Chiropractic Legislative History


1922

The Chiropractic Initiative Act of California

Initiative measure approved by the electors

November 7, 1922, effective December 21, 1922.

1942
 CCA gained passage of legislation which included Chiropractic in the Workers Compensation act.

1963
 CCA formed CCA-HSF (Health Service Foundation) to negotiate Chiropractic inclusion in all insurance programs.

1964 - 1969
 CCA gained Chiropractic inclusion for some of the state's largest unions, including the Teamsters.

1965
 CCA successfully lobbied for inclusion in the Medi-Cal program. The newly formed CCA-HSF stopped threatened exclusion of Chiropractic from auto medical insurance.

1966
 CCA included Doctors of Chiropractic into a bill that exempted doctors from civil damages in reporting child abuse cases to authorities.

1967
 CCA co-sponsored the anti-quackery bill. CCA blocked an attempt to eliminate Doctors of Chiropractic from the workers compensation program.

1968
 CCA sponsored legislation which amended the Insurance Code to provide equality of payments to Chiropractic Doctors.

1969
 CCA acquired the assistance of 20 California Congressional members in submitting a bill to amend Medicare to include Chiropractic. CCA supported the Radiation Control Act and gained the appointment of a Chiropractic Doctor to the certification commission.

1970
 CCA sponsored the bill which allows Doctors of Chiropractic to incorporate their practices. CCA sponsored the legislation which requires continuing education of Doctors of Chiropractic for license renewal and gave the State Board disciplinary power over Doctors of Chiropractic engaged in unprofessional conduct.

1976
 An amendment to the Chiropractic Act required that specific pre-Chiropractic subjects and/or requirements be in accordance with the standards adopted by the Council on Chiropractic Education.

1982
 AB 868 (Lehman) - The CCA Key Doctor Program was established to support the passage of AB 868 (Lehman) in 1982. The scope of practice bill passed the Assembly but failed in the Senate Business and Professions Committee. The intent of the bill was to specifically define the doctor of chiropractic scope of practice indicating which health care modalities he/she is licensed to perform.

 AB 3304 - Opposed by CCA in 1982 and withdrawn by the author. This bill would have changed the Medi-Cal law and, in effect eliminated Chiropractic.

1983
 AB 610-Signed into law in 1983. This bill allowed greater patient access to health records, as well as requiring exchange of health records, including X-rays, by providers. CCA amended the bill to include Chiropractic Doctors. This bill required medical doctors to release X-rays to Doctors of Chiropractic upon request.

 AB 738 (Torres)- Passed in 1983 and provided inclusion of Doctors of Chiropractic in a health program established in 1980 which rnandated that female students in grade seven and male students in grade eight undergo a screening examination to detect the presence of scoliosis.

 AB 1883 - Signed by the Governor in 1983. A CCA-sponsored bill, AB 1883 brought the Chiropractic profession under the provisions of state law requiring a Certificate of Merit to be filed in a medical malpractice suit. This bill reduced the number of frivolous malpractice suits by requiring attorneys to consult with a qualified professional in the same health care field prior to filing a malpractice complaint.

1984
 AB 2947 (Bane) - Signed by the Governor in 1984. This CCA- sponsored legislation gave Doctors of Chiropractic a fair opportunity to enter into contracts with health insurance companies and health care plans for the delivery of services to subscribers and members at alternative rates of` reimbursement in delivery systems organized pursuant to the insurance contracting laws enacted in 1982.

 SB 1777 (Dills) - Approved by the Legislature in 1984. It authorized the State of California to become self insured employer with respect to health plans offered to its employees. CCA amended the bill to require the state, in organizing self-insured plans, to utilize, as fully as possible the services of allied health care providers, including Doctors of Chiropractic, in delivering health care services to the employees as patients.

 AB 2634 (Alatorre) - Signed by the Governor in 1984. It clarified the legal immunity afforded members of Chiropractic peer review committees. This law gives necessary legal protection to doctors who review and evaluate, as recognized peer review committees, the quality of care rendered by their professional colleagues and recognizes Chiropractic peer review as an effective self-policing of our profession by its members.

 AB 3791 (Isenberg) - Signed by the Governor in 1984. It imposed criminal sanctions for violation of the law giving patients access to their own medical records. CCA supported this bill because of problems Doctors of Chiropractic encounter in obtaining the transfer of x-rays and other medical records from some physicians.

1985
 SB 98 (Rosenthal) - Signed in 1985. This bill amended the workers compensation law to permit the injured worker to see his/her personal Chiropractor no later than five days following injury in the workplace.

