Rules of Department of Commerce and Insurance Division 2070—State Board of Chiropractic Examiners Chapter 2—General Rules

Title Page

20 CSR 2070-2.020 Diagnostic Procedures and Instruments (Rescinded October 30, 2019) ...... 3 20 CSR 2070-2.025 Use of X-rays (Rescinded October 30, 2019) ...... 3 20 CSR 2070-2.030 Diagnostic and Adjunctive Procedures ...... 3 20 CSR 2070-2.031 Meridian Therapy/Acupressure/Acupuncture...... 3 20 CSR 2070-2.032 Specialty Certification...... 4 20 CSR 2070-2.033 Manipulation Under Anesthesia ...... 5 20 CSR 2070-2.040 Application for Licensure ...... 5 20 CSR 2070-2.045 Board-Approved Chiropractic Colleges (Rescinded October 30, 2019) ...... 6 20 CSR 2070-2.050 Examination (Rescinded October 30, 2019)...... 6 20 CSR 2070-2.060 Professional Conduct Rules ...... 6 20 CSR 2070-2.065 Public Complaint Handling and Disposition ...... 7 20 CSR 2070-2.066 Post-Board Order Activity (Rescinded October 30, 2019)...... 7 20 CSR 2070-2.070 Reciprocity (Rescinded October 30, 2019) ...... 7 20 CSR 2070-2.080 Biennial License Renewal ...... 8 20 CSR 2070-2.081 Application for Continuing Education ...... 9 20 CSR 2070-2.090 Fees ...... 10 20 CSR 2070-2.100 Professional Corporations ...... 11 20 CSR 2070-2.110 Nonresident Military Spouse Licensure ...... 12

JOHN R. ASHCROFT (6/30/20) CODE OF STATE REGULATIONS 1 Secretary of State Chapter 2—General Rules 20 CSR 2070-2

Title 20—DEPARTMENT OF visual acuity charts, weight measurement Amended: Filed March 29, 2019, effective COMMERCE AND INSURANCE scales, dermathermagraph, vasculizer, and Oct. 30, 2019. Division 2070—State Board of routine orthopedic and neurologic procedures; Chiropractic Examiners 2. Palpation; or *Original authority: 331.010, RSMo 1939, amended 3. Auscultation, including the use of a 1969, 1982, 1995, 2007. Chapter 2—General Rules stethoscope, tuning forks, audiograph, and phonocardiograph. 20 CSR 2070-2.020 Diagnostic Procedures (B) Diagnostic imaging: 20 CSR 2070-2.031 Meridian Therapy/ and Instruments 1. Motionless diagnostic X-ray study; Acupressure/Acupuncture (Rescinded October 30, 2019) 2. Fluoroscopy; 3. Cineradiography; PURPOSE: This rule sets out the acceptable AUTHORITY: section 331.010, RSMo 2000. 4. Magnetic Resonance Imaging (MRI); qualifications, procedures, and continuing This rule originally filed as 4 CSR 70-2.020. 5. Computerized Tomography (CT education requirements for the use of meridi- This version of rule filed Dec. 17, 1975, SCAN); an therapy/acupressure/acupuncture (in this effective Dec. 27, 1975. Amended: Filed July 6. Ultrasound; or rule Meridian Therapy) by Missouri licensed 5, 1978, effective Oct. 13, 1978. Rescinded 7. Magnetic Resonance Angiogram chiropractors. and readopted: Filed July 9, 1982, effective (MRA). Nov. 11, 1982. Amended: Filed April 18, (C) Clinical laboratory tests: (1) For the purpose of the rules meridian 1989, effective July 13, 1989. Amended: 1. Blood specimen; therapy includes meridian therapy, acupres- Filed July 31, 2003, effective Jan. 30, 2004. 2. Urine specimen; sure, and acupuncture as set forth in section Moved to 20 CSR 2070-2.020, effective Aug. 3. Fecal specimen; 331.030.8, RSMo. 28, 2006. Rescinded: Filed March 29, 2019, 4. Sputum specimen; effective Oct. 30, 2019. 5. Hair specimen; or (2) An applicant for certification in meridian 6. Mucosal specimen. therapy shall submit the following to the (D) Muscle testing with strength and board: 20 CSR 2070-2.025 Use of X-rays endurance curves during isometric or isoki- (A) An application for certification accom- (Rescinded October 30, 2019) netic exercise. panied by the required fee, pursuant to 20 CSR 2070-2.090(1); AUTHORITY: section 331.100.2, RSMo (3) Those adjunctive chiropractic procedures (B) An official transcript or certificate of 1986. This rule originally filed as 4 CSR 70- presently approved by the board include, but completion documenting a minimum of one 2.025. Original rule filed April 16, 1990, are not limited to: hundred (100) hours of credit of undergradu- effective June 30, 1990. Amended: Filed Feb. (A) Heat and heat-producing devices; ate or postgraduate study or a combination of 4, 1991, effective July 8, 1991. Moved to 20 (B) Ice and cooling packs; each in the use and administration of meridi- an therapy. The hours of education in merid- CSR 2070-2.025, effective Aug. 28, 2006. (C) Extension therapy; or ian therapy shall be approved by the board or Rescinded: Filed March 29, 2019, effective (D) Therapeutic exercise, muscle therapy, from a chiropractic college accredited by the Oct. 30, 2019. reflex techniques, and postural and structural Commission on Accreditation of the Council supports. of Chiropractic Education. For the purpose of 20 CSR 2070-2.030 Diagnostic and Adjunc- (4) In order to avoid overutilization of ioniz- this rule, the one hundred (100) hours of tive Procedures ing radiation, a chiropractic physician shall study in meridian therapy shall not be offered observe the following guidelines: electronically to include via the internet, PURPOSE: This rule outlines diagnostic and (A) Routine radiography of any patient webinars, or similar delivery methods and adjunctive procedures that may be used by shall not be performed without due regard for shall not include dry needling; and chiropractic physicians. clinical need; and (C) Official examination results document- (B) Repeat radiographic evaluation of the ing passing one (1) of the following examina- (1) The board approves the use of those diag- patient shall not be undertaken without clini- tions: nostic procedures and instruments which are cal indication, as determined by the treating 1. National Board of Chiropractic Examiners (NBCE); commonly taught by approved chiropractic chiropractic physician. 2. American Board of Chiropractic colleges. (5) The licensee shall comply with all appli- Acupuncture (ABCA); or 3. National Certification Commission (2) Diagnostic procedures approved by the cable state and federal requirements concern- for Acupuncture and Oriental Medicine board include, but are not limited to, the fol- ing any registration or maintenance of X-ray (NCCAOM). lowing— equipment. (A) Physical Examination: AUTHORITY: section 331.010, RSMo 2016.* (3) The board adopts the passing score estab- 1. Inspection, including the use of instru- This rule originally filed as 4 CSR 70-2.030. lished by NBCE, ACBA, or NCCAOM as the mentation such as an ophthalmoscope, oto- This version of rule filed Dec. 17, 1975, passing score for Missouri applicants. scope, tongue-depressor, tape measure, ther- effective Dec. 27, 1975. Amended: Filed July mometer, percussion hammer, pinwheel, 5, 1978, effective Oct. 13, 1978. Rescinded (4) An applicant for certification in meridian sphygmomanometer, proctoscope, nervo- and readopted: Filed July 9, 1982, effective therapy shall comply with the examination scope, neurocalometer, neurodermagraph, Nov. 11, 1982. Amended: Filed July 31, provider’s rules for test administration relat- electromyograph, heartometer, phonocardio- 2003, effective Jan. 30, 2004. Moved to 20 ed to applicant conduct and shall authorize graph, electrocardiograph, spirometer, vitalor, CSR 2070-2.030, effective Aug. 28, 2006. the examination provider to submit the results

