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H*3891 Session 115 (2003-2004) H*3891(Rat #0413, Act #0010 of 2005) General Bill, By Quinn, Herbkersman, Altman, Anthony, Bailey, Bingham, G. Brown, J. Brown, Cato, Clemmons, Cobb-Hunter, Duncan, Edge, Gilham, Harrison, Harvin, Haskins, Hayes, J. Hines, Lee, Littlejohn, Lucas, Mahaffey, McGee, Merrill, Parks, M.A. Pitts, Scarborough, F.N. Smith, J.E. Smith, Talley, Toole, Umphlett, Viers, Young and Pinson AN ACT TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING ARTICLE VERSIONS OF THIS BILL
3/27/2003 5/21/2003 5/22/2003 5/27/2003 5/28/2003 4/21/2004 5/12/2004 5/13/2004 5/27/2004 6/1/2004 6/2/2004 (A10, R413, H3891 of 2004)
AN ACT TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING Be it enacted by the General Assembly of the State of South Carolina: South Carolina Acupuncture Act SECTION 1. Chapter 47, Title 40 of the 1976 Code is amended by adding:
 Article 6
Section 40-47-700. This
Section 40-47-705. For purposes of this (1) 'Acupuncture' means a form of health care developed from traditional and modern oriental concepts for health care that employs oriental medical techniques, treatment, and adjunctive therapies for the promotion, maintenance, and restoration of health and the prevention of disease. The practice of acupuncture does not include: (a) osteopathic medicine and osteopathic manipulative treatment; (b) 'chiropractic' or 'chiropractic practice' as defined in Section 40-9-10; or (c) 'physical therapy' as defined in Section 40-45-20 or therapies allowed as part of the practice of physical therapy. (2) 'Auricular (ear) detoxification therapy' means the insertion of disposable sterile acupuncture needles into the five auricular acupuncture points stipulated by the National Acupuncture Detoxification Association protocol for the sole purpose of treatment of chemical dependency, detoxification, and substance abuse. (3) 'Board' means the State Board of Medical Examiners.
(4) 'Committee' means the Acupuncture Advisory Committee as established by this (5) 'NADA' means the National Acupuncture Detoxification Association. (6) 'NCAAOM' means the National Certification Commission for Acupuncture and Oriental Medicine. (7) 'ACAOM' means Accreditation Commission for Acupuncture and Oriental Medicine. (8) 'Auricular therapy' means the insertion of disposable needles into and limited only to the ear, to treat a limited number of conditions.
Section 40-47-710. (A) There is established the Acupuncture Advisory Committee to be composed of five members to be appointed by the Board of Medical Examiners for terms of four years and until their successors are appointed and qualify. Three members must be licensed to practice acupuncture under this (B) Vacancies must be filled in the manner of the original appointment for the unexpired portion of the term. The board, after notice and opportunity for hearing, may remove any member of the committee for negligence, neglect of duty, incompetence, revocation or suspension of license, or other dishonorable conduct. No member may serve more than two full four-year terms consecutively but may be eligible for reappointment four years from the date the last full four-year term expired. (C) The committee shall meet at least two times yearly and at other times as may be necessary. Four members constitute a quorum. At its initial meeting, and at the beginning of each year thereafter, the committee shall elect from its membership a chairman, vice chairman, and secretary to serve for a term of one year.