 SB 522 (Royce) - Sponsored by CCA in 1985 that required PERS to ensure that every active and retired employee has the opportunity to enroll in a plan which provides Chiropractic services. This bill was signed by the Governor.

 AB 1403 (Johnson) - CCA-sponsored bill in 1985 which required compensation for lost time of all health care practitioners who give deposition concerning their treatment and care of the injured litigant.

 SJR 9 (Rosenthal) - CCA-sponsored bill in 1985 which urged Congress to eliminate the preemption of state laws requiring minimum standards and other features of health care insurance. This bill was enacted into law.

1986
 SB 2183 (Carpenter) - Sponsored by CCA in 1986. It required adding a permanent Chiropractic member to the Radiologic Technology Certification Committee. This committee establishes standards for the use of ionizing radiation in health care practices. The bill was signed into law.

1987
 SB 1642 (Keens) - Successfully defeated by CCA in 1987. This bill would have repealed Section 10176 of the Insurance Code which is California's Freedom of Choice statue. Section 10176 states that health insurance companies cannot prohibit patients from selecting the services of Chiropractic Doctors for covered services to be paid under the insurance policy. SB 1642 became a rallying point for the profession as hundreds of doctors contacted their local legislators to oppose the bill. The CCA Key Doctor Program was instrumental in organizing this strong grass roots effort.

1988
 SB 2872 (Dills) - Signed by the Governor in 1988. This CCA-sponsored bill added one additional Doctor of Chiropractic to the Medical and Chiropractic Advisory Committee. This committee significantly impacts the Chiropractic profession by recommending and developing policy on workers' compensation, as well as advising the Division of Industrial Accidents regarding reasonable levels of fees for physicians and surgeons and Doctors of Chiropractic performing services under Labor Code 139.

SB 2151 (Rosenthal) - Not signed by the Governor in 1988. This CCA-sponsored bill clarifies Section 4601(b) of the Labor Code and its procedure for requesting a change of physician by an injured worker. The bill provided a clear statement that the request for a change of physician can be made at anytime after the worker's injury.

1989
AB 1891 (Isenberg) - Vetoed by the Governor in 1989 on the grounds that it was duplicative of existing law. This CCA sponsored legislation called for HMOs who offer Chiropractic services to give reasonable consideration to written proposal for Chiropractic care from Doctors of Chiropractic.

AB 710 (Floyd) - Passed through the Legislature but was vetoed by Governor Deukmejian in 1989. AB 7l0 would have subjected the Division of Industrial Accidents to the procedures set forth in the California Administrative Procedures Act.

 SB 1672 (Campbell, W.) - Signed by the Governor in 1989. SB 1672 provides Chiropractic Doctors with injunctive relief in the courts against the unlicensed practice of Chiropractic.

1991
 SB 1379 (Leonard) - Signed and became law in January 1991. Clarified the 30-day rule for injured workers seeking to change their physicians.

 AB 3324 (Hunter) - Signed into law in January of 1991. Allowed Doctors of Chiropractic to have minority interest in medical corporations.

 AB 2980 (Wright)- Signed and became law in January of 1991. Further protects patient records by requiring the subpoena to be delivered to both the Doctor of Chiropractic and the patient.

 AB 3318 (McClintock) - Died in its first policy committee, but would have given hospital privileges to Chiropractic Doctors.

 AB 4216 (Isenberg)- Vetoed by the Governor, required HMOs who offer the Chiropractic benefit to reasonably consider affiliation applications from Chiropractic Doctors.

 AB 2044 (Bane)- Vetoed by the Governor. Required disability insurers to apply the same conditions, limitations or restrictions on all providers of the same or similar service.

1992
 AB 621 (Bane) - Vetoed by the Governor, similar to AR 2044 (Bane), would have prohibited disability insurers from selectively imposing conditions limiting payments for the diagnosis or treatment of any illness or disability by type of health care practitioner.

 SB 1165 (Davis)- Signed by the Governor. Requires HMOs who offer Chiropractic benefits to give reasonable consideration to affiliation applications from Doctors of Chiropractic.

 AB 316 (Epple) - Signed by the Governor. Established the operating conditions for Chiropractic group advertising and referral services.

1993
 In 1933, CCA successfully secured amendments to the 1993 Workers' Compensation Reform Act which ensured the injured worker's right to Chiropractic care in a managed care system, the worker's right to predesignate a personal chiropractor, parity for payment between Doctors of Chiropractic and MDs and doctor's ability to render in-office physical medicine services.

