1.1                          A bill for an act
  1.2             relating to occupations and professions; establishing 
  1.3             licensure for acupuncture practitioners by the board 
  1.4             of medical practice; authorizing rulemaking; providing 
  1.5             penalties; proposing coding for new law as Minnesota 
  1.6             Statutes, chapter 147B. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  [147B.01] [PURPOSE.] 
  1.9      Acupuncture practice is recognized as a clearly defined 
  1.10  system of health care with its own specialized body of 
  1.11  knowledge.  The knowledge and skills of the acupuncture 
  1.12  practitioner directly affect the quality and safety of treatment 
  1.13  received by the practitioner's client.  It is therefore in the 
  1.14  public interest to ensure that acupuncture practitioners meet 
  1.15  the generally accepted standards of competence in the 
  1.16  profession.  The purpose of Minnesota Statutes, chapter 147B, is 
  1.17  to limit the practice of acupuncture to persons who meet those 
  1.18  standards of competence.  
  1.19     Sec. 2.  [147B.02] [DEFINITIONS.] 
  1.20     Subdivision 1.  [APPLICABILITY.] The definitions in this 
  1.21  section apply to this chapter. 
  1.22     Subd. 2.  [ACUPRESSURE.] "Acupressure" means the 
  1.23  application of pressure to acupuncture points. 
  1.24     Subd. 3.  [ACUPUNCTURE PRACTICE.] "Acupuncture practice" 
  1.25  means a comprehensive system of health care using Oriental 
  1.26  medical theory and its unique methods of diagnosis and 
  2.1   treatment.  Its treatment techniques include the insertion of 
  2.2   acupuncture needles through the skin and the use of other 
  2.3   biophysical methods of acupuncture point stimulation, including 
  2.4   the use of heat, Oriental massage techniques, electrical 
  2.5   stimulation, herbal supplemental therapies, dietary guidelines, 
  2.6   breathing techniques, and exercise based on Oriental medical 
  2.7   principles. 
  2.8      Subd. 4.  [ACUPUNCTURE NEEDLE.] "Acupuncture needle" means 
  2.9   a needle designed exclusively for acupuncture purposes.  It has 
  2.10  a solid core, with a tapered point, and is 0.12 mm to 0.45 mm in 
  2.11  thickness.  It is constructed of stainless steel, gold, silver, 
  2.12  or other board-approved materials as long as the materials can 
  2.13  be sterilized according to recommendations of the National 
  2.14  Centers for Disease Control and Prevention. 
  2.15     Subd. 5.  [ACUPUNCTURE POINTS.] "Acupuncture points" means 
  2.16  specific anatomically described locations as defined by the 
  2.17  recognized acupuncture reference texts.  These texts are listed 
  2.18  in the study guide to the examination for the NCCA certification 
  2.19  exam. 
  2.20     Subd. 6.  [ACUPUNCTURE PRACTITIONER.] "Acupuncture 
  2.21  practitioner" means a person licensed to practice acupuncture 
  2.22  under this chapter. 
  2.23     Subd. 7.  [BOARD.] "Board" means the board of medical 
  2.24  practice or its designee. 
  2.25     Subd. 8.  [BLOOD BORNE DISEASE.] "Blood borne disease" 
  2.26  means a disease that is spread through exposure to blood, 
  2.27  inoculation or injection of blood, or exposure to 
  2.28  blood-contaminated body fluids or tissues.  Blood borne disease 
  2.29  includes infection caused by such agents as human 
  2.30  immunodeficiency virus (HIV) and hepatitis B virus (HBV). 
  2.31     Subd. 9.  [BREATHING TECHNIQUES.] "Breathing techniques" 
  2.32  means Oriental breathing exercises taught to a patient as part 
  2.33  of a treatment plan. 
  2.34     Subd. 10.  [CUPPING.] "Cupping" means a therapy in which a 
  2.35  jar-shaped instrument is attached to the skin and negative 
  2.36  pressure is created by using suction. 
  3.1      Subd. 11.  [DERMAL FRICTION.] "Dermal friction" means 
  3.2   rubbing on the surface of the skin, using topical ointments with 
  3.3   a smooth-surfaced instrument without a cutting edge that can be 
  3.4   sterilized or, if disposable, a one-time only use product. 
  3.5      Subd. 12.  [DIPLOMATE IN ACUPUNCTURE.] "Diplomate in 
  3.6   acupuncture" means a person who is certified by the NCCA as 
  3.7   having met the standards of competence established by the NCCA, 
  3.8   who subscribes to the NCCA code of ethics, and who has a current 
  3.9   and active NCCA certificate.  Current and active NCCA 
  3.10  certification indicates successful completion of continued 
  3.11  professional development and previous satisfaction of NCCA 
  3.12  requirements. 
  3.13     Subd. 13.  [ELECTRICAL STIMULATION.] "Electrical 
  3.14  stimulation" means a method of stimulating acupuncture points by 
  3.15  an electrical current of .001 to 100 milliamps, or other current 
  3.16  as approved by the board.  Electrical stimulation may be used by 
  3.17  attachment of a device to an acupuncture needle or may be used 
  3.18  transcutaneously without penetrating the skin. 
  3.19     Subd. 14.  [HERBAL THERAPIES.] "Herbal therapies" are the 
  3.20  use of herbs and patent herbal remedies as supplements as part 
  3.21  of the treatment plan of the patient. 
  3.22     Subd. 15.  [INFECTION CONTROL.] "Infection control" means 
  3.23  programs, procedures, and methods to reduce the transmission of 
  3.24  agents of infection for the purpose of preventing or decreasing 
  3.25  the incidence of infectious diseases. 
  3.26     Subd. 16.  [NCCA.] "NCCA" means the National Commission for 
  3.27  Certification of Acupuncturists, a not-for-profit corporation 
  3.28  organized under section 501(c)(4) of the Internal Revenue Code. 
  3.29     Subd. 17.  [NEEDLE SICKNESS.] "Needle sickness" is a 
  3.30  temporary state of nausea and dizziness that is a potential side 
  3.31  effect to needle insertion and from which full recovery occurs 
  3.32  when the needles are removed. 
  3.33     Subd. 18.  [ORIENTAL MEDICINE.] "Oriental medicine" means a 
  3.34  system of healing arts that perceives the circulation and 
  3.35  balance of energy in the body as being fundamental to the 
  3.36  well-being of the individual.  It implements the theory through 
  4.1   specialized methods of analyzing the energy status of the body 
  4.2   and treating the body with acupuncture and other related 
  4.3   modalities for the purpose of strengthening the body, improving 
  4.4   energy balance, maintaining or restoring health, improving 
  4.5   physiological function, and reducing pain. 
  4.6      Sec. 3.  [147B.03] [LICENSURE.] 
  4.7      Subdivision 1.  [LICENSURE REQUIRED.] Except as provided 
  4.8   under subdivision 4, it is unlawful for any person to engage in 
  4.9   the practice of acupuncture without a valid license after 
  4.10  September 1, 1995.  Each licensed acupuncture practitioner shall 
  4.11  conspicuously display the license in the place of practice. 
  4.12     Subd. 2.  [DESIGNATION.] A person licensed under this 
  4.13  chapter shall use the title of licensed acupuncturist or L.Ac. 
  4.14  following the person's name in all forms of advertising, 
  4.15  professional literature, and billings.  A person may not, in the 
  4.16  conduct of an occupation or profession pertaining to the 
  4.17  practice of acupuncture or in connection with the person's name, 
  4.18  use the words or letters licensed acupuncturist, Minnesota 
  4.19  licensed acupuncturist, or any other words, letters, 
  4.20  abbreviations, or insignia indicating or implying that a person 
  4.21  is an acupuncturist without a license issued under this 
  4.22  section.  A student attending an acupuncture training program 
  4.23  must be identified as a student acupuncturist. 
  4.24     Subd. 3.  [PENALTY.] A person who violates this section is 
  4.25  guilty of a misdemeanor and subject to discipline under section 
  4.26  147.091. 
  4.27     Subd. 4.  [EXCEPTIONS.] The following persons may practice 
  4.28  acupuncture within the scope of their practice without an 
  4.29  acupuncture license: 
  4.30     (1) a physician licensed under this chapter; 
  4.31     (2) an osteopath licensed under this chapter; 
  4.32     (3) a chiropractor licensed under chapter 148; 
  4.33     (4) a person who is studying in a formal course of study or 
  4.34  tutorial intern program approved by the acupuncture advisory 
  4.35  council established in section 147B.06 so long as the person's 
  4.36  acupuncture practice is supervised by a licensed acupuncturist; 
  5.1      (5) a visiting acupuncturist practicing acupuncture within 
  5.2   an instructional setting for the sole purpose of teaching at a 
  5.3   school registered with the Minnesota higher education 
  5.4   coordinating board, who may practice without a license for a 
  5.5   period of one year, with two one-year extensions permitted; and 
  5.6      (6) a visiting acupuncturist who is in the state for the 
  5.7   sole purpose of providing a tutorial or workshop not to exceed 
  5.8   30 days in one calendar year. 
  5.9      Subd. 5.  [LICENSURE BY EQUIVALENCY DURING TRANSITIONAL 
  5.10  PERIOD.] (a) From July 1, 1995, to June 30, 1997, a person may 
  5.11  qualify for licensure if the person has engaged in acupuncture 
  5.12  practice for at least three years in the period from July 1, 
  5.13  1991, to June 30, 1995, with at least 500 patient visits in each 
  5.14  of the three years with at least 100 different patients.  
  5.15  Acupuncture practice must be the primary means of treatment, not 
  5.16  an adjunctive therapy.  The person must also provide 
  5.17  documentation of successful completion of a clean needle 
  5.18  technique course approved by the acupuncture advisory council 
  5.19  and provide documentation of practice through at least four of 
  5.20  the following methods: 
  5.21     (1) original notarized letters from employers specifying 
  5.22  the dates and hours worked, nature of the practice, and number 
  5.23  of visits; 
  5.24     (2) notarized affidavits from a minimum of 20 patients with 
  5.25  current phone numbers and addresses for each, specifying the 
  5.26  time period of treatment and the nature of the treatment; 
  5.27     (3) notarized affidavits from at least two other health 
  5.28  care professionals, state or local acupuncture or Oriental 
  5.29  medicine associations, schools or colleges, with testimony based 
  5.30  on personal knowledge regarding the dates, volume, scope, and 
  5.31  type of practice; 
  5.32     (4) notarized affidavits from at least two other members 
  5.33  within the community with testimony based on personal knowledge 
  5.34  regarding the dates, volume, scope, and type of practice; and 
  5.35     (5) notarized copies of patient records.  The person must 
  5.36  also meet any other requirements established by the board. 
  6.1      (b) All documentation submitted in a foreign language must 
  6.2   be accompanied by an accurate translation in English.  Each 
  6.3   translated document must bear the affidavit of the translator 
  6.4   certifying that the translator is competent in both the language 
  6.5   of the document and in the English language and that the 
  6.6   translation is true and a complete translation of the foreign 
  6.7   language original and must be sworn before a notary public.  
  6.8   Translation of any document relative to a person's application 
  6.9   is at the expense of the applicant. 
  6.10     (c) Application for licensure under this subdivision must 
  6.11  be submitted to the board from July 1, 1995, to June 30, 1997.  
  6.12  All of the required patient visits must have been completed 
  6.13  before application for licensure. 
  6.14     Subd. 6.  [LICENSE BY RECIPROCITY.] The board shall issue 
  6.15  an acupuncture license to a person who holds a current license 
  6.16  or certificate as an acupuncturist from another jurisdiction if 
  6.17  the board determines that the standards for certification or 
  6.18  licensure in the other jurisdiction meet or exceed the 
  6.19  requirements for licensure in Minnesota and a letter is received 
  6.20  from that jurisdiction that the acupuncturist is in good 
  6.21  standing in that jurisdiction. 
  6.22     Subd. 7.  [LICENSURE REQUIREMENTS.] (a) An applicant for 
  6.23  licensure must: 
  6.24     (1) submit a completed application for licensure on forms 
  6.25  provided by the board, which must include the applicant's name, 
  6.26  address of record, which shall be public; 
  6.27     (2) unless licensed under subdivision 5 or 6, submit a 
  6.28  notarized copy of a current NCCA certification; 
  6.29     (3) sign a statement that the information in the 
  6.30  application is true and correct to the best of the applicant's 
  6.31  knowledge and belief; 
  6.32     (4) submit with the application all fees required; and 
  6.33     (5) sign a waiver authorizing the board to obtain access to 
  6.34  the applicant's records in this state or any state in which the 
  6.35  applicant has engaged in the practice of acupuncture.  
  6.36     (b) The board may ask the applicant to provide any 
  7.1   additional information necessary to ensure that the applicant is 
  7.2   able to practice with reasonable skill and safety to the public. 
  7.3      (c) The board may investigate information provided by an 
  7.4   applicant as to whether the information is accurate and complete.
  7.5   The board shall notify an applicant of action taken on the 
  7.6   application and the reasons for denying licensure if licensure 
  7.7   is denied. 
  7.8      Subd. 8.  [LICENSURE EXPIRATION.] Licenses issued under 
  7.9   this section expire annually. 
  7.10     Subd. 9.  [RENEWAL.] (a) To renew a license an applicant 
  7.11  must: 
  7.12     (1) annually complete a renewal application on a form 
  7.13  provided by the board; 
  7.14     (2) submit the renewal fee; 
  7.15     (3) provide evidence annually of one hour of continuing 
  7.16  education in the subject of infection control, including blood 
  7.17  borne pathogen diseases; 
  7.18     (4) provide documentation of current and active NCCA 
  7.19  certification; and 
  7.20     (5) if licensed under subdivision 5 or 6, meet half of the 
  7.21  NCCA professional development activity requirements. 
  7.22     (b) An applicant must submit any additional information 
  7.23  requested by the board to clarify information presented in the 
  7.24  renewal application.  The information must be submitted within 
  7.25  30 days after the board's request, or the renewal request shall 
  7.26  be nullified. 
  7.27     Subd. 10.  [LICENSURE RENEWAL NOTICE.] At least 30 days 
  7.28  before the license renewal date, the board shall send out a 
  7.29  renewal notice to the last known address of the licensee.  The 
  7.30  notice must include a renewal application and a notice of fees 
  7.31  required for renewal.  If the licensee does not receive a 
  7.32  renewal notice, the licensee must still meet the requirements 
  7.33  for licensure renewal under this section. 
  7.34     Subd. 11.  [RENEWAL DEADLINE.] The renewal application and 
  7.35  fee must be postmarked on or before June 30 of the year of 
  7.36  renewal or as determined by the board. 
  8.1      Subd. 12.  [INACTIVE STATUS.] (a) A license may be placed 
  8.2   in inactive status upon application to the board and upon 
  8.3   payment of an inactive status fee.  The board may not renew or 
  8.4   restore a license that has lapsed and has not been renewed 
  8.5   within two annual license renewal cycles. 
  8.6      (b) An inactive license may be reactivated by the license 
  8.7   holder upon application to the board.  A licensee whose license 
  8.8   is canceled for nonrenewal must obtain a new license by applying 
  8.9   for licensure and fulfilling all the requirements then in 
  8.10  existence for the initial license to practice acupuncture in the 
  8.11  state of Minnesota.  The application must include: 
  8.12     (1) evidence of current and active NCCA certification; 
  8.13     (2) evidence of the certificate holder's payment of an 
  8.14  inactive status fee; 
  8.15     (3) an annual fee; and 
  8.16     (4) all back fees since previous renewal. 
  8.17     (c) A person licensed under subdivision 5 or 6 who places 
  8.18  the license in inactive status must become NCCA certified before 
  8.19  the license is reactivated. 
  8.20     Subd. 13.  [ACUPRESSURE.] Nothing in this section is 
  8.21  intended to prohibit the practice of acupressure or any other 
  8.22  therapy except acupuncture. 
  8.23     Sec. 4.  [147B.04] [NCCA PROFESSIONAL DEVELOPMENT ACTIVITY 
  8.24  REQUIREMENTS.] 
  8.25     Subdivision 1.  [NCCA REQUIREMENTS.] Unless a person is 
  8.26  licensed under section 147B.03, subdivision 5 or 6, each 
  8.27  licensee is required to meet the NCCA professional development 
  8.28  activity requirements to maintain NCCA certification.  These 
  8.29  requirements may be met through a board approved continuing 
  8.30  education program. 
  8.31     Subd. 2.  [BOARD APPROVAL.] The board shall approve a 
  8.32  continuing education program if the program meets the following 
  8.33  requirements: 
  8.34     (1) it directly relates to the practice of acupuncture; 
  8.35     (2) each member of the faculty shows expertise in the 
  8.36  subject matter by holding a degree or certificate from an 
  9.1   educational institution, has verifiable experience in 
  9.2   traditional Oriental medicine, or has special training in the 
  9.3   subject area; 
  9.4      (3) the program lasts at least one contact hour; 
  9.5      (4) there are specific written objectives describing the 
  9.6   goals of the program for the participants; and 
  9.7      (5) the program sponsor maintains attendance records for 
  9.8   four years.  
  9.9      Subd. 3.  [CONTINUING EDUCATION TOPICS.] (a) Continuing 
  9.10  education program topics may include, but are not limited to, 
  9.11  Oriental medical theory and techniques including Oriental 
  9.12  massage; Oriental nutrition; Oriental herbology and diet 
  9.13  therapy; Oriental exercise; western sciences such as anatomy, 
  9.14  physiology, biochemistry, microbiology, psychology, nutrition, 
  9.15  history of medicine; and medical terminology or coding.  
  9.16     (b) Practice management courses are excluded under this 
  9.17  section. 
  9.18     Subd. 4.  [VERIFICATION.] The board shall periodically 
  9.19  select a random sample of acupuncturists and require the 
  9.20  acupuncturist to show evidence of having completed the NCCA 
  9.21  professional development activities requirements.  Either the 
  9.22  acupuncturist, the state, or the national organization that 
  9.23  maintains continuing education records may provide the board 
  9.24  documentation of the continuing education program. 
  9.25     Sec. 5.  [147B.05] [BOARD ACTION ON APPLICATIONS.] 
  9.26     Subdivision 1.  [VERIFICATION OF APPLICATION 
  9.27  INFORMATION.] The board or acupuncture advisory council 
  9.28  established under section 147B.06, with the approval of the 
  9.29  board, may verify information provided by an application for 
  9.30  licensure under section 147B.03 to determine if the information 
  9.31  is accurate and complete. 
  9.32     Subd. 2.  [NOTIFICATION OF BOARD ACTION.] Within 120 days 
  9.33  of receipt of the application, the board shall notify each 
  9.34  applicant in writing of the action taken on the application. 
  9.35     Subd. 3.  [REQUEST FOR HEARING BY APPLICANT DENIED.] An 
  9.36  applicant denied licensure must be notified of the 
 10.1   determination, and the grounds for it, and may request a hearing 
 10.2   on the determination by filing a written statement of issues 
 10.3   with the board within 20 days after receipt of the notice from 
 10.4   the board.  After the hearing, the board shall notify the 
 10.5   applicant in writing of its decision. 
 10.6      Sec. 6.  [147B.06] [ACUPUNCTURE ADVISORY COUNCIL.] 
 10.7      Subdivision 1.  [CREATION.] (a) The advisory council to the 
 10.8   board of medical practice for acupuncture consists of seven 
 10.9   members appointed by the board to three-year terms.  Four 
 10.10  members must be licensed acupuncture practitioners, one member 
 10.11  must be a licensed physician or osteopath who also practices 
 10.12  acupuncture, one member must be a licensed chiropractor who is 
 10.13  NCCA certified, and one member must be a member of the public 
 10.14  who has received acupuncture treatment as a primary therapy from 
 10.15  a NCCA certified acupuncturist. 