JOHN R. ASHCROFT (9/30/19) CODE OF STATE REGULATIONS 3 Secretary of State 20 CSR 2070-2—DEPARTMENT OF COMMERCE AND INSURANCE Division 2070—State Board of Chiropractic Examiners

to the board, along with any information or hours which are obtained from a chiro- board will consider articles from scholarly relating to any adverse incident(s) involving practic college accredited by the Commission journals, treatises, textbooks used by board- the applicant during the course of the exami- on Accreditation of the Council of Chiroprac- approved Council of Chiropractic Education nation. Any cost associated with reporting tic Education. Hours for reinstatement of the (CCE) colleges of chiropractic, syllabi and/or examination results to the board shall be the certification in meridian therapy cannot be curriculum materials used in education and applicant’s responsibility. the same one hundred (100) hours used for training in the specialty area, and scholarly original certification. studies or research; (5) Any licensee certified in meridian therapy (D) Education and/or training require- shall follow universal precautions as defined AUTHORITY: sections 331.010, 331.050.1, ments including how and where education by the United States Department of Labor’s and 331.100.2, RSMo 2016, and sections may be obtained and whether education Occupational Safety and Health Administra- 331.030.5 and .8, RSMo Supp. 2018.* This and/or training is provided from a postgradu- tion (“OSHA”) (Bloodborne Pathogens Stan- rule originally filed as 4 CSR 70-2.031. Orig- ate board-approved CCE chiropractic col- dard 29 CFR 1910. 1.030(B) relating to inal rule filed Jan. 5, 1987, effective April lege; infection control with respect to certain 11, 1987. Amended: Filed March 4, 1994, (E) A statement describing why the spe- cialty area does not exceed the scope of prac- human body fluids as if they were known to effective Aug. 8, 1994. Amended: Filed April tice as defined in section 331.010, RSMo; be infections for Human Immunodeficiency 14, 2000, effective Oct. 30, 2000. Amended: (F) Any examination or residency Virus (HIV), Hepatitis B Virus (HBV), or Filed April 1, 2004, effective Sept. 30, 2004. required; and other blood borne pathogens, and the most Moved to 20 CSR 2070-2.031, effective Aug. 28, 2006. Amended: Filed Aug. 15, 2008, (G) Hours of continuing education to current version of the Clean Needle Tech- maintain the certification. nique (CNT) manual as published by the effective Feb. 28, 2009. Amended: Filed Aug. 27, 2009, effective Feb. 28, 2010. Rescinded Council of Colleges of Acupuncture and Ori- and readopted: Filed March 29, 2019, effec- (3) The board will review an application for ental Medicine©. tive Oct. 30, 2019. recognition of a specialty area and required documentation to determine compliance with (6) A licensee certified in meridian therapy *Original authority: 331.010, RSMo 1939, amended the following factors: shall use only disposable acupuncture needles 1969, 1982, 1995, 2004, 2007; 331.030, RSMo 1939, (A) Whether the certification is for a spe- and shall dispose of such needles in compli- amended 1945, 1947, 1949, 1969, 1981, 1988, 1993, cialty area, or for a technique; ance with established standards for biohaz- 1995, 1997, 2007, 2018; 331.050, RSMo 1939, amended 1945, 1947, 1969, 1981, 1987, 1999, 2001, 2004; and (B) Whether the specialty area is within ardous waste. 331.100.2, RSMo 1939, amended 1949, 1969, 1980, the scope of practice of chiropractic as 1981, 2008, 2013. defined in section 331.010, RSMo; (7) The acupuncture certification shall be (C) Whether the specialty area is safe for renewed at the time of licensure renewal. its intended purpose(s); The licensee shall obtain twelve (12) hours of 20 CSR 2070-2.032 Specialty Certification (D) Whether there are sufficient sources of board approved continuing education in accredited core and postgraduate education at meridian therapy prior to the expiration date PURPOSE: This rule outlines the require- board-approved CCE colleges of chiroprac- of the license. The twelve (12) hours of con- ments for applying to the board for recogni- tic; and tinuing education in meridian therapy shall tion of a specialty to include documentation (E) Whether recognition of a specialty area apply to the twenty-four (24) hours of formal required and information reviewed by the will create potential public confusion in the continuing education required to maintain the board in determining whether a practice area event the specialty area is already being com- chiropractic license and shall not include dry is a specialty. monly utilized by licensees. needling. (1) Any person or entity may submit an appli- (4) The applicant shall be responsible for pro- (8) An expired certification in meridian ther- cation to the board seeking recognition of a viding documentation and have the burden of apy can be reinstated up to five (5) years from specialty area as authorized by section demonstrating that the specialty area should the expiration date by submitting an applica- 331.030.9, RSMo. be recognized by the board. A final determi- tion and required fee pursuant to 20 CSR (A) For the purpose of this regulation a nation of whether an area will by recognized specialty shall consist of advanced education as a specialty is within the sole discretion of 2070-2.090(1) along with proof of complet- and/or training to be proficient in an area of the board. ing twelve (12) hours of board approved con- practice and shall not include a technique of tinuing education in meridian therapy which manipulation or treatment. (5) Upon approval of a specialty area, the shall be completed prior to submitting the board shall promulgate a regulation establish- reinstatement application. (2) An application for recognition of a spe- ing the minimum initial and continuing edu- cialty area shall be submitted on a form pro- cation requirements, application fee, and doc- (9) A certification in meridian therapy vided by the board accompanied by the umentation required for verification of expired for more than five (5) years from the required fee as defined in 20 CSR 2070- compliance with all educational require- expiration date of the certification can be 2.090 with the following documentation: ments. reinstated by submitting an application for (A) Name and description of the specialty certification, required fee pursuant to 20 CSR certification area; (6) Licensees receiving board-approved spe- 2070-2.090(1), and documenting completion (B) Conditions and/or disorders to which cialty certification are entitled to use the of a minimum of one hundred (100) hours of the specialty area is directed; terms “specialty” or “specializing in” on credit of postgraduate study in the use and (C) Proof of acceptance of the specialty advertisements, letterhead, and signage. The administration of meridian therapy. The hours area by the chiropractic profession to include specialty certification shall be preceded by of education in meridian therapy shall be safety and efficacy of the specialty area. the licensee’s name and by one (1) of the fol- either hours which are approved by the board 1. For the purpose of this regulation the lowing:

