Analysis by the Legislative Reference Bureau
Under current law, a person must have a license, certificate, or permit (license)
to practice medicine and surgery, midwifery, professional nursing, chiropractic,
dentistry, perfusion, respiratory care, physical therapy, podiatry, occupational
therapy, optometry, psychology, psychotherapy, clinical social work, marriage and
family therapy, professional counseling, pharmacy, speech pathology, audiology,
acupuncture, barbering or cosmetology, aesthetics, electrology, manicuring, and
selling and fitting hearing aids. Additionally, a license is required under current law
to practice as a physician assistant or to act as an ambulance service provider.
This bill allows a person who provides a complimentary and alternative health
service (CAHS provider) to practice any of the above activities without a license as
long as they do not do any of the following:
1. Puncture the skin, except by pricking a finger for purposes of blood
screening.
2. Prescribe or administer X-ray services.
3. Prescribe or dispense a prescription drug, a controlled substance, or other
device that may only be prescribed or dispensed by a licensed health care provider.
4. Perform a chiropractic adjustment or manipulation of joints or a spine.
5. Recommend that a patient discontinue treatment that is prescribed by a
licensed health care provider.
6. Make a specific diagnosis using medical terms that are used in conventional
western medicine.

This bill defines a complimentary and alternative health service as any health
care practice or method or healing therapy or modality that is not one of the
prohibited acts listed above and that is provided by an individual who is not licensed
to provide the health care practice, healing therapy, or modality, or method. Under
this bill, if a CAHS provider does one of the prohibited acts listed above, he or she is
subject to any applicable penalties for unauthorized practice. Additionally, a person
who suffers an injury due to a CAHS provider doing one of the prohibited acts, may
sue the CAHS provider and may recover treble damages and costs, including
attorney fees.
Under this bill, before providing a complementary and alternative health
service for a fee, a CAHS provider must provide a consumer with written information
that contains the CAHS provider's contact information; the fact that the CAHS
provider is not licensed as a health care provider; a description of the complementary
and alternative health service that is to be provided; and the CAHS provider's
education or other qualifications that relate to the service that is to be provided. The
CAHS provider must also obtain written acknowledgment from the consumer that
he or she received the required written information and post a similar written
statement in a place that is visible to consumers. This bill also requires a CAHS
provider to update the required written information to reflect any relevant changes
and to obtain a new written acknowledgment from a consumer before performing a
complementary and alternative health service after the written information is
changed.
Under the bill, a CAHS provider who fails to provide a consumer with the
required written information or fails to obtain the consumer's written
acknowledgment may be subject to a forfeiture. The Department of Health Services
may also pursue a temporary restraining order or permanent injunction against the
offending CAHS provider.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB280, s. 1 1Section 1. 146.86 of the statutes is created to read:
SB280,2,3 2146.86 Provision of complementary and alternative health practices.
3(1) In this section:
SB280,3,24 (a) "Complementary and alternative health service" means any health care
5practice or method or healing therapy or modality that is not prohibited under sub.
6(2) (a) to (f) and that is provided by an individual who is not a health care provider