 10.16     (b) The members of the advisory council required to be 
 10.17  acupuncture practitioners, who are appointed to the initial 
 10.18  advisory committee, need not be licensed under section 147B.03, 
 10.19  but must satisfy the qualifications for licensure provided in 
 10.20  section 147B.03, subdivision 6, and must have been engaged in 
 10.21  acupuncture practice a minimum of three years. 
 10.22     (c) One member of the initial advisory committee appointed 
 10.23  must have an initial term of one year, two members an initial 
 10.24  term of two years, and two members an initial term of three 
 10.25  years. 
 10.26     Subd. 2.  [ADMINISTRATION; COMPENSATION; REMOVAL; 
 10.27  QUORUM.] The advisory council is governed by section 15.059, 
 10.28  except that the council shall not expire. 
 10.29     Subd. 3.  [DUTIES.] The advisory council shall: 
 10.30     (1) advise the board on issuance, denial, renewal, 
 10.31  suspension, revocation, conditioning, or restricting of licenses 
 10.32  to practice acupuncture; 
 10.33     (2) advise the board on issues related to receiving, 
 10.34  investigating, conducting hearings, and imposing disciplinary 
 10.35  action in relation to complaints against acupuncture 
 10.36  practitioners; 
 11.1      (3) maintain a register of acupuncture practitioners 
 11.2   licensed under section 147B.03; 
 11.3      (4) maintain a record of all advisory council actions; 
 11.4      (5) prescribe registration application forms, license 
 11.5   forms, protocol forms, and other necessary forms; 
 11.6      (6) review the patient visit records submitted by 
 11.7   applicants during the transition period; 
 11.8      (7) advise the board regarding standards for 
 11.9   acupuncturists; 
 11.10     (8) distribute information regarding acupuncture practice 
 11.11  standards; 
 11.12     (9) review complaints; 
 11.13     (10) advise the board regarding continuing education 
 11.14  programs; 
 11.15     (11) review the investigation of reports of complaints and 
 11.16  recommend to the board whether disciplinary action should be 
 11.17  taken; and 
 11.18     (12) perform other duties authorized by advisory councils 
 11.19  under chapter 214, as directed by the board. 
 11.20     Sec. 7.  [147B.07] [PROFESSIONAL CONDUCT.] 
 11.21     Subdivision 1.  [PRACTICE STANDARDS.] (a) Before treatment 
 11.22  of a patient, an acupuncture practitioner shall ask whether the 
 11.23  patient has been examined by a licensed physician or other 
 11.24  professional, as defined by section 145.61, subdivision 2, with 
 11.25  regard to the patient's illness or injury, and shall review the 
 11.26  diagnosis as reported. 
 11.27     (b) The practitioner shall obtain informed consent from the 
 11.28  patient, after advising the patient of the following information 
 11.29  which must be supplied to the patient in writing before or at 
 11.30  the time of the initial visit: 
 11.31     (1) the practitioner's qualifications including: 
 11.32     (i) education; 
 11.33     (ii) license information; and 
 11.34     (iii) outline of the scope of practice of acupuncturists in 
 11.35  Minnesota; and 
 11.36     (2) side effects which may include the following: 
 12.1      (i) some pain in the treatment area; 
 12.2      (ii) minor bruising; 
 12.3      (iii) infection; 
 12.4      (iv) needle sickness; or 
 12.5      (v) broken needles. 
 12.6      (c) The practitioner shall obtain acknowledgment by the 
 12.7   patient in writing that the patient has been advised to consult 
 12.8   with the patient's primary care physician about the acupuncture 
 12.9   treatment if the patient circumstances warrant or the patient 
 12.10  chooses to do so and whether the patient has a pacemaker or 
 12.11  bleeding disorder. 
 12.12     Subd. 2.  [STERILIZED EQUIPMENT.] An acupuncture 
 12.13  practitioner shall use sterilized equipment that has been 
 12.14  sterilized under standards of the National Centers for Disease 
 12.15  Control and Prevention. 
 12.16     Subd. 3.  [STATE AND MUNICIPAL PUBLIC HEALTH 
 12.17  REGULATIONS.] An acupuncture practitioner shall comply with all 
 12.18  applicable state and municipal requirements regarding public 
 12.19  health. 
