TBCE Proposes New Rules (March 2019)
Written by Editor   
Tuesday, March 19, 2019 12:18 PM

The Texas Board of Chiropractic Examiners (TBCE) proposes new amendments to their rules.  

Rules effected include: 

  • 75.1 Unsafe and Unsanitary Conditions
  • 77.4 Misleading Claims
  • 78.14 Acupuncture
  • and the repeal of 80.4 Schedule of Sanctions and the adoption of a new 80.4 Schedule of Penalties.

Rule 75.1, Unsafe and Unsanitary Conditions is proposed to establish basic sanitary and safety standards for locations where chiropractic is practiced in response to a recommendation made by the Texas Sunset Commission as part of its review of agency policies, procedures, and operations. 

The propposed rule reads:

§75.1.Unsafe and Unsanitary Conditions.

(a) "Unsanitary" means a condition that could reasonably pose a risk of harm to the health of a patient, employee, contractor of a licensee, or the public.

(b) "Unsafe" means a condition that could reasonably pose a risk of injury to a patient, employee, contractor of a licensee, or the public.

(c) Reasonable and normal wear and tear or aging of chiropractic equipment does not constitute an unsafe or unsanitary condition.

(d) Any location where a licensee practices chiropractic shall be free of unsafe and unsanitary conditions.

An amendment to rule 77.4, Misleading Claims is to make clear that claims, if untrue or exaggerated, regarding the negative consequences of not receiving chiropractic treatment may also be misleading. 

The proposed amendment reads:

§77.4.Misleading Claims.

(a) A person advertising chiropractic services shall not use false, deceptive, unfair, or misleading advertising, including, but not limited to:

(1) claims intended or reasonably likely to embellish or create a false expectation of the favorable results from chiropractic treatment;

(2) claims intended or reasonably likely to create a false expectation of the cost of treatment or the amount of treatment to be provided;

(3) claims reasonably likely to deceive or mislead because the claims in context represent only a partial disclosure of the conditions and relevant facts of the extent of treatment the licensee expects to provide;

(4) claims that state or imply chiropractic services can provide a cure for any condition;

(5) claims that chiropractic services cure or lessen the effects of ailments, injuries, or other disorders of the human body which are outside the scope of chiropractic practice as defined by Chapter 201 of the Occupations Code and Title 22, Part 3 of the Texas Administrative Code;

(6) claims that state or imply the results of chiropractic services are guaranteed; or

(7) claims that chiropractic services offer results that are not within the realm of scientific proof beyond testimonial statements or manufacturer's claims; or [.]

(8) claims intended or reasonably likely to create a false expectation of the adverse consequences of not receiving chiropractic treatment.

(b) Subsection (a)(2) of this section is not meant to be applicable to circumstances where the cost or amount of treatment varies from an original quotation or advertisement by a reasonable amount.

(c) The standard for to be used in determining whether a violation of this rule has occurred taken place is the generally accepted standards of care within the chiropractic profession in Texas.

Amendments to rule 78.14 (Acupuncture) are to clarify the requirements for obtaining an acupuncture permit for those licensees who have been practicing acupuncture since before 2010. In order to qualify for an acupuncture permit, those licensees must have practiced acupuncture in compliance with previous Board rules and, if they choose this qualification option, they must have satisfied the training and examination requirement before January 1, 2010.

The proposed amendments read:

§78.14.Acupuncture.

(a) Acupuncture, and the related practices of acupressure and meridian therapy, includes methods for diagnosing and treating a patient by stimulating specific points on or within the musculoskeletal system by various means, including manipulation, heat, cold, pressure, vibration, laser, ultrasound, light electrocurrent, and the insertion of acupuncture needles or solid filiform needles for the purpose of obtaining a bio-positive reflex response by nerve stimulation.

(b) A licensee shall practice acupuncture only after obtaining a permit from the Texas Board of Chiropractic Examiners (Board).

(c) The Board shall place on each renewal license to practice chiropractic a statement that a licensee who has met all Board requirements is permitted to practice acupuncture. A licensee whose license does not contain the statement permitting the practice of acupuncture shall not practice or advertise the practice of acupuncture.

(d) A licensee with an acupuncture permit cannot delegate the performance of acupuncture.

