Subchapter B. LICENSURE AND PRACTICE OF ACUPUNCTURISTS AND PRACTITIONERS OF ORIENTAL MEDICINE
(Editor’s Note: The final-form rulemaking published at 54 Pa.B 2780 (May 18, 2024) overlooked the amendment of the Subchapter B heading published at 53 Pa.B. 5759 (September 16, 2023).)
Sec.
18.11. Definitions.
18.12. Licensure as an acupuncturist.
18.13. Requirements for licensure as an acupuncturist.
18.13a. Requirements for licensure as a practitioner of Oriental medicine.
18.14. Biennial registration requirements.
18.15. Practice responsibilities of acupuncturist and practitioner of Oriental medicine who is not a physician; practice responsibilities of an acupuncturist who is licensed as a medical doctor.
18.15a. Scope of practice of acupuncturists and practioners of Oriental medicine.
18.16. [Reserved].
18.17. [Reserved].
18.18. Disciplinary and corrective measures.
18.19. [Reserved].
18.20. Professional liability insurance coverage for acupuncturists and practitioners of Oriental medicine.§ 18.11. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
Acupuncture—(i) The stimulation of certain points on or near the surface of the body by the insertion of needles to prevent or alleviate the perception of pain or to normalize physiological functions, including pain control, for the treatment of certain diseases or dysfunctions of the body.
(ii) The term also includes the use of supplemental techniques.
Acupuncture educational program—Training and instruction in acupuncture or supplemental acupuncture techniques offered by a degree-granting institution authorized by the Department of Education that leads to a master’s degree, master’s level certificate or diploma or first professional degree, that meets the relevant and appropriate requirements of 22 Pa. Code (relating to education) and 24 Pa.C.S. Chapter 65 (relating to private colleges, universities and seminaries) and that meets or exceeds the standards required for acupuncture or Oriental medicine programs established by an accrediting agency recognized by the United States Department of Education.
Acupuncture examination—An examination recognized by the Board to test whether an individual has accumulated sufficient academic knowledge with respect to the practice of acupuncture to qualify for the privilege of practicing as an acupuncturist in this Commonwealth.
Acupuncture medical program—An academic or clinical program of study in acupuncture which has been given category I continuing medical education credit by an institution accredited or recognized by the Accreditation Council on Continuing Medical Education to conduct category I continuing medical education courses.
Acupuncturist—An individual licensed to practice acupuncture by the Board.
East Asian herbology—The use of herbal preparations and products that contain as active ingredients parts of plants, minerals and other organic materials, or a combination thereof, administered according to East Asian medicine tradition to normalize function.
East Asian herbology examination—An examination recognized by the Board to test whether an acupuncturist has accumulated sufficient academic knowledge with respect to the practice of herbal therapy to qualify for licensure as a practitioner of Oriental medicine in this Commonwealth.
Herbal therapy—The application of East Asian herbology to the treatment of acupuncture patients.
NCCAOM—The National Certification Commission for Acupuncture and Oriental Medicine or its successor organization.
OET—The English language test for healthcare professionals or its successor examination.
Practitioner of Oriental medicine—An acupuncturist who is licensed by the Board to use herbal therapy.
Supplemental techniques—The use of traditional and modern Oriental therapeutics, heat therapy, moxibustion, electrical and low-level laser stimulation, acupressure and other forms of massage, and counseling that includes the therapeutic use of foods and supplements and lifestyle modifications.
TOEFL®—The Test of English as a Foreign Language offered by Educational Testing Service (ETS).
Authority The provisions of this § 18.11 amended under section 3 of the Acupuncture Licensure Act (63 P.S. § 1803); and section 8 of the Medical Practice Act of 1985 (63 P.S. § 422.8).
