EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb0867*
HOUSE BILL 867
J2 5lr2488
By: Delegate Cullison
Introduced and read first time: January 30, 2025
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
State Board of Physicians – Naturopathic Doctors – Prescriptive Authority and 2
Administration of Medication 3
FOR the purpose of repealing the Naturopathic Doctors Formulary Council within the 4
State Board of Physicians; altering the drugs that may be prescribed by a 5
naturopathic doctor; altering the methods by which a naturopathic doctor may 6
administer medication; and generally relating to naturopathic doctors. 7
BY repealing and reenacting, with amendments, 8
Article – Health Occupations 9
Section 14–5F–01 and 14–5F–14 10
Annotated Code of Maryland 11
(2021 Replacement Volume and 2024 Supplement) 12
BY repealing 13
Article – Health Occupations 14
Section 14–5F–04.1 15
Annotated Code of Maryland 16
(2021 Replacement Volume and 2024 Supplement) 17
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 18
That the Laws of Maryland read as follows: 19
Article – Health Occupations 20
14–5F–01. 21
(a) In this subtitle the following words have the meanings indicated. 22
(b) “Approved naturopathic medical program” means a naturopathic medical 23
education program: 24 2 HOUSE BILL 867
(1) In the United States that: 1
(i) Provides the degree of Doctor of Naturopathy or Doctor of 2
Naturopathic Medicine; 3
(ii) Offers a 4–year graduate–level, full–time didactic and 4
supervised clinical training; 5
(iii) Is accredited, or has achieved candidacy status for accreditation, 6
by the Council on Naturopathic Medical Education or an equivalent federally and 7
Board–recognized accrediting body for naturopathic medical programs; and 8
(iv) Is part of an institution of higher education that is either 9
accredited, or is a candidate for accreditation, by a regional or national institutional 10
accrediting agency recognized by the United States Secretary of Education; or 11
(2) In a diploma–granting, degree–equivalent college or university in 12
Canada that: 13
(i) Offers graduate–level, full–time didactic and supervised clinical 14
training; 15
(ii) Is accredited, or has achieved candidacy status for accreditation, 16
by the Council on Naturopathic Medical Education or an equivalent federally and 17
Board–recognized accrediting body for naturopathic medical programs; and 18
(iii) Has provincial approval for participation in government–funded 19
student aid programs. 20
(c) “Auto–injectable epinephrine” means a portable, disposable drug delivery 21
device that contains a premeasured single dose of epinephrine that is used to treat 22
anaphylaxis in an emergency situation. 23
(d) “Board” means the State Board of Physicians. 24
(e) “Committee” means the Naturopathic Medicine Advisory Committee. 25
[(f) “Council” means the Naturopathic Doctors Formulary Council.] 26
[(g)] (F) (1) “Device” means a device used in the diagnosis, treatment, or 27
prevention of disease. 28
(2) “Device” does not include: 29
(i) Any surgical or dental instrument; 30
HOUSE BILL 867 3
(ii) Any physical therapy equipment; 1
(iii) Any X–ray apparatus; or 2
(iv) Any component part or accessory of any of the items listed in 3
items (i) through (iii) of this paragraph. 4
[(h) “Formulary” means a list of drugs and devices developed and adopted in 5
accordance with § 14–5F–04.1 of this subtitle.] 6
[(i)] (G) “Licensed naturopathic doctor” means a naturopathic doctor who is 7
licensed to practice naturopathic medicine. 8
[(j)] (H) “Naturopathic doctor” means an individual who practices naturopathic 9
medicine. 10
[(k)] (I) (1) “Naturopathic medicine” means the prevention, diagnosis, and 11
treatment of human health conditions, injury, and disease using only patient education and 12
naturopathic therapies and therapeutic substances recognized by the Council of 13
Naturopathic Medical Education. 14
(2) “Naturopathic medicine” includes: 15
(i) Counseling; 16
(ii) The practice of the mechanical sciences of healing, including 17
mechanotherapy, articular manipulation, corrective an d orthopedic gymnastics, 18
hydrotherapy, electrotherapy, and phototherapy; 19
(iii) The practice of the material sciences of healing, including 20
nutrition, phytotherapy, treatment by natural substances, and external applications; and 21
(iv) Prescribing, dispensing, or administering nonprescription and 22
prescription drugs and devices [listed in the formulary] AS AUTHORIZED UNDER THIS 23
TITLE. 24
[(l)] (J) “Naturopathic musculoskeletal mobilization” means the treatment by 25
manual and other mechanical means of all body tissues exclusive of high–velocity thrusts 26
at or beyond the end range of normal joint motion. 27
[(m)] (K) “Nonprescription drug” means a drug that: 28
(1) May be sold without a prescription; and 29
(2) Is labeled for use by a consumer in accordance with State and federal 30
law. 31 4 HOUSE BILL 867
[(n)] (L) “Prescription drug” means any drug defined in § 503(b) of the federal 1
Food, Drug, and Cosmetic Act if the drug’s label is required to bear the statement “Rx only”. 2
[14–5F–04.1. 3
(a) (1) There is a Naturopathic Doctors Formulary Council within the Board. 4
(2) The Council consists of the following members: 5
(i) The Deputy Secretary of Public Health Services, or the Deputy 6
Secretary’s designee; and 7
(ii) The following members, appointed by the Board: 8
1. Two individuals who: 9
A. Practice naturopathic medicine in the State; 10
B. Are certified by the North American Board of 11
Naturopathic Examiners; 12
C. Have a minimum of 2 years experience; and 13