(D) The committee shall receive and account for all monies under the provisions of this Section 40-47-715. (A) The committee may:
(1) recommend regulations to the board relating to professional conduct to carry out the provisions of this (2) recommend requirements to the board for continuing professional education acupuncturists, auricular therapists, and auricular detoxification specialists to the board; (3) request and receive the assistance of state educational institutions or other state agencies and recommend to the board information of consumer interest describing the regulatory functions of the advisory committee and the procedures by which consumer complaints are filed with and resolved by the board. The board shall make the information available to the public and appropriate state agencies. (B) The committee shall: (1) conduct hearings and keep records and minutes necessary to carry out its functions;
(2) provide notice of all hearings authorized under this (3) determine the qualifications and make recommendations regarding the issuance of licenses to qualified acupuncturists, auricular therapists, and auricular detoxification specialists;
(4) recommend to the board whether to issue or renew licenses under those conditions prescribed in this (5) keep a record of its proceedings and a register of all licensees, including their names and last known places of employment and residence. The board shall annually compile and make available a list of acupuncturists, auricular therapists, and auricular detoxification specialists authorized to practice in this State. An interested person may obtain a copy of this list upon application to the board and payment of an amount sufficient to cover the cost of printing and mailing; (6) report annually to the board on duties performed, actions taken, and recommendations made; (7) hear disciplinary cases and recommend findings of fact, conclusions of law, and sanctions to the board. The board shall conduct a final hearing at which it shall make a final decision; (8) perform such duties and tasks as may be delegated to the committee by the board. Section 40-47-720. (A) Each applicant for a license to practice acupuncture shall: (1) submit a completed application as prescribed by the board; (2) submit fees as provided for in Section 40-47-800; (3) hold an active certification in acupuncture by the National Commission for the Certification of Acupuncturists and Oriental Medicine; (4) be of good moral character; (5) not have pled guilty or nolo contendere to or been convicted of a felony or crime of moral turpitude. (B) The application must be complete in every detail before it may be approved. When the administrative staff of the board has reviewed the entire application for completeness and correctness, has found the applicant eligible, and the applicant has appeared before the committee or a designated board member, a temporary license may be issued. At the next committee meeting the entire application must be considered, and if qualified, the committee may recommend to the board that a permanent license be issued. If the committee declines to recommend issuance of a permanent license, the committee may extend or withdraw the temporary license.
Section 40-47-725. (A)(1)An acupuncturist who is currently approved by the board to practice acupuncture in this State, who has remained in good standing, and who has successfully completed a nationally recognized clean needle technique course approved by the board must receive initial licensure under this (a) a completed application as prescribed by the board; (b) fees as provided for in Section 40-47-800.
(2) However, a license issued pursuant to subsection (A)(1) is only valid for two years. Thereafter for license renewal, the individual must hold an active certification from the National Commission for the Certification of Acupuncture and Oriental Medicine and satisfy the licensure and renewal requirements prescribed in this (B) An individual who has continuously practiced acupuncture in this State since 1980, who has remained in good standing, must be issued a license and renewal licenses without meeting the requirements of this chapter after submitting: (1) a completed application as prescribed by the board; and (2) fees as provided for in Section 40-47-800. Section 40-47-730. (A) An applicant for a license to perform auricular therapy: (1) must be twenty-one years of age; (2) shall submit a completed application as prescribed by the medical board; (3) shall submit fees as provided for in Section 40-47-800; (4) shall provide evidence of certification as having been trained to utilize auricular points only, in addition to those utilized by a detoxification specialist; (5) successful completion of a national certified program approved by the Acupuncture Advisory Committee and the State Board of Medical Examiners; (6) successful completion of a Clean Needle Technique course approved by the board. (B) The application must be complete in every detail before it may be approved. When the administrative staff of the board has reviewed the entire application for completeness and correctness, has found the applicant eligible, and the applicant has appeared before the committee or a designated board member, a temporary license may be issued. At the next committee meeting the entire application must be considered, and if qualified, the committee may recommend to the board that a permanent license be issued, if the committee declines to recommend issuance of a permanent license, the committee may extend or withdraw the temporary license. Section 40-47-735. (A) An applicant for a license to perform auricular detoxification therapy: (1) must be at least twenty-one years of age; (2) shall submit a completed application as prescribed by the board; (3) shall submit fees as provided for in Section 40-47-800; (4) shall have successfully completed a nationally recognized training program in auricular detoxification therapy for the treatment of chemical dependency detoxification and substance abuse, as approved by the board; (5) shall have successfully completed a nationally recognized clean needle technique course approved by the board. (B) The application must be complete in every detail before it may be approved. When the administrative staff of the board has reviewed the entire application for completeness and correctness, has found the applicant eligible, and the applicant has appeared before the committee or a designated board member, a temporary license may be issued. At the next committee meeting the entire application must be considered, and if qualified, the committee may recommend to the board that a permanent license be issued. If the committee declines to recommend issuance of a permanent license, the committee may extend or withdraw the temporary license.
