Attention: The State of Michigan’s added requirements for X-Ray operators may affect your practice (July 2024)

Actions needed immediately for the new requirements:

1.)        Prepare a written “Statement of Assurance” for every Chiropractic Assistant (C.A.) or any other unlicensed person taking x-rays in your office.

2.)        Unlicensed staff-members taking x-rays in your office then have until March 13, 2027 to complete a new required forty (40) hour training program.

      If any Chiropractic Assistant’s (C.A.’s) take x-rays in your office, you must comply with a new state of Michigan requirement. M.I.O.S.H.A., the Michigan Occupational Safety and Health Administration has now adopted the standards of the American Registry of Radiologic Technologists, A.R.R.T. for all staff taking x-rays in Michigan.

      You must prepare and keep a written ‘Statement of Assurance’ for each unlicensed C.A. or other staff person who takes x-rays in your office under these new rules.  Licensed Chiropractors taking x-rays are not required to prepare the written Statement as x-ray taking is already within your scope.

      Any unlicensed individuals taking x-rays in your office have until March 17, 2027, to complete a forty (40) hour training program including clinical and lecture components. The necessary training is currently in development.
      The written Statement of Assurance must state that the operator is competent to apply machine-produced ionizing radiation to human beings; State the nature of the equipment and procedures the individual is competent to utilize; be signed and dated by a licensed practitioner in the facility; and, be kept on file and made available for inspection by the Michigan Department of Labor and Economic Opportunity and/or Department of Radiological Health.

     For more information refer to the Michigan Department of Labor and Economic Opportunity, Radiation Safety Section, Ionizing Radiation Rules Governing the Use of Radiation Machines, Part 5. Operator Qualifications

Michigan Department of Labor and Economic Opportunity’s FAQ X-Ray Operator Qualification Rules

 Here’s a sample template for the Michigan X-ray Written Statement of Assurance:

                 Written Statement of Assurance for X-ray-taking in Michigan

Facility Name: _______________________________________________

Facility Address: _____________________________________________

Operator’s Name: __________________ (separate form for each individual taking x-rays)

Date: ___________________________

Competency Statement: I, the undersigned, hereby affirm that the above-named operator is competent to apply machine-produced ionizing radiation to human beings. This competency includes the safe and effective use of the following equipment and procedures:

Equipment and Procedures:

• [List specific X-ray equipment and procedures the operator is competent to use]

Licensed Practitioner: I, the undersigned licensed practitioner, confirm that the above-named operator has demonstrated the necessary skills and knowledge to safely operate the specified X-ray equipment and perform the listed procedures. This document is designed to meet State of Michigan regulatory requirements.

Signed:

Practitioner’s Name/Degree: _____________________________________________________

Practitioner’s License Number: ___________________________________________________

Signature: _______________________________________________________________________

Practice Name: __________________________________________________________________

Date: _____________________________________________________________________________

Implicit Bias Training update (October 2023):

L.A.R.A. has recently announced that the 2 required hours in Implicit Bias training may now BE INCLUDED as part of each D.C.'s required 30 hours of Continuing Education during each license renewal period (no longer required IN ADDITION to the 30 C.E. hours.)   Note that the M.C.C.A.  annual November seminar includes Implicit Bias training for all live seminar attendees at no extra charge.

From L.A.R.A. on May 24, 2023:

A Message from the Michigan Department of Health and Human Services and the Department of Financial and Insurance Services:

Dear Health Care Provider,

Nationwide, Medicaid beneficiaries will once again have to renew their coverage starting this year to comply with federal legislation. In Michigan, annual eligibility renewals will begin in June 2023. It is important that you are aware of this federally required process because it has the risk of leaving some of your patients without health insurance.

