Legislative Service Commission
127th General Assembly
(As Reported by H. Health)
Sens. Schuring, D. Miller, Spada
· Permits an acupuncturist who has completed an initial supervisory period to perform acupuncture for a patient without receiving a referral or prescription for acupuncture and without being supervised by the patient's physician or chiropractor.
License to practice as an acupuncturist
(R.C. 4762.04 and 4762.08)
Under current law, the practice of acupuncture is regulated primarily through the State Medical Board. A person seeking to practice as an acupuncturist must apply to the Board, and if the Board determines the applicant is qualified, the Board issues to the applicant a certificate of registration as an acupuncturist.
The bill changes the name of the licensing document issued by the Board to acupuncturists. In place of a "certificate of registration" as an acupuncturist, the bill provides for issuance of a "certificate to practice" as an acupuncturist.
Existing law permits an acupuncturist who holds a certificate from the Board to use specified titles, initials, and abbreviations. Within the provisions governing this authority, the bill includes "Licensed Acupuncturist" and "L. Ac." and eliminates "Registered Acupuncturist," "R. Ac.," "Reg. Ac.," "Certified Acupuncturist," "C.A.," and "C. Ac."
(R.C. 4762.10(A), (B), and (D)(4) and 4762.11)
Current law permits an acupuncturist to perform acupuncture for a patient only if the patient has received a written referral or prescription for acupuncture from a physician or chiropractor. As specified in the referral or prescription, the acupuncturist must provide reports on the patient's condition or progress and comply with any conditions or restrictions on the course of treatment. Further, the acupuncturist must practice under the general supervision of the referring or prescribing physician or chiropractor; however, they are not required to practice in the same office.
Under the bill, the requirement that an acupuncturist practice pursuant to a referral or prescription and under the general supervision of the patient's physician or chiropractor apply to an acupuncturist only during a supervisory period determined as follows:
(1) If an acupuncturist practicing on the effective date of the bill has been practicing for less than one year and is not subject to disciplinary action, the supervisory period begins on the bill's effective date and ends when the acupuncturist has practiced for one year from the date the initial certificate was granted. However, an acupuncturist subject to disciplinary action during this period must continue to be supervised until the acupuncturist completes a full year without being subject to disciplinary action (R.C. 4762.10(B)(1)).
(2) An acupuncturist who is granted an initial certificate on or after the bill's effective date is subject to a one-year supervisory period beginning on the date the certificate is granted. However, an acupuncturist subject to disciplinary action during that year must continue to be supervised until the acupuncturist completes a full year without being subject to disciplinary action. (R.C. 4762.10(B)(2).)
After an acupuncturist's supervisory period has ended, the bill requires the acupuncturist to comply with the following provisions regarding the medical or chiropractic diagnostic examination of patients:
Prior diagnostic examination: Before treating a patient for a particular condition, the acupuncturist must confirm whether the patient has undergone within the past six months a diagnostic examination that was related to the condition for which the patient is seeking acupuncture and was performed by a physician or chiropractor acting within the physician or chiropractor's scope of practice. The acupuncturist must obtain from the patient a signed form stating that the patient has undergone the examination. Confirmation that the diagnostic examination was performed may be made by obtaining from the patient a signed form stating that the patient has undergone the examination.
Recommendation to obtain a diagnostic examination: If the patient does not provide the signed form or the acupuncturist otherwise determines that the patient has not undergone a relevant diagnostic examination within the past six months, the acupuncturist must provide to the patient a written recommendation to undergo a diagnostic examination by a physician or chiropractor.
Supervision of students
Current law prohibits the unauthorized practice of acupuncture. The prohibition, however, does not apply to a person who performs acupuncture as a part of a qualified training program in acupuncture.
The bill requires that a student in a qualified training program also practice under the general supervision of an acupuncturist. The supervising acupuncturist must hold a certificate to practice and not be practicing within the supervisory period required by the bill.
Professional liability insurance
(R.C. 4762.13(B)(23) and 4762.22)
The bill requires a licensed acupuncturist to have professional liability insurance coverage in an amount that is not less than $500,000. If an acupuncturist fails to have adequate coverage, the bill requires the Board to take disciplinary action against the acupuncturist. Disciplinary actions that may be taken include the following: limiting, revoking, or suspending a certificate to practice; refusing to issue a certificate to an applicant; refusing to reinstate a certificate; reprimanding a certificate holder; and placing a certificate holder on probation.
Conforming and technical changes
To correspond with the bill's provisions for issuance of certificates to practice rather than certificates of registration as an acupuncturist, conforming changes are included in the following Revised Code sections: 4762.02, 4762.03, 4762.031, 4762.05, 4762.06, 4762.08, 4762.09, 4762.13, 4762.131, 4762.132, 4762.15, 4762.16, and 4762.18.
The bill corrects a reference to health insuring corporations in a provision of existing law that requires health care facilities to report information to the State Medical Board regarding disciplinary actions taken against acupuncturists (R.C. 4762.16(A)).
Educational requirements for certain physician assistants
Current law establishes educational requirements for eligibility for a certificate to practice as a physician assistant. Effective January 1, 2008, to receive a certificate an applicant must have a master's or higher degree. However, if an applicant presents evidence satisfactory to the Board of holding a current, valid license or other form of authority to practice issued by another jurisdiction, it is not necessary for the applicant to hold a master's or higher degree.
The bill adds for an applicant to hold a master's or higher degree for an initial certificate, or retaining or renewing the certificate, if the applicant presents evidence satisfactory to the State Medical Board of (1) holding a degree, other than a master's degree or higher, that is obtained as a result of being enrolled on January 1, 2008, in a program in Ohio that is accredited by the Accreditation Review Commission on Education for the Physician Assistant but did not grant a master's degree or higher to individuals enrolled in the program on that date and (2) completing the program on or before December 31, 2009.
Conditions for the prescription of certain anti-inflammatories by optometrists
Under recently enacted Sub. H.B. 149, an optometrist may prescribe drugs classified as anti-inflammatories, excluding all oral steroids other than methylpredisolone. Methylpredisolone may be used in an optometrist's practice if it is prescribed under all of the following conditions: (1) for use in allergy cases, (2) for use by an adult, (3) on the basis of a particular episode of illness, and (4) in an amount not exceeding the amount packaged for a single course of therapy. However, the statute could be interpreted as requiring an optometrist to meet these conditions when prescribing any drug that is an anti-inflammatory.
The bill clarifies that the conditions listed above apply only to the prescription of methylpredisolone, not to all anti-inflammatories.
 Sub. S.B. 33 of the 127th General Assembly established a process whereby a chiropractor may practice acupuncture by obtaining a certificate to practice acupuncture through the State Chiropractic Board.
 Examples of the licensing documents issued by the Board in its regulation of other professions include the following: (1) physicians receive a certificate to practice medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery, as appropriate, (2) physician assistants receive a certificate to practice as a physician assistant, (3) anesthesiologist assistants receive a certificate of registration as an anesthesiologist assistant, and (4) massage therapists, cosmetic therapists, and other practitioners of limited branches of medicine receive a certificate to practice that corresponds to the limited branch of medicine being practiced (R.C. Chapters 4730., 4731., and 4760.).
 The Board has authority under existing law to limit an acupuncturist's certificate, reprimand the acupuncturist, or place the acupuncturist on probation (R.C. 4762.13).