A.R.S. tit. 32 ch. 39 — Arizona Revised Statutes Title 32 Chapter 39 — Acupuncture

32-3901. Definitions In this chapter, unless the context otherwise requires: 1. "Acupuncture": (a) Means a system of medicine based in traditional practices and informed by contemporary science. (b) Includes the following: (i) Puncturing the skin by thin, solid needles to reach subcutaneous structures. (ii) Stimulating the needles to effect a positive therapeutic response. (iii) Removing needles. (iv) Using and prescribing adjunctive therapies. (v) Using and prescribing herbal therapies commensurate with the acupuncturist's education and training. (vi) Using decision-support tools, including physical and clinical examinations. (vii) Ordering diagnostic imaging and clinical laboratory procedures to determine the nature of care or to form a basis for referral to other licensed health care professionals, or both. 2. "Acupuncture assistant" means an unlicensed person who has completed a training program approved by the board, who assists in basic health care duties in the practice of acupuncture under the supervision of a licensed acupuncturist and who performs delegated duties commensurate with the acupuncture assistant's education and training, but who does not evaluate, interpret, design or modify established treatment programs of acupuncture care. 3. "Adjunctive therapies" means the manual, mechanical, magnetic, thermal, electrical or electromagnetic stimulation of acupuncture points and energy pathways, auricular and detoxification therapy, the use of ion cord devices, electroacupuncture, nutritional counseling, therapeutic exercise, the use of nonionizing lasers and acupressure. 4. "Board" means the acupuncture board of examiners. 5. "Herbal therapies" means prescribing, administering, injecting, compounding and dispensing herbal medicines and plant, animal, mineral and natural substances. 6. "Supervision" means that the supervising licensed acupuncturist is present in the facility where the acupuncture assistant is performing services and is available for consultation regarding procedures that the licensed acupuncturist has authorized and for which the licensed acupuncturist remains responsible. 7. "Trauma" means the experience of significant psychological distress following any terrible or life-threatening event. 8. "Unprofessional conduct" includes the following, whether occurring in this state or elsewhere: (a) Wilfully disclosing a professional secret or wilfully violating a privileged communication except as either of these may otherwise be required by law. (b) Committing a felony as evidenced by conviction by a court of competent jurisdiction. (c) Being habitually intemperate in the use of alcohol or any substance abuse that interferes with the ability to safely practice acupuncture. (d) Committing conduct that the board determines is gross malpractice, repeated malpractice or any malpractice resulting in the death of a patient. (e) Impersonating another acupuncturist or any other practitioner of the healing arts. (f) Falsely acting or assuming to act as a member, an employee or an authorized agent of the board. (g) Procuring or attempting to procure a license pursuant to this chapter by fraud or misrepresentation. (h) Refusing to divulge to the board on demand the acupuncture method used in the treatment of a patient. (i) Giving or receiving or aiding or abetting the giving or receiving of rebates, either directly or indirectly. (j) Knowingly making any false or fraudulent statement, written or oral, in connection with the practice of acupuncture. (k) Having a license refused, revoked or suspended by any other state, district or territory of the United States or any other country, unless the action was not taken for reasons relating to the person's ability to safely and skillfully practice acupuncture or relating to an act of unprofessional conduct. (l) Committing conduct that is contrary to the recognized standards or ethics of the acupuncture profession or that may constitute a danger to the health, welfare or safety of the patient or the public. (m) Committing any conduct or having any condition that may impair the ability to safely and skillfully practice acupuncture. (n) Violating or attempting to violate, directly or indirectly, assisting in or abetting the violation of or conspiring to violate this chapter or board rules. (o) Advertising in a false, deceptive or misleading manner. (p) Failing or refusing to maintain adequate patient health records or failing or refusing to make health records promptly available to the patient or to another health practitioner or provider on request and receipt of proper authorization. (q) Deriving direct or indirect compensation from referring a patient without disclosing to the patient in writing the extent of the compensation. (r) Deriving a financial interest in products the acupuncturist endorses or recommends to the patient without disclosing to the patient in writing the extent of the financial interest. (s) Having sexual intimacies with a patient in the practice of acupuncture. (t) Failing to appropriately exercise control over or supervise an acupuncture student employed by or assigned to the practitioner in the practice of acupuncture. (u) Failing to furnish information in a timely manner to the board or its investigators or representatives if the information is legally requested by the board. (v) Supervising or engaging in a clinical training program in acupuncture without being approved and registered by the board for that program. (w) Knowingly making a false, fraudulent or misleading statement, written or oral, to the board. (x) Failing to exercise proper care for a patient by abandoning or neglecting a patient in need of immediate care without making reasonable arrangements for the continuation of care or by failing to refer the patient to another appropriate health care provider when necessary. (y) Failing to use needles that have been sterilized according to clean needle technique principles approved by the board. (z) Failing to demonstrate professional standards of care and training and education qualifications, as established by the board in rule, for performing a therapeutic modality. (aa) Prescribing or administering medicine or drugs, except as allowed pursuant to this chapter. 