4 CODE OF STATE REGULATIONS (9/30/19) JOHN R. ASHCROFT Secretary of State Chapter 2—General Rules 20 CSR 2070-2

(A) D.C.; pleted a certification course in MUA of not board office by the college or university or (B) Chiropractor; less than twenty-four (24) didactic academic submitted with the application in an envelope (C) Doctor of Chiropractic; or hours and completed six (6) proctored MUA sealed by the registrar’s office of the college (D) Chiropractic Physician. procedures as part of the certification course. or university: The MUA certification course must be spon- (B) Official transcript documenting com- (7) Licensees shall be prohibited from using sored by a chiropractic college accredited by pletion of a chiropractic degree. The tran- any term in any advertisement, letterhead, the Council of Chiropractic Education script must be forwarded to the state board solicitation, or signage stating or suggesting (CCE); and office by the chiropractic college or universi- that the licensee is certified in any specialty (D) The chiropractic physician follows the ty or submitted with the application in an area, unless the board has approved the spe- appropriate protocol as adopted by rule by the envelope sealed by the registrar’s office of the cialty area for certification and the licensee Missouri State Board of Chiropractic Exa- chiropractic college or university. Transcripts has met all requirements for certification miners; and from foreign countries which are not in thereunder. (E) The consumer of chiropractic service English shall have a certified English transla- MUA has been evaluated by a medical doctor tion attached; AUTHORITY: section 331.030.9, RSMo or doctor of osteopathy, who is familiar with (C) Official scores from the National Supp. 2018.* This rule originally filed as 4 Board of Chiropractic Examiners (NBCE) for CSR 70-2.032. Original rule filed April 1, MUA, prior to the MUA procedure who Parts I, II, III, IV, and physiotherapy; 2005, effective Oct. 30, 2005. Moved to 20 approves the procedure and the administra- CSR 2070-2.032, effective Aug. 28, 2006. tion of the anesthesia. 1. The board adopts the cut score or Amended: Filed June 27, 2007, effective Jan. passing score established by the NBCE for (3) Nothing in this rule shall be construed as parts I, II, III, IV, and physiotherapy. 30, 2008. Amended: Filed March 29, 2019, to require a facility licensed by the Missouri effective Oct. 30, 2019. 2. An examination candidate shall com- Department of Health and Senior Services— ply with the examination provider’s rules for Health Services Regulation or approved by *Original authority: 331.030, RSMo 1939, amended test administration related to the administra- the JCAHO, AOA, or AAAHC to grant allied tion of parts I, II, III, IV and the physiother- 1945, 1947, 1949, 1969, 1981, 1988, 1993, 1995, 1997, hospital privileges to a chiropractic physi- 2004, 2007, 2018. apy examination and authorize the examina- cian. tion provider to submit the results to the AUTHORITY: section 331.100.2, RSMo board, along with any information relating to 20 CSR 2070-2.033 Manipulation Under 2016.* This rule originally filed as 4 CSR 70- any adverse incident(s) involving the appli- Anesthesia 2.033. Original rule filed March 4, 1994, cant during the course of the examination. effective Oct. 30, 1994. Moved to 20 CSR Any costs associated with reporting examina- PURPOSE: This rule is to advise chiroprac- 2070-2.033, effective Aug. 28, 2006. Amend- tion results to the board shall be the appli- tic physicians when they may perform manip- ed: Filed March 29, 2019, effective Oct. 30, cant’s responsibility. ulation under anesthesia. 2019. (D) A composite score of seventy-five per- cent (75%) on the jurisprudence examination *Original authority: 331.100.2, RSMo 1939, amended (1) The Missouri State Board of Chiropractic 1949, 1969, 1980, 1981, 2008, 2013. regarding Missouri statutes and regulations; Examiners places the following restrictions (E) A completed background check from on chiropractic physicians who engage in the the Missouri State Highway Patrol’s approved practice of chiropractic while the consumer 20 CSR 2070-2.040 Application for Licen- vendor(s) for both a Missouri State Highway of the chiropractic service is under anesthe- sure Patrol and Federal Bureau of Investigation sia. criminal history background check. Any fees PURPOSE: This rule states where to secure associated with the background check are the (2) A chiropractic physician may not engage an application and how to complete the appli- applicant’s responsibility. in the practice of chiropractic while the con- cation and documentation required to accom- (F) When licensed in another state, verifi- sumer of the chiropractic service is under pany the application form provided by the cation of licensure from that state. anesthesia, unless: executive director. (G) When applying for licensure in this (A) The manipulation under anesthesia state based upon current licensure in another (MUA) is performed at a facility that is (1) An application for licensure or temporary state, official transcripts and examination licensed by the Missouri Department of licensure shall be made on a form provided scores are not required, unless requested by Health—Bureau of Hospital Licensing and by the state board, accompanied by the the board. Certification and approved by one (1) of the required fee. Forms are available at following: Joint Commission on Accredita- pr.mo.gov/chiropractors, upon written (3) An application for temporary licensure tion of Healthcare Organizations (JCAHO), request to the state board at PO Box 672, Jef- submitted pursuant to section 331.032, American Osteopathic Association (AOA), ferson City, MO 65102-0672, by calling the RSMo, shall be written or printed in black Accreditation Association of Ambulatory state board office at (573) 751-2104, or via e- ink, signed, and notarized. The following is Health Care (AAAHC), or Medicare; and mail at [email protected]. required for temporary licensure: (B) The anesthetic, sedative, or other drug (A) Composite score of seventy-five per- is administered to the consumer by a licensed (2) The application for licensure shall be cent (75%) on the jurisprudence examination medical doctor or doctor of osteopathy who printed in black ink, signed, and notarized. regarding Missouri statutes and regulations; is a board-eligible or board-certified anesthe- The following is required for licensure: (B) Completing a criminal history back- siologist or under the direct supervision of (A) Official educational transcript(s) docu- ground check from the Missouri State High- that professional; and menting all undergraduate course work. The way Patrol’s approved vendor(s) for both a (C) The chiropractic physician has com- transcript must be forwarded to the state Missouri State Highway Patrol and Federal

JOHN R. ASHCROFT (6/30/20) CODE OF STATE REGULATIONS 5 Secretary of State 20 CSR 2070-2—DEPARTMENT OF COMMERCE AND INSURANCE Division 2070—State Board of Chiropractic Examiners

Bureau of Investigation criminal history. 2006 and 331.100.2, RSMo 2000. This rule for at least seven (7) years from the date of Any fees for the background check are the originally filed as 4 CSR 70-2.050. Original the last visit to the licensee’s office. applicant’s responsibility. rule filed Dec. 17, 1975, effective Dec. 27, (C) Verification of licensure from each 1975. Rescinded and readopted: Filed July 9, (4) A licensed chiropractic physician shall state the applicant is licensed. 1982, effective Nov. 11, 1982. Amended: maintain patient records that are legible. Filed April 8, 1983, effective July 11, 1983. Patient records shall include, at a minimum, (4) A temporary license may be renewed for Amended: Filed Sept. 12, 1983, effective Jan. the following: an additional ninety (90) days upon applica- 13, 1984. Amended: Filed April 10, 1986, (A) Patient history; tion to the board and payment of the required effective July 11, 1986. Amended: Filed Aug. (B) Examination; fee. 14, 1986, effective Nov. 13, 1986. Rescinded (C) Diagnosis; and readopted: Filed May 15, 1987, effective (D) Prognosis and treatment; AUTHORITY: sections 43.543 and 331.030, Aug. 27, 1987. Amended: Filed Aug. 18, (E) When abbreviations or symbols are RSMo Supp. 2018, and section 331.100.2, 1987, effective Nov. 12, 1987. Amended: used, a key to the abbreviations or symbols; RSMo 2016.* This rule originally filed as 4 Filed March 8, 1988, effective July 28, 1988. and CSR 70-2.040. This version of rule filed Dec. Amended: Filed Dec. 1, 1988, effective April (F) A licensed chiropractic physician shall 13, 1989. Rescinded and readopted: Filed 17, 1975, effective Dec. 27, 1975. Rescinded follow the Subjective Objective Assessment April 18, 1989, effective July 13, 1989. and readopted: Filed July 9, 1982, effective Plan or “S.O.A.P.” method of patient record Amended: Filed April 18, 1990, effective Nov. 11, 1982. Amended: Filed Sept. 12, keeping as commonly taught in a chiropractic June 30, 1990. Amended: Filed Aug. 14, 1983, effective Jan. 13, 1984. Amended: college or chiropractic program in a universi- Filed Aug. 14, 1986, effective Nov. 13, 1986. 1990, effective Dec. 31, 1990. Amended: ty. Rescinded and readopted: Filed April 18, Filed June 15, 1992, effective Jan. 15, 1993. Amended: Filed Aug. 26, 1993, effective 1989, effective July 13, 1989. Rescinded and (5) A licensed chiropractic physician shall not readopted: Filed Aug. 14, 1990, effective April 9, 1994. Amended: Filed Jan. 24, 1996, effective July 30, 1996. Amended: increase charges when a patient utilizes a Dec. 31, 1990. Amended: Filed Sept. 13, third-party payment program. 1995, effective March 30, 1996. Amended: Filed March 30, 1998, effective Sept. 30, 1998. Amended: Filed Aug. 12, 1999, effec- Filed March 30, 1998, effective Sept. 30, (6) For the purpose of this rule, an advertise- 1998. Amended: Filed Aug. 12, 1999, effec- tive Feb. 29, 2000. Amended: Filed March 15, 2000, effective Oct. 30, 2000. Amended: ment shall be defined as any form of public tive Feb. 29, 2000. Amended: Filed July 31, notice, regardless of medium, using a 2003, effective Jan. 30, 2004. Amended: Filed July 31, 2003, effective Jan. 30, 2004. licensee’s name, trade name, or other profes- Filed April 1, 2005, effective Oct. 30, 2005. Moved to 20 CSR 2070-2.050, effective Aug. sional designation of the licensee or chiro- Moved to 20 CSR 2070-2.040, effective Aug. 28, 2006. Amended: Filed June 27, 2007, practic business. 28, 2006. Amended: Filed June 27, 2007, effective Jan. 30, 2008. Rescinded: Filed (A) Any advertisement shall include the effective Jan. 30, 2008. Rescinded and read- March 29, 2019, effective Oct. 30, 2019. name of the licensee responsible for the con- opted: Filed March 29, 2019, effective Oct. tent of the advertisement and the term chiro- 30, 2019. 20 CSR 2070-2.060 Professional Conduct practor, doctor of chiropractic, chiropractic *Original authority: 43.543, RSMo 1993, amended 2003, Rules physician, or D.C. 2005, 2008, 2013, 2018; 331.030, RSMo 1939, amended 1945, 1947, 1949, 1969, 1981, 1988, 1993, 1995, 1997, PURPOSE: This rule explains the profession- (7) A solicitation shall be defined as any form 2004, 2007, 2018; and 331.100.2, RSMo 1939, amended of contact used to entice or urge a person to 1949, 1969, 1980, 1981, 2008, 2013. al conduct of licensed chiropractic physi- cians. utilize a chiropractic physician. (A) For the purpose of this rule, any con- 20 CSR 2070-2.045 Board-Approved Chi- (1) Each licensed chiropractic physician shall tact, whether made in person, in writing, by ropractic Colleges notify the board of a change in name, busi- telephone or “auto-dialing” or by any form of (Rescinded October 30, 2019) ness and residential address, or telephone electronic medium for the purpose of solicit- number(s). The board must be notified with- ing or offering chiropractic treatment made AUTHORITY: sections 331.030 and 331.100.2, in fifteen (15) days of such change. Notifica- on behalf of a chiropractic physician by any RSMo 2000. This rule originally filed as 4 tion may be mailed to the board at 3605 Mis- third party or parties, including but not limit- CSR 70-2.045. Original rule filed April 8, souri Boulevard, or PO Box 672, Jefferson ed to marketing consultants or services, shall 1983, effective July 11, 1983. Amended: City, MO 65102-0672, faxing the board be deemed to be contact personally made by Filed April 10, 1986, effective July 11, 1986. office at (573) 751-0735, or sending an email the chiropractic physician. Rescinded and readopted: Filed April 18, to [email protected]. (B) A chiropractic physician shall not 1989, effective July 13, 1989. Amended: solicit any person involved in a motor vehicle Filed July 31, 2003, effective Jan. 30, 2004. (2) When closing a chiropractic practice the accident or other type of traumatic accident, Moved to 20 CSR 2070-2.045, effective Aug. licensee shall take adequate measures to pro- within thirty (30) days of the accident, if the 28, 2006. Rescinded: Filed March 29, 2019, vide for the transfer of patient records and chiropractic physician knows or reasonably effective Oct. 30, 2019. take reasonable steps to notify all patients, in should know that the physical, emotional, or writing, of what such patients must do to mental state of the person makes it unlikely obtain their records, or to arrange for trans- that the person would exercise reasonable 20 CSR 2070-2.050 Examination fer to another chiropractic physician or health judgment regarding a decision to seek chiro- (Rescinded October 30, 2019) care provider. practic treatment. The burden of persuasion shall be on the licensee to establish that any AUTHORITY: sections 331.030, RSMo Supp. (3) The licensee shall retain patient records such solicitation, made within thirty (30)

