Fiscal impact reports (FIRs) are prepared by the Legislative Finance Committee (LFC) for standing finance
committees of the Legislature. LFC does not assume responsibility for the accuracy of these reports if they
are used for other purposes.
F I S C A L I M P A C T R E P O R T
SPONSOR Hochman-Vigil
LAST UPDATED
ORIGINAL DATE 2/3/2025
SHORT TITLE Chiropractic Licensing Changes
BILL
NUMBER House Bill 189
ANALYST
Hanika-Ortiz
REVENUE*
(dollars in thousands)
Type FY25 FY26 FY27 FY28 FY29
Recurring or
Nonrecurring
Fund
Affected
RLD
(licensing
fees)
Indeterminate
but minimal
gain
Indeterminate
but minimal
gain
Indeterminate
but minimal
gain
Indeterminate
but minimal
gain
Recurring
Chiropractic
Board Fund
Parentheses ( ) indicate revenue decreases.
*Amounts reflect most recent analysis of this legislation.
ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT*
(dollars in thousands)
Agency/Program
FY25 FY26 FY27
3 Year
Total Cost
Recurring or
Nonrecurring
Fund
Affected
RLD (system
upgrades)
$600.0 No fiscal impact $600.0 Nonrecurring
Chiropractic
Board Fund
Parentheses ( ) indicate expenditure decreases.
*Amounts reflect most recent analysis of this legislation.
Sources of Information
LFC Files
Agency Analysis Received From Regulation Licensing Department (RLD)
Agency Analysis was Solicited but Not Received From
The Medical Board has been consulted on this expanded scope of practice for chiropractors.
SUMMARY
Synopsis of House Bill 189
House Bill 189 (HB189) amends the Chiropractic Physician Practice Act (Chapter 61, Article 4,
NMSA 1978) to delineate the scope of practice for level one and level two “certified advanced
practice chiropractic physicians” or CAPCPs. These chiropractors may prescribe, administer, or
dispense dangerous drugs and, if level two, can conduct certain clinical procedures.
The requirements for level one include (1) 90 hours in pharmacology, pharmacognosy,
medication administration, and toxicology; (2) a license to practice chiropractic medicine; and House Bill 189 – Page 2
(3) 10 hours of continuing education each year. The requirements for level two include (1)
supervised clinical rotation under an accredited institution that includes 500 hours of instruction,
(2) a license to practice chiropractic medicine, and (3) 20 hours of continuing education each
year.
A level one CAPCP may prescribe, inject and dispense under the drug classes of antispastics and
antispasmodics, steroids, nonsteroidal anti-inflammatory drugs, desiccated thyroid extract and
local anesthetics. A level two CAPCP may prescribe, inject, dispense, and administer dangerous
drugs, commensurate with care provided in a physician level whole person primary care practice.
This bill does not contain an effective date and, as a result, would go into effect 90 days after the
Legislature adjourns if enacted, or June 20, 2025.
FISCAL IMPLICATIONS
The Regulation and Licensing Department (RLD) reports the cost to update its NM Plus
licensing system is $600 thousand. The December 2024 LFC Cash Balance Report notes a fund
balance for the Chiropractor Board of $524 thousand. HB189 may require a special appropriation
to implement. RLD can absorb the rulemaking costs.
SIGNIFICANT ISSUES
Chiropractors are increasingly working alongside primary care physicians and others to integrate
chiropractic care into the healthcare delivery system. However, health insurance plans still offer
limited coverage for chiropractic services. This bill has the potential to improve access to
primary care. New Mexico’s physician-to-population ratio is significantly below the national
average.
RLD noted the Board of Pharmacy’s concerns with HB189:
There is no specified minimum training standard or requirement for level one CAPCP,
who may prescribe, administer, inject, or dispense dangerous drugs.
Level two CAPCP may prescribe, administer, inject, and dispense dangerous drugs that
are used in primary care practice.
An additional 500 hours of training in core areas does not qualify a chiropractic physician
to act as a primary care practitioner.
A level two CAPCP could prescribe, administer, and dispense any dangerous drug,
including Schedule II through V controlled substances.
Currently, no other state in the country allows chiropractic physicians to prescribe.
Lastly, nurse practitioners may not dispense. Level two CAPCP is less restricted in their
scope of practice than advanced practice nurses and may act as primary care physicians.
AMENDMENTS
Because of the changes required to integrate level one and two licenses into the registry, RLD
requests an extension of the effective date of the bill to January 1, 2026.
AHO/sgs/hg/sgs