient or the patient's authorized agent before the diagnostic test or treatment, including disclosing to the patient or authorized agent any research protocol, contract the licensee has with researchers, if applicable, and information on the institutional review committee used to establish patient protection. ( b ) Conforming to generally accepted research or experimental criteria, including following protocols, maintaining detailed records, periodically analyzing results and periodically submitting to review by a peer review committee. 18. Having a professional connection with an illegal practitioner of chiropractic, misrepresenting oneself as a current or past board member, a current or past board staff member or a current or past board chiropractic consultant or claiming professional superiority in the practice of chiropractic under section 32-925. 19. Violating the health insurance portability and accountability act. 20. Habitually using or having habitually used alcohol, narcotics or stimulants to the extent of incapacitating the licensee in performing professional duties. 21. Being Convicted by a court of competent jurisdiction of a class 1, 2, 3, 4 or 5 felony. 22. In any other jurisdiction, having an action taken against the licensee's professional license, having any limit or restriction placed on the license, having the license placed on probation or suspension or revoked or surrendered as a disciplinary measure or having a license application or license renewal denied for a reason related to unprofessional conduct. 23. Directly or indirectly dividing a professional fee for patient referrals among health care providers or health care institutions or between providers and institutions or entering into a contractual arrangement to that effect. This paragraph does not prohibit the members of any regularly and properly organized business entity recognized by law from dividing fees received for professional services among themselves as they determine. 24. Violating any federal or state statute, rule or regulation that applies to the practice of chiropractic. 25. Filing an anonymous complaint against another licensee. B. The board may not adopt rules that alter or amend unprofessional conduct as prescribed in subsection A of this section. END_STATUTE Sec. 3. Section 32-904, Arizona Revised Statutes, is amended to read: START_STATUTE 32-904. Powers and duties of the board; rules; removal of executive director A. The board may administer oaths, summon witnesses and take testimony on matters within its the board's powers and duties. B. The board shall: 1. Adopt a seal, which shall be affixed to licenses issued by the board. 2. Adopt rules that are necessary and proper for the enforcement of this chapter. 3. Adopt rules regarding chiropractic assistants who assist a doctor of chiropractic, and the board shall determine the qualifications and regulation of chiropractic assistants who are not otherwise licensed by law. 4. At least once each fiscal year and before establishing the amount of a fee for the subsequent fiscal year, review the amount of each fee authorized in this chapter in a public hearing. 5. Develop policies and procedures for determining when the board will require a licensee to undergo psychosexual evaluations and how the board will use the evaluation results. C. A copy of the rules adopted pursuant to this section shall be filed with the secretary of state upon on adoption as provided by law. D. The board shall terminate the executive director of the board for any of the following: 1. Subpoenaing information that is unrelated to a complaint allegation. 2. Failing to refer to the appropriate law enforcement agency a complaint or information indicating that a licensee or certificate holder may have committed a misdemeanor or felony within two business days after receiving the complaint or information. 3. Advocating in support of or against a legislative proposal in the executive director's official capacity before the board has taken a formal position on the proposal in a public meeting. END_STATUTE Sec. 4. Title 32, chapter 8, article 1, Arizona Revised Statutes, is amended by adding section 32-904.01, to read: START_STATUTE 32-904.01. Conflict of interest requirements; annual trainings on conflict of interest, open meetings and board authority A. Each board member and employee, on appointment or hire, shall complete a conflict-of-interest disclosure form, including an attestation that no conflict exists, if applicable, and shall update the disclosure form annually. B. The board shall retain all conflict-of-interest disclosure forms and make the disclosure forms and meeting minutes available to the public on request. C. Each board member and employee, on hire or appointment and annually thereafter, shall complete a training approved by the attorney general's office on the following: 1. Conflict-of-interest requirements, processes and disclosure forms, including how this state's conflict-of-interest requirements relate to their individual roles and responsibilities. 2. Open meetings law requirements. 3. The board's authority to investigate complaints and issue subpoenas. END_STATUTE Sec. 5. Section 32-905, Arizona Revised Statutes, is amended to read: START_STATUTE 32-905. Executive director of board; duties; prohibitions; other personnel; immunity A. Subject to title 41, chapter 4, article 4, the board shall appoint an executive director who is not a member of the board and who shall serve serves at the pleasure of the board. B. The executive director shall: 1. Keep a record of the proceedings of the board. 2. Collect all monies due and payable to the board. 3. Deposit, pursuant to sections 35-146 and 35-147, all monies received by the board in the board of chiropractic examiners fund. 4. Prepare bills for autho [Text truncated for display. Full text available on LegiScan.]