1994
 AB 1130 (Bornstein) - Vetoed by the Governor. This bill would have allowed judges to award reasonable attorneys fees to the non-prevailing party in disputes over medical liens.

 AB 3783 (Burton) - Held in the Assembly Health Committee. This bill would have required health care service plans and other entitles responsible for delivering health care benefits to accept all providers who meet the terms and requirements spelled out in health plan contracts. (Also known as Any-Willing-Provider legislation.)

 AB 3132 (Katz) - Signed into law by the Governor. CCA sponsored an amendment to this bill which allows Doctors of Chiropractic to perform medical exams for California drivers seeking Class A or B commercial drivers licenses.

1995
 AB 1152 (Bordonaro) - Signed into law by the Governor. This bill requires all health plans and disability insurers to develop written policies to facilitate continuity of care for new enrollees receiving services from a nonparticipating provider.

 AB 1204 (Gallegos) - Signed into law by the Governor. It overturns an Appellant Court decision, Brun v. Hailcy which distinguished between fact and opinion questions.

1996
 AB 1106 (Aguilar) and AB 1474 (Pringle) - CCA successfully defeated both these bills which would have awarded medical control to an employer for a year. AB 1106 would have eliminated an employee's right to annually designate or change the designation of their HCO or doctor.

 AB 3013 (Alby) & SB 1805 (Rosenthal) signed into law by the Governor. CCA successfully amended these bills, which prohibit gag rules and loyalty oaths in health care contracts, so that the prohibition applies to health care contracts with all health care providers, not just MDs.

1997
 AB 150 (Alby) - Signed by the Governor. Protects chiropractors from potential payroll tax liability by clarifying the law regarding independent contractor status for chiropractors.

 AB 434 (Gallegos) - Vetoed by the Governor. CCA co-sponsored this measure to protect patients by prohibiting managed care organizations from terminating or non-renewing health care providers without reason or due process. The bill was amended multiple times over the 1997-98 legislative session and eventually vetoed in 1998.

1998
 SB 1255 (Polanco) - Signed by the Governor. Empowers health care providers to grant discounts for medical care to uninsured or underinsured patients without fear of spurious fraud prosecutions.

 SB 1951 (Brulte) - Signed by the Governor. Managed care companies are prohibited from adopting onerous advertising restrictions in their contracts because of this CCA-sponsored measure.

 SB 2209 (Brulte) - Failed in its second senate committee hearing. CCA's first attempt to prohibit Silent PPOs from inappropriately marketing doctor's panels and their negotiated contract rates.

1999
 AB 440 (Corbett) - Stalled in the Senate Appropriations Committee. This is CCA's effort to force managed care companies that use withholds to retain a portion of a doctor's reimbursement to return payments in a timely manner and to disclose certain financial information.

 SB 320 - Vetoed by the Governor. Doctors of chiropractic rallied to defeat this workers' compensation benefits increase that also would have eliminated the treating physician's presumption of correctness.

 SB 559 (Brulte) - Signed by the Governor. CCA's successful effort against Silent PPOs was included as part of a major managed care reform package. The bill prevents entities from marketing doctor's panels and their negotiated contract rates without meeting certain disclosure, notification, and patient steerage requirements.

 SB 1287 (Murray) - Signed by the Governor. CCA secured an amendment to this bill - the Occupational Therapist Licensure Act - that specifically prohibits OTs from performing spinal manipulation.

2000
 AB 2245 (Corbett) - Stalled in Senate Appropriations Committee due to an unknown fiscal impact. CCA sponsored AB 2245 to expand the current two-visit-per-month limitation for Medi-Cal patients seeking chiropractic and other non-MD provider services.

 SB 1732 (Burton) - Successfully maintained provider disclosure and other protections contained in CCA sponsored SB 559 (Brulte) of 1999 that regulated Silent PPOs.

 SB 2034 (Figueroa) - "Hands Off My Profession" was successfully amended by CCA to protect chiropractic scope of practice from being placed under legislative control.

 CCA successfully lobbied the Governor to include in the 2000-2001 State Budget a 130% Medi-Cal reimbursement increase to $16.72 for chiropractic services.

2001

SB 1048 (Speier) – Signed by the Governor. CCA successfully defeated a provision that would have prevented chiropractors from performing DMV physical examinations on truck drivers.

AB 1179 (Calderon) – Signed by the Governor. Prohibits a bill review company from reducing a treating physician's billing for services unless the submitted documentation has been reviewed.

