SB762,46,2 21448.9755 Fee splitting and billing requirements. (1) Fee splitting. No
22licensee may give or receive, directly or indirectly, to or from any other person any
23fee, commission, rebate, or other form of compensation or anything of value for
24sending, referring, or otherwise inducing a person to communicate with a licensee

1in a professional capacity, or for any professional services not actually rendered
2personally by the licensee or at the licensee's direction.
SB762,46,13 3(2) Separate billing required. Except as provided in sub. (4), a licensee who
4renders any spinal medicine service or assistance, or gives any spinal medicine
5advice or any similar advice or assistance, to any patient, primary spinal care
6practitioner, chiropractor, physician, physician assistant, advanced practice nurse
7prescriber certified under s. 441.16 (2), partnership, or corporation, or to any other
8institution or organization, including a hospital, for which a charge is made to a
9patient, shall, except as authorized by Title 18 or Title 19 of the federal Social
10Security Act, render an individual statement or account of the charge directly to the
11patient, distinct and separate from any statement or account by any other primary
12spinal care practitioner, chiropractor, physician, physician assistant, advanced
13practice nurse prescriber, or other person.
SB762,46,18 14(3) Billing for tests performed by the state laboratory of hygiene. A
15licensee who charges a patient, other person, or 3rd-party payer for services
16performed by the state laboratory of hygiene shall identify the actual amount
17charged by the state laboratory of hygiene and shall restrict charges for those
18services to that amount.
SB762,46,23 19(4) Billing by entity. If 2 or more licensees form an entity for the practice of
20spinal medicine, the entity may not render a single bill for health care services
21provided in the name of the entity unless each individual licensed, registered, or
22certified under this chapter or ch. 446, 449, 450, 455, 457, or 459, who provides
23services is individually identified on the bill as having rendered those services.
SB762,47,3 24448.976 Disciplinary proceedings and actions. (1) In this section,
25"unprofessional conduct" means an act or attempted act of commission or omission,

1as defined by the affiliated credentialing board by rule, or an act by a primary spinal
2care practitioner otherwise in violation of this subchapter or in violation of ch. 446,
3450, or 961.
SB762,47,10 4(2) Investigation; hearing; action. (a) 1. The affiliated credentialing board
5shall investigate allegations of unprofessional conduct and negligence in the practice
6of spinal medicine. The affiliated credentialing board shall refer an allegation of a
7violation of ch. 446 to the chiropractic examining board for investigation, unless the
8alleged conduct also involves a violation of this subchapter or ch. 450 or 961, in which
9case the affiliated credentialing board and the chiropractic examining board shall
10consult concerning the investigation.
SB762,47,1311 2. The affiliated credentialing board shall investigate information contained
12in reports filed with the affiliated credentialing board under s. 49.45 (2) (a) 12r., 50.36
13(3) (b), 609.17, or 632.715, or under 42 CFR 1001.2005.
SB762,47,1614 3. The affiliated credentialing board may use information contained in a report
15filed with the affiliated credentialing board under s. 50.36 (3) (c) as the basis of an
16investigation of a person named in the report.
SB762,47,2117 4. The affiliated credentialing board may require a person to undergo and may
18consider the results of a physical, mental, or professional competency examination
19if the affiliated credentialing board believes that the results of the examination may
20be useful to the affiliated credentialing board in conducting an investigation under
21this paragraph.
SB762,47,2522 (b) 1. After an investigation, if the affiliated credentialing board finds that
23there is probable cause to believe that a person is guilty of unprofessional conduct
24or negligence in the practice of spinal medicine, the affiliated credentialing board
25shall hold a hearing.
SB762,48,5
12. The affiliated credentialing board may require a person to undergo and may
2consider the results of a physical, mental, or professional competency examination
3if the affiliated credentialing board believes that the results of the examination may
4be useful to the affiliated credentialing board in conducting a hearing under subd.
51.
SB762,48,96 3. A finding by a court that a person has acted negligently in the practice of
7spinal medicine is conclusive evidence that the person is guilty of that negligence.
8A certified copy of the order of a court is presumptive evidence that the finding of
9negligence was made.
SB762,48,1310 4. The affiliated credentialing board shall render a decision within 90 days
11after the date on which a hearing is held under subd. 1. or, if subsequent proceedings
12are conducted under s. 227.46 (2), within 90 days after the date on which those
13proceedings are completed.
SB762,48,1914 (c) 1. After a disciplinary hearing under par. (b), the affiliated credentialing
15board may, when it determines that a court has found that a person has been
16negligent in the practice of spinal medicine or when it finds a person guilty of
17unprofessional conduct or negligence in the practice of spinal medicine, warn or
18reprimand that person, or limit, suspend, or revoke the person's license granted by
19the affiliated credentialing board.
SB762,48,2520 2. The affiliated credentialing board may condition the removal of limitations
21on a license, or the restoration of a suspended or revoked license, upon obtaining
22minimum results specified by the affiliated credentialing board on a physical,
23mental, or professional competency examination if the affiliated credentialing board
24believes that obtaining the minimum results is related to correcting one or more of
25the bases upon which the limitation, suspension, or revocation was imposed.
SB762,49,2
1(d) A person whose license under this subchapter is limited shall be permitted
2to continue practice if the he or she agrees to do all of the following:
SB762,49,33 1. Refrain from engaging in unprofessional conduct.
SB762,49,54 2. Appear before the affiliated credentialing board or its officers or agents at
5such times and places designated by the affiliated credentialing board.
SB762,49,76 3. Fully disclose to the affiliated credentialing board or its officers or agents the
7nature of the person's practice and conduct.
SB762,49,98 4. Fully comply with the limits placed on the person's practice and conduct by
9the affiliated credentialing board.
SB762,49,1110 5. Obtain additional training, education or supervision required by the
11affiliated credentialing board.
SB762,49,1212 6. Cooperate with the affiliated credentialing board.
SB762,49,1713 (e) Unless a suspended license is revoked during the period of suspension, upon
14expiration of the period of suspension the affiliated credentialing board shall
15reinstate the person's license, except that the affiliated credentialing board may, as
16a condition precedent to the reinstatement of the license, require the person to pass
17any examination required for the original grant of the license.
SB762,49,2018 (f) The affiliated credentialing board shall comply with rules of procedure for
19the investigation, hearing, and action promulgated by the department under s.
20440.03 (1).
SB762,50,3 21(3) Suspension pending hearing. (a) The affiliated credentialing board may
22summarily suspend a license granted by the affiliated credentialing board for a
23period not to exceed 30 days pending hearing if the affiliated credentialing board has
24in its possession evidence establishing probable cause to believe that the licensee has
25violated the provisions of this subchapter and that it is necessary to suspend the

1license immediately to protect the public health, safety, or welfare. The licensee shall
2be granted an opportunity to be heard before the affiliated credentialing board
3decides whether probable cause exists.
SB762,50,64 (b) The affiliated credentialing board may designate any of its officers to
5exercise the authority to suspend summarily a license, for a period not exceeding 72
6hours.
SB762,50,127 (c) If a license has been summarily suspended under par. (a) or (b), the affiliated
8credentialing board may, while the hearing is in progress, extend the initial period
9of suspension for not more than an additional 30 days, except that if the licensee has
10caused a delay in the hearing process, the affiliated credentialing board may suspend
11the license from the time the hearing is commenced until a final decision is issued
12or may delegate such authority to the hearing examiner.
SB762,50,14 13(4) Voluntary surrender. The affiliated credentialing board may negotiate
14stipulations in consideration for accepting the surrender of a license under s. 440.19.
SB762,50,17 15(5) Restoration of a license. The affiliated credentialing board may restore
16a license that has been voluntarily surrendered or revoked on such terms and
17conditions as it considers appropriate.
SB762,50,24 18448.9765 Hospital reports. (1) Within 30 days after receipt of a report under
19s. 50.36 (3) (c), the affiliated credentialing board shall notify the licensee, in writing,
20of the substance of the report. The licensee and the licensee's authorized
21representative may examine the report and may place into the record a statement,
22of reasonable length, of the licensee's view of the correctness or relevance of any
23information in the report. The licensee may institute an action in circuit court to
24amend or expunge any part of the licensee's record related to the report.
SB762,51,6
1(2) If the affiliated credentialing board determines that a report submitted
2under s. 50.36 (3) (c) is without merit or that the licensee has sufficiently improved
3his or her conduct, the affiliated credentialing board shall remove the report from the
4licensee's record. If no report about a licensee is filed under s. 50.36 (3) (c) for 2
5consecutive years, the licensee may petition the affiliated credentialing board to
6remove any prior reports not resulting in disciplinary action from his or her record.
SB762,51,7 7(3) (a) In this subsection, "hospital" has the meaning specified in s. 50.33 (2).
SB762,51,128 (b) Upon the request of a hospital, the affiliated credentialing board shall
9provide the hospital with all information relating to a licensee's loss, reduction, or
10suspension of staff privileges from other hospitals and all information relating to the
11licensee's being found guilty of unprofessional conduct or negligence in the practice
12of chiropractic medicine under s. 448.976.
SB762,51,18 13448.977 Injunctive relief. If the affiliated credentialing board has reason to
14believe that a person is violating this subchapter or a rule promulgated under this
15subchapter, the affiliated credentialing board, the department, the attorney general,
16or the district attorney of the proper county may investigate and may, in addition to
17all other remedies, bring an action in the name and on behalf of this state to enjoin
18the person from the violation.
SB762,51,19 19448.9775 Penalties; appeal.
SB762,51,22 20(1) Penalties. (a) Except as provided in par. (b), a person who violates a
21provision of this subchapter or a rule promulgated under this subchapter may be
22fined not more than $10,000 or imprisoned for not more than 9 months or both.
SB762,51,2323 (b) A person who violates s. 448.9755 (3) may be fined not more than $250.
SB762,52,3 24(2) Appeal. A person aggrieved by an action taken under this subchapter by
25the affiliated credentialing board, its officers, or its agents may apply for judicial

1review as provided in ch. 227, and shall file notice of such appeal with the affiliated
2credentialing board within 30 days. No court of this state may enter an ex parte stay
3of an action taken by the affiliated credentialing board under this subchapter.
SB762,52,6 4448.978 Rules. The affiliated credentialing board shall promulgate rules
5defining the acts or attempted acts of commission or omission that constitute
6unprofessional conduct under s. 448.976 (1).
SB762,52,15 7448.9785 Informed consent. Any primary spinal care practitioner who
8treats a patient shall inform the patient about the availability of reasonable
9alternate modes of treatment and about the benefits and risks of these treatments.
10The reasonable primary spinal care practitioner standard is the standard for
11informing a patient under this section. The reasonable primary spinal care
12practitioner standard requires disclosure only of information that a reasonable
13primary spinal care practitioner would know and disclose under the circumstances.
14The primary spinal care practitioner's duty to inform the patient under this section
15does not require disclosure of any of the following:
SB762,52,17 16(1) Detailed technical information that in all probability a patient would not
17understand.
SB762,52,18 18(2) Risks apparent or known to the patient.
SB762,52,20 19(3) Extremely remote possibilities that might falsely or detrimentally alarm
20the patient.
SB762,52,22 21(4) Information in emergencies where failure to provide treatment would be
22more harmful to the patient than treatment.
SB762,52,23 23(5) Information in cases where the patient is incapable of consenting.
SB762,53,3
1(6) Information about alternate modes of treatment for any condition the
2primary spinal care practitioner has not included in his or her diagnosis at the time
3the primary spinal care practitioner informs the patient.
SB762,91 4Section 91. Subchapter VIII of chapter 448 [precedes 448.980] of the statutes,
5as created by 2015 Wisconsin Act 116, is renumbered subchapter IX of chapter 448
6[precedes 448.980].
SB762,92 7Section 92. 450.10 (3) (a) 5. of the statutes is amended to read:
SB762,53,108 450.10 (3) (a) 5. A physician, physician assistant, podiatrist, primary spinal
9care practitioner,
physical therapist, physical therapist assistant, occupational
10therapist, or occupational therapy assistant licensed under ch. 448.
SB762,93 11Section 93. 450.11 (8) (f) of the statutes is created to read:
SB762,53,1312 450.11 (8) (f) The spinal medicine affiliated credentialing board, insofar as this
13section applies to primary spinal care practitioners.
SB762,94 14Section 94. 454.02 (2) (a) of the statutes is amended to read:
SB762,53,1815 454.02 (2) (a) Services performed by a person licensed, certified or registered
16under the laws of this state as a physician, physician assistant, podiatrist, primary
17spinal care practitioner,
physical therapist, nurse or funeral director if those services
18are within the scope of the license, certificate or registration.
SB762,95 19Section 95. 462.02 (2) (g) of the statutes is created to read:
SB762,53,2320 462.02 (2) (g) A primary spinal care practitioner licensed under s. 448.9725 or
21a person under the direct supervision of such a primary spinal care practitioner, if
22the person has successfully completed a course of instruction approved by the
23chiropractic examining board related to X-ray examinations.
SB762,96 24Section 96. 462.04 of the statutes is amended to read:
SB762,54,8
1462.04 Prescription or order required. A person who holds a license or
2limited X-ray machine operator permit under this chapter may not use diagnostic
3X-ray equipment on humans for diagnostic purposes unless authorized to do so by
4prescription or order of a physician licensed under s. 448.04 (1) (a), a dentist licensed
5under s. 447.04 (1), a podiatrist licensed under s. 448.63, a primary spinal care
6practitioner licensed under s. 448.9725,
a chiropractor licensed under s. 446.02, an
7advanced practice nurse certified under s. 441.16 (2), or a physician assistant
8licensed under s. 448.04 (1) (f).
SB762,97 9Section 97. 600.03 (38s) of the statutes is created to read:
SB762,54,1110 600.03 (38s) "Primary spinal care practitioner" has the meaning given in s.
11448.971 (4).
SB762,98 12Section 98. 600.03 (41s) of the statutes is created to read:
SB762,54,1313 600.03 (41s) "Spinal medicine" has the meaning given in s. 448.971 (5).
SB762,99 14Section 99. 609.70 (title) of the statutes is amended to read:
SB762,54,15 15609.70 (title) Chiropractic and spinal medicine coverage.
SB762,100 16Section 100. 628.46 (2m) (a) of the statutes is amended to read:
SB762,54,2317 628.46 (2m) (a) Notwithstanding subs. (1) and (2) and except as provided in
18par. (b), a claim for payment for chiropractic or spinal medicine services is overdue
19if not paid within 30 days after the insurer receives clinical documentation from the
20chiropractor or primary spinal care practitioner that the services were provided
21unless, within those 30 days, the insurer provides to the insured and to the
22chiropractor or primary spinal care practitioner the written statement under s.
23632.875 (2).
SB762,101 24Section 101. 632.32 (2) (am) of the statutes is amended to read:
SB762,55,4
1632.32 (2) (am) "Medical payments coverage" means coverage to indemnify for
2medical payments or chiropractic payments or both for the protection of all persons
3using the insured motor vehicle from losses resulting from bodily injury or death.
4"Medical payments coverage" includes coverage for spinal medicine.
SB762,102 5Section 102. 632.64 of the statutes is amended to read:
SB762,55,16 6632.64 Certification of disability. For the purpose of insurance policies that
7they issue, insurers doing a life insurance business in this state shall afford equal
8weight to a certification of disability signed by a physician with respect to matters
9within the scope of the physician's professional license, to a certification of disability
10signed by a chiropractor with respect to matters within the scope of the chiropractor's
11professional license, and to a certification of disability signed by a podiatrist with
12respect to matters within the scope of the podiatrist's professional license, and to a
13certification of a disability signed by a primary spinal care practitioner with respect
14to matters within the scope of the primary spinal care pratitioner's professional
15license
. This section does not require an insurer to treat a certificate of disability as
16conclusive evidence of disability.
SB762,103 17Section 103. 632.87 (3) (a) (intro.) of the statutes is amended to read:
SB762,56,218 632.87 (3) (a) (intro.) No policy, plan or contract may exclude coverage for
19diagnosis and treatment of a condition or complaint by a licensed chiropractor or
20licensed primary spinal care practitioner
within the scope of the chiropractor's his
21or her
professional license, if the policy, plan or contract covers diagnosis and
22treatment of the condition or complaint by a licensed physician or osteopath, even
23if different nomenclature is used to describe the condition or complaint.
24Examination by or referral from a physician shall not be a condition precedent for

1receipt of chiropractic or spinal medicine care under this paragraph. This paragraph
2does not:
SB762,104 3Section 104. 632.87 (3) (a) 1. of the statutes is amended to read:
SB762,56,54 632.87 (3) (a) 1. Prohibit the application of deductibles or coinsurance
5provisions to chiropractic, spinal medicine, and physician charges on an equal basis.
SB762,105 6Section 105. 632.87 (3) (a) 2. of the statutes is amended to read:
SB762,56,107 632.87 (3) (a) 2. Prohibit the application of cost containment or quality
8assurance measures to chiropractic or spinal medicine services in a manner that is
9consistent with cost containment or quality assurance measures generally
10applicable to physician services and that is consistent with this section.
SB762,106 11Section 106. 632.87 (3) (b) (intro.) of the statutes is amended to read:
SB762,56,1512 632.87 (3) (b) (intro.) No insurer, under a policy, plan or contract covering
13diagnosis and treatment of a condition or complaint by a licensed chiropractor or
14licensed primary spinal care practitioner
within the scope of the chiropractor's his
15or her
professional license, may do any of the following:
SB762,107 16Section 107. 632.87 (3) (b) 1. of the statutes is amended to read:
SB762,56,2217 632.87 (3) (b) 1. Restrict or terminate coverage for the treatment of a condition
18or a complaint by a licensed chiropractor or licensed primary spinal care practitioner
19within the scope of the chiropractor's his or her professional license on the basis of
20other than an examination or evaluation by or a recommendation of a licensed
21chiropractor or licensed primary spinal care practitioner or a peer review committee
22that includes a licensed chiropractor or licensed primary spinal care practitioner.
SB762,108 23Section 108. 632.87 (3) (b) 2. of the statutes is amended to read:
SB762,56,2524 632.87 (3) (b) 2. Refuse to provide coverage to an individual because that
25individual has been treated by a chiropractor or primary spinal care practitioner.
SB762,109
1Section 109. 632.87 (3) (b) 3. of the statutes is amended to read:
SB762,57,42 632.87 (3) (b) 3. Establish underwriting standards that are more restrictive for
3chiropractic or spinal medicine care than for care provided by other health care
4providers.
SB762,110 5Section 110. 632.87 (3) (b) 4. of the statutes is amended to read:
SB762,57,86 632.87 (3) (b) 4. Exclude or restrict health care coverage of a health condition
7solely because the condition may be treated by a chiropractor or primary spinal care
8practitioner
.
SB762,111 9Section 111. 632.875 (1) (b) of the statutes is amended to read:
SB762,57,1210 632.875 (1) (b) "Independent evaluation" means an examination or evaluation
11by or recommendation of a chiropractor or licensed primary spinal care practitioner
12or a peer review committee under s. 632.87 (3) (b) 1.
SB762,112 13Section 112. 632.875 (1) (bm) of the statutes is created to read:
SB762,57,1514 632.875 (1) (bm) "Licensed primary spinal care practitioner" means a person
15licensed under s. 448.9725.
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