As a health care provider, you can play a role in helping your patients stay informed and covered, and we are asking for your help. If you have Medicaid beneficiaries as patients, please consider asking them to do the following:

• Make sure their address, phone number and email address are up to date at Michigan.gov/MIBridges. They can also call their local MDHHS office. If they do not have an online account for MI Bridges to access their Medicaid case or report changes, they can sign up for an account. They can also locate organizations that can provide local help by searching for community partners.
• Report any changes to their household or income by visiting Michigan.gov/MIBridges or by calling their local MDHHS office.
• If they receive a renewal packet, make sure to fill it out, sign the forms, and return it by the due date with any proof requested. If they do not complete and return the renewal, they may lose Medicaid coverage even if they are otherwise eligible.

If one of your patients receives notice that a member of their household is no longer eligible for Medicaid or MIChild benefits, it is important that they know they have options for alternative health insurance, including no and low-cost coverage, and they should take quick action to avoid a lapse in coverage. For more information about options, including purchasing a low- or -no-cost health plan on the Health Insurance Marketplace, they can visit Michigan.gov/StayCovered. To help you communicate with your patients, a toolkit is available online that includes a flyer, sample newsletter articles, and more.

For patients with questions about purchasing a health plan on HealthCare.gov, they can visit Michigan.gov/HealthInsurance, or call the Michigan Department of Insurance and Financial Services (DIFS) at 877-999-6442, Monday through Friday from 8 a.m. to 5 p.m. More information about changes to food assistance and Medicaid benefits connected to the COVID-19 Public Health Emergency can be found at Michigan.gov/2023BenefitChanges.

As a health care provider, you know that having health insurance is critical, not just for when people are sick or hurt, but also to help them stay healthy and afford the care they need. Thank you for taking these steps to make sure your patients are aware of the actions they need to take to stay covered so they can protect themselves and their families.

Centers for Medicare and Medicaid Services Issue Updated ABN Form

The Medicare Advance Beneficiary Notice of Noncoverage (ABN) Form CMS-R-131 and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The use of the renewed form with the expiration date of Jan. 31, 2026, will be mandatory as of June 30. You may continue to use the ABN form with the expiration date of June 30, 2023, until the renewed form (expiration date Jan. 31, 2026) becomes mandatory on June 30. More information about the ABN form and instructions can be found here.

From L.A.R.A. on March 30, 2023:

March 30, 2023

 The Bureau of Professional Licensing (BPL) within the Department of Licensing and Regulatory Affairs (LARA) would like to inform you that the new Chiropractic rules were effective as of March 29, 2023. A list of the notable changes is below. This is not intended to provide a comprehensive listing of all changes or current requirements. Licensees should review the rules and statute for a complete understanding of all applicable requirements.

The new rules:

• Adopt by reference accreditation standards for chiropractic educational programs.
• Incorporate the recent legislative changes that allow licensure by endorsement for individuals licensed in another state or a province of Canada.
• Allow proof of licensure in another province of Canada as a pathway to relicensure.
• Clarify the period in which a licensee must request a waiver of continuing education.
• Lessen a few of the requirements related to attending live, in-person programs for continuing education.
• Clarify that a proposed continuing education provider must file the application and supporting documentation with the department for review not less than one-hundred twenty (120) days before the scheduled program date.

Please click HERE to view the revised Chiropractic Rules.

Our office is diligently working on updating relative information on our website to reflect the revisions of the revised rules. For more information, please visit our website at www.michigan.gov/bpl.

Please send questions about the revised rules to BPLHELP@michigan.gov.

Thank you.   Bureau of Professional Licensing  -  Licensing Division

Note that the 2 hours of C.E. in Physical Measures and the 2 hours of C.E.

in Performance & Ordering of Tests no longer need to be in-person.

From L.A.R.A. on February 2, 2023:

Track your continuing education compliance online!

      The Bureau of Professional Licensing (BPL) has partnered with CE Broker to help licensed Chiropractors keep track of their continuing education (CE) credits and stay in compliance with requirements. These requirements are established by the Michigan Board of Chiropractic to help protect the health and safety of Michigan residents. While using CE Broker is optional, it will allow you to keep all your continuing education transcripts in one place.