1or who is a health care provider but is not acting under his or her certificate, permit,
2or license as a health care provider.
SB280,3,33 (b) "Controlled substance" has the meaning given in s. 961.01 (4).
SB280,3,44 (c) "Deliver" has the meaning given in s. 450.01 (5).
SB280,3,55 (d) "Device" has the meaning given in s. 450.01 (6).
SB280,3,66 (e) "Dispense" has the meaning given in s. 450.01 (7).
SB280,3,87 (f) "Health care provider" has the meaning given in s. 146.81 (1) (a) to (hp) and
8(q) to (s) and includes a person licensed under s. 440.982 (1), 454.04 (1), or 459.02 (1).
SB280,3,99 (g) "Prescription drug" has the meaning given in s. 450.01 (20).
SB280,3,18 10(2) Notwithstanding ss. 256.15 (2), 440.982 (1), 441.06 (4), 441.15 (2), 446.02
11(1), 447.03 (1) and (2), 448.03 (1) (a), (b), and (c) and (1m), 448.51 (1), 448.61, 448.961
12(1) and (2), 449.02 (1), 450.03 (1), 451.04 (1), 454.04 (1), 455.02 (1m), 457.04 (4), (5),
13(6), and (7), 459.02 (1), and 459.24 (1), a person who provides a complementary and
14alternative health service does not violate s. 256.15 (2), 440.982 (1), 441.06 (4),
15441.15 (2), 446.02 (1), 447.03 (1) and (2), 448.03 (1) (a), (b), and (c) and (1m), 448.51
16(1), 448.61, 448.961 (1) and (2), 449.02 (1), 450.03 (1), 451.04 (1), 454.04 (1), 455.02
17(1m), 457.04 (4), (5), (6), and (7), 459.02 (1), or 459.24 (1) unless the person providing
18the complementary and alternative health service does any of the following:
SB280,3,2019 (a) Punctures the skin, except by pricking a finger for purposes of blood
20screening.
SB280,3,2121 (b) Prescribes or administers X-ray services.
SB280,3,2422 (c) Prescribes, directly applies, delivers, or dispenses a prescription drug, a
23controlled substance, or a device that may be prescribed, directly applied, delivered,
24or dispensed only by a health care provider.
SB280,3,2525 (d) Performs a chiropractic adjustment or manipulation of joints or a spine.
SB280,4,3
1(e) Recommends to the individual receiving the complementary and
2alternative health service that he or she discontinue treatment that is prescribed by
3a health care provider.
SB280,4,64 (f) Makes a specific diagnosis using a medical term that is commonly used and
5understood in conventional western medicine. None of the following are prohibited
6under this paragraph:
SB280,4,77 1. Use of medical terminology or common words to describe a health condition.
SB280,4,98 2. Advice that the individual should consult a health care provider in order to
9rule out a diagnosable condition.
SB280,4,1110 3. A statement that the individual's symptoms may be indicative of or
11consistent with a specific medical condition.
SB280,4,1312 (g) Holds himself or herself out as or implies that he or she is a health care
13provider, if he or she does not hold the applicable certificate, permit, or license.
SB280,4,17 14(3) A person who is not a health care provider acting under his or her certificate,
15permit, or license as a health care provider and who charges a fee for a
16complementary and alternative health service shall, before performing the service,
17do all of the following:
SB280,4,1918 (a) Provide to the individual to be served, in writing, all of the following
19information:
SB280,4,2120 1. The name, business address, and telephone number of the person who is
21providing the complementary and alternative health service.
SB280,4,2322 2. If the person is not a health care provider, the fact that the person does not
23hold a certificate, permit, or license as a health care provider in this state.
SB280,5,3
13. If the person is a health care provider who is not acting under his or her
2certificate, permit, or license as a health care provider, the fact that the person is
3providing a service that he or she is not licensed to provide.
SB280,5,54 4. A description of the complementary and alternative health service that the
5person proposes to provide to the individual.
SB280,5,86 5. Any education, training, experience, credentials, or other qualifications the
7person has with respect to the complementary and alternative health service that the
8person proposes to provide to the individual.
SB280,5,139 (b) Post in a location that is readily visible to an individual who is going to
10receive a complementary and alternative health service, a written statement,
11printed in not less than 12-point boldface type, that contains the information in par.
12(a) 1., 2., 3., and 5. and a description of the complementary and alternative health
13services that the person generally provides.
SB280,5,1614 (c) Attempt to ensure that the individual who is going to receive a
15complementary and alternative health service understands the statement under
16par. (a).
SB280,5,2117 (d) Before the first instance of providing a complementary and alternative
18health service to an individual, obtain a written acknowledgment from the
19individual that the individual has been provided the written statement under par.
20(a). The person who is going to provide the complementary and alternative health
21service shall do all of the following:
SB280,5,2322 1. Provide the individual receiving the service with a copy of the written
23acknowledgment.
SB280,5,2424 2. Keep the acknowledgment confidential.
SB280,6,2
13. Maintain the acknowledgment for 2 years from the date the individual signs
2the acknowledgment.
SB280,6,43 (e) If the information that is required to be provided under par. (a) changes, do
4all of the following:
SB280,6,65 1. Change the written statement under par. (a) to reflect the changes in the
6information.
SB280,6,77 2. Post the changed statement as required under par. (b).
SB280,6,98 3. Provide the changed statement to any individual who receives services after
9the statement is changed.
SB280,6,1310 4. Before the first instance of providing a complementary and alternative
11health service to an individual after changing the written statement, obtain a
12written acknowledgment from any individual who is going to receive complementary
13and alternative health services under par. (d).
SB280,6,16 14(4) (a) If the department is notified that a person is violating sub. (3), the
15department shall contact the alleged violator, determine if a violation has occurred,
16and attempt to bring the alleged violator into compliance with sub. (3).
SB280,6,2117 (b) If the alleged violator does not comply with sub. (3) in a reasonable amount
18of time, as determined by the department, the department may serve a notice on the
19person ordering the person to cease violating sub. (3). The order shall be served in
20the manner provided for the service of a summons under s. 801.11. The order is
21subject to judicial review under ch. 227.
SB280,7,422 (c) If the department determines that a person continues to violate sub. (3) after
23being served a notice under par. (b), the department shall serve a notice on the person
24informing him or her that the department will hold a hearing to determine if the
25person is violating sub. (3). The department shall serve the notice in the manner

1provided for the service of a summons under s. 801.11. The department may not hold
2the hearing sooner than 10 days after service of the notice. The person may present
3evidence, subpoena witnesses, and be represented by counsel at the hearing. The
4department shall record the proceedings.
SB280,7,115 (d) Within 30 days after the hearing is held, the department shall issue a
6decision that includes findings of fact and conclusions of law based on the testimony
7presented. If the department determines that a person continues to violate sub. (3)
8after being served a notice under par. (b), the department may order the person to
9pay a forfeiture not to exceed $5,000. The violator shall be provided a copy of the
10findings of fact, conclusions of law, and the order to pay the forfeiture. The
11department's decision and order are subject to judicial review under ch. 227.
SB280,7,1512 (e) In addition to the remedy under par. (d), if the department determines that
13a person continues to violate sub. (3) after being served a notice under par. (b), the
14department may petition the circuit court for a temporary restraining order or
15permanent injunction to enjoin the person from violating sub. (3).
SB280,7,19 16(5) Any person suffering injury as the result of a provider of a complementary
17and alternative health service doing any of the acts listed in sub. (2) (a) to (f) may sue
18for damages and may recover treble the amount of his or her damages, together with
19costs, including reasonable attorney fees, notwithstanding s. 814.04 (1).
SB280,7,2020 (End)
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