Source The provisions of this § 18.11 adopted January 2, 1987, effective immediately and applies retroactively to December 31, 1986, 17 Pa.B. 24; amended May 19, 1989, effective May 20, 1989, 19 Pa.B. 2161; amended April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644; amended January 8, 2010, effective January 9, 2010, 40 Pa.B. 250; amended September 15, 2023, effective September 16, 2023, 53 Pa.B. 5759. Immediately preceding text appears at serial pages (347371) to (347372).
Cross References This section cited in 49 Pa. Code § 5.81 (relating to unprofessional and immoral conduct); and 49 Pa. Code § 18.15a (relating to scope of practice of acupuncturists and practitioners of Oriental medicine).
§ 18.12. Licensure as an acupuncturist.
A medical doctor who intends to practice acupuncture and any other individual who intends to practice acupuncture shall obtain a license from the Board as an acupuncturist.
Authority The provisions of this § 18.12 amended under section 3 of the Acupuncture Licensure Act (63 P.S. § 1803); and section 8 of the Medical Practice Act of 1985 (63 P.S. § 422.8).
Source The provisions of this § 18.12 amended April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644; amended January 8, 2010, effective January 9, 2010, 40 Pa.B. 250. Immediately preceding text appears at serial page (342668).
Cross References This section cited in 49 Pa. Code § 5.81 (relating to unprofessional and immoral conduct).
§ 18.13. Requirements for licensure as an acupuncturist.
(a) The Board will license as an acupuncturist a person who satisfies the following requirements:
(1) Has successfully completed an acupuncture educational program which includes a course in needle sterilization techniques.
(2) Has been certified by NCCAOM or has obtained a passing grade on the NCCAOM examination component in acupuncture and sterilization procedures, its successor examination or other equivalent Board-approved examination. The Board will make available a list of successor or other equivalent Board-approved examinations on its web site. If the examination was not taken in English, but is otherwise acceptable and a passing score was secured, the Board will accept the examination result if the applicant has also demonstrated English language proficiency by one of the following methods:
(i) The applicant’s acupuncture educational program was conducted in English.
(ii) The applicant has achieved a scaled score of at least 83 on the TOEFL® Internet-based test (IBT), a 220 for the TOEFL® computer-based test (CBT) or a 550 on the TOEFL® paper based test (PBT) or an equivalent score on a successor examination of the TOEFL®. The Board will make available a list of Board-approved successor examinations on its web site.
(iii) The applicant has achieved a score of at least 350 on each of the four sub-tests of the OET for any of the health-related professions.
(iv) The applicant has achieved a passing score on an English language proficiency examination, equivalent to the TOEFL® or OET, as determined by the Board. The Board will make available a list of equivalent Board-approved English language proficiency examinations on its web site.
(b) The Board will license as an acupuncturist a medical doctor who satisfies the following requirements:
(1) Has successfully completed 200 hours of training in acupuncture medical programs including examinations required by those programs.
(2) Submits an application to register as an acupuncturist accompanied by the required fee as provided under § 16.13 (relating to licensure, certification, examination and registration fees).
(c) [Reserved].
Authority The provisions of this § 18.13 amended under section 3 of the Acupuncture Licensure Act (63 P.S. § 1803); section 8 of the Medical Practice Act of 1985 (63 P.S. § 422.8); and 23 Pa.C.S. § 6383(b)(2).
Source The provisions of this § 18.13 adopted January 2, 1987, effective immediately and applies retroactively to December 31, 1986, 17 Pa.B. 24; amended May 19, 1989, effective May 20, 1989, 19 Pa.B. 2161; amended April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644; amended January 8, 2010, effective January 9, 2010, 40 Pa.B. 250; amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1899; amended September 15, 2023, effective September 16, 2023, 53 Pa.B. 5759. Immediately preceding text appears at serial page (409189).
Cross References This section cited in 49 Pa. Code § 5.81 (relating to unprofessional and immoral conduct); and 49 Pa. Code § 18.13a (relating to requirements for licensure as a practitioner of Oriental medicine).
