Chapter 446

446.02(7)(b) (b) A chiropractor may not delegate to a person who is not licensed under this chapter the making of a diagnosis, the performance of a chiropractic adjustment, the analysis of a diagnostic test or clinical information or any practice or service that the examining board, by rule, prohibits a chiropractor from delegating to a person who is not licensed under this chapter.

446.02(7)(c) (c) A chiropractor who delegates the performance of a service that is adjunctive to the practice of chiropractic to a person who is not licensed under this chapter shall verify, according to standards and procedures established by the examining board by rule, that the person has adequate education, training and experience to perform the delegated service safely, and is responsible for that person’s performance of the delegated service.

446.02(7)(d) (d) A chiropractor may delegate X-ray services only to a chiropractic radiological technician or a health care professional acting within the scope of his or her license, registration, or certification.

446.02(7d) (7d) 

446.02(7d)(a) (a) A chiropractor shall evaluate each patient before commencing treatment of the patient to determine whether the patient has a condition that is treatable by the practice of chiropractic. The evaluation shall be based upon an examination that is appropriate to the patient. To conduct the evaluation, the chiropractor shall utilize chiropractic science, as defined by the examining board by rule, and the principles of education and training of the chiropractic profession.

446.02(7d)(b) (b) A chiropractor shall discontinue the practice of chiropractic on a patient if, at any time after the evaluation under par. (a) or during or following treatment of the patient, the chiropractor determines or reasonably believes that the patient’s condition is not treatable by the practice of chiropractic, or will not respond to further practice of chiropractic by the chiropractor, except that a chiropractor may provide maintenance, supportive, and wellness care to the patient if the patient is being treated by another health care professional.

446.02(7d)(c) (c) A chiropractor who discontinues the practice of chiropractic as required in par. (b) shall inform the patient of the reason for discontinuing the practice of chiropractic and shall refer the patient to a physician licensed under subch. II of ch. 448. A chiropractor may continue to provide maintenance, supportive, and wellness care to a patient referred under this paragraph who requests these services from the chiropractor. A referral under this paragraph shall describe the chiropractor’s findings. If the referral is written, the chiropractor shall provide the patient with a copy and shall maintain a copy in the patient’s records. If the referral is oral, the chiropractor shall communicate the referral directly to the physician, shall notify the patient about the referral, and shall make a written record of the oral referral. The written record of the oral referral shall include the name of the physician to whom the patient was referred and the date of the referral. The chiropractor shall maintain a copy of the written record of the oral referral in the patient’s records.

446.02(7m) (7m) 

446.02(7m)(a) (a) A chiropractor shall create and maintain a patient record for every patient the chiropractor examines or treats. A patient record created and maintained under this paragraph shall contain complete and comprehensive health care information, as defined by the examining board by rule.

446.02(7m)(b) (b) A chiropractor shall preserve a patient record created and maintained under par. (a) for at least 3 years after the chiropractor makes his or her last entry or notation in the patient record or for any longer period that is otherwise required by law.

446.02(8) (8) Every practicing chiropractor shall have in effect professional liability insurance. The examining board shall promulgate rules establishing the minimum amount of insurance required under this subsection.

446.02(9) (9) No license under this chapter is required for any of the following:

446.02(9)(a) (a) A student or graduate of a college of chiropractic who practices chiropractic, in a program for the clinical training of students and graduates that is reviewed and approved by the examining board, under the supervision of a chiropractor who is approved by the examining board to supervise the clinical training of the student or graduate and who is licensed under this chapter and is responsible for the student’s or graduate’s practice in an infirmary, clinic, hospital or private chiropractic office that is connected or associated for training purposes with a college of chiropractic approved by the examining board.

446.02(9)(b) (b) An individual who is licensed to practice chiropractic in another state or territory of the United States and who practices chiropractic under the jurisdiction of the U.S. armed forces, as defined in s. 40.02 (57m), federal public health service or U.S. department of veterans affairs.

446.02(9)(c) (c) An individual who is licensed to practice chiropractic in another state or territory of the United States or in another country and who holds a temporary permit that is granted under the rules promulgated under sub. (3r).

446.02(9)(d) (d) A person who performs adjunctive services that are delegated to the person under sub. (7).

446.02(9)(e) (e) A naturopathic doctor or limited-scope naturopathic doctor acting within the scope of his or her license under ch. 466.

446.02(10) (10) 

446.02(10)(a) (a) A chiropractor may waive all or a portion of an insured patient’s copayments, coinsurance, or deductibles due to a chiropractor who engages in the practice of chiropractic on behalf of the insured patient if all of the following are satisfied:

446.02(10)(a)1. 1. The chiropractor receives from and maintains written documentation of the patient’s financial hardship, as defined by the examining board by rule.