6 CODE OF STATE REGULATIONS (6/30/20) JOHN R. ASHCROFT Secretary of State Chapter 2—General Rules 20 CSR 2070-2

days of a known accident, is not a violation of Amended: Filed Nov. 6, 1996, effective May (4) The complainant shall be informed in this rule. 30, 1997. Amended: Filed April 29, 1998, writing as to whether the complaint is being (C) A chiropractic physician shall not effective Nov. 30, 1998. Amended: Filed July investigated, progress of the investigation, solicit or transmit a solicitation at the scene 31, 2003, effective Jan. 30, 2004. Amended: and final disposition of the complaint. of an accident or en route to a hospital, emer- Filed April 1, 2005, effective Oct. 30, 2005. gency care center, or other health care facili- Moved to 20 CSR 2070-2.060, effective Aug. AUTHORITY: section 331.100.2, RSMo ty. 28, 2006. Amended: Filed June 27, 2007, 2016.* This rule originally filed as 4 CSR 70- (D) A solicitation shall not refer to phras- effective Jan. 30, 2008. Rescinded and read- 2.065. Original rule filed Dec. 19, 1975, es such as “no out-of-pocket expense,” “we opted: Filed Dec. 19, 2019, effective July 30, effective Dec. 29, 1975. Rescinded and read- accept what your insurance will pay” or any 2020. opted: Filed Dec. 9, 1981, effective April 11, similar statement prior to the retention of ser- 1982. Amended: Filed Oct. 13, 1982, effec- *Original authority: 331.060, RSMo 1939, amended tive Feb. 11, 1983. Amended: Filed Sept. 12, vices that a payment made by an insurance 1969, 1971, 1972, 1981, 1987 and 331.100.2, RSMo carrier or other third party payor with copay- 1939, amended 1949, 1969, 1980, 1981, 2008, 2013. 1983, effective Jan. 13, 1984. Amended: ment or deductible features will be accepted Filed Dec. 7, 1984, effective April 11, 1985. by the licensee as payment in full. Amended: Filed June 7, 1985, effective Oct. 20 CSR 2070-2.065 Public Complaint Han- 26, 1985. Amended: Filed Dec. 3, 1990, (8) Violation of the Health Care Payment dling and Disposition effective April 29, 1991. Amended: Filed Fraud and Abuse Act, Missouri Revised April 1, 1992, effective Sept. 6, 1992. Statutes section 191.900 et seq. or the “anti- PURPOSE: This rule establishes a procedure Amended: Filed July 31, 2003, effective Jan. kickback” portions of the Medicare/Medicaid for the receipt, handling, and disposition of 30, 2004. Moved to 20 CSR 2070-2.065, anti-fraud and abuse statute, 42 United States public complaints by the board. effective Aug. 28, 2006. Amended: Filed Code section 1320a-7b[b], by knowingly and March 29, 2019, effective Oct. 30, 2019. willingly offering, paying, soliciting, or (1) The State Board of Chiropractic Examin- receiving remuneration in order to induce ers shall receive and process each complaint *Original authority: 331.100.2, RSMo 1939, amended 1949, 1969, 1980, 1981, 2008, 2013. business reimbursed under the Medicare or made against any licensee or unlicensed indi- state administered health care programs will vidual or entity, which complaint alleges cer- be considered, at minimum, unprofessional tain acts or practices which may constitute 20 CSR 2070-2.066 Post-Board Order or improper conduct in the practice of chiro- one (1) or more violations of the provisions Activity practic. Conduct will not be considered a vio- of Chapter 331, RSMo or administrative (Rescinded October 30, 2019) lation of this rule, if the ownership or invest- rules promulgated thereunder. Any member ment interest in such service meets the of the public, the profession, or any federal, AUTHORITY: section 331.100.2, RSMo requirements of the “safe harbor” provisions state, or local official may make and file a 1986. This rule originally filed as 4 CSR 70- of Title 42 Code of Federal Regulations part complaint with the board. Complaints may be 2.066. Original rule filed June 11, 1985, 1001. received from sources outside Missouri and effective Oct. 26, 1985. Amended: Filed April will be processed in the same manner as 10, 1986, effective July 11, 1986. Moved to AUTHORITY: sections 331.060 and those originating within Missouri. No mem- 20 CSR 2070-2.066, effective Aug. 28, 2006. 331.100.2, RSMo 2016.* This rule originally ber of the State Board of Chiropractic Exam- Rescinded: Filed March 29, 2019, effective filed as 4 CSR 70-2.060. This version of rule iners shall file a complaint with this board Oct. 30, 2019. filed Dec. 17, 1975, effective Dec. 27, 1975. while that member holds that office, unless Amended: Filed April 6, 1978, effective Aug. that member excuses him/herself from fur- 11, 1978. Amended: Filed July 5, 1978, ther board deliberations or activity concern- 20 CSR 2070-2.070 Reciprocity effective Oct. 13, 1978. Rescinded and read- ing the matters alleged within that complaint. (Rescinded October 30, 2019) opted: Filed Dec. 9, 1981, effective April 11, The executive director or any staff member of 1982. Rescinded and readopted: Filed July 9, the board may file a complaint pursuant to AUTHORITY: sections 331.030, RSMo Supp. 1982, effective Nov. 11, 1982. Amended: this rule in the same manner as any member 2006 and 331.100.2, RSMo 2000. This rule Filed Sept. 12, 1983, effective Jan. 13, 1984. of the public. Amended: Filed June 11, 1985, effective Oct. originally filed as 4 CSR 70-2.070. This ver- 26, 1985. Rescinded and readopted: Filed sion of rule filed Dec. 17, 1975, effective (2) Complaints, whether submitted in writing April 18, 1989, effective July 13, 1989. Dec. 27, 1975. Rescinded and readopted: or using the board’s complaint form, shall Amended: Filed April 18, 1990, effective Filed July 9, 1982, effective Nov. 11, 1982. June 30, 1990. Amended: Filed Aug. 14, clearly identify the complainant by name and Amended: Filed Sept. 12, 1983, effective Jan. 1990, effective Dec. 31, 1990. Amended: address, and be mailed or delivered to the fol- 13, 1984. Amended: Filed March 8, 1984, Filed March 4, 1991, effective July 8, 1991. lowing address: Missouri State Board of Chi- effective July 12, 1984. Amended: Filed Aug. Amended: Filed Sept. 17, 1991, effective Feb. ropractic Examiners, 3605 Missouri Blvd., 14, 1986, effective Nov. 13, 1986. Rescinded 6, 1992. Amended: Filed Dec. 3, 1991, effec- PO Box 672, Jefferson City, MO 65102-0672 and readopted: Filed April 18, 1989, effec- tive April 9, 1992. Amended: Filed Jan. 23, or sent via email to [email protected]. tive July 13, 1989. Amended: Filed April 18, 1992, effective June 25, 1992. Amended: 1990, effective June 30, 1990. Amended: Filed Feb. 4, 1992, effective June 25, 1992. (3) The board shall maintain a record of the Filed Aug. 13, 1990, effective Dec. 31, 1990. Amended: Filed May 13, 1992, effective Jan. complaint that includes the complainant’s Amended: Filed Dec. 3, 1991, effective April 15, 1993. Amended: Filed June 15, 1992, name, address, respondent’s name and 9, 1992. Amended: Filed March 30, 1998, effective Jan. 15, 1993. Amended: Filed July address, date the complaint is received, and effective Sept. 30, 1998. Amended: Filed 22, 1993, effective Jan. 31, 1994. Amended: the allegation(s) or reason(s) for filing the Aug. 12, 1999, effective Feb. 29, 2000. Filed Dec. 21, 1995, effective June 30, 1996. complaint. Amended: Filed July 31, 2003, effective Jan.