     All licensed Chiropractors have access to a free Basic Account, so you’ll have helpful CE tracking tools right at your fingertips. To activate your free CE Broker account, please:

1. Visit https://cebroker.com/mi/account/basic/
2. Enter your license number
3. Start tracking your CE!

Free Access to CE Broker

      Within the free Basic Account, you will have access to your Course History and CE Compliance Status. This lists all of the courses which have been reported thus far and indicates whether or not you have satisfied your renewal requirements. CE Broker is 100% free to use and you will never have to pay to access all of the necessary tools to renew your license!

* If you already have a CE Broker account, follow these simple steps to add your Michigan license.

Comprehensive Course Search

      One of the best free tools CE Broker provides is the Course Search. You can easily find every course needed to successfully complete your license renewal, with just a few clicks! After you are finished with each course, educational providers will report the credits directly into CE Broker for you - but you should always retain a copy of the certificates for your records. To find courses, visit courses.cebroker.com/search/mi and select your applicable board and profession.

Helpful Support Center

      CE Broker’s support center is based in Jacksonville, FL and staffed with experts who have been thoroughly trained on the rules & regulations of your Board. Open 8AM- 8PM ET, Monday through Friday, you can reach them by phone at 877-434-6323, or via email and live chat. For additional information and helpful guides, please visit: https://help.cebroker.com/.

Upgraded Account Options

       For additional cost, you can also subscribe to the Professional or Concierge Account, which offers above-and-beyond CE tracking tools to further simplify your renewal process. With the Professional account, you can access a personalized CE Transcript which outlines exactly what requirements you have left to complete. The Concierge account even includes your own CE Broker account manager who can guide you through the reporting process, step by step.

Other Benefits of Using CE Broker

• Track and know precisely how many hours you’ve completed and how many hours are remaining;
• Available convenience features like a personalized transcript and a personal account manager;
• Bring CME compliance wherever you go with the CE Broker mobile app (available on iPhone and Android).

Medicare Revalidation Reminder

Medicare requires you to revalidate your enrollment record every five years to continue billing Medicare. D.C.’s may NOT opt out of Medicare but choose to be “participating” or “non-participating” with Medicare. Remember to revalidate with Medicare before your five-year due date to prevent deactivation of your Medicare billing privileges and to avoid a hold being placed on your Medicare payments.

To locate the due date for your Medicare revalidation:
 ·      Revalidate online using PECOS  https://pecos.cms.hhs.gov/pecos/login.do#headingLv1

·      Search the Medicare Revalidation List at https://data.cms.gov/tools/medicare-revalidation-list

 C.M.S. posts the revalidation due dates seven months in advance. You should revalidate if you are within three months of your revalidation due date, even if you haven’t received a notification.

DO NOT Revalidate if your due date is more than seven months away unless you receive a revalidation notice as unsolicited revalidations will be returned.

Important Information about Michigan Chiropractic Continuing Education...

The Board of Chiropractic will NOT permit duplication of courses within a D.C.'s two (2) year period of license renewal. Doctors must complete 30 hours of approved Continuing Education (C.E.) in the 2 year period before their license expires every two years.

Specific courses must be included in the 30 required hours including:

• Physical Measures - 2 hours
• The Ordering and Performance of Tests - 2 hours
• Professional Ethics - 1 hour
• Sexual Boundaries - 1 hour
• Pain and Symptom Management - 1 hour

***Up to 15 of the 30 hours may be completed online within the re-licensure period.

The Board will NOT accept "identical to or substantially identical to" courses within the 30 mandated Continuing Education credits. Thus if you attend the Ethics and/or Sexual Boundaries courses, BE SURE TO complete additional distinct courses to ensure that you meet all of the criteria. Do NOT count the Ethics and Boundaries courses twice within the 2 year re-licensure period.

No more than 12 credit hours of continuing education shall be earned in a 24-hour period. Credit for CE programs that are “identical to or substantially identical to” programs already taken during the licensure cycle shall not be granted.