AB 938 (Cohn) - Signed by the Governor. Requires health plans to disclose any limitations on the patient's choice of non-MD health care practitioners, and to include any general authorization requirement for referrals to non MDs.

2002

AB 131 (Corbett) – Stalled in Senate Appropriations Committee. CCA sponsored this bill to expand the current two-visit-per-month limitation for Medi-Cal patients seeking chiropractic and other non-MD provider services.

AB 749 (Calderon) – Signed by the Governor. Amended workers' compensation reform legislation to retain the “presumption of correctness” when a worker predesignates a personal chiropractor.

SB 1642 (Soto) – Signed by the Governor. This bill rectified a technicality in state law that prevented chiropractors from referring patients to a dietician working in their chiropractic clinic.  

AB 15 (Harman) – Signed by the Governor. Allows cities to regulate independent contractors who perform massage therapy in a doctor's office. CCA worked with the Legislature to allow cities to regulate independent contractors who operate as massage therapists without forcing chiropractic employees to register as massage therapists.  

CCA is successful in maintaining chiropractic as part of the Medi-Cal program and also stopped a proposal to reduce the chiropractic reimbursement rates  back to the pre-2000 level of $7.27 per visit.

2003

SB 228 (Alarcon) – Signed by the Governor. Institutes a 24-visit cap on chiropractic, physical and occupational therapy on injuries occurring on or after January 1, 2004 unless an insurance carrier authorizes additional visits. Repeals the treating physician's presumption of correctness for all dates of injury; requires all employers to adopt utilization review systems, makes changes to existing carrier reimbursement requirements, reduces physician rates by 5 percent, eliminates the IMC.  

AB 227 (Vargas) – Signed by the Governor. Increases maximum fine for workers' compensation fraud, requires the state insurance commissioner to take into account the projected savings from the changes enacted this session in workers' compensation rules when determining the advisory pure premium rates, provides that employer assessments shall account for the total costs for the administration of the workers' compensation program and repeals existing provisions of law relating to vocational rehabilitation and instead provides for a supplemental job displacement benefit.

CCA lobbied strenuously in opposition of SB 228 and AB 227. CCA held the historic “Chiropractors for Injured Workers Rally” at the State Capitol with 1,500 doctors of chiropractic, their staff and patients, and students of chiropractic in attendance to call on state lawmakers not to erect roadblocks to injured workers seeking chiropractic care. CCA was able to defeat more severe treatment caps – with the Senate advocating a 15-visit cap on chiropractic care with carrier-approved additional care, and the Assembly pushing for a 19-visit “hard cap” on chiropractic care with no further treatment after 19 visits. Additionally, CCA was able to kill a proposal that would have prevented chiropractors from serving as primary treating physicians.

2004

SB 867 (Burton) – Would have allowed an acupuncturist to become a QME. CCA was instrumental in lobbying in opposition and consequently, this bill died in committee.

AB 1812 (Berm

2005

AB 1113 (Yee) – Vetoed by Governor. Would have allowed acupuncturists to diagnose within their scope of practice. In vetoing the measure, the governor stated that the term scope of practice was vague and left room for interpretation. CCA opposed this legislation.

SB 367 (Speier) – Signed by Governor. Enacts the Patient and Provider Protection Act that revises the way complaints from providers and consumers are handled by the state Department of Insurance (DOI).

SB 634 (Speier) – Signed by the Governor. This bill extends certain claims payment protections afforded to health care providers who deliver care to enrollees of health care service plans to providers who provide services to patients with health insurance policies.   Requires greater disclosure to individual policyholders about their potential costs when obtaining services from a provider who does not have a contract with the insured's health insurer.

AB 1735 (De La Torre) - Signed by Governor. Prevents the governor from implementing a five percent provider reimbursement rate cut in Medi-Cal fees and the prospective implementation of a rate reduction until January 1, 2006.

AB 1459 (Canciamilla) - Signed by the Governor. Increases the ceiling for claims brought in small claims court against persons from $5,000 to $7,500.

2006

SB 412 (Figueroa) – Stalled on Assembly floor. CCA negotiated for over a year with massage therapists to allow statewide certification of massage therapists and eliminate local regulation. Ultimately, CCA was forced to kill this legislation because the massage therapists insisted on including authority to independently see patients, determine is massage is indicated and perform joint movement in the passive range of motion without supervision.

AB 3014 (Koretz) - Vetoed by governor. CCA fought against this legislation that would have expanded the acupuncture scope of practice to include “manual therapy.”

AB 2590 (Keene) - Died. Would have allowed injured workers' to pay cash after workers' compensation benefits are exhausted.