32-3902. Acupuncture board of examiners; members; qualifications; terms; removal; compensation A. The acupuncture board of examiners is established consisting of the following members who are appointed by the governor: 1. Through January 16, 2022, four members who are licensed to practice acupuncture pursuant to this chapter and who have practiced acupuncture in this state or any other state for at least one year. Not more than two of these members may be graduates of the same school or college of acupuncture. The governor may make these appointments from a list of names submitted by a statewide acupuncture society. 2. Through January 17, 2022, three consumers who: (a) Are not employed in a health profession. (b) Do not have any pecuniary interest in a school of medicine or health care institution. (c) Demonstrate an interest in health issues in this state. 3. Through January 17, 2022, two members who are licensed pursuant to chapter 8, 13, 14, 17 or 29 of this title. These members shall not be licensed pursuant to the same chapter. 4. Beginning January 17, 2022, one member who is certified or licensed to practice auricular acupuncture or acupuncture pursuant to this chapter. 5. Beginning January 20, 2022, three members who are licensed to practice acupuncture pursuant to this chapter and who have practiced acupuncture in this or any other state for at least one year. Not more than two of these members may be graduates of the same school or college of acupuncture. The governor may make these appointments from a list of names submitted by a statewide acupuncture society. 6. For appointments made on or after January 18, 2022, two consumers who meet all of the following: (a) Are not employed in a health profession. (b) Do not have any pecuniary interest in a school of medicine or health care institution. (c) Demonstrate an interest in health issues in this state. 7. For appointments made on or after January 18, 2022, one member who is licensed pursuant to chapter 8, 13, 14, 17 or 29 of this title. B. Before appointment by the governor, a prospective member of the board shall submit a full set of fingerprints to the governor for the purpose of obtaining a state and federal criminal records check pursuant to section 41-1750 and Public Law 92-544. The department of public safety may exchange this fingerprint data with the federal bureau of investigation. C. Board members shall be residents of this state for at least one year immediately preceding their appointment. D. Board members serve three-year terms to begin and end on the third Monday in January. A member shall not serve more than two consecutive terms. E. The board shall meet in January of each year to elect a chairperson and vice chairperson. F. The board shall meet quarterly and at the call of the chairperson or a majority of board members. G. Board members are eligible to receive compensation in an amount not to exceed $50 per day for each day of actual service in the business of the board and are eligible for reimbursement of expenses necessarily and properly incurred in attending board meetings. H. The governor may remove a board member from office for malfeasance, dishonorable conduct or unprofessional management of board duties. I. The term of any member automatically ends on resignation or absence from this state for a period of at least six months. The governor shall fill vacancies for an unexpired portion of a term in the same manner as regular appointments. J. Board members and board employees are not subject to civil liability for any act done or proceeding undertaken or performed in good faith and in furtherance of the purposes of this chapter. 32-3903. Powers and duties of the board A. The board shall: 1. Adopt rules necessary to enforce this chapter. 2. Initiate investigations and take disciplinary actions to enforce this chapter. 3. Evaluate the qualifications of applicants and issue licenses to qualified applicants. 4. Adopt and use a seal to authenticate official board documents. 5. Establish fees pursuant to section 32-3927. 6. Adopt rules for clinical training. B. The board may: 1. Subject to title 41, chapter 4, article 4, employ personnel needed to carry out board functions. 2. Purchase, lease, rent, sell or otherwise dispose of personal and real property for the operations of the board. 3. Approve examinations for licensure. 32-3904. Executive director; personnel; duties; compensation A. Subject to title 41, chapter 4, article 4, the board may appoint an executive director who serves at the pleasure of the board. The executive director shall not be a board member. B. The executive director is eligible to receive compensation set by the board within the range determined pursuant to section 38-611. C. The executive director shall: 1. Perform the administrative duties of the board. 2. Subject to title 41, chapter 4, article 4, employ personnel needed to carry out board functions. 