PURPOSE: This rule sets out the acceptable qualifications, procedures and continuing education requirements for the use of meridian therapy/acupressure/acupuncture (in this rule Meridian Therapy) by Missouri licensed chiropractors.

1. (1) When used in the rules of the board, the terms Meridian Therapy or acupressure or acupuncture shall mean methods of diagnosing and the treatment of a patient by stimulating specific points on or within the body by various methods including, but not limited to, manipulation, heat, cold, pressure, vibration, ultrasound, light, electrocurrent, and shortneedle insertion for the purpose of obtaining a biopositive reflex response by nerve stimulation.
2. (2) Acceptable practice and use of Meridian Therapy shall be limited to those methods and procedures that are commonly taught in chiropractic colleges having status with the Council on Chiropractic Education or are methods or procedures which have been approved by the board.
3. (3) In order to ensure that the public health and safety are protected and to maintain high standards of trust and confidence in the chiropractic profession and ensure the proper FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION

conduct of the chiropractic practice involving the use of Meridian Therapy, the requirements contained in this rule must be met prior to one engaging in therapeutic procedures or announcing the availability of therapeutic procedures to the public.

1. (A) Each licensee seeking to provide Meridian Therapy in any of its aspects shall obtain a certificate from the board, which shall indicate that the licensee has complied with the provisions of this rule and has met the minimum standards contained in this rule. The application for a certificate shall be on a form provided by the board and accompanied by the required fee.
2. (B) In addition to the other information required to be provided on the application, each applicant shall certify to the board that s/he has either—1) successfully completed at least one hundred (100) hours’ training, of undergraduate or postgraduate or a combination of each, in the use and administration of Meridian Therapy, which training was presented by a college of chiropractic having status with the Council on Chiropractic Education or 2) successfully completed at least one hundred (100) hours’ training in the use and administration of Meridian Therapy in a course of study approved by the board.
3. (C) Effective March 1, 2005, an applicant for certification in Meridian Therapy shall pass the examination for acupuncture administered by the National Board of Chiropractic Examiners (N.B.C.E.) or an exam approved by the board.

4. (D) In order to maintain a valid certificate in Meridian Therapy, a licensee who holds a certificate at the time of making his/her license renewal must certify to the board that s/he has completed biennially a minimum of twelve (12) hours of continuing education, approved by the board, in Meridian Therapy. This continuing education shall apply toward attainment of the twelve (12) required hours of continuing education pursuant to 20 CSR 2070-2.080(5), the general studies category of continuing education.

   1. 1. Continuing education in the area of

Meridian Therapy, acupuncture, and acupressure may also be submitted to the board for approval as formal continuing education hours.

1. (E) If a licensee allows his/her certification to lapse, the certification may be reinstated up to three (3) years after it has lapsed by submitting an application for reinstatement on a form provided by the board accompanied by the required fee, and upon the presentation to the board of twelve (12) hours of postgraduate study in Meridian Therapy, acupuncture, or acupressure prior to reinstatement of certification. The postgraduate study must be a course approved by the board.
2. (F) If a licensee allows his/her certification to lapse for more than three (3) years the licensee shall comply with the requirements of subsection (3)(B) of this rule, providing the hours were not used to obtain the original certification.

1. (4) Any licensee who shall advertise or announce to the public in any communication or solicitation that s/he engages in or provides Meridian Therapy in any of its aspects without having first complied with this rule shall be deemed to have engaged in false, misleading, or deceptive advertising.

2. (5) Sterilization of Nondisposable Needles and Disposition of Disposable Needles.

   1. (A) Where nondisposable needles are used for acupuncture, the needles must be sterilized by—

      1. 1. Autoclave;
      2. 2. Dry heat sterilization; or
      3. 3. Ethylene oxide sterilization in accor-

dance with directions of the manufacturer.

1. (B) Needles must be individually packaged for each patient. The individually packaged needles must either be discarded following patient treatment or sterilized according to the methods of sterilization listed in subsection (5)(A) when nondisposable needles are used.
2. (C) Needles must be disposed of according to Missouri and federal laws regarding disposal of infectious waste. In addition, all needles must be placed in rigid, leakproof and puncture resistant containers and sealed before disposal pursuant to 10 CSR 80-7.010. Noncorrosive needles must be used.

AUTHORITY: sections 331.010, 331.030.5 and .8, 331.050.1, and 331.100.2, RSMo Supp. 2008.* This rule originally filed as 4 CSR 70-2.031. Original rule filed Jan. 5, 1987, effective April 11, 1987. Amended: Filed March 4, 1994, effective Aug. 8, 1994. Amended: Filed April 14, 2000, effective Oct. 30, 2000. Amended: Filed April 1, 2004, effective Sept. 30, 2004. Moved to 20 CSR 2070-2.031, effective Aug. 28, 2006. Amended: Filed Aug. 15, 2008, effective Feb. 28, 2009. Amended: Filed Aug. 27, 2009, effective Feb. 28, 2010. *Original authority: 331.010, RSMo 1939, amended 1969, 1982, 1995, 2004, 2007; 331.030, RSMo 1939, amended 1945, 1947, 1949, 1969, 1981, 1988, 1993, 1995, 1997, 2007; 331.050, RSMo 1939, amended 1945, 1947, 1969, 1981, 1987, 1999, 2001, 2004; and 331.100.2, RSMo 1939, amended 1949, 1969, 1980, 1981, 2008.