D. Are licensed naturopathic doctors; 14
2. Two licensed physicians who practice in the State; 15
3. One pharmacist who has a background in pharmacognosy 16
and who practices in the State; and 17
4. One consumer. 18
(3) (i) The term of an appointed member is 4 years. 19
(ii) At the end of a term, an appointed member continues to serve 20
until a successor is appointed. 21
(4) A member of the Council: 22
(i) May not receive compensation as a member of the Council; but 23
(ii) Is entitled to reimbursement for expenses under the Standard 24
State Travel Regulations, as provided in the State budget. 25
(5) The Board shall designate the chair of the Council. 26
HOUSE BILL 867 5
(6) The Board shall provide staff for the Council. 1
(b) The Council shall: 2
(1) Develop and recommend to the Board a formulary for use by licensed 3
naturopathic doctors; 4
(2) Annually review the formulary adopted by the Board under subsection 5
(c) of this section to determine if any changes are necessary for compliance with current 6
prescribing standards or the practice of naturopathic medicine; 7
(3) Otherwise review the formulary at the direction of the Board; and 8
(4) Make recommendations to the Board based on the reviews conducted 9
under items (2) and (3) of this subsection. 10
(c) (1) The Board shall adopt a formulary based on the recommendations of 11
the Council made under subsection (b) of this section. 12
(2) The Board may modify or reject any recommendation of the Council 13
regarding the formulary. 14
(d) (1) The formulary adopted by the Board shall include: 15
(i) Nonprescription drugs and devices; 16
(ii) Prescription oxygen and auto–injectable epinephrine; and 17
(iii) Prescription diaphragms and cervical caps for contraception. 18
(2) The formulary may not include: 19
(i) Except as provided in paragraph (1)(ii) and (iii) of this subsection, 20
prescription drugs or devices; or 21
(ii) Controlled substances.] 22
14–5F–14. 23
(a) A license authorizes a licensee, consistent with naturopathic education and 24
training and competence demonstrated by passing the naturopathic physician licensing 25
examination, to: 26
(1) Order and perform physical and laboratory examinations for diagnostic 27
purposes, including phlebotomy, clinical laboratory tests, orificial examinations, 28
electrocardiograms with over read by a cardiologist, and physiological function tests; 29
6 HOUSE BILL 867
(2) Order diagnostic imaging studies and interpret the reports of diagnostic 1
imaging studies; 2
(3) Dispense or order natural medicines of mineral, animal, or botanical 3
origin, including food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, 4
enzymes, botanicals and their extracts, botanical medicines, homeopathic medicines, and 5
all dietary supplements and nonprescription drugs [listed in the formulary] that use 6
various routes of administration, including oral, nasal, auricular, ocular, rectal, vaginal, 7
transdermal, [and] intramuscular, SUBCUTANEOUS , AND INTRAVENOUS ; 8
(4) Administer natural medicines of mineral, animal, or botanical origin, 9
including food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, enzymes, 10
botanicals and their extracts, botanical medicines, homeopathic medicines, and all dietary 11
supplements and nonprescription drugs [listed in the formulary] using various routes of 12
administration, including oral, nasal, auricular, ocular, rectal, vaginal, [and] transdermal, 13
INTRAMUSCULAR , SUBCUTANEOUS , AND INTRAVENOUS ; 14
(5) Administer auto–injectable epinephrine; 15
(6) Administer or perform hot or cold hydrotherapy, naturopathic physical 16
medicine, electromagnetic energy, and therapeutic exercise for the purpose of providing 17
basic therapeutic care services, except that if a referral to another licensed provider is 18
appropriate for ongoing rehabilitation or habilitation services, the naturopathic doctor shall 19
make the referral; 20
(7) Provide health education and health counseling; [and] 21
(8) Perform naturopathic musculoskeletal mobilization; AND 22
(9) PRESCRIBE WITHIN THE SCOPE OF NATUROPATHI C MEDICINE: 23
(I) A PRESCRIPTION DRUG; AND 24
(II) A SCHEDULE III, SCHEDULE IV, OR SCHEDULE V 25
CONTROLLED DANGEROUS SUBSTANCE. 26
(b) A license does not authorize a licensee to: 27
(1) Except for a prescription drug [or device included in the formulary 28
under § 14–5F–04.1(d)(1)(ii) or (iii) of this subtitle] DESCRIBED IN SUBSECTION (A)(9) 29
OF THIS SECTION , prescribe, dispense, or administer any prescription drug or device OR 30
A SCHEDULE II CONTROLLED DANGEROUS SUBSTANCE; 31
(2) Perform surgical procedures; 32
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(3) Practice or claim to practice as a medical doctor or physician, an 1
osteopath, a dentist, a podiatrist, an optometrist, a psychologist, a nurse practitioner, a 2
physician assistant, a chiropractor, a physical therapist, an acupuncturist, or any other 3
health care professional unless licensed under this article; 4
(4) Use general or spinal anesthetics; 5
(5) Administer ionizing radioactive substances for therapeutic purposes; 6
(6) Perform chiropractic adjustments or manipulations that include 7
high–velocity thrusts at or beyond the end range of normal joint motion unless the licensee 8
is also a licensed chiropractor; 9
(7) Perform acupuncture unless the licensee is also a licensed 10
acupuncturist; or 11
(8) Prescribe, dispense, or administer any prescription or nonprescription 12
drug or device [listed in the formulary] for cosmetic purposes. 13
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 14
October 1, 2025. 15