446.02(10)(a)2. 2. The chiropractor accurately reports to the patient’s insurer the actual fee charged, if any, to the patient. If the chiropractor waives all or a portion of the patient’s copayments, coinsurance, or deductibles due to the chiropractor, the chiropractor may not seek payment from the insurer for any portion of the copayment, coinsurance, or deductible waived by the chiropractor unless the claim for the services related to the copayment, coinsurance, or deductible is reduced by an equal amount. In this subdivision and in par. (b), “insurer” has the meaning given in s. 600.03 (27).

446.02(10)(b) (b) A chiropractor who violates par. (a) shall refund the insurer for all payments received from the insurer that are related to the day on which a patient’s payment was waived or reduced or for the course of treatment for which the patient’s payment was waived or reduced.

446.02(10m) (10m) A licensed chiropractor who has a valid federal motor carrier safety administration medical examiner certification credential issued under 49 CFR 390.109 may conduct medical examinations for the federal motor carrier safety administration pursuant to 49 USC 31149 and 49 CFR parts 390 and 391.

446.02(11) (11) The examining board shall promulgate rules implementing s. 446.08.

446.02 History History: 1975 c. 39, 199, 383; 1977 c. 29, 418; 1979 c. 98, 162, 337; 1981 c. 380; 1991 a. 39; 1993 a. 31; 1995 a. 94, 166; 2001 a. 70; 2005 a. 25; 2007 a. 20, 104; 2009 a. 28; 2011 a. 32, 209; 2013 a. 20, 345; 2017 a. 180, 288, 331; 2021 a. 130; 2021 a. 238 ss. 27, 28, 44; 2021 a. 253; 2023 a. 186; s. 35.17 correction in (6m).

446.02 Cross-reference Cross-reference: See also Chir, Wis. adm. code.

446.025 446.025 Regulation of chiropractic radiological technicians.

446.025(1) (1) 

446.025(1)(a) (a) No person may provide X-ray services on behalf of a chiropractor in connection with the practice of chiropractic unless the person is a chiropractic radiological technician and is under the direct, on-premises supervision of a chiropractor licensed under this chapter.

446.025(1)(b) (b) No person may designate himself or herself as a “chiropractic radiological technician” or “chiropractor radiological technician,” use or assume the title “chiropractic radiological technician” or “chiropractor radiological technician” or any title that includes “chiropractic radiological technician”or “chiropractor radiological technician,” append to the person’s name the letters “C.R.T.,” or use any other title or designation that represents or implies that he or she is a chiropractic radiological technician unless the person is certified by the examining board under this section.

446.025(2) (2) 

446.025(2)(a) (a) The examining board shall certify as a chiropractic radiological technician an individual who does all of the following:

446.025(2)(a)1. 1. Submits an application to the department on a form provided by the department.

446.025(2)(a)2. 2. Pays the fee specified in s. 440.05 (1).

446.025(2)(a)3. 3. Submits evidence satisfactory to the examining board that the individual has completed a course of study approved by the examining board.

446.025(2)(a)4. 4. Subject to ss. 111.321, 111.322, and 111.335, submits evidence satisfactory to the examining board that the individual does not have an arrest or conviction record.

446.025(2)(a)5. 5. Completes any other requirements established by the examining board by rule.

446.025(2)(b) (b) The department shall assign a unique certificate number to each individual certified under this section.

446.025(3) (3) 

446.025(3)(a) (a) The renewal date and fees for a certificate issued under this section are specified in s. 440.08 (2) (a).

446.025(3)(b) (b) A chiropractic radiological technician shall, at the time that he or she applies for renewal of a certificate under par. (a), submit evidence satisfactory to the examining board that he or she has completed at least 12 continuing educational credit hours in programs established by rules promulgated by the examining board.

446.025 History History: 2009 a. 28.

446.026 446.026 Regulation of chiropractic technicians.

446.026(1) (1) 

446.026(1)(a) (a) No person may provide adjunctive services unless the person is a chiropractic technician or is described under s. 446.02 (7) (a) 3. and is under the direct, on-premises supervision of a chiropractor licensed under this chapter, or the person is a health care professional, subject to s. 446.02 (7).

446.026(1)(b) (b) Except as provided in s. 446.025 (1) (b), no person may designate himself or herself as a “chiropractic technician” or “chiropractor technician,” use or assume the title “chiropractic technician” or “chiropractor technician” or any title that includes “chiropractic technician” or “chiropractor technician,” append to the person’s name the letters “C.T.,” or use any other title or designation that represents or implies that he or she is a chiropractic technician unless the person is certified by the examining board under this section.

446.026(2) (2) 

446.026(2)(a) (a) The examining board shall certify as a chiropractic technician an individual who does all of the following:

446.026(2)(a)1. 1. Submits an application to the department on a form provided by the department.

446.026(2)(a)2. 2. Pays the fee specified in s. 440.05 (1).

446.026(2)(a)3. 3. Submits evidence satisfactory to the examining board that the individual has completed a course of study approved by the examining board.

446.026(2)(a)4. 4. Subject to ss. 111.321, 111.322, and 111.335, submits evidence satisfactory to the examining board that the individual does not have an arrest or conviction record.

446.026(2)(a)5. 5. Completes any other requirements established by the examining board by rule.

446.026(2)(b) (b) The department shall assign a unique certificate number to each individual certified under this section.

446.026(3) (3) 

446.026(3)(a) (a) The renewal date and fees for a certificate issued under this section are specified in s. 440.08 (2) (a).

446.026(3)(b) (b) A chiropractic technician shall, at the time that he or she applies for renewal of a certificate under par. (a), submit evidence satisfactory to the examining board that he or she has completed at least 6 continuing educational credit hours in programs established by rules promulgated by the examining board.

446.026 History History: 2009 a. 28; 2017 a. 180; 2023 a. 186.

446.028 446.028 Continuing education approval; program sponsors.

446.028(1) (1) In this section:

446.028(1)(a) (a) “Program sponsor” means any of the following:

446.028(1)(a)1. 1. The Wisconsin Chiropractic Association.

446.028(1)(a)2. 2. The International Chiropractors Association.

446.028(1)(a)3. 3. A college of chiropractic approved by the examining board.

446.028(1)(a)4. 4. A college of medicine or osteopathy accredited by an accrediting body listed as nationally recognized by the secretary of the federal department of education.

446.028(1)(a)5. 5. A member-based state or national chiropractic organization that satisfies all of the following:

446.028(1)(a)5.a. a. The organization is an entity that is described in section 501 (c) of the Internal Revenue Code and that is exempt from federal income tax under section 501 (a) of the Internal Revenue Code and has existed as an entity that is described in section 501 (c) of the Internal Revenue Code for at least 5 years.

446.028(1)(a)5.b. b. The purpose of the organization is not solely providing continuing education programs.

446.028(1)(a)5.c. c. The organization engages in measurable advocacy efforts to promote the chiropractic profession.

446.028(1)(b) (b) “Program sponsor” does not include an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide instruction in the use of an automated external defibrillator.

446.028(2) (2) Each program sponsor of a continuing education program required to be completed by a chiropractor as a condition of license renewal, or by a chiropractic radiological technician or a chiropractic technician as a condition of certificate renewal, shall submit the program to the examining board for approval. A sponsor of a continuing education program approved by the examining board shall notify the examining board of any information or change to information related to satisfying the requirements under this section.

446.028(3) (3) No program sponsor may delegate the tasks of monitoring or recording attendance, providing evidence of attendance, verifying required course content, or providing information on instructors for a continuing education program. A person who intentionally violates this subsection may be punished as provided in s. 446.07.

446.028 History History: 2009 a. 28; 2021 a. 253.

446.03 446.03 Reprimand; revocation, limitation, or suspension of a license or certificate. The examining board, by order, may reprimand a licensee, certificate holder, or registrant and may deny, limit, suspend or revoke any license, certificate, or certificate of registration if the licensee, certificate holder, or registrant does any of the following:

446.03(1) (1) Obtains the license, certificate, or certificate of registration through error or fraud.

446.03(2) (2) Is addicted to alcohol or other drugs.

446.03(3) (3) Is hereafter convicted in a court of competent jurisdiction, either within or without this state, or in federal court, of any violation of any law governing the practice of chiropractic or of any felony, subject to ss. 111.321, 111.322 and 111.335, a certified copy of the record of conviction to be conclusive evidence of such conviction.

446.03(4) (4) Has obtained or sought to obtain anything of value by fraudulent representation in the practice of chiropractic.

446.03(5) (5) Is guilty of unprofessional conduct.

446.03(6) (6) Has continued practice, knowingly having an infectious or contagious disease.

446.03(7) (7) Maintains a professional connection or association with any other person continuing to violate this chapter after 10 days’ notice in writing by the department.

446.03 History History: 1977 c. 29, 125, 418; 1981 c. 334 s. 25 (1); 1981 c. 380; 1983 a. 289; 1991 a. 39; 2009 a. 28.

446.04 446.04 Unprofessional conduct. Unprofessional conduct includes, without limitation because of enumeration, all of the following:

446.04(1) (1) Any conduct of a character likely to deceive or defraud the public.

446.04(2) (2) Loaning of a chiropractic license or certificate to anyone.

446.04(4) (4) Splitting or dividing any fee for chiropractic service with any person except an associate licensed chiropractor.

446.04(5) (5) Use of unprofessional advertising which includes, without limitation because of enumeration, all of the following:

446.04(5)(a) (a) Any advertising statement of a character tending to deceive or mislead the public.

446.04(5)(b) (b) Advertising professional superiority or performance of professional services in a superior manner.