Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 154 Second Substitute (2022GS)

Sponsor

Sen. Kennedy, M.

Final action

Governor Signed 3/24/2022

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• describes what categories of prescription drugs a naturopathic physician may prescribe;
• allows the Division of Occupational and Professional Licensing to determine whether a naturopathic physician may prescribe newly created prescription drug categories;
• repeals the naturopathic formulary peer committee; and
• makes technical changes.

Every vote on this bill

Bill text

NATUROPATHIC PHYSICIAN AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Michael S. Kennedy
House Sponsor: 
James A. Dunnigan
LONG TITLE
General Description:
This bill modifies the prescribing authority of naturopathic physicians.
Highlighted Provisions:
This bill:
▸ describes what categories of prescription drugs a naturopathic physician may
prescribe;
▸ allows the Division of Occupational and Professional Licensing to determine
whether a naturopathic physician may prescribe newly created prescription drug
categories;
▸ repeals the naturopathic formulary peer committee; and
▸ makes technical changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
58-71-102
, as last amended by Laws of Utah 2014, Chapter 110
58-71-804
, as last amended by Laws of Utah 2009, Chapter 42
ENACTS:
58-71-203
, Utah Code Annotated 1953
REPEALS:
58-71-202
, as last amended by Laws of Utah 2014, Chapter 110
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
58-71-102
 is amended to read:
58-71-102.
Definitions.
In addition to the definitions in Section 
58-1-102
, as used in this chapter:
(1) "Acupuncture" [
has the same definition as
] 
means the same as that term is defined
in Section 
58-72-102
.
(2) "Administrative penalty" means a monetary fine imposed by the division for acts or
omissions determined to constitute unprofessional or unlawful conduct, as a result of an
adjudicative proceeding conducted in accordance with Title 63G, Chapter 4, Administrative
Procedures Act.
(3) "Board" means the Naturopathic Physicians Licensing Board created in Section
58-71-201
.
(4) "Controlled substance" means the same as that term is defined in Section 
58-37-2
.
[
(4)
] 
(5)
 "Diagnose" means:
(a) to examine in any manner another [
person, parts of a person's
] 
individual, parts of
an individual's
 body, substances, fluids, or materials excreted, taken, or removed from [
a
person's
] 
an individual's
 body, or produced by [
a person's
] 
an individual's
 body, to determine
the source, nature, kind, or extent of a disease or other physical or mental condition;
(b) to attempt to conduct an examination or determination described under Subsection
[
(4)
] 
(5)
(a);
(c) to hold oneself out as making or to represent that one is making an examination or
determination as described in Subsection [
(4)
] 
(5)
(a); or
(d) to make an examination or determination as described in Subsection [
(4)
] 
(5)
(a)
upon or from information supplied directly or indirectly by another [
person
] 
individual
,
whether or not in the presence of the [
person making or attempting the diagnosis or
examination
] 
individual the examination or determination concerns
.
[
(5)
] 
(6)
 "Local anesthesia" means an agent, whether a natural medicine or
nonscheduled prescription drug, which:
(a) is applied topically or by injection associated with the performance of minor office
procedures;
(b) has the ability to produce loss of sensation [
at the site of minor office procedures;
and
] 
to a targeted area of an individual's body;
(c) does not cause loss of consciousness or produce general sedation[
.
]
; and
(d) is part of the competent practice of naturopathic medicine during minor office
procedures.
[
(6)
] 
(7)
 "Medical naturopathic assistant" means an unlicensed individual working
under the direct and immediate supervision of a licensed naturopathic physician and engaged in
specific tasks assigned by the licensed naturopathic physician in accordance with the standards
and ethics of the profession.
[
(7)
] 
(8)
 (a) "Minor office procedures" means:
(i) the use of operative, electrical, or other methods for repair and care of superficial
lacerations, abrasions, and benign lesions;
(ii) removal of foreign bodies located in the superficial tissues, excluding the eye or
ear;
(iii) the use of antiseptics and local anesthetics in connection with minor office surgical
procedures; and
(iv) [
if approved by the United States Food and Drug Administration,
] percutaneous
injection into skin, tendons, ligaments, muscles, and joints with:
[
(A) local anesthetics and nonscheduled prescription medications; and
]
(A) local anesthesia or a prescription drug described in Subsection (9)(d); or
(B) natural substances.
(b) "Minor office procedures" does not include:
(i) general or spinal anesthesia;
(ii) office procedures more complicated or extensive than those set forth in Subsection
[
(7)
] 
(8)
(a);
(iii) procedures involving the eye; and
(iv) any office procedure involving [
tendons,
] nerves, veins, or arteries.
[
(8)
] 
(9)
 "Natural medicine" means 
any
:
[
(a) food, food extracts, dietary supplements as defined by the federal Food, Drug, and
Cosmetics Act, all homeopathic remedies, and plant substances that are not designated as
prescription drugs or controlled substances;
]
(a) food, food extract, dietary supplement as defined by the Federal Food, Drug, and
Cosmetic Act, 21 U.S.C. Sec. 301 et seq., homeopathic remedy, or plant substance that is not
designated a prescription drug or controlled substance;
(b) over-the-counter [
medications
] 
medication
;
(c) other nonprescription [
substances
] 
substance
, the prescription or administration of
which is not otherwise prohibited or restricted under federal or state law; 
or
[
(d) prescription drugs:
]
[
(i) that, except as provided in Subsection (8)(e), are not controlled substances as
defined in Section 
58-37-2
;
]
[
(ii) the prescription of which is consistent with the competent practice of naturopathic
medicine; and
]
[
(iii) the prescription of which is approved by the division in collaboration with the
naturopathic formulary advisory peer committee; and
]
[
(e) testosterone, if the testosterone is:
]
[
(i) bio-identical;
]
[
(ii) designed to be:
]
[
(A) administered topically, for transdermal absorption; or
]
[
(B) absorbed across the mucosal membranes of the mouth; and
]
[
(iii) prescribed or administered, in accordance with the requirements of federal and
state law, solely for the purpose of treating a patient with a low testosterone level in order to
restore the patient to a normal testosterone level.
]
(d) prescription drug:
(i) the prescription of which is consistent with the competent practice of naturopathic
medicine;
(ii) that is not a controlled substance except for testosterone; and
(iii) that is not any of the following as determined by the federal Food and Drug
Administration's general drug category list:
(A) an anticoagulant for the management of a bleeding disorder;
(B) an anticonvulsant;
(C) an antineoplastic;
(D) an antipsychotic;
(E) a barbiturate;
(F) a cytotoxic;
(G) a sedative;
(H) a sleeping drug;
(I) a tranquilizer; or
(J) any drug category added after April 1, 2022, unless the division determines the drug
category to be consistent with the practice of naturopathic medicine under Section 
58-71-203
.
[
(9)
] 
(10)
 (a) "Naturopathic childbirth" means uncomplicated natural childbirth assisted
by a naturopathic physician[
, and includes the use of:
]
.
(b) "Naturopathic childbirth" includes the use of:
(i) natural medicines; and
(ii) uncomplicated episiotomy.
[
(b)
] 
(c)
 "Naturopathic childbirth" does not include the use of:
(i) forceps delivery;
(ii) general or spinal anesthesia;
(iii) caesarean section delivery; or
(iv) induced labor or abortion.
[
(10)
] 
(11) (a)
 "Naturopathic mobilization therapy"[
: (a)
] means manually
administering mechanical treatment of body structures or tissues for the purpose of restoring
normal physiological function to the body by normalizing and balancing the musculoskeletal
system of the body;
(b) 
"Naturopathic mobilization therapy"
 does not mean manipulation or adjustment of
the joints of the human body beyond the elastic barrier; and
(c) 
"Naturopathic mobilization therapy"
 does not include manipulation as used in Title
58, Chapter 73, Chiropractic Physician Practice Act.
[
(11)
] 
(12)
 (a) "Naturopathic physical medicine" means the use of the physical agents
of air, water, heat, cold, sound, light, and electromagnetic nonionizing radiation, and the
physical modalities of electrotherapy, acupuncture, diathermy, ultraviolet light, ultrasound,
hydrotherapy, naturopathic mobilization therapy, and exercise.
(b) "Naturopathic physical medicine" does not include the practice of physical therapy
or physical rehabilitation.
[
(12)
] 
(13)
 "Practice of naturopathic medicine" means:
(a) a system of primary health care for the prevention, diagnosis, and treatment of
human health conditions, injuries, and diseases that uses education, natural medicines, and
natural therapies, to support and stimulate the patient's intrinsic self-healing processes 
by
:
(i) using naturopathic childbirth, but only if:
(A) the licensee meets standards of the American College of Naturopathic
Obstetricians (ACNO) or [
its
] 
ACNO's
 successor as determined by the division in collaboration
with the board; and
(B) the licensee follows a written plan for naturopathic physicians practicing
naturopathic childbirth approved by the division in collaboration with the board, which
includes entering into an agreement with a consulting physician and surgeon or osteopathic