Credits do not "roll over" after the end of the re-licensure period thus you must be aware of your license expiration date and your C.E. courses completed within the prior 2-year period to meet all state requirements.

Remember, the required 30 hours is the MINIMUM. It is highly recommended that you exceed the minimum.  Learning never ends!
 

You must carefully review all of your certificates of Continuing Education and double check to ensure that you have met all of the requirements.

When you pay your re-licensure fees every two years you formally attest that you have completed all requirements. Do not submit any copies of your documents unless you are requested to do so by an audit by the state of Michigan.

It is recommended that you keep all of your Continuing Education documents in a single permanent file for future reference and for easy access in the event of a state C.E. audit. Retaining all of your C.E. certificates in one place will also make it easy to update your comprehensive C.V./resume to include the list of your completed courses. 

Implicit Bias Training Requirement for all Michigan healthcare workers has been announced by the state:

On June 1, 2021 the State of Michigan announced that beginning June 2022, all health care professionals, including D.C.'s will be required to attend 2 hours of formal training on implicit biases to maintain state licensure. Training is available through the M.C.C.A. to meet this requirement at our annual November seminar.  The Implicit Bias training is included with no additional charge as part of the annual seminar. Also, keep an eye on this website for further information.

Regarding Implicit Bias training - on May 9, 2022 the state of Michigan's L.A.R.A. provided the following:

Dear Licensee –

The Bureau of Professional Licensing (BPL) within the Department of Licensing and Regulatory Affairs (LARA) would like to remind you that the Michigan Public Health Code – General Rules were revised last year and now require implicit bias training for your profession. The requirements apply to both new applicants as well as those renewing their existing licenses or registrations starting on June 1, 2022.

Below are some frequently asked questions and answers regarding the new training requirements:

What is Implicit Bias Training?

A: A new rule was added to the Public Health Code – General Rules earlier this year. The rule defines implicit bias as “an attitude or internalized stereotype that affects an individual’s perception, action, or decision making in an unconscious manner and often contributes to unequal treatment of people based on race, ethnicity, nationality, gender, gender identity, sexual orientation, religion, socioeconomic status, age, disability, or other characteristic." Rule 338.7001(c).

Training on Implicit Bias is required as a condition for initial licensure or registration as well as license or registration renewal. This training is in addition to any continuing education training required for your profession. Unlike the human trafficking training requirement, this is not a “one time” training. Implicit Bias training is required every time you renew your license.

What professions need to comply with this new rule regarding Implicit Bias Training?

A: All professions licensed or registered under the Michigan Public Health Code, except for Veterinary Medicine, are required to take Implicit Bias Training.

This includes the following: Acupuncture, Athletic Trainers, Audiologists, Behavior Analysts, Chiropractors, Counselors, Dentistry, Genetic Counseling, Marriage & Family Therapy, Massage Therapy, Medicine, Midwifery, Nursing, Nursing Home Administrators, Occupational Therapy, Optometry, Osteopathic Medicine & Surgery, Pharmacy (Pharmacists, Pharmacy, Technicians, etc.), Physical Therapy, Physician’s Assistants, Podiatric Medicine & Surgery, Psychology, Respiratory Therapy, Sanitarian, Social Worker, and Speech-Language Pathology

When does this requirement begin?

A: The new requirement takes effect on June 1, 2022, which is one year after the promulgation of the rule. If the 90-day renewal window for your license or registration spans across June 1, 2022 the training is not required if you renew prior to June 1, 2022. However, if you choose to renew on or after June 1, 2022, the training is required.

Also, the training will be required for all new applications for licensure or registration received on or after June 1, 2022.

How many hours of training do I need?

A: New Applicants for licensure or registration are required to have completed 2 hours of implicit bias
training within the 5 years immediately preceding issuance of the license or registration.

Renewing licensees and registrants are required to complete 1 hour of implicit bias training for each
year of their license or registration cycle. However, for initial renewal after June 1, 2021, licensees
will only need to have 1 hour for each year since the rule’s promulgation date of June 1, 2021.