§ 18.13a. Requirements for licensure as a practitioner of Oriental medicine.
(a) An acupuncturist who also intends to use herbal therapy is required to be licensed by the Board as a practitioner of Oriental medicine.
(b) The Board will license an acupuncturist as a practitioner of Oriental medicine if the licensee, in addition to meeting the requirements under § 18.13 (relating to requirements for licensure as an acupuncturist) has fulfilled one of the following:
(1) Successfully completed an acupuncture education program that includes the study of East Asian herbology and has passed an East Asian herbology examination. Board-approved East Asian herbology examinations include the NCCAOM examination component in Chinese herbology, its successor examination or other equivalent Board-approved East Asian herbology examination. The Board will make available a list of successor or other equivalent Board-approved examinations on its web site.
(2) Has obtained NCCAOM certification in Chinese herbology or Oriental medicine, which includes passing the NCCAOM examination component in Chinese herbology.
(c) An acupuncturist registered with the Board prior to April 14, 2007, may obtain a license as a practitioner of Oriental medicine if the acupuncturist can demonstrate one of the following:
(1) Successful completion of an East Asian herbology or Oriental medicine education program recognized by the licensing authority of another state or United States territory for the practice of herbal therapy or Oriental medicine and successful completion of an examination in East Asian herbology or Oriental medicine recognized by the licensing authority of another state or United States territory for the practice of herbal therapy or Oriental medicine.
(2) NCCAOM certification in Chinese herbology or Oriental medicine.
(3) The achievement of cumulative qualifications that the Board determines to be equivalent to the standard requirements for registration as a practitioner of Oriental medicine.
(d) This section does not apply to a medical doctor licensed as an acupuncturist nor does it restrict the practice of medicine by a medical doctor.
(e) This section does not limit a registered naturopathic doctor who is also licensed as an acupuncturist when recommending herbs, minerals and other supplements, or combinations, according to traditions other than Oriental medicine traditions.
Authority The provisions of this § 18.13a amended under section 3 of the Acupuncture Licensure Act (63 P.S. § 1803); section 8 of the Medical Practice Act of 1985 (63 P.S. § 422.8); and sections 202(6), 203(b) and (c) and 207 of the Naturopathic Doctor Registration Act (63 P.S. § § 272.202(6), 272.203(b) and (c) and 272.207).
Source The provisions of this § 18.13a adopted April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644; amended January 8, 2010, effective January 9, 2010, 40 Pa.B. 250; amended September 15, 2023, effective September 16, 2023, 53 Pa.B. 5759; amended May 17, 2024, effective May 18, 2024, 54 Pa.B. 2780. Immediately preceding text appears at serial pages (415580) to (415581).
Cross References This section cited in 49 Pa. Code § 5.81 (relating to unprofessional and immoral conduct).
§ 18.14. Biennial registration requirements.
(a) Acupuncturists and practitioners of Oriental medicine shall register biennially and submit the appropriate registration fee to engage in the practice of acupuncture for the biennial period.
(b) Procedures for biennial registration of acupuncturists and practitioners of Oriental medicine are outlined in § 16.15 (relating to biennial registration; inactive status and unregistered status).
(c) The biennial registration fee is set forth in § 16.13 (relating to licensure, certification, examination and registration fees).
(d) As a condition of biennial registration, acupuncturists and practitioners of Oriental medicine shall complete at least 2 hours of approved training in child abuse recognition and reporting in accordance with § 16.108(b) (relating to child abuse recognition and reporting—mandatory training requirement).
Authority The provisions of this § 18.14 amended under section 3 of the Acupuncture Licensure Act (63 P.S. § 1803); section 8 of the Medical Practices Act of 1985 (63 P.S. § 422.8); and 23 Pa.C.S. § 6383(b)(2).
Source The provisions of this § 18.14 amended April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644; amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1899. Immediately preceding text appears at serial page (347375).