JOHN R. ASHCROFT (6/30/20) CODE OF STATE REGULATIONS 7 Secretary of State 20 CSR 2070-2—DEPARTMENT OF COMMERCE AND INSURANCE Division 2070—State Board of Chiropractic Examiners

30, 2004. Amended: Filed April 1, 2005, 1. Diagnostic imaging (X ray); relevant to chiropractic provided by a CCE- effective Oct. 30, 2005. Moved to 20 CSR 2. Differential or physical diagnosis or approved chiropractic college; and 2070-2.070, effective Aug. 28, 2006. Amend- both; (D) The chiropractic college shall be ed: Filed June 27, 2007, effective Jan. 30, 3. Record keeping and/or Subjective responsible for submitting course(s) to the 2008. Rescinded: Filed March 29, 2019, Objective Assessment Plan (SOAP) notes; board for approval and for verifying atten- effective Oct. 30, 2019. 4. Principles, techniques, and/or adjunc- dance by the teacher or faculty member. tive procedures; or 5. Meridian Therapy/acupressure/acu- (7) Chiropractic physicians who teach contin- 20 CSR 2070-2.080 Biennial License puncture. uing education approved by the board may Renewal receive up to a maximum of four (4) hours (4) Continuing education hours in compliance per year of continuing education credit for PURPOSE: This rule establishes the licen- with 20 CSR 2070-2.080(3) may be obtained teaching board-approved courses as defined sure renewal requirements. via the Internet pursuant to 20 CSR 2070- in 20 CSR 2070-2.080(3)(A). 2.081(2)(B) and board approval. (1) A license shall be renewed biennially con- (8) Chiropractic physicians certified by the tingent upon the licensee completing the (5) The remaining required continuing educa- board in Meridian Therapy/acupressure/acu- required hours of continuing education as tion hours, which shall be deemed “general” puncture (MTAA) or insurance consulting defined in section (2)— continuing education hours, may be obtained who teach continuing education approved by (A) For the purpose of this regulation one from one (1) or more of the following areas: the board may receive up to twelve (12) hours (1) hour of continuing education shall consist (A) Continuing education programs, semi- biennially of continuing education for teach- of at least fifty (50) minutes of instruction or nars, and/or workshops approved by the ing courses pursuant to 20 CSR 2070-2.031 study; board pursuant to 20 CSR 2070-2.080(3); MTAA or 20 CSR 2070-4.010 insurance con- (B) A chiropractic physician issued a (B) Continuing education programs, semi- sulting. license within one (1) year of graduation nars, and/or workshops related to the practice from an approved chiropractic college shall of chiropractic and not approved by the board (9) A licensee acting as an associate examin- be exempt from the continuing education for formal continuing education hours; er for Part IV of the national examination requirements until the end of the first bienni- (C) Attending relevant professional meet- administered by the National Board for Chi- al licensure cycle following initial license ings. Such meetings can be international, ropractic Examiners (NBCE) is eligible to issuance; and national, regional, state, or local and must be receive a maximum of ten (10) hours of con- (C) A chiropractic physician at least sixty- related to the practice of chiropractic; tinuing education as follows: five (65) years old and licensed in this state (D) Reading scholarly material relating to (A) Four (4) hours of formal continuing for at least thirty-five (35) years shall com- the practice of chiropractic to include books, education; plete at least twenty-four (24) hours of formal journals, periodicals, and articles whether (B) Six (6) hours of general continuing continuing education biennially as defined in printed, provided via the Internet, or other education; and section (4) of this rule. The remaining bien- electronic means; (C) To obtain the continuing education, the nial hours of continuing education shall be (E) Writing articles for scholarly publica- associate examiner must attend the orienta- waived. tions such as books, national or international tion and administer the Part IV examination journals, and periodicals. Articles must be for the day(s) scheduled. (2) Every two (2) years (hereinafter referred relevant to the practice of chiropractic; and to as biennially) and prior to the expiration (F) Chiropractic physicians teaching an (10) If the licensee pays the continuing edu- date of a license, a licensee shall complete approved postgraduate course may receive cation penalty fee for continuing education forty-eight (48) hours of continuing education continuing education credits for teaching the credits earned late, those hours shall be as defined in sections (3) and (5) of this rule. course providing the instructor’s name was applied to the requirements to renew the If a licensee is unable to complete the submitted with the course content when license and not be applied to the next renew- required biennial continuing education, prior requesting approval of the course. al cycle. A licensee who has failed to obtain to the expiration date of the license, the and document the requisite number of contin- licensee may submit a written request to the (6) Chiropractic physicians who are faculty uing education credits shall be subject to dis- board for an extension in order to comply members at a CCE–accredited college may ciplinary action by the board at the board’s with the continuing education requirement receive up to a maximum of forty-eight (48) discretion, pursuant to the authority granted and shall pay the required late continuing hours biennially of continuing education in section 331.060, RSMo. education fee. credit for teaching or attending course(s) at a CCE-accredited chiropractic college: (11) A licensee shall be responsible for main- (3) At least twenty-four (24) hours of the (A) The areas of study shall be in compli- taining all documentation of continuing edu- required forty-eight (48) hours of continuing ance with 20 CSR 2070-2.080(3); cation compliance for the previous and cur- education shall be earned by attending formal (B) For the purpose of this rule, the facul- rent biennial licensure cycles. In the event the continuing education programs, seminars, ty member must either teach or attend a licensee is selected for a compliance audit, and/or workshops that have been approved by course at a CCE-approved chiropractic col- the licensee shall provide the required docu- the board. lege for a minimum of four (4) clock hours as mentation of compliance within sixty (60) (A) A licensee shall obtain the required defined in 20 CSR 2070-2.080(3); days of the written request from the board. formal continuing education hours from no (C) Any remaining continuing education Failure to comply with a board audit or other less than two (2) of the following formal cat- study required for licensure renewal may be request for such documentation shall be a egories: obtained by teaching or attending course(s) basis for disciplinary action against the

