Alaska Association of Naturopathic Physicians v. State, Division of Corporations, Business & Professional Licensing

414 P.3d 630
CourtAlaska Supreme Court
DecidedMarch 16, 2018
Docket7229 S-16530
StatusPublished
Cited by17 cases

This text of 414 P.3d 630 (Alaska Association of Naturopathic Physicians v. State, Division of Corporations, Business & Professional Licensing) is published on Counsel Stack Legal Research, covering Alaska Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Alaska Association of Naturopathic Physicians v. State, Division of Corporations, Business & Professional Licensing, 414 P.3d 630 (Ala. 2018).

Opinion

BOLGER, Justice.

I. INTRODUCTION

An association representing naturopathic physicians challenges a new regulation that effectively forbids naturopaths from using and prescribing injectable vitamins and minerals. The association argues that the statutory definition of naturopathy includes the use of dietetics, that dietetics include injectable vitamins and minerals obtained by pharmaceutical prescription, and that the statutory restrictions on the practice of naturopathy prohibit the use of only prescription drugs , not all prescription medicines . But we conclude that the statutory text, the larger statutory context, and the legislative history together suggest that the legislature did not intend to grant prescriptive authority to naturopaths. We therefore affirm the superior court's decision to grant summary judgment against the association on this issue.

II. FACTS AND PROCEEDINGS

A. Regulatory Backdrop

Naturopathy is a method of treating disease "that avoids drugs and surgery and emphasizes the use of natural agents (such as air, water, and herbs) and physical means *632 (such as tissue manipulation and electrotherapy )." 1 Alaska first established a licensing structure for naturopaths in 1986, codified at AS 08.45. 2 This statute defines the practice of naturopathy, provides requirements for obtaining and maintaining a naturopathy license, and establishes restrictions on the practice of naturopathy. 3 It defines naturopathy to include a range of practices: "hydrotherapy, dietetics, electrotherapy, sanitation, suggestion, [and] mechanical and manual manipulation for the stimulation of physiological and psychological action to establish a normal condition of mind and body." 4 And it defines dietetics to "include[ ] herbal and homeopathic remedies." 5 The statute forbids naturopaths from engaging in three types of conduct: "A person who practices naturopathy may not (1) give, prescribe, or recommend in the practice (A) a prescription drug; (B) a controlled substance; (C) a poison; (2) engage in surgery; (3) use the word 'physician' in the person's title." 6

In 1992 the State conferred authority to promulgate regulations implementing AS 08.45 on the Department of Commerce, Community, and Economic Development. 7 The Department adopted regulations implementing the naturopathy statute in 1994. Among those regulations were definitions of some of the key statutory terms:

(1) "dietetics" includes the use of nutritional therapies, nutritional counseling, nutritional substances, vitamins, minerals, and supplements to promote health and to diagnose, treat, and prevent disease, illness, and conditions;
....
(3) "herbal remedy" includes medicines derived from or a concentrate or extract of a plant, tree, root, moss, fungus, or other natural substance; "herbal remedy" does not include a controlled substance;
....
(8) "prescription drug" includes a controlled substance or other medicine commonly requiring a written prescription from a physician licensed under AS 08.64; "prescription drug" does not include a device or herbal or homeopathic remedy or dietetic substance in a form that is not a controlled substance [ 8 ]

In the ensuing years, naturopaths and the Department developed conflicting interpretations of these regulatory definitions. Naturopaths distinguished prescription drugs, which they acknowledged they were not permitted to prescribe or administer, from non-drug prescription medicines, which they interpreted the statute as permitting them to prescribe or administer. Accordingly, Alaska naturopaths routinely administered or prescribed dietetics requiring a prescription, such as injectable vitamins and minerals (e.g., a Vitamin B-12 shot or a magnesium shot). 9 In contrast, the Department interpreted the regulation to prohibit naturopaths from administering and prescribing all medicines requiring a prescription, even if the prescription medicine was also a dietetic. These clashing interpretations resulted in some pharmacists refusing to fill prescriptions for naturopaths and the State launching investigations of naturopaths who used prescription medicines and the pharmacists who filled the prescriptions.

In 2012 the Department issued a notice of proposed changes to the regulatory definitions that would clarify naturopaths' prescriptive authority. After the public comment period closed, the Department amended the *633 definitions in two ways to effectively bar naturopaths from using or prescribing any medicine that requires a prescription, including dietetics (injectable vitamins and minerals), herbal, and homeopathic remedies. 10 First, the new regulation broadened the definition of prescription drug so that it encompassed any medicine requiring a prescription and no longer excluded dietetics, herbal, and homeopathic remedies: " '[P]rescription drug' means a controlled substance or other medicine requiring a prescription from a physician licensed under AS 08.64 or from another health care professional authorized to issue prescriptions by the law of this state." 11 Second, the new regulation explicitly excluded prescription drugs from the definitions of dietetics, herbal remedy, and homeopathic remedy:

(1) "dietetics"
(A) includes the use of nutritional therapies, nutritional counseling, nutritional substances, vitamins, minerals, and supplements to promote health and to diagnose, treat, and prevent disease, illness, and conditions;
(B) does not include the use of a prescription drug, poison, or controlled substance;
....
(3) "herbal remedy"
(A) includes medicines derived from or a concentrate or extract of a plant, tree, root, moss, fungus, or other natural substance;
(B) does not include a prescription drug, poison, or controlled substance;
(4) "homeopathic remedy" means a remedy defined in the Homeopathic Pharmacopoeia of the United States Abstracts 1993 , revised as of December 1992 and adopted by reference except for prescription drug, poison, or controlled substance[.] [ 12 ]

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Cite This Page — Counsel Stack

Bluebook (online)
414 P.3d 630, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alaska-association-of-naturopathic-physicians-v-state-division-of-alaska-2018.