Section 40-47-740. (A) An auricular therapist or an auricular detoxification specialist who is currently approved by the board to practice in this State, who has remained in good standing, and who has successfully completed a nationally recognized clean needle technique course approved by the board must receive initial licensure under this (1) a completed application as prescribed by the board; (2) fees as provided for in Section 40-47-800.
(B) However, a license issued pursuant to subsection (A) is only valid for two years. Thereafter for license renewal the individual must have successfully passed a board-approved nationally recognized training program in auricular therapy or auricular detoxification and satisfy the licensure requirements prescribed in this
Section 40-47-745. (A) It is unlawful for a person not licensed under this
(B) For the purpose of any investigation or proceeding under this
(C) If the board has sufficient evidence that a person is violating a provision of this (D) Each communication, whether oral or written, made by or on behalf of a person or firm to the board or a person designated by the board to investigate or otherwise hear matters relating to the revocation, suspension, or other restriction on a license or other discipline of a license holder, whether by way of complaint or testimony, is privileged and exempt from disclosure for any reason except to the extent disclosed in proceedings before the board. No action or proceeding, civil or criminal, may lie against the person or firm for the communication except upon other proof that the communication was made with malice.
(E) No provision of this Section 40-47-750. Auricular therapy may take place under the supervision of a licensed acupuncturist or a person licensed to practice medicine under this chapter. A treatment by an auricular therapist is strictly limited to inserting needles into the ear. Inserting needles anywhere else on the body is considered practicing acupuncture without a license. Section 40-47-755. Auricular detoxification therapy may take place under the direct supervision of a licensed acupuncturist or a person licensed to practice medicine under this chapter. A treatment by an auricular detoxification specialist is strictly limited to the five ear-point treatment protocol for detoxification, substance abuse, or chemical dependency as stipulated by NADA.
Section 40-47-760. This (1) the practice of acupuncture if it is an integral part of the program of study by students enrolled in an acupuncture education program under the direct clinical supervision of a licensed acupuncturist with at least five years of clinical experience and the program is accredited or is a candidate for accreditation or is actively seeking accreditation from ACAOM; (2) a person employed as an acupuncturist or an auricular detoxification specialist by the United States Government if these services are provided solely under the direction or control of the United States Government. Section 40-47-765. Misconduct constituting grounds for revocation, suspension, probation, reprimand, restrictions, or denial of a license must be found when an acupuncturist, auricular therapist, or auricular detoxification specialist: (1) has knowingly allowed himself or herself to be misrepresented as a medical doctor; (2) has filed or has had filed on his or her behalf with the board any false, fraudulent, or forged statement or documents; (3) has performed any work assignment, task, or other activity which is outside the scope of practice of licensure; (4) misuses alcohol or drugs to such a degree to render him or her unfit to practice; (5) has been convicted of a felony or a crime involving moral turpitude or drugs; (6) has sustained any physical or mental disability which renders further practice dangerous to the public; (7) has engaged in any dishonorable or unethical conduct that is likely to deceive or harm patients; (8) has used or made any false or fraudulent statement in any document connected with practice or licensure; (9) has obtained or assisted another person in obtaining fees under dishonorable, false, or fraudulent circumstances;
(10) has violated or conspired with another person to violate any provision of this (11) otherwise demonstrates a lack of the ethical or professional competence required to practice; (12) has failed to refer to a licensed medical doctor or dentist, as appropriate, a patient whose medical condition should have been determined to be beyond their scope of practice; or (13) continues to provide acupuncture, auricular detoxification therapy, or auricular therapy services to any patient who the licensee treats at least one time per month for three consecutive months, and has not demonstrated clinical improvement, unless the licensee provides the patient with written notice, on or before the expiration of the third month, that the patient may need to seek a medical diagnosis from a licensed medical doctor or dentist before continuing with acupuncture, auricular detoxification therapy, or auricular therapy services, unless the patient was referred to the licensee by a licensed medical doctor or dentist. Upon a finding of misconduct, the board may impose any sanction that the board is otherwise authorized to impose for misconduct under this chapter. Section 40-47-770. The board or a person designated by the board may make unscheduled inspections of any office or facility employing an acupuncturist or auricular detoxification specialist.