Cross References This section cited in 49 Pa. Code § 5.81 (relating to unprofessional and immoral conduct).
§ 18.15. Practice responsibilities of acupuncturist and practitioner of Oriental medicine who is not a physician; practice responsibilities of an acupuncturist who is licensed as a medical doctor.
(a) Responsibilities to patient and public—acupuncturist who is not a physician. An acupuncturist who is not a physician:
(1) Shall perform an acupuncture evaluation and develop an acupuncture treatment plan.
(1.1) May treat an individual presenting with no symptoms of a condition for an unlimited period of time.
(2) May treat an individual presenting with symptoms of a condition for 60 calendar days from the date of the first treatment without the condition being diagnosed by a physician, dentist or podiatrist.
(3) May treat an individual presenting with symptoms of a condition beyond 60 calendar days from the date of first treatment if the patient has obtained an examination and diagnosis from a physician, dentist or podiatrist.
(4) Shall promptly refer the patient presenting with symptoms of a condition to a physician, dentist or podiatrist, as appropriate to the patient’s condition, if the acupuncturist determines that further acupuncture treatment is contraindicated for the patient or determines that the patient’s symptoms have worsened.
(5) Shall consult with the patient’s physician, dentist, podiatrist or other health care practitioner upon request of the patient.
(6) Shall cooperate with the patient’s physician, dentist or podiatrist in regard to the coordination of the patient’s care, and comply with restrictions or conditions as directed by the physician, dentist or podiatrist.
(7) May not diagnose a physical or mental ailment or condition or prescribe or dispense a drug. This provision does not prohibit the use of diagnostic billing codes for billing or reimbursement purposes.
(8) Shall comply strictly with sterilization standards relative to aseptic practices.
(9) Shall maintain patient records in a manner consistent with § 16.95 (relating to medical records).
(10) Shall wear a tag or badge with lettering clearly visible to the patient bearing the acupuncturist’s name and the title ‘‘acupuncturist.’’ The use of the words doctor, physician or any title or abbreviation implying licensure as a physician on this tag or badge is prohibited, provided, however, that an individual licensed as an acupuncturist who also possesses a current and active registration as a naturopathic doctor may utilize the title ‘‘doctor of naturopathic medicine’’ or ‘‘naturopathic doctor’’ in addition to the title ‘‘acupuncturist.’’
(b) [Reserved].
(b.1) Additional responsibilities to patient and public—practitioner of Oriental medicine who is not a physician. In addition to the responsibilities in subsection (a)(1)—(9), a licensed practitioner of Oriental medicine who provides, or contemplates providing, herbal therapy:
(1) Shall perform an herbal therapy evaluation and, if appropriate, develop an appropriate treatment plan utilizing, in whole or in part, East Asian herbology modalities.
(2) Shall promptly refer a patient presenting with symptoms of a condition to a physician, dentist or podiatrist, as appropriate to the patient’s condition, if the practitioner of Oriental medicine determines that further treatment of the patient by East Asian herbology modalities is contraindicated for the patient, may interfere with known drugs prescribed to the patient, or determines that the patient’s symptoms have worsened.
(3) Shall wear a tag or badge with lettering clearly visible to the patient bearing the licensee’s name, as well as the title ‘‘practitioner of Oriental medicine.’’ The use of the words doctor, physician or any title or abbreviation implying licensure as a physician on this tag or badge is prohibited, provided, however, that an individual licensed as a practitioner of Oriental medicine who also possesses a current and active registration as a naturopathic doctor may utilize the title ‘‘doctor of naturopathic medicine’’ or ‘‘naturopathic doctor’’ in addition to the title ‘‘practitioner of Oriental medicine.’’
(c) Responsibilities to patient and public—acupuncturist who is currently licensed as a medical doctor. An acupuncturist who also holds a current and active license as a medical doctor in this Commonwealth:
(1) Shall include in the patient’s medical records evidence of having performed an acupuncture evaluation and development of an acupuncture treatment plan for patients considered for, or who receive, acupuncture.