8 CODE OF STATE REGULATIONS (6/30/20) JOHN R. ASHCROFT Secretary of State Chapter 2—General Rules 20 CSR 2070-2

licensee, pursuant to section 331.060, RSMo. (D) Proof of compliance with 20 CSR Filed Dec. 10, 1984, effective April 11, 1985. 2070-2.080(2), (3), and (5). If licensed in Amended: Filed April 10, 1986, effective July (12) If a licensee requires a waiver or an another state and not practicing in Missouri, 11, 1986. Amended: Filed Aug. 14, 1986, extension of time to complete the continuing the continuing education required to maintain effective Nov. 13, 1986. Amended: Filed April education requirements, a written request, the license in that state may be used in lieu of 18, 1990, effective June 30, 1990. Amended: explaining the reason for the request for an meeting the requirements of sections (2), (3), Filed April 30, 1991, effective Oct. 31, 1991. extension, must be submitted to the board in and (5) of this rule. Amended: Filed July 7, 1992, effective Feb. advance of the license expiration date. Any 26, 1993. Amended: Filed July 22, 1993, extension of time to complete the continuing (16) A license that is expired or inactive for effective Jan. 31, 1994. Amended: Filed education requirements or waiver of the con- more than five (5) years and the applicant is March 4, 1994, effective Aug. 28, 1994. tinuing education requirements shall be not licensed in another state, the following Amended: Filed Dec. 18, 1995, effective June granted solely at the discretion of the board shall be submitted: 30, 1996. Amended: Filed July 23, 1998, and based upon terms and conditions deemed (A) A completed reinstatement form avail- effective Feb. 28, 1999. Amended: Filed April appropriate by the board. able from the board; 14, 2000, effective Oct. 30, 2000. Amended: (B) Reinstatement fee as defined in 20 Filed July 31, 2003, effective Jan. 30, 2004. (13) A Missouri licensed chiropractor that CSR 2070-2.090(1)(D); Amended: Filed April 1, 2005, effective Oct. practices in another state and is not practicing (C) A criminal history background check 30, 2005. Moved to 20 CSR 2070-2.080, effective Aug. 28, 2006. Rescinded and read- in Missouri may use the approved continuing from the Missouri State Highway Patrol’s opted: Filed June 27, 2007, effective Jan. 30, education hours required of the state in which approved vendor(s) for both the Missouri 2008. Amended: Filed Aug. 15, 2008, effec- they practice for biennial renewal of the Mis- State Highway Patrol and Federal Bureau of Investigation. Any fees for the background tive Feb. 28, 2009. Amended: Filed Aug. 27, souri license, without prior approval by the 2009, effective Feb. 28, 2010. Amended: board. If the state in which the chiropractic check are the applicant’s responsibility; (D) An official transcript from a Council Filed March 29, 2019, effective Oct. 30, physician is practicing does not have continu- 2019. ing education requirements for renewal or on Chiropractic Education accredited chiro- practic college documenting completion of licensure reinstatement, the out-of-state chi- *Original authority: 331.050, RSMo 1939, amended ropractic physician must earn the requisite the following: 1945, 1947, 1969, 1981, 1987, 1999, 2001, 2004 and number of continuing education hours 1. Four (4) semester hours in chiroprac- 331.100, RSMo 1939, amended 1949, 1969, 1980, 1981, tic clinical reasoning; 2008, 2013. required in Missouri as defined in sections (2), (3), and (5) of this rule. 2. Four (4) semester hours clinical diag- nosis; 20 CSR 2070-2.081 Application for Contin- (14) Within two (2) years of the expiration 3. Four (4) semester hours of diagnostic uing Education date, a license may be reinstated upon sub- imaging; and mission of the following: (E) Completion of the jurisprudence exam- PURPOSE: This rule defines continuing edu- (A) A completed reinstatement form avail- ination regarding Missouri statutes and regu- cation, sets out the requirements for sponsor- able from the board; lations; with a minimum composite score of ing organizations. (B) Renewal and reinstatement fees as seventy-five percent (75%) on the jurispru- defined in 20 CSR 2070-2.090(1)(B) and dence examination. (1) The term postgraduate study may be used (D); and interchangeably with the terms continuing (C) Proof of compliance with continuing (17) Prior to the expiration date of the education or CE. education requirements pursuant to sections license, an application for renewal of the (2), (3), and (5) of this rule. If licensed in license shall be postmarked and sent via reg- (2) For board approval of formal continuing another state and not practicing in Missouri, ular or overnight mail to the state board education courses or seminars a sponsor or office, or electronically renewed by the the continuing education required to maintain provider shall forward to the board one (1) licensee. The licensee shall verify the number the license in that state may be used in lieu of copy of the completed application and appli- of continuing education hours completed dur- meeting the requirements of 20 CSR 2070- cable fee pursuant to 20 CSR 2070-2.090(1). ing the renewal cycle on the renewal form 2.080(2), (3), and (5). This material must be received in the board mailed to the board office or submitted office at least thirty (30) days prior to the online. (15) A license that is expired or inactive for seminar to receive board approval. more than two (2) years and less than five (5) (A) The board may consider a request for (18) A license may be placed on inactive sta- years from the expiration or inactive date may formal continuing education after the seminar tus upon submission of a written request and be reinstated upon submission of the follow- has occurred by submitting an application and payment of the required fee pursuant to 20 ing: fee, along with a written explanation regard- CSR 2070-2.090(1)(C). (A) A completed reinstatement form avail- ing why the application was not submitted at able from the board; AUTHORITY: sections 331.050 and least thirty (30) days prior to the seminar. (B) Reinstatement fee as defined in 20 331.100.2, RSMo 2016.* This rule originally (B) For continuing education obtained via CSR 2070-2.090(1)(D); filed as 4 CSR 70-2.080. This version of rule the Internet, the sponsor or provider shall (C) A criminal history background check filed Dec. 17, 1975, effective Dec. 27, 1975. submit along with the application and fee, a from the Missouri State Highway Patrol’s Rescinded and readopted: Filed Dec. 9, detailed explanation of the following: approved vendor(s) for both the Missouri 1981, effective March 11, 1982. Rescinded 1. Delivery format explaining how the State Highway Patrol and Federal Bureau of and readopted: Filed July 9, 1982, effective continuing education material is presented to Investigation. Any fees for the background Nov. 11, 1982. Amended: Filed Sept. 12, include applicable security safeguarding the check are the applicant’s responsibility; and 1983, effective Jan. 13, 1984. Amended: licensee’s identity;

JOHN R. ASHCROFT (6/30/20) CODE OF STATE REGULATIONS 9 Secretary of State 20 CSR 2070-2—DEPARTMENT OF COMMERCE AND INSURANCE Division 2070—State Board of Chiropractic Examiners

