HB136 Alabama 2018 Session

Summary

Primary Sponsor

Ken Johnson

Republican

Session

Regular Session 2018

Title

Chiropractors, chiropractic agreements with patients, not considered insurance, license to sell or market not required, requirements for agreement established, discontinuance of services under the agreement, Ala. Chiropractors Direct Pay Act

Summary

HB 136 creates a direct-pay chiropractic agreement option, making it not insurance and laying out rules for payments, disclosures, and termination.

What This Bill Does

The bill defines what a chiropractic agreement is and states it is not insurance and not subject to state insurance laws. It lets chiropractors offer, market, or enter into such agreements without needing an extra license beyond their chiropractic license. It requires these agreements to meet minimum rules, including being in writing, signed by both parties, describing covered services, listing fees, and stating the duration with no more than 12 months prepaid, plus clear bold disclosures about insurance status and ACA-related implications. It also requires refunds of unearned fees if the patient ends the agreement and allows chiropractors to discontinue care for specified reasons (nonpayment, fraud, noncompliance, abuse, or practice closure).

Who It Affects

• Patients who enter into a chiropractic direct-pay agreement, including uninsured individuals, who would pay a periodic fee for services and receive specified care under the agreement; they would be told the arrangement is not insurance and may face ACA-related considerations.
• Chiropractors and chiropractic practices in Alabama who offer, market, or enter into direct-pay agreements; they would be subject to minimum agreement requirements, refunds of unearned fees, and rules for when they can discontinue care, but would not need additional licenses beyond their current license.

Key Provisions

• Defines 'chiropractic agreement' as a contract for chiropractic services for an agreed-upon fee and time period, with a per-visit charge below the monthly equivalent of the periodic fee.
• The agreement is not insurance and is not subject to state insurance laws; it is not a discount medical plan.
• No extra license or authority is required beyond maintaining a current chiropractic license.
• Minimum requirements: the agreement must be in writing, signed by both parties, allow termination with at least 30 days' written notice, describe the covered services, specify the periodic fee and any additional fees, specify the duration and renewal terms with a limit of no more than 12 months prepaid, and include bold disclosures about insurance status, ACA penalties for uninsured individuals, insured patients' preventive care benefits, and that payments may not count toward deductibles.
• If the patient terminates the agreement, unearned fees must be returned to the patient.
• Chiropractors may discontinue care under the agreement for specified reasons: nonpayment, fraud, noncompliance with the treatment plan, abuse or danger to staff or patients, practice closure, or other conditions as allowed by law or board rules.
• The act becomes effective on the first day of the third month after passage and approval.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health