THE BILL ITSELF
CS/CS/HB 439
Practice of Chiropractic Medicine
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A bill to be entitled
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An act relating to the practice of chiropractic
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medicine; amending s. 460.403, F.S.; revising the
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definition of the term "practice of chiropractic
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medicine"; authorizing chiropractic physicians to
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possess, for emergency purposes only at the
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chiropractic physician's office or place of business,
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prescription medical oxygen; authorizing chiropractic
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physicians to possess specified solutions in aerosol
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form; authorizing chiropractic physicians to order,
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store, possess, prescribe, and administer, only by
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means of injection at the chiropractic physician's
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office, certain sterile substances, including
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vitamins, minerals, and nutritional supplements;
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prohibiting chiropractic physicians from administering
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certain sterile substances by means of injection
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unless he or she has been certified by the board;
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prohibiting chiropractic physicians from administering
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certain any substance through intravenous therapy;
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creating s. 460.4086, F.S.; requiring a chiropractic
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physician to be certified before administering sterile
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substances in a specified manner; requiring the Board
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of Chiropractic Medicine to establish minimum
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standards of practice for the administration of
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certain sterile substances by means of injection by
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chiropractic physicians; providing requirements for
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such standards; requiring the board to issue a
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chiropractic physician a letter certifying that he or
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she is authorized to administer specified sterile
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substances by means of injection under certain
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conditions; providing rulemaking authority; providing
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an effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Paragraph (c) of subsection (9) of section
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460.403, Florida Statutes, is amended to read:
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460.403 Definitions.—As used in this chapter, the term:
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(9)
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(c)1. Chiropractic physicians may adjust, manipulate, or
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treat the human body by manual, mechanical, electrical, or
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natural methods; by the use of physical means or physiotherapy,
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including light, heat, water, or exercise; by the use of
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acupuncture; by the use of monofilament intramuscular
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stimulation treatment, also known as dry needling, for trigger
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points or myofascial pain; or by the administration of foods,
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food concentrates, food extracts, and items for which a
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prescription is not required and may apply first aid and
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hygiene, but chiropractic physicians are expressly prohibited
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from prescribing or administering to any person any legend drug
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except as authorized under subparagraph 2., from performing any
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surgery except as stated herein, or from practicing obstetrics.
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2. Notwithstanding the prohibition against prescribing and
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administering legend drugs under subparagraph 1. or s.
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499.83(2)(c), pursuant to board rule chiropractic physicians
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may:
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a. Order, store, possess and administer, for emergency
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purposes only at the chiropractic physician's office or place of
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business, prescription medical oxygen. and may also
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b. Order, store, possess, and administer any solution the
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following topical anesthetics in aerosol form:
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(I)a. Any solution Consisting of 25 percent ethyl
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chloride ethylchloride and 75 percent dichlorodifluoromethane;
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or.
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(II)b. Any solution Consisting of 15 percent
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dichlorodifluoromethane and 85 percent
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trichloromonofluoromethane.
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c. Order, store, possess, prescribe, and administer by
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means of injection, vitamins, minerals, and nutritional
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supplements in sterile form that are proprietary or over-the-
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counter drugs as defined in s. 499.003; however, the
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administration of such sterile substances may only take place at
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the chiropractic physician's office or place of business.
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However, this paragraph does not authorize a chiropractic
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physician to prescribe medical oxygen as defined in s.
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499.82(10) or to administer any substance through intravenous
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therapy.
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Section 2. Section 460.4086, Florida Statutes, is created to read:
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460.4086 Administration of sterile substances by
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chiropractic physicians.—
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(1) A chiropractic physician must be certified before
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administering sterile substances by means of injection to a
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patient.
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(2) The board shall establish minimum standards of
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practice for the administration of sterile substances by means
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of injection by chiropractic physicians, including, at a
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minimum, all of the following:
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(a) Completion of 36 hours of continuing education
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consisting of didactic lectures and laboratory training on the
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safe and effective administration of vitamins, minerals, and
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nutritional supplements, including, but not limited to,
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protocols, indications, and contraindications.
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(b) Passage of a written and practical examination.
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(c) A requirement that the administration of sterile
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substances by means of injection may not be performed without
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patient consent and education on the risks and adverse events
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that could occur. Such patient consent and education must be
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included as part of the patient's documented plan of care.
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(d) A requirement that the administration of sterile
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substances by means of injection may not be delegated to any
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person other than a chiropractic physician who is authorized to
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administer sterile substances by means of injection under this
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chapter.
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(3) When a chiropractic physician submits documentation to
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the board verifying completion of the continuing education
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requirements and passage of examination under this section, the
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board must issue the chiropractic physician a letter certifying
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that the chiropractic physician is authorized to administer the
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sterile substances.
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(4) The board shall adopt rules to implement this section.
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Section 3. This act shall take effect July 1, 2026.