3. Perform other duties as directed by the board. 32-3905. Acupuncture board of examiners fund (L24, Ch. 222, sec. 47. Eff. until 7/1/28) A. The acupuncture board of examiners fund is established consisting of fees collected pursuant to section 32-3927. The board shall administer the fund. Pursuant to sections 35-146 and 35-147, the board shall deposit fifteen percent of all monies collected under this chapter in the state general fund and deposit the remaining eighty-five percent in the acupuncture board of examiners fund. B. Monies deposited in the acupuncture board of examiners fund are subject to section 35-143.01. 32-3905. Acupuncture board of examiners fund (L24, Ch. 222, sec. 48. Eff. 7/1/28) A. The acupuncture board of examiners fund is established consisting of fees collected pursuant to section 32-3927. The board shall administer the fund. Pursuant to sections 35-146 and 35-147, the board shall deposit ten percent of all monies collected under this chapter in the state general fund and deposit the remaining ninety percent in the acupuncture board of examiners fund. B. Monies deposited in the acupuncture board of examiners fund are subject to section 35-143.01. 32-3906. Third party reimbursements This chapter does not require direct third party reimbursement to persons who are licensed pursuant to this chapter. 32-3921. Licensure; acts and persons not affected A. A person shall not practice acupuncture without a license issued pursuant to this chapter. B. This chapter does not apply to: 1. Health care professionals licensed pursuant to this title practicing within the scope of their license. 2. A student enrolled in a school of acupuncture approved by the board practicing acupuncture under the direct supervision of an acupuncturist licensed pursuant to this chapter as a part of a course of study approved by the board. 3. The practice of acupuncture in this state by a person licensed or certified to perform acupuncture by any other jurisdiction if the person is doing so in the course of regular instruction of a school of acupuncture approved by the board or in an educational seminar by a professional organization of acupuncture, if in the case of an educational seminar the practice is supervised directly by a person licensed pursuant to this chapter or by a health professional licensed pursuant to this title whose scope of practice includes acupuncture. 4. An acupuncturist who resides outside the state and who is authorized to practice acupuncture in that jurisdiction, if the person engages in a single or infrequent consultation with an acupuncturist licensed in this state and the consultation regards a specific patient or patients. 5. A person who self-administers acupuncture. 32-3922. Acupuncture detoxification specialist for chemical dependency or trauma; certificate; requirements; fingerprint clearance card; informed consent; definition A. The board may issue an acupuncture detoxification specialist certificate to a person who practices auricular acupuncture for the purpose of treating alcoholism, substance abuse, trauma or chemical dependency if the person does all of the following: 1. Provides documentation of successfully completing a board-approved training program in acupuncture for treating alcoholism, substance abuse, trauma or chemical dependency that meets or exceeds standards of training established by the national acupuncture detoxification association or a board-approved group. 2. Provides documentation satisfactory to the board of successfully completing a board-approved clean needle technique course. 3. Submits an application as prescribed by the board and a fee prescribed by section 32-3927. 4. Discloses in an application for initial certification or recertification all other active and past professional health care licenses and certificates issued to the applicant in this state or by another state, district or territory of the United States. B. Beginning January 1, 2023, an applicant for initial certification or recertification pursuant to this section shall possess a valid fingerprint clearance card issued pursuant to title 41, chapter 12, article 3.1. C. A certificate issued pursuant to this section allows the certificate holder to practice auricular acupuncture under the supervision of a person who is licensed pursuant to this chapter. D. A certificate issued pursuant to this section is valid for one year. The certificate may be renewed by the board if the certificate holder submits an application as prescribed by the board and a fee prescribed by section 32-3927 before the certificate expires. E. Before treating a patient, an auricular acupuncturist shall obtain from the patient a signed informed consent that has been approved by the board. F. For the purposes of this section, "auricular acupuncture" means applying acupuncture needles to the pinna, lobe or auditory meatus to treat alcoholism, substance abuse, trauma or chemical dependency. 32-3923. Use of title or abbreviation by licensee; prohibited acts; posting of license A. A person who is licensed pursuant to this chapter may use the title "licensed acupuncturist" and the abbreviation "L.Ac.". B. A person who is not licensed pursuant to this chapter shall not use any title, abbreviation, words, letters, signs or figures to indicate that the person is licensed pursuant to this chapter. C. Possession of a license pursuant to this chapter does not by itself entitle a person to use the title "doctor" or "physician". D. A person who is licensed pursuant to this chapter shall post the license or an official duplicate of the license in a conspicuous location in the reception area of each office facility of that licensee. E. A person who is licensed pursuant to this chapter shall not represent to any member of the public that, by virtue of that license, the person is licensed to practice any modality other than acupuncture. 