SB234 Alabama 2018 Session

Summary

Primary Sponsor

Priscilla Dunn

Democrat

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

SB 234 creates the Alabama Chiropractor Direct Pay Act to allow direct-pay chiropractor-patient agreements that are not insurance and set clear rules for those agreements.

What This Bill Does

It defines what a chiropractic agreement is and says it is not insurance or subject to insurance laws. It allows chiropractors to offer these agreements without obtaining extra licenses beyond a current chiropractic license. It sets minimum writing and disclosure requirements, outlines the fees and duration, and requires refunds of unearned fees if a patient ends the agreement. It also allows chiropractors to discontinue care under certain conditions and specifies when the law takes effect.

Who It Affects

• Chiropractors licensed to practice in Alabama who enter into or market direct-pay chiropractic agreements with patients (they may do so without an additional license and must follow the agreement requirements).
• Patients in Alabama who enter into a chiropractic agreement (they will pay a periodic fee, must be informed the agreement is not insurance, and have protections such as 30-day termination and refunds of unearned fees).

Key Provisions

• A chiropractic agreement is defined and declared not to be insurance and not subject to state insurance laws.
• Chiropractors may offer or market these agreements without needing an extra license or certificate of authority beyond a current chiropractic license.
• Agreements must be in writing, signed, allow 30 days' written termination, describe the covered services, specify the periodic fee and any extra fees, state the duration and renewal terms with a cap of prepaid fees (no more than 12 months), and include prominent disclosures about insurance status and ACA considerations.
• Disclosures must inform that the agreement is not health insurance, that uninsured patients may face ACA penalties, that some preventive care may be covered by insurance plans, and that payments under the agreement may not count toward insurance deductibles or out-of-pocket limits.
• If the patient terminates, unearned fees must be refunded to the patient.
• Chiropractors may discontinue care under the agreement for specified reasons, including nonpayment, fraud, nonadherence to treatment, abuse, practice cessation, or other board-rule-based grounds.
• 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