(e) Requirements for an acupuncture permit:

(1) On or after the effective date of this rule, a licensee may receive an acupuncture permit from the Board by completing at least one hundred (100) hours of training in acupuncture and passing the National Board of Chiropractic Examiners' examination. The training must be provided by an accredited chiropractic college, or post-secondary university, or other educational or testing institution approved by the Board. Such training shall include didactic, clinical, and practical training in the practice of acupuncture, clean needle techniques, examination, and protocols that meet the blood-borne pathogen standard established by the Occupational Safety and Health Administration.

(2) A person who became a licensee after January 1, 2010, and before the effective date of this rule, who has been practicing acupuncture in compliance with previous Board rules, shall have until September 1, 2019, to obtain an acupuncture permit from the Board by passing the National Board of Chiropractic Examiners' standardized certification examination in acupuncture and completing 100 hours of acupuncture training.

(3) A person who became a licensee before January 1, 2010, and has been practicing acupuncture in compliance with previous Board rules, shall have until September 1, 2019, to obtain an acupuncture permit from the Board by having:

(A) successfully [Successfully] completed and passed an examination in a one hundred (100) hour training course in acupuncture before January 1, 2010; or

(B) successfully  [Successfully] completed and passed either the National Board of Chiropractic Examiners' standardized certification examination in acupuncture or the examination offered by the National Certification Commission of Acupuncture before the effective date of this rule; or

(C) successfully [Successfully] completed formal training along with providing a statement to the Board of having practiced acupuncture in clinical practice for at least ten years before January 1, 2010, and is in good standing with the Board and the regulatory entities of the other jurisdictions in which the licensee is licensed. The Board may audit any statement for accuracy.

(4) Documentation of acupuncture training shall be in the form of signed certificates of attendance or completion, or diplomas from course sponsors or instructors.

(f) A licensee permitted to practice acupuncture must complete a minimum of eight (8) hours in Board-approved acupuncture courses every biennium.

(g) A licensee shall not practice acupuncture until the licensee has submitted proof of compliance with subsection (e) and has received a permit from the Board.

(h) A licensee practicing acupuncture shall not advertise in a manner that suggests the licensee possesses a license to practice acupuncture issued by the Texas State Board of Acupuncture Examiners, including using any of the terms "acupuncturist," "licensed acupuncturist," "L.Ac.," "Traditional Chinese Medicine," or "degreed in acupuncture."

(i) A licensee's advertising may include the terms "Board Certified" or "Board Certified in Chiropractic Acupuncture" if it also clearly identifies the nationally recognized certifying board and credentials.

(j) Approved programs in clinical acupuncture or meridian therapy offered by accredited chiropractic colleges or universities are designed for doctors of chiropractic and other disciplines. These courses are not intended as a substitute for a full curriculum teaching traditional Chinese medicine; rather they focus on the principle, theory, scientific findings, and practical modern application of acupuncture as currently practiced by doctors of chiropractic.

(k) The practice of acupuncture by a licensee who has not complied with the requirements of this section constitutes unprofessional conduct and subjects the licensee to disciplinary action. A licensee who advertises acupuncture without first obtaining a permit also has engaged in unprofessional conduct.

The TBCE proposes the repeal of rule 80.4 Schedule of Sanctions and propose a new rule 80.4 to bring the Board's rules in compliance with changes to Occupations Code Chapter 201 that removed the registration of chiropractic facilities from the Board's jurisdiction. The secondary reason is to update the schedule to reflect new rule citations after the recent renumbering and renaming of the majority of Board rules in November 2018.

The newly proposed rule reads:

§80.4.Schedule of Penalties.

(a) The following table contains the maximum administrative penalty the Board may impose for each category of violation of statutes and rules under the Board's jurisdiction:

Figure: 22 TAC §80.4(a) (.pdf)

(b) For a violation of statute or rule not listed in the table for which the Board may take disciplinary action, the maximum penalty is up to $1000 and revocation.

TBCE’s next meeting is scheduled for May 16, 2019.


Source:  https://www.sos.state.tx.us/texreg/archive/March82019/Proposed%20Rules/22.EXAMINING%20BOARDS.html#8