 12.20     Subd. 4.  [SCOPE OF PRACTICE.] The scope of practice of 
 12.21  acupuncture includes, but is not limited to, the following: 
 12.22     (1) using Oriental medical theory to assess and diagnose a 
 12.23  patient; 
 12.24     (2) using Oriental medical theory to develop a plan to 
 12.25  treat a patient.  The treatment techniques that may be chosen 
 12.26  include: 
 12.27     (i) insertion of sterile acupuncture needles through the 
 12.28  skin; 
 12.29     (ii) acupuncture stimulation including, but not limited to, 
 12.30  electrical stimulation or the application of heat; 
 12.31     (iii) cupping; 
 12.32     (iv) dermal friction; 
 12.33     (v) acupressure; 
 12.34     (vi) herbal therapies; 
 12.35     (vii) dietary counseling based on traditional Chinese 
 12.36  medical principles; 
 13.1      (viii) breathing techniques; or 
 13.2      (ix) exercise according to Oriental medical principles. 
 13.3      Subd. 5.  [PATIENT RECORDS.] An acupuncturist shall 
 13.4   maintain a patient record for each patient treated, including: 
 13.5      (1) a copy of the informed consent; 
 13.6      (2) evidence of a patient interview concerning the 
 13.7   patient's medical history and current physical condition; 
 13.8      (3) evidence of a traditional acupuncture examination and 
 13.9   diagnosis; 
 13.10     (4) record of the treatment including points treated; and 
 13.11     (5) evidence of evaluation and instructions given to the 
 13.12  patient. 
 13.13     Subd. 6.  [REFERRAL TO OTHER HEALTH CARE PRACTITIONERS.] 
 13.14  Referral to other health care practitioners is required when an 
 13.15  acupuncturist practitioner sees patients with potentially 
 13.16  serious disorders including, but not limited to: 
 13.17     (1) cardiac conditions including uncontrolled hypertension; 
 13.18     (2) acute, severe abdominal pain; 
 13.19     (3) acute, undiagnosed neurological changes; 
 13.20     (4) unexplained weight loss or gain in excess of 15 percent 
 13.21  of the body weight in less than a three-month period; 
 13.22     (5) suspected fracture or dislocation; 
 13.23     (6) suspected systemic infections; 
 13.24     (7) any serious undiagnosed hemorrhagic disorder; and 
 13.25     (8) acute respiratory distress without previous history. 
 13.26     The acupuncturist shall request a consultation or written 
 13.27  diagnosis from a licensed physician for patients with 
 13.28  potentially serious disorders. 
 13.29     Subd. 7.  [DATA PRACTICES.] Data maintained on an 
 13.30  acupuncture patient by an acupuncture practitioner is subject to 
 13.31  section 144.336. 
 13.32     Sec. 8.  [147B.08] [DISCIPLINE; REPORTING.] 
 13.33     For purposes of this chapter, acupuncturist licensees and 
 13.34  applicants are subject to the provisions of sections 147.091 to 
 13.35  147.162. 
 13.36     Sec. 9.  [147B.09] [FEES.] 
 14.1      Subdivision 1.  [ANNUAL LICENSE FEE.] The board shall 
 14.2   establish the fee of $150 for initial licensure and $150 annual 
 14.3   licensure renewal.  The board may prorate the initial licensure 
 14.4   fee. 
 14.5      Subd. 2.  [PENALTY FEE FOR LATE RENEWALS.] The penalty fee 
 14.6   for late submission for renewal application is $50. 
 14.7      Sec. 10.  [147B.10] [RULES.] 
 14.8      The board may adopt rules under chapter 14 to establish 
 14.9   additional criteria for licensure or discipline of 
 14.10  acupuncturists consistent with the standards of the NCCA or 
 14.11  other board approved relevant practice standards. 
 14.12     Sec. 11.  [EFFECTIVE DATE.] 
 14.13     This act is effective the day following final enactment.