(2) Shall comply strictly with sterilization standards relative to aseptic practices when providing acupuncture to patients.
Authority The provisions of this § 18.15 amended under section 3(b) of the Accupuncture Licensure Act (63 P.S. § 1803(b)); sections 202(6), 203(b) and (c) and 207 of the Naturopathic Doctor Registration Act (63 P.S. § § 272.202(6), 272.203(b) and (c) and 272.207; and section 8 of the Medical Practice Act of 1985 (63 P.S. § 422.8).
Source The provisions of this § 18.15 amended January 8, 2010, effective January 9, 2010, 40 Pa.B. 250; amended September 15, 2023, effective September 16, 2023, 53 Pa.B. 5759; amended May 17, 2024, effective May 18, 2024, 54 Pa.B. 2780. Immediately preceding text appears at serial pages (415582) to (415583).
Cross References This section cited in 49 Pa. Code § 5.81 (relating to unprofessional and immoral conduct); and 49 Pa. Code § 18.18 (relating to disciplinary and corrective measures).
§ 18.15a. Scope of practice of acupuncturists and practitioners of Oriental medicine.
(a) An acupuncturist may practice acupuncture and use supplemental techniques, including the use of non-prescription topical remedies which contain as active ingredients parts of plants, minerals and other organic materials, but may not use herbal therapy as defined in § 18.11 (relating to definitions) unless licensed by the Board as a practitioner of Oriental medicine.
(b) A practitioner of Oriental medicine may practice acupuncture and use supplemental techniques including herbal therapy. A practitioner of Oriental medicine is not prohibited from dispensing or administering therapeutic herbs that contain ingredients that are similar or equivalent to active ingredients in drugs as classified by the Federal Food and Drug Administration, unless otherwise prohibited by law or regulation.
(c) This section does not limit the scope of practice of a medical doctor who is registered as an acupuncturist.
(d) This section does not limit a registered naturopathic doctor when recommending herbs, minerals and other supplements, or combinations, according to traditions other than Oriental medicine traditions.
Authority The provisions of this § 18.15a amended under section 3 of the Acupuncture Licensure Act (63 P.S. § 1803); section 8 of the Medical Practice Act of 1985 (63 P.S. § 422.8); and sections 202(6), 203(b) and (c) and 207 of the Naturopathic Doctor Registration Act (63 P.S. § § 272.202(6), 272.203(b) and (c) and 272.207).
Source The provisions of this § 18.15a adopted April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644; amended January 8, 2010, effective January 9, 2010, 40 Pa.B. 250; amended September 15, 2023, effective September 16, 2023, 53 Pa.B. 5759; amended May 17, 2024, effective May 18, 2024, 54 Pa.B. 2780. Immediately preceding text appears at serial pages (415583) to (415584).
Cross References This section cited in 49 Pa. Code § 5.81 (relating to unprofessional and immoral conduct).
§ 18.16. [Reserved].
Source The provisions of this § 18.16 reserved April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644. Immediately preceding text appears at serial pages (222908) to (222909).
§ 18.17. [Reserved].
Source The provisions of this § 18.17 reserved April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644. Immediately preceding text appears at serial pages (222909) to (222910).
§ 18.18. Disciplinary and corrective measures.
(a) The Board may impose any of the disciplinary sanctions authorized under section 42 of the act (63 P.S. § 422.42) or 63 Pa.C.S. § 3108(b) (relating to civil penalties) for any of the following:
(1) Failing to comply with the duties and requirements in § 18.15 (relating to practice responsibilities of acupuncturist and practitioner of Oriental medicine who is not a physician; practice responsibilities of an acupuncturist who is licensed as a medical doctor).
(2) Practicing or holding out as being able to practice acupuncture without a current and valid license to practice acupuncture.