Section 40-47-775. A person who holds a license issued in accordance with this
Section 40-47-780. (A) An acupuncture license issued under this (1) submits a completed license renewal application as prescribed by the board; (2) submits the applicable fees provided for in Section 40-47-800;
(3) is not in violation of this (4) fulfills requirements for continuing education and professional development, as prescribed by the board in regulation; (5) remains actively certified by the NCCAOM.
(B) An auricular therapist or auricular detoxification specialist license issued under this (1) submits a completed license renewal application prescribed by the board; (2) submits the applicable fees provided for in Section 40-47-800;
(3) is not in violation of this (4) fulfills requirements for continuing education and professional development as prescribed by the board in regulation; (5) remains active in the practice of auricular therapy or auricular detoxification. Section 40-47-785. Under procedures and conditions established by the board, a license holder may request that his or her license be declared inactive. The licensee may apply for active status at any time and, upon meeting the conditions established by the board in regulation, may be declared active.
Section 40-47-790. No person licensed under this Section 40-47-800. Fees for acupuncturist, auricular therapist, and auricular detoxification specialist licensure must be established and adjusted biennially in accordance with Section 40-1-50(D) to ensure that they are sufficient but not excessive to cover expenses including the total of the direct and indirect costs to the State for the operations of the committee: (1) initial licensing fee; (2) renewal of license fee; (3) late renewal fee; (4) reactivation application fee.
Section 40-47-810. Nothing in this Initial appointees SECTION 2. (A) Of the initial appointees to the Acupuncture Advisory Board established pursuant to Section 40-47-710 of the 1976 Code, as added by this act, a member who satisfies the requirements to be licensed as an acupuncturist may be appointed prior to obtaining licensure. Subsequent appointees must be licensed as required by Section 40-47-710. (B) Of the initial appointees to the advisory board, two acupuncturists shall serve terms of four years, one individual licensed to practice medicine under Chapter 47, Title 40 of the 1976 Code and the at-large consumer member shall serve terms of three years, and one acupuncturist shall serve a term of two years. Continued practice SECTION 3. An individual who prior to this act's effective date was approved pursuant to Section 40-47-70 of the 1976 Code to engage in the practice of acupuncture who does not meet the requirements of Section 40-47-735 of the 1976 Code, as added by Section 1 of this act, may continue to practice acupuncture and has two years from this act's effective date to comply with the provisions of Section 40-47-735. Repeal SECTION 4. Sections 40-47-70 and 40-47-75 of the 1976 Code are repealed. Anatomic Pathology Services Claims SECTION 5. Title 44 of the 1976 Code is amended by adding:
Section 44-132-10. Except as provided in Section 44-132-20, no person licensed to practice in this State as a physician, surgeon, or osteopath, a dentist or dental surgeon, a nurse practitioner, or a physician's assistant shall charge, bill, or otherwise solicit payment for outpatient anatomic pathology services unless the services were rendered personally by the licensed practitioner or under the licensed practitioner's supervision. Section 44-132-20. A person who is licensed to practice medicine in this State or the professional legal entity of which the person is a shareholder, partner, employee, or owner, may submit a bill for outpatient anatomic pathology services only to: (1) the patient directly; (2) the responsible insurer or other third-party payor; (3) the hospital, public health clinic, or nonprofit health clinic; or (4) the referral laboratory or the primary laboratory. Section 44-132-30. The health professional licensing boards of this State which license and regulate the practitioners specified in Section 44-132-10, in addition to all other authority granted to them under state law, may revoke, suspend, or deny the renewal of the license of any practitioner who violates the provisions of this chapter. In addition, no patient, insurer, third-party payor, hospital, public health clinic, or nonprofit health clinic is required to reimburse these practitioners for charges or bills submitted in violation of this chapter. Section 44-132-40. The provisions of this chapter do not prohibit billing between laboratories for anatomic pathology services in instances where a sample or samples must be sent to another specialist. Section 44-132-50. For purposes of this chapter, the term 'anatomic pathology services' means: (1) histopathology or surgical pathology meaning the gross and microscopic examination of organ tissue performed by a physician or osteopath or under the supervision of a physician or osteopath; (2) cytopathology meaning the examination of cells, from fluids, washings, brushings, or smears, including the Pap test examination