For example, if you are scheduled to renew your license in August of 2022, you would only be required
to have 1 hour of training, even if the length of your license was 3 years. Remember: The rule also
specifically states that this training is in addition to any continuing education requirements required
for renewal.

Subsequent renewals will require 1 hour of implicit bias training for each year of the license or
registration cycle.

Who can provide training?

A: The new rule provides a detailed description of what the training should cover and who is an acceptable sponsor of the training. Any training that meets the requirements of the rule is acceptable. Please note the Department does not pre-approve these training programs. We recommend that applicants refer to the standards that have been established in rule for guidance
on what is acceptable. 

The new rule also requires licensees to retain documentation of meeting the requirements of this rule for a period of 6 years from the date of applying for licensure, registration, or renewal.

If I took training that qualifies before June 1, 2021, can I count this training at my next renewal?

A: Training that was taken prior the promulgation of the rule (June 1, 2021) and within the license cycle that is up for renewal, qualifies toward the requirement for renewals. However, the rule allows new applicants for licensure or registration to complete the training within the 5 years immediately preceding issuance of the license or registration.

If I am required to have 3 hours of training to renew my 3-year license, can I take one three-hour class or do have to take 1 hour of training each year?

A: In this example you could take a single three-hour class to meet the training requirement. The rule does not require one hour IN each year of the license cycle only one hour FOR each year of the license or registration cycle.

Does watching a video meet the requirements of the training?

A: Training should provide opportunities for interaction among participants and with the instructor. In this manner the educational experience will accommodate various learning styles and provide meaningful engagement. If the training incorporates interaction among the participants (with each other and the instructor), the rule requirement will be satisfied.

How will this new rule be enforced?

A: At time of application and renewal an applicant, licensee or registrant will attest to compliance with the new rule. Rule 338.704(4) provides the following:

The department may select and audit a sample of a licensees or registrants and request documentation of proof of compliance with this rule. If audited by the department, a licensee or registrant shall provide the proof of completion of training, including either of the following:
(a) A completion certificate issued by the training program that includes the date of the training, the program sponsor’s name, the title of the program, and licensee’s or registrant’s name.
(b) A self-attestation by the licensee or registrant that includes the date of the training, the program sponsor’s name, the title of the program, and licensee’s or registrant’s name.

Implicit Bias Requirements for Doctors of Chiropractic:

• For Chiropractic licenses that expire in the year 2022, the State requires completion of one (1) hour of Implicit Bias training. You must complete this training hour before the end of your license renewal period.
• In the following years you are required to complete two (2) hours of Implicit Bias training before you renew your license to practice.
• The requirement for implicit Bias training is separate and additional to the required thirty (30) hours of Chiropractic Continuing Education with specific mandates for license renewal.
• Implicit Bias training is NOT ‘one-time’ but is an ongoing re-licensure requirement in addition to the C.E. requirements. Two (2) hours of Implicit Bias Training are required during each D.C.’s renewal period, every two (2) years.

More information about the Implicit Bias Requirement:

• The Implicit Bias training requirement affects ALL licensed or registered health care professions, excluding only Veterinarians. Each licensee must complete one hour of Implicit Bias training for each year of licensure.
• See the link below for additional information about the State of Michigan’s Implicit Bias training requirements:
• FAQs for Implicit Bias Training This link is from the Bureau of Professional Licensing of the Michigan Department of Licensing and Regulatory Affairs.

Change in Michigan License Expiration Dates information:

All D.C. licenses currently expire at the end of November every 2 years but the State of Michigan will be implementing a new software system known as "MiPLUS" (Michigan Professional Licensing User System) for their database of Michigan's healthcare providers. Each D.C.'s license expiration date will be based on YOUR initial licensure date. The State of Michigan's new "Mi-PLUS" system became available for your online license renewal on Oct. 5, 2021. If your license expires in 2022, your new license expiration date will not begin until your next renewal period.