2. Process used for gathering informa- tic imaging in the areas of anatomy and phys- (B) Name, address, and license number of tion for the continuing education course, to iology, diagnosis, or condition and pathology the licensee in attendance at the approved include if course material is updated, how shall be taught by a Diplomate, American seminar; often, and who determines when such update Board of Chiropractic Radiology (DACBR), (C) Course approval number which will be is required; or a medical radiologist. provided to the sponsor at the time the spon- 3. Method used for monitoring atten- sor is notified by the board of its approval of dance; (6) A continuing education program address- the seminar; 4. Time a licensee is allowed to com- ing a topic, or combination of topics, pur- (D) Title, date(s), and location of the sem- plete the online continuing education course. suant to 20 CSR 2070-2.080 shall be taught inar; and The explanation must specify if a licensee has by an instructor with a doctor of chiropractic (E) The total number of hours that the unlimited time and unlimited number of degree and expertise in the subject matter to licensee was in attendance at the seminar. attempts to complete the continuing educa- be presented. These hours must be reflected according to tion course and if multiple attempts to com- (A) Instructors for continuing education the categories defined in 20 CSR 2070- plete the course are monitored; programs addressing a topic, or combination 2.080(3). 5. Whether a test is required and, if so, of topics, pursuant to 20 CSR 2070-2.080 how the results are reported to the licensee; AUTHORITY: sections 331.050 and that do not have a doctor of chiropractic 6. How a licensee communicates with 331.100.2, RSMo 2016.* This rule originally degree shall document training and expertise the sponsoring organization in the event there filed as 4 CSR 70-2.081. Original rule filed are questions or problems; in the subject matter to be presented. Such April 16, 1990, effective June 30, 1990. 7. Documentation provided to the documentation shall include: Amended: Filed Aug. 26, 1993, effective licensee when a course is completed; 1. Undergraduate or graduate course April 9, 1994. Amended: Filed March 4, 8. Amount of time a sponsoring organi- work verified with a transcript; and/or 1994, effective Aug. 28, 1994. Amended: zation maintains records of a licensee com- 2. Work experience, seminars, work- Filed Dec. 18, 1995, effective June 30, 1996. pleting a course of study; and shops, or training verified with a resume or Amended: Filed July 23, 1998, effective Feb. 9. Names and credentials of individuals vitae. 28, 1999. Amended: Filed July 31, 2003, responsible for the content of the continuing (B) Continuing education sponsored totally effective Jan. 30, 2004. Moved to 20 CSR education course. or in part by a product distributor, product 2070-2.081, effective Aug. 28, 2006. Amend- (C) A sponsor or provider wishing to pro- line, or company or demonstrating, promot- ed: Filed June 27, 2007, effective Jan. 30, vide continuing education via the Internet ing, or endorsing a product or service must 2008. Amended: Filed Aug. 15, 2008, effec- shall provide the board access to the online utilize instructors in compliance with 20 CSR tive Feb. 28, 2009. Amended: Filed Aug. 27, course for the purpose of reviewing areas 2070-2.080. The subject matter of the contin- 2009, effective Feb. 28, 2010. Amended: such as content and delivery method. uing education must address the diagnosis and Filed March 29, 2019, effective Oct. 30, treatment of conditions as authorized by sec- 2019. (3) All postgraduate education programs shall tion 331.010.1, RSMo. Product information be subject to the following criteria: *Original authority: 331.050, RSMo 1939, amended shall not be the primary focus relating to diag- 1945, 1947, 1969, 1987, 1999, 2001, 2004 and (A) The program shall meet the definition nosis and/or treatment and shall be presented 331.100.2, RSMo 1939, amended 1949, 1969, 1980, of postgraduate education as defined in sec- only as an adjunct to the course material. 1981, 2008, 2013. tion (1) of this rule; (B) The sponsor or provider shall properly (7) Any postgraduate program offered for monitor the attendance of the chiropractic license renewal must carry the following dis- 20 CSR 2070-2.090 Fees physician at the program; claimer: “Approval of this course is not an (C) The sponsor shall notify the board of acknowledgement or ruling by the board that PURPOSE: This rule establishes and fixes the various fees and charges authorized by the date, title, hours, names of speakers, and the methods taught in this course are recog- Chapter 331, RSMo. location of seminar and contact person; and nized and approved by the board as the appro- (D) The sponsor shall provide a certificate priate practice of chiropractic as defined in of completion to the licensee no later than (1) The following fees hereby are established section 331.010, RSMo.” This disclaimer thirty (30) days after completion of the con- by the State Board of Chiropractic Examin- shall be on all brochures and handouts or on tinuing education. ers: a separate piece of paper distributed at each (A) Application Fee $200 (4) An application for formal continuing edu- program. (B) Renewal Fee $125 cation that is not approved by the board or is (C) Inactive Status Fee $100 (8) All postgraduate education sponsors shall incomplete, will be returned to the continuing (D) License Reinstatement Fee $100 education sponsor with a written explanation provide each licensee with a certificate veri- (E) Meridian Therapy/Acupressure/ regarding why the application was not fying his/her attendance at an approved post- Acupuncture Certification approved or was incomplete. Upon correct- graduate education seminar. The certificate Application Fee $100 ing any deficiencies or omissions on the shall be provided to the licensee by the spon- (F) Insurance Consultant application or documentation, the sponsor sor within thirty (30) days from the date of Certification Application Fee $100 may resubmit the application and shall pay the licensee’s attendance at the seminar and (G) Fingerprinting Fee the applicable per session fee pursuant to 20 contain, at a minimum, the following infor- (amount determined by the CSR 2070-2.090(1). mation: Missouri State Highway Patrol) (A) Name, address, and telephone number (H) Continuing Education Sponsor (5) Continuing education addressing diagnos- of the sponsoring organization; Fee (per session) $ 5

10 CODE OF STATE REGULATIONS (6/30/20) JOHN R. ASHCROFT Secretary of State Chapter 2—General Rules 20 CSR 2070-2

(I) Biennial Continuing Education 13, 1989. Amended: Filed April 18, 1990, form a professional corporation with a person Sponsor Fee $500** effective June 30, 1990. Amended: Filed Aug. licensed by the State Board of Chiropractic (J) Continuing Education 14, 1990, effective Dec. 31, 1990. Amended: Examiners. Late Fee $150 Filed Oct. 15, 1990, effective April 4, 1991. (B) A chiropractor licensed to practice chi- (K) Returned Check Fee $ 25 Emergency amendment filed Dec. 21, 1990, ropractic in Missouri may combine with any (L) Temporary License Fee $100 effective Dec. 31, 1990, expired April 29, of the professions defined as a professional (M) Renewal Temporary 1991. Amended: Filed Dec. 3, 1990, effective service in section 356.021, RSMo in the License $ 25 April 29, 1991. Amended: Filed April 30, same professional corporation to further the (N) Specialty Certification 1991, effective Oct. 31, 1991. Amended: providing of health-care services of the Review Fee $150 Filed July 7, 1992, effective Feb. 26, 1993. respective professions and services ancillary (O) Specialist Certification Amended: Filed Jan. 29, 1993, effective Aug. to that profession. Application Fee $100 9, 1993. Amended: Filed March 4, 1994, (C) The term ancillary services, as used in (P) Specialty Certification effective Aug. 28, 1994. Amended: Filed this rule, shall mean any service directly Reinstatement Fee $ 25 Sept. 13, 1995, effective March 30, 1996. related to providing primary health care in the form of treatment or therapy to a person. Amended: Filed Jan. 24, 1996, effective July (D) Any professional corporation formed **This fee provides continuing education 30, 1996. Amended: Filed Nov. 6, 1996, pursuant to this rule shall comply with all sponsors with the option of paying one (1) effective May 30, 1997. Amended: Filed Jan. applicable requirements of Chapter 356, biennial fee in lieu of paying the five dollar 20, 1998, effective Sept. 1, 1998. Amended: RSMo. As soon as practicable, but no later ($5) fee required with each session on an Filed July 23, 1998, effective Jan. 30, 1999. application for continuing education course than thirty (30) days from the date of issuance Amended: Filed June 15, 1999, effective Nov. of a Certificate of Incorporation by the Mis- approval. The fee is applicable to the appli- 30, 1999. Amended: Filed April 14, 2000, souri secretary of state, each professional cation(s) filed by the continuing education effective Oct. 30, 2000. Amended: Filed July corporation shall provide the board with a sponsor for programs offered in any one (1) 31, 2003, effective Jan. 30, 2004. Amended: copy of the Articles of Incorporation, certi- biennial cycle and will not carry over into Filed April 1, 2005, effective Oct. 30, 2005. fied by the secretary of the corporation that another biennial cycle. No additional fee will Amended: Filed June 29, 2005, effective Jan. the articles are true and correct copies and be assessed on subsequent applications for 30, 2006. Moved to 20 CSR 2070-2.090, also shall provide a copy of the Certificate of continuing education course approval filed for effective Aug. 28, 2006. Amended: Filed June Incorporation issued by the Missouri secre- programs offered throughout one (1) biennial 27, 2007, effective Jan. 30, 2008. Amended: tary of state. cycle, regardless of the number of initial Filed Aug. 15, 2008, effective Feb. 28, 2009. (E) No professional corporation shall dis- applications filed by the continuing education Amended: Filed Aug. 27, 2009, effective Feb. solve or elect to cease being a professional sponsor. If an application for formal continu- 28, 2010. Emergency amendment filed Oct. corporation under the provisions of section ing education is not approved by the board, or 27, 2014, effective Nov. 6, 2014, expired May 356.201, RSMo, until the corporation has is incomplete, the sponsor may resubmit the 4, 2015. Amended: Filed Oct. 27, 2014, provided the board with information which in application and shall pay the applicable per effective April 30, 2015. Amended: Filed the board’s view is sufficient to assure the session fee. March 29, 2019, effective Oct. 30, 2019. board that adequate measures have been taken by the corporation to provide for the transfer (2) The provisions of this rule are declared *Original authority: 43.543, RSMo 1993, amended 2003, of patient records, including X-rays, to either severable. If any fee fixed by this rule is held 2005, 2008, 2013, 2018; 331.070, RSMo 1939, amended the patient or another health care provider of invalid by a court of competent jurisdiction or 1969, 1981, 1985; and 331.100.2, RSMo 1939, amended the patient’s choosing or to assure the board by the Administrative Hearing Commission, 1949, 1969, 1980, 1981, 2008, 2013. that the patient does not desire the records the remaining provisions of this rule shall delivered to him/her or another health care remain in full force and effect unless other- provider. 20 CSR 2070-2.100 Professional Corpora- wise determined by a court of competent (F) A chiropractor licensed pursuant to tions jurisdiction or by the Administrative Hearing Chapter 331, RSMo shall not: Commission. 1. Select or use any name for a profes- PURPOSE: This rule informs professionals sional corporation which is false, deceptive, what must be done before and after they form AUTHORITY: sections 331.070 and 331.100.2, a professional corporation. or misleading to the general public concern- RSMo 2016, and section 43.543, RSMo ing the nature of professional services offered Supp. 2018.* This rule originally filed as 4 (1) Professional Corporations—Organization. or provided by the professional corporation; CSR 70-2.090. Emergency rule filed June 30, (A) A person licensed as a chiropractor in and 1981, effective July 9, 1981, expired Nov. 11, this state may form or be a member of a pro- 2. Be a member of any professional cor- 1981. Original rule filed June 30, 1981, fessional corporation organized under and poration having a name in violation of this effective Oct. 12, 1981. Amended: Filed Dec. existing in compliance with Chapter 356, subsection. The name of any professional 10, 1984, effective April 11, 1985. Amended: RSMo, which corporation may be composed corporation formed pursuant to this rule shall Filed Aug. 14, 1986, effective Nov. 13, 1986. of any combination of the professions defined comply with section 356.071, RSMo. Amended: Filed Oct. 17, 1986, effective Jan. as a professional service in section 356.021, (G) No chiropractor licensed pursuant to 30, 1987. Emergency amendment filed March RSMo provided, that each person is duly Chapter 331, RSMo shall practice in the form 18, 1987, effective March 28, 1987, expired licensed to practice his/her profession in this of a professional corporation or other busi- July 26, 1987. Amended: Filed March 18, state under the laws applicable to that profes- ness entity where a person who is not a 1987, effective May 28, 1987. Amended: sion and provided further that the licensing licensed chiropractor has the right to direct or Filed Dec. 1, 1988, effective April 13, 1989. authority of each profession by rule has control the professional judgment of the chi- Amended: Filed April 18, 1989, effective July authorized the members of that profession to ropractic physician.

JOHN R. ASHCROFT (6/30/20) CODE OF STATE REGULATIONS 11 Secretary of State 20 CSR 2070-2—DEPARTMENT OF COMMERCE AND INSURANCE Division 2070—State Board of Chiropractic Examiners

AUTHORITY: sections 331.060, 331.070, the United States in which the applicant has 331.100.2, 356.041.4, 356.111, and ever been licensed verifying: 356.191, RSMo 2016.* This rule originally 1. The status of the applicant’s license filed as 4 CSR 70-2.100. Original rule filed and, when licensed in that jurisdiction, if April 8, 1983, effective July 11, 1983. there were any complaints and/or disciplinary Rescinded and readopted: Filed Jan. 5, 1987, action on the license; effective April 11, 1987. Amended: Filed May 2. The applicant has not committed an 15, 1987, effective Aug. 27, 1987. Amended: act in any jurisdiction where the applicant Filed March 4, 1991, effective July 8, 1991. holds or held a license that would have con- Amended: Filed Dec. 3, 1991, effective April stituted grounds for the refusal, suspension, 9, 1992. Amended: Filed Sept. 25, 1992, or revocation of a license or certificate to effective May 6, 1993. Amended: Filed July practice at the time the act was committed; 21, 1995, effective Feb. 25, 1996. Amended: and Filed March 15, 2000, effective Oct. 30, 3. The applicant has not been disci- 2000. Amended: Filed July 31, 2003, effec- plined under the laws of a licensing or cre- tive Jan. 30, 2004. Moved to 20 CSR 2070- dentialing entity in another jurisdiction and is 2.100, effective Aug. 28, 2006. Amended: not the subject of an unresolved complaint, Filed March 29, 2019, effective Oct. 30, review procedure, or disciplinary proceeding 2019. under the laws of a licensing or credentialing entity in any other jurisdiction. *Original authority: 331.060, RSMo 1939, amended (F) Submission of fingerprints to the Mis- 1969, 1971, 1972, 1981, 1987; 331.070, RSMo 1939, amended 1969, 1981, 1985; 331.100.2, RSMo 1939, souri State Highway Patrol’s approved vendor amended 1949, 1969, 1980, 1981, 2008, 2013; for both a Missouri State Highway Patrol and 356.041.4, RSMo 1986; 356.111, RSMo 1986, amended Federal Bureau of Investigation (FBI) finger- 1991, 1993; and 356.191, RSMo 1986. print criminal history background check. Any fees due for fingerprint background checks 20 CSR 2070-2.110 Nonresident Military shall be paid by the applicant directly to the Spouse Licensure fingerprint vendor or as otherwise set out in the board’s rules; PURPOSE: This rule states the requirements (G) If the board is unable initially to deter- and procedures for a nonresident spouse of mine if the licensing requirements of the an active duty member of the military who is state, district, or territory in which the appli- transferred to this state in the course of the cant is currently licensed are equivalent to member’s military duty to obtain a temporary Missouri’s licensing requirements, the appli- courtesy license to practice chiropractic for cant shall, upon request, submit documenta- one hundred eighty (180) days, subject to tion as necessary to assist the board in deter- possible extension as provided by law. mining whether such other jurisdiction’s licensing requirements are equivalent to the (1) The board shall grant a temporary cour- licensing requirements of this state; tesy license to practice chiropractic without (H) Proof of satisfactory completion of the examination to a “nonresident military jurisprudence examination regarding the laws spouse” as defined in section 324.008.1, and rules of the State of Missouri related to RSMo, who provides the board the following: the applicant’s profession; (A) A completed application form; (I) Such additional information as the (B) A non-refundable application fee, as board may request to determine eligibility for established by 20 CSR 2070-2.090, made a temporary courtesy license pursuant to the payable to the board; provisions of 20 CSR 2070-2.040(3). (C) Verification sent directly to the board office from a state, district, or territory veri- AUTHORITY: sections 324.008 and 331.100, fying that the applicant holds a current and RSMo 2016.* Original rule filed March 29, active license in that state, district, or territo- 2019, effective Oct. 30, 2019. ry; *Original authority: 324.008, RSMo 2011 and 331.100, (D) Proof that the applicant has been RSMo 1939, amended 1949, 1969, 1980, 1981, 2008, engaged in the practice of chiropractic in a 2013. state, district, or territory of the United States in which the applicant is currently licensed for at least two (2) years of the five (5) years immediately preceding the application for temporary licensure; (E) Verification sent directly to the board office from each state, district, or territory of

12 CODE OF STATE REGULATIONS (6/30/20) JOHN R. ASHCROFT Secretary of State