performed by a physician or osteopath or under the supervision of a physician or osteopath; (3) hematology meaning the microscopic evaluation of bone marrow aspirations and biopsies performed by a physician or osteopath, or under the supervision of a physician or osteopath, and peripheral blood smears when the attending or treating physician or osteopath, or technologist requests that a blood smear be reviewed by a pathologist; (4) sub-cellular pathology and molecular pathology; and (5) blood-banking services performed by pathologists. This chapter does not apply to any clinical laboratory service that is not included in the definition of anatomic pathology as set forth in this section. Nothing contained in this chapter may be construed to prohibit payments for anatomic pathology services by government agencies or their specified public or private agent, agency, or organization on behalf of the recipient of the services. Nothing in this chapter may be construed to mandate the right of assignment of benefits for anatomic pathology services as defined in this chapter." Cardiovascular invasive specialists SECTION 6. A. The General Assembly recognizes that the practice of cardiovascular invasive specialists is potentially harmful to the public in that the public does not have an adequate method to verify the qualifications of those persons who hold themselves out as qualified to practice. B. Chapter 47, Title 40 of the 1976 Code is amended by adding:
Article 10
Section 40-47-1510. This
Section 40-47-1520. As used in this (1) 'Cardiologist' means a physician who has successfully completed an approved cardiology training program including, but not limited to, a program approved by the Accreditation Committee on Graduate Medical Education, or its equivalent or successor. (2) 'Cardiovascular Invasive Specialist' means a cardiovascular invasive specialist who is currently registered by Cardiovascular Credentialing International, has graduated from an accredited program of Cardiovascular Invasive Technology and who working under the direct supervision of a cardiologist performs procedures on patients resulting in accurate diagnosis and/or optimal treatment of congenital or acquired heart disease. (3) 'Supervising cardiologist' means a South Carolina licensed physician currently possessing an active, unrestricted license to practice medicine in South Carolina who practices in the medical specialty of cardiology and has successfully completed a residency in cardiology, approved by the Accreditation Committee on Graduate Medical Education, or its equivalent or successor. (4) 'Supervision' means medically directing and accepting responsibility for the cardiac services rendered by a registered cardiovascular invasive specialist in a manner provided for in law and the adopted protocol of the licensed facility. The supervising cardiologist must be in the facility and in the operative area such that he can be immediately available to participate directly in the care of the patient with whom the invasive cardiovascular specialist and the cardiologist are jointly involved. Section 40-47-1530. A person may not wilfully practice or offer to practice as a cardiovascular invasive specialist unless that person is registered by the department. A person who uses the title cardiovascular specialist in any advertisement, business card or letterhead, or billing document or who makes another verbal or written communication indicating that the person is a cardiovascular specialist or who acquiesces in that representation violates this section. Section 40-47-1540. To be registered by the department as a cardiovascular invasive specialist, a person must: (1) apply in writing to the department on a form available from the department; (2) successfully complete an approved cardiology training program including, but not limited to, a program approved by the Accreditation Committee of Graduate Medical Education, or its equivalent or successor approved by the South Carolina Board of Medical Examiners; (3) provide satisfactory evidence of current registration with Cardiovascular Credentialing International; (4) provide satisfactory evidence that the applicant's practice protocol is in place, signed by each supervising cardiologist and by an appropriate representative of each licensed facility where practice is anticipated; (5) pay a fee established by the department. Section 40-47-1550. (A) Registration by the department as a cardiovascular invasive specialist must be renewed every two years. To renew a registration, a person shall: (1) submit a complete application in writing;
