The fee schedule applies to all acupuncturists who apply for licensure or license renewal and auricular detoxification specialists. In this chapter, the following term has the meaning indicated. Term Defined. “Board” means the State Board of Acupuncture. The following fees are established by the Board: Initial application — $525; Renewal application — December 1997 and beyond — $525; Application for inactive status — $100; Late application (any application) — $100; Reinstatement — $200; Fine for failure to notify Board of change in name or address — $50; Examination equivalency review plus all necessary travel, accommodations, and translation or other expenses — $250; Application for professional corporate name — $20; Application for certification to practice acupuncture on animals — $100; Auricular detoxification specialist registration — $50; Auricular detoxification specialist registration renewal — $25; Auricular detoxification specialist registration reinstatement — $100; License verification — $50; and Roster — $25. Corporations and Associations Article, §§5-101 — 5-131;Health Occupations Article, §§1A-205, 1A-206, and 1A-302; Annotated Code of Maryland Effective date: Regulations .01—.04 adopted as an emergency provision under COMAR 10.26.02 effective December 23, 1994 (22:2 Md. R. 72); emergency status expired June 23, 1995 Regulations .01—.03 adopted effective July 3, 1995 (22:13 Md. R. 967) Regulation .01 amended effective April 20, 2009 (36:8 Md. R. 596) Regulation .02 amended effective October 1, 2001 (28:19 Md. R. 1685); April 20, 2009 (36:8 Md. R. 596) Regulation .03 amended effective June 17, 1996 (23:12 Md. R. 871) Regulation .03 amended as an emergency provision effective December 5, 1997 (24:26 Md. R. 1752); amended permanently effective May 4, 1998 (25:9 Md. R. 680) Regulation .03 amended effective October 1, 2001 (28:19 Md. R. 1685) Regulation .03 amended as an emergency provision effective December 7, 2001 (28:26 Md. R. 2270); emergency status expired June 4, 2002 Regulation .03 amended as an emergency provision effective June 1, 2002 (29:12 Md. R. 924); amended permanently effective August 5, 2002 (29:15 Md. R. 1142) Regulation .03 amended effective April 20, 2009 (36:8 Md. R. 596); October 17, 2011 (38:21 Md. R. 1279) Regulation .03A, M amended effective August 5, 2013 (40:15 Md. R. 1229) Regulation .03D amended effective December 11, 2003 (30:24 Md. R. 1741) Regulation .03G amended effective December 21, 2015 (42:25 Md. R. 1543) Regulation .03M, N adopted effective April 11, 2005 (32:7 Md. R. 681) This chapter governs the practice of acupuncture. This chapter does not apply to: An individual employed by the federal government as an acupuncturist while practicing within the scope of that employment; A student, trainee, or visiting teacher designated as such while participating in a course of study or training under the supervision of a licensed acupuncturist in a program approved by the Board or the Maryland Higher Education Commission; or An individual practicing a health occupation who is authorized to practice under a provision of the Annotated Code of Maryland, including: A physician authorized under Health Occupations Article, Title 14, Annotated Code of Maryland, to perform acupuncture as it is defined in that title, A dentist authorized under Health Occupations Article, Title 4, Annotated Code of Maryