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  CS/CS/HB 439  2026
1A bill to be entitled
2An act relating to the practice of chiropractic
3medicine; amending s. 460.403, F.S.; revising the
4definition of the term "practice of chiropractic
5medicine"; authorizing chiropractic physicians to
6possess, for emergency purposes only at the
7chiropractic physician's office or place of business,
8prescription medical oxygen; authorizing chiropractic
9physicians to possess specified solutions in aerosol
10form; authorizing chiropractic physicians to order,
11store, possess, prescribe, and administer, only by
12means of injection at the chiropractic physician's
13office, certain sterile substances, including
14vitamins, minerals, and nutritional supplements;
15prohibiting chiropractic physicians from administering
16certain sterile substances by means of injection
17unless he or she has been certified by the board;
18prohibiting chiropractic physicians from administering
19certain any substance through intravenous therapy;
20creating s. 460.4086, F.S.; requiring a chiropractic
21physician to be certified before administering sterile
22substances in a specified manner; requiring the Board
23of Chiropractic Medicine to establish minimum
24standards of practice for the administration of
25certain sterile substances by means of injection by
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26chiropractic physicians; providing requirements for
27such standards; requiring the board to issue a
28chiropractic physician a letter certifying that he or
29she is authorized to administer specified sterile
30substances by means of injection under certain
31conditions; providing rulemaking authority; providing
32an effective date.
33
34    Be It Enacted by the Legislature of the State of Florida:
35
36Section 1.  Paragraph (c) of subsection (9) of section
37    460.403, Florida Statutes, is amended to read:
38460.403       Definitions.—As used in this chapter, the term:
39(9)
40(c)1.       Chiropractic physicians may adjust, manipulate, or
41    treat the human body by manual, mechanical, electrical, or
42    natural methods; by the use of physical means or physiotherapy,
43    including light, heat, water, or exercise; by the use of
44    acupuncture; by the use of monofilament intramuscular
45    stimulation treatment, also known as dry needling, for trigger
46    points or myofascial pain; or by the administration of foods,
47    food concentrates, food extracts, and items for which a
48    prescription is not required and may apply first aid and
49    hygiene, but chiropractic physicians are expressly prohibited
50    from prescribing or administering to any person any legend drug
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51    except as authorized under subparagraph 2., from performing any
52    surgery except as stated herein, or from practicing obstetrics.
532.      Notwithstanding the prohibition against prescribing and
54    administering legend drugs under subparagraph 1. or s.
55    499.83(2)(c), pursuant to board rule chiropractic physicians
56    may:
57a.      Order, store, possess and administer, for emergency
58    purposes only at the chiropractic physician's office or place of
59    business, prescription medical oxygen. and may also
60b.      Order, store, possess, and administer any solution the
61    following topical anesthetics in aerosol form:
62(I)a.       Any solution  Consisting of 25 percent ethyl
63    chloride ethylchloride and 75 percent dichlorodifluoromethane;
64    or.
65(II)b.       Any solution  Consisting of 15 percent
66    dichlorodifluoromethane and 85 percent
67    trichloromonofluoromethane.
68c.      Order, store, possess, prescribe, and administer by
69    means of injection, vitamins, minerals, and nutritional
70    supplements in sterile form that are proprietary or over-the-
71    counter drugs as defined in s. 499.003; however, the
72    administration of such sterile substances may only take place at
73    the chiropractic physician's office or place of business.
74
75    However, this paragraph does not authorize a chiropractic
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76     physician to prescribe medical oxygen as defined in s.
77     499.82(10) or to administer any substance through intravenous
78     therapy.
79Section 2.  Section 460.4086, Florida Statutes, is created
80     to read:
81460.4086  Administration of sterile substances by
82     chiropractic physicians.—
83(1)     A chiropractic physician must be certified before
84     administering sterile substances by means of injection to a
85     patient.
86(2)     The board shall establish minimum standards of
87     practice for the administration of sterile substances by means
88     of injection by chiropractic physicians, including, at a
89     minimum, all of the following:
90(a)     Completion of 36 hours of continuing education
91     consisting of didactic lectures and laboratory training on the
92     safe and effective administration of vitamins, minerals, and
93     nutritional supplements, including, but not limited to,
94     protocols, indications, and contraindications.
95(b)     Passage of a written and practical examination.
96(c)     A requirement that the administration of sterile
97     substances by means of injection may not be performed without
98     patient consent and education on the risks and adverse events
99     that could occur. Such patient consent and education must be
100    included as part of the patient's documented plan of care.
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101(d)     A requirement that the administration of sterile
102    substances by means of injection may not be delegated to any
103    person other than a chiropractic physician who is authorized to
104    administer sterile substances by means of injection under this
105    chapter.
106(3)     When a chiropractic physician submits documentation to
107    the board verifying completion of the continuing education
108    requirements and passage of examination under this section, the
109    board must issue the chiropractic physician a letter certifying
110    that the chiropractic physician is authorized to administer the
111    sterile substances.
112(4)     The board shall adopt rules to implement this section.
113Section 3.  This act shall take effect July 1, 2026.
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