32-3924. Qualifications for licensure; fingerprint clearance card A. To receive a license to practice acupuncture pursuant to this chapter, a person shall submit an application as prescribed by the board. The applicant shall disclose in an application for initial licensure all other active and past professional health care licenses and certificates issued to the applicant in this state or by another state, district or territory of the United States. The application shall document to the board's satisfaction that the applicant has successfully completed a clean needle technique course approved by the board and meets both of the following: 1. Has either: (a) Been certified in acupuncture by the national certification commission for acupuncture and oriental medicine, or its successor organization, or another certifying body or examination that is recognized by the board. (b) Passed the point location module, foundations of oriental medicine module, biomedicine module and acupuncture module offered by the national certification commission for acupuncture and oriental medicine. (c) Been licensed by another state with substantially similar standards and has not had certification or licensure revoked. 2. Has graduated from or completed training in a board-approved program of acupuncture with a minimum of one thousand eight hundred fifty hours of training that includes at least eight hundred hours of board-approved clinical training. B. Beginning January 1, 2023, an applicant for initial licensure or license renewal pursuant to this article shall possess a valid fingerprint clearance card issued pursuant to title 41, chapter 12, article 3.1. 32-3925. Renewal of license; continuing education A. Except as provided in section 32-4301, a license issued pursuant to this chapter is subject to renewal each year and expires unless renewed. B. The executive director shall send a renewal application to each licensee at least sixty days before expiration of the license. C. A licensee shall submit to the board on request documentation satisfactory to the board that the licensee has successfully completed at least fifteen hours of board-approved continuing education each year. D. On compliance with board requirements for the renewal of licenses, the board may reinstate a license canceled for failure to renew. 32-3926. Visiting professor certificate A. The board may issue a visiting professor certificate to an acupuncturist who has received a teaching position in a school of acupuncture in this state if that person demonstrates to the satisfaction of the board that the person has at least five years' experience in the practice of acupuncture and has adequate skill and training. The acupuncturist shall submit an application as prescribed by the board and shall submit the fee prescribed pursuant to section 32-3927. B. A certificate issued pursuant to this section allows the certificate holder to practice acupuncture only in relation to the certificate holder's faculty position duties. C. A certificate issued pursuant to this section is valid for one year. The board may grant a one year extension if the certificate holder submits an application at least thirty days before the certificate expires. The board may grant a total of two one-year extensions. 32-3927. Fees A. By a formal vote at its annual meeting the board shall establish nonrefundable fees that do not exceed the following: 1. For issuance of an initial license, six hundred dollars. 2. For an application for a license or certificate, one hundred fifty dollars. 3. For renewal of a license, six hundred dollars. 4. For late renewal of a license, an additional one hundred dollars. 5. For issuance of a duplicate license or certificate, fifty dollars. 6. For issuance of an initial visiting professor certificate, six hundred dollars. 7. For renewal of a visiting professor certificate, six hundred dollars. 8. For issuance of an initial auricular acupuncture certificate, two hundred fifty dollars. 9. For renewal of an auricular acupuncture certificate, two hundred fifty dollars. 10. For copying records, documents, letters, minutes, applications and files, twenty-five cents a page. 11. For a copy of the minutes to board meetings during the current calendar year, twenty-five dollars for each set of minutes. B. The board shall charge additional fees for services not required to be provided by this chapter but that the board determines are necessary and appropriate to carry out this chapter. The fees shall not exceed the actual cost of providing these services. 32-3928. Treating animals; certification; requirements; definition A. An acupuncturist may apply for certification by the board to treat animals if the acupuncturist is nationally certified by the American board of animal acupuncture or the national certification commission for acupuncture and oriental medicine to treat animals. The board may prescribe the procedure for applying for certification and the certification fee. An acupuncturist who receives certification to treat animals may apply all appropriate modalities prescribed in this chapter and the rules adopted pursuant to this chapter in treating animals. B. An acupuncturist who is certified by the board to treat animals may treat an animal pursuant to section 32-2231. C. The board shall adjudicate complaints arising from acupuncture treatment on animals and shall consult a licensed veterinarian as a subject matter expert on animal health. D. For the purposes of this section, "licensed veterinarian" has the same meaning prescribed in section 32-2201. 