(2) demonstrate continued competency including current registration with Cardiovascular Credentialing International and other requirements as provided by this (3) pay a fee established by the department. (B) A registration by the department as a cardiovascular invasive specialist automatically lapses if the registered person fails to make a timely and complete application for renewal or if the registered person fails to maintain current registration with Cardiovascular Credentialing International or another organization approved by the board. Section 40-47-1560. (A) Cardiovascular invasive specialists may perform medical tasks and services within the framework of a facility's written practice protocol developed for the cardiovascular invasive specialist. Within this practice protocol the registered cardiovascular invasive specialist, under the supervision of a cardiologist may engage in these functions and duties: (1) perform baseline patient assessment; (2) evaluate patient response to diagnostic or interventional maneuvers and medications during cardiac catheterization laboratory procedures; (3) provide patient care and drug administration commonly used in the cardiac catheterization laboratory under the direction of a qualified physician and subject to the oversight of the facility; (4) act as the first assistant during diagnostic and therapeutic catheterization procedures; and (5) assist in advanced cardiac life support procedures. (B) A cardiovascular invasive specialist shall practice only under the supervision of a physician who is actively and directly engaged in the clinical practice of medicine as a cardiologist. (C) A cardiovascular invasive specialist practicing at all sites shall practice pursuant to written scope of the facility's practice protocols signed by all supervising cardiologists and the cardiovascular invasive specialists. Copies of the protocols must be on file at all practice sites. The protocols shall include at a minimum the: (1) name, license number, and practice addresses of the supervising cardiologists; (2) name and practice address of the cardiovascular invasive specialists; (3) date the protocol was developed and dates it was reviewed or amended; (4) situations that require direct evaluation by or immediate referral to a cardiologist.
Section 40-47-1570. The department is responsible for all administrative activities of the registration program. The department shall employ and supervise personnel necessary to effectuate the provisions of this (B) The department shall maintain a registry of all applications for registration and of all persons holding registration and shall make the roster of registered cardiovascular invasive specialists available on the department web site. (C) The Board of Medical Examiners may promulgate regulations as necessary to effectuate this chapter.
Section 40-47-1580. If the department has reason to believe that a person registered pursuant to this
Section 40-47-1590. (A) If, after investigation, it appears that the person registered pursuant to this (B) The Administrative Law Judge Court, after opportunity for hearing, may order that the registration be revoked, suspended, or otherwise disciplined in accordance with Section 40-1-120 on the grounds that the registrant:
(1) used a false, fraudulent, or forged statement or document or committed a fraudulent, deceitful, or dishonest act or omitted a material fact in obtaining registration pursuant to this (2) has had an authorization to practice a regulated profession or occupation in another state or jurisdiction canceled, revoked, or suspended, or has otherwise been disciplined by another jurisdiction; (3) has lost or let lapse an underlying credential that served as the basis of registration; (4) has intentionally used a false or fraudulent statement in a document connected with the practice of a registered cardiovascular invasive specialist; (5) has obtained fees or assisted in obtaining fees under fraudulent circumstances; or (6) has sustained a physical or mental disability or uses alcohol or drugs to such a degree as to render further practice as a registered cardiovascular invasive specialist dangerous to the public. Section 40-47-1600. (A) A cardiovascular invasive specialist may not: (1) perform a task which has not been listed and approved on the scope of the practice protocol currently on file with the facility; (2) prescribe drugs, medications, or devices of any kind. (B) A cardiovascular invasive specialist must clearly identify himself or herself to ensure that the cardiovascular invasive specialist is not mistaken or misrepresented as a physician. A cardiovascular invasive specialist must wear a clearly legible identification badge or other adornment at least one inch by three inches in size bearing the cardiovascular invasive specialist's name and the words 'Registered Cardiovascular Invasive Specialist'. Patients in facilities utilizing cardiovascular invasive specialists must be informed when a cardiovascular invasive specialist will be involved in their cardiac care.
Section 40-47-1610. (A) The Administrative Law Judge Division, after opportunity for hearing, may order injunctive relief against a person who, without possessing a valid certificate pursuant to this
(B) A person who is not registered as required by this
Section 40-47-1620. The Department of Labor, Licensing and Regulation shall promulgate regulations necessary to ensure implementation or the provisions of this Time effective SECTION 7. This act takes effect upon approval by the Governor. Ratified the 3rd day of June, 2004. Vetoed by the Governor -- 12/15/04. Veto overridden by House -- 1/12/05. Veto overridden by Senate -- 1/13/05.
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