(3) Practicing or holding out as being able to practice East Asian herbology without a current and valid license as a practitioner of Oriental medicine.
(4) Practicing acupuncture or East Asian herbology without current professional liability insurance coverage as required under section 3.2 of the Acupuncture Licensure Act (63 P.S. § 1803.2) and § 18.20 (relating to professional liability insurance coverage for acupuncturists and practitioners of Oriental medicine).
(5) Engaging in conduct prohibited under section 41 of the act (63 P.S. § 422.41) for Board-regulated practitioners.
(6) Failure to notify the Board within 30 days of licensee’s failure to be covered by insurance under as required under section 3.2 of the Acupuncture Licensure Act and § 18.20.
(b) The Board will order the emergency suspension of the license of an acupuncturist or practitioner of Oriental medicine who presents an immediate and clear danger to the public health and safety, as required under section 40 of the act (63 P.S. § 422.40).
(c) The license of an acupuncturist or practitioner of Oriental medicine shall automatically be suspended, as required under section 40 of the act.
Authority The provisions of this § 18.18 amended under section 3 of the Acupuncture Licensure Act (63 P.S. § 1803); and section 8 of the Medical Practice Act of 1985 (63 P.S. § 422.8).
Source The provisions of this § 18.18 adopted January 2, 1987, effective immediately and applies retroactively to December 31, 1986, 17 Pa.B. 24; amended May 19, 1989, effective May 20, 1989, 19 Pa.B. 2161; amended April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644; amended January 8, 2010, effective January 9, 2010, 40 Pa.B. 250; amended September 15, 2023, effective September 16, 2023, 53 Pa.B. 5759. Immediately preceding text appears at serial page (347377).
Cross References This section cited in 49 Pa. Code § 5.81 (relating to unprofessional and immoral conduct).
§ 18.19. [Reserved].
Source The provisions of this § 18.19 corrected January 9, 1987, effective immediately and applies retroactively to December 31, 1986, 17 Pa.B. 185; reserved April 13, 2007, effective April 14, 2007, 37 Pa.B. 1644. Immediately preceding text appears at serial page (222910).
§ 18.20. Professional liability insurance coverage for acupuncturists and practitioners of Oriental medicine.
(a) A licensed acupuncturist shall maintain a level of professional liability insurance coverage in the minimum amount of $1 million per occurrence or claims made, as required under section 3.2 of the Acupuncture Licensure Act (63 P.S. § 1803.2).
(b) Proof of professional liability insurance coverage may include:
(1) A certificate of insurance or copy of the declaration page from a personally purchased professional liability insurance policy setting forth the effective date, expiration date and dollar amount of coverage.
(2) A certificate of insurance or copy of the declaration page from an employer purchased professional liability insurance policy describing the licensee by name as a covered party under the policy, the effective date, expiration date and dollar amount of coverage.
(3) Evidence of a plan of self-insurance approved by the Insurance Commissioner of the Commonwealth under regulations of the Insurance Department in 31 Pa. Code Chapter 243 (relating to medical malpractice and health-related self-insurance plans).
(c) A licensee who does not have current professional liability insurance coverage as required under section 3.2 of the Acupuncture Licensure Act may not practice as an acupuncturist or as a practitioner of Oriental medicine in this Commonwealth.
(d) The professional liability insurance coverage for a licensed practitioner of Oriental medicine shall cover claims related to acupuncture as well as claims related to the provision of herbal therapy.
(e) The license of an acupuncturist or practitioner of Oriental medicine shall automatically be suspended upon failure to be covered by the required professional liability insurance required in this section and shall not be restored until submission to the Board of satisfactory evidence that the licensee has the required professional liability insurance coverage.
Source The provisions of this § 18.20 added September 15, 2023, effective September 16, 2023, 53 Pa.B. 5759.
Cross References This section cited in 49 Pa. Code § 18.18 (relating to disciplinary and corective measures).
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