32-3951. Denial, revocation or suspension of license; hearings; alternative sanctions A. The board may deny, revoke or suspend a license issued under this chapter for any of the following reasons: 1. Conviction of a felony or a misdemeanor involving moral turpitude. The record of the conviction or a certified copy from the clerk of the court where the conviction occurred or from the judge of that court is sufficient evidence of conviction. 2. Securing a license under this chapter through fraud or deceit. 3. Unprofessional conduct or incompetence in the conduct of the licensee's practice. 4. Using a false name or alias in the practice of the licensee's profession. 5. Violating this chapter or board rules. B. If the board determines pursuant to a hearing that grounds exist to revoke or suspend a license, the board may do so permanently or for a fixed period of time and may impose conditions prescribed by the board. The board may also impose a civil penalty of not more than ten thousand dollars for each violation of this chapter. The board shall deposit, pursuant to sections 35-146 and 35-147, civil penalties collected pursuant to this subsection in the state general fund. C. The board may deny a license without holding a hearing. After receiving notification of the denial, the applicant may request a hearing to review the denial. D. The board shall conduct any hearing to revoke or suspend a license pursuant to title 41, chapter 6, article 10. Any person appearing before the board may be represented by an attorney. E. Instead of denying, revoking or suspending a license the board may file a letter of concern, issue a decree of censure, prescribe a period of probation or restrict or limit the practice of a licensee. The board may also issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment. F. The board shall promptly notify a licensee's employer if the director initiates a disciplinary action against the licensee. G. The board may appoint an investigator to provide information to the board concerning an alleged violation of this chapter. H. The board on its own initiative or on application of any person involved in an investigation or proceeding conducted by the board may issue subpoenas compelling the attendance and testimony of witnesses or demanding the production for examination or copying of documents, reports, records or any other evidence relating to a board investigation or proceeding. 32-3952. Right to examine and copy evidence In connection with a board investigation conducted pursuant to 32-3951, the board at all reasonable times has the right to examine and copy any documents, reports, records or other physical evidence of any person being investigated or reports, records and any other documents maintained by and in the possession of any clinic, licensee's office or other public or private agency and any health care institution as defined in section 36-401 if the board believes this information is related to unprofessional conduct or the mental or physical ability of a licensee to practice acupuncture. 32-3953. Injunctive relief; bond; service of process A. In addition to all other available remedies, if the board has any reason to believe that a person has violated this chapter or a board rule, the board through the attorney general or the county attorney of the county in which the violation is alleged to have occurred may apply to the superior court in that county for an injunction restraining that person from engaging in the violation. B. The court shall issue a temporary restraining order, a preliminary injunction or a permanent injunction without requiring the board to post a bond. C. Service of process may be on the defendant in any county of this state where the defendant is found. 32-3954. Violation; classification A person who violates this chapter is guilty of a class 1 misdemeanor. 32-3955. Acupuncture assistants; scope of duties; registration required; use of title A. This chapter does not prohibit an acupuncture assistant from assisting a licensed acupuncturist pursuant to rules adopted by the board, consistent with the following: 1. An acupuncture assistant may: (a) Remove acupuncture needles. (b) Monitor acupuncture procedures such as the application of heat or moxibustion. (c) Perform noncritical functions such as gathering basic patient information, taking blood pressure and attending to patient treatment rooms. 2. An acupuncture assistant may not insert acupuncture needles or evaluate, interpret, design or modify established treatment programs of acupuncture care. 3. An acupuncture assistant shall register with the board on a form prescribed by the board. The board may suspend or revoke the registration of an acupuncture assistant who violates any provision of this chapter related to the practice of acupuncture or who indulges in conduct or a practice that is detrimental to the health or safety of the public. B. It is unlawful for a person to do either of the following: 1. Work as an acupuncture assistant except under the supervision of a licensed acupuncturist pursuant to this chapter and the rules adopted by the board. 2. Use the abbreviation "A.A." or the term "acupuncture assistant" unless the person is working under the supervision of a licensed acupuncturist pursuant to this chapter and the rules adopted by the board.