DO NOT renew your license until you have completed the State of Michigan’s continuing education requirements for license renewal. This includes 30 hours of Michigan Board of Chiropractic-approved Continuing Education over the two-year re-licensure period. Required Continuing Education hours include 1 hour in ethics, 1 hour in sexual boundaries, 1 hour in pain and symptom management, 2 hours in physical measures (live, in-person program) and 2 hours in the performance and ordering of tests (live, in-person program). 

The rules of the Michigan Board of Chiropractic state that at least 15 of your C.E. hours must be earned by attending a live, in-person program. Up to 15 hours of C.E. may be earned through online courses.

Human Trafficking: The state requires all Michigan-licensed health care providers to complete one time training in identifying victims of Human Trafficking. This requirement was established in 2018. If you have completed the training keep the documentation available permanently if you are audited by the state. If you have NOT yet completed this training (not required as a full hour of C.E., just as a stand-alone learning module) please complete the training without delay. The MAC organization has a Webinar PowerPoint presentation available to D.C.'s at no charge that meets the requirement. There are other online courses that also meet the state requirements. Avoid any problems with your re-licensure by completing this Human Trafficking training and maintaining the documented proof of your completion.

Canadian Chiropractic Examinations acceptable in Michigan:

A special Board of Chiropractic meeting was held on Monday, June 21, 2021 at 2:00 p.m. The Board voted to support adoption of the Master Resolution on the Canadian National Examination. Essentially, the Board agreed that the Canadian National Board examinations are equal to the American National Board of Chiropractic Examiners (N.B.C.E.) testing. This means that Doctors of Chiropractic desiring to gain a Michigan Chiropractic license who have successfully passed the Canadian National Examinations would not have to take the N.B.C.E. exams to apply for Michigan licensure. There was no other significant business conducted at this special Board meeting. 

On Dec. 7, 2021 L.A.R.A. announced the following:

Dear Licensees and Stakeholders,

In 2017, the Bureau of Professional Licensing (BPL) started a project to migrate over 700,000 licenses to a new licensing platform called MiPLUS. We are happy to report this project was completed in October of this year. We would like to this opportunity to thank you for your patience and support during this multi-year transition.

We are happy to have the benefits MiPLUS offers which include an online account and an electronic application. As soon as your license is issued or renewed, you will receive an electronic copy of your license via email. Electronic copies of licenses are also stored in your MiPLUS account and can be accessed at any time.

Due to the functionality of MiPLUS, paper copies of licenses will no longer be automatically mailed upon issuance or renewal beginning January 1, 2022. Instead, licensees will be able to choose if they’d prefer to have a copy of their license mailed to them during the application or renewal process.

Not only does this change benefit licensees because an electronic copy is immediately available, but this change will have a positive impact on our environment by saving up to 300,000 pieces of paper each year.

To access your MiPLUS account, please visit www.michigan.gov/miplus. If you have any questions, please contact us at bplhelp@michigan.gov or 517-241-0199.

Debra Gagliardi, Director
Bureau of Professional Licensing
Department of Licensing and Regulatory Affairs

January 5, 2022  Covid Update:

       The U.S. Centers for Disease Control and Prevention (CDC) has released new guidance shortening the isolation time for healthcare workers who test positive for COVID-19. Health care workers with COVID-19 may now return to work after seven days if they are asymptomatic and test negative within 48 hours of returning to work. Healthcare workers with COVID-19 who are asymptomatic can now return to work after seven (7) days with a negative test, and that isolation time can be cut further if there are staffing shortages. Additionally, healthcare workers who have received all recommended COVID-19 vaccine doses, including a booster, do not need to quarantine at home following high-risk exposures.

       Please note: Isolation relates to behavior after a confirmed infection, and quarantine is following exposure to the virus but without a confirmed infection.
       CDC also released new guidelines for the general public, shortening the recommended time for isolation from ten (10) days for people with COVID-19 to five (5) days, if asymptomatic, followed by five (5) days of wearing a mask when around others. For more information, see here.