physician, in cases where the scope of practice of naturopathic childbirth may be exceeded and
specialty care and delivery is indicated, detailing the guidelines by which the naturopathic
physician will:
(I) refer patients to the consulting physician; and
(II) consult with the consulting physician;
(ii) using naturopathic mobilization therapy;
(iii) using naturopathic physical medicine;
(iv) using minor office procedures;
(v) prescribing or administering natural medicine;
(vi) prescribing medical equipment and devices, diagnosing by the use of medical
equipment and devices, and administering therapy or treatment by the use of medical devices
necessary and consistent with the competent practice of naturopathic medicine;
(vii) prescribing barrier devices for contraception;
(viii) using dietary therapy;
(ix) taking and using diagnostic x-rays, electrocardiograms, ultrasound, and
physiological function tests;
(x) taking of body fluids for clinical laboratory tests and using the results of the tests in
diagnosis;
(xi) taking of a history from and conducting of a physical examination upon a human
patient; and
[
(xii) prescribing and administering natural medicines and medical devices, except a
naturopathic physician may only administer:
]
[
(A) a prescription drug, as defined in Section 
58-17b-102
, in accordance with
Subsection (8)(d); and
]
[
(B) local anesthesia that is not a controlled substance, and only in the performance of
minor office procedures;
]
(xii) administering local anesthesia during the performance of a minor office
procedure;
(b) to maintain an office or place of business for the purpose of doing any of the acts
described in Subsection [
(12)
] 
(13)
(a), whether or not for compensation; or
(c) to use, in the conduct of any occupation or profession pertaining to the diagnosis or
treatment of human diseases or conditions, in any printed material, stationery, letterhead,
envelopes, signs, or advertisements, the designation "naturopathic physician," "naturopathic
doctor," "naturopath," "doctor of naturopathic medicine," "doctor of naturopathy,"
"naturopathic medical doctor," "naturopathic medicine," "naturopathic health care,"
"naturopathy," "N.D.," "N.M.D.," or any combination of these designations in any manner that
might cause a reasonable person to believe the individual using the designation is a licensed
naturopathic physician.
[
(13)
] 
(14)
 "Prescribe" means to issue a prescription:
(a) orally or in writing; or
(b) by telephone, facsimile transmission, computer, or other electronic means of
communication as defined by division rule.
[
(14)
] 
(15)
 "Prescription device" means an instrument, apparatus, implement, machine,
contrivance, implant, in vitro reagent, or other similar or related article, and any component
part or accessory, which is required under federal or state law to be prescribed by a practitioner
and dispensed by or through a person [
or entity
] licensed under this chapter or exempt from
licensure under this chapter.
[
(15)
] 
(16)
 "Prescription drug" means a drug that is required by federal or state law or
rule to be dispensed only by prescription or is restricted to administration only by practitioners.
[
(16)
] 
(17)
 "Unlawful conduct" [
is as defined in
] 
means the same as that term is
defined in
 Sections 
58-1-501
 and 
58-71-501
.
[
(17)
] 
(18)
 "Unprofessional conduct" [
is as defined in
] 
means the same as that term is
defined in
 Sections 
58-1-501
 and 
58-71-502
, and as may be further defined by division rule.
Section 2. Section 
58-71-203
 is enacted to read:
 58-71-203.
Drug category review.
(1) As used in this section, "FDA" means the federal Food and Drug Administration.
(2) After April 1, 2022, if the FDA adds a new drug category to the FDA's general drug
category list, the division shall determine whether the drug category is consistent with the
practice of naturopathic medicine.
(3) To make the determination described in Subsection (2), the division shall consult
with:
(a) the board; and
(b) the board described in Section 
58-67-201
.
(4) In accordance with Title 63, Chapter 3, Utah Administrative Rulemaking Act, the
division shall make rules to implement this section.
Section 3. Section 
58-71-804
 is amended to read:
58-71-804.
Insurance coverage not mandated.
(1) This chapter does not mandate health insurance coverage for naturopathic medical
services.
(2) This chapter does not establish a class of health care providers for the purposes of
Section 
31A-22-618
.
(3) This chapter does not mandate health insurance coverage for the prescription or
administration of testosterone[
, as described in Subsection 
58-71-102
(8)(e),
] by a naturopathic
physician.
Section 4. 
Repealer.
This bill repeals:
Section 
58-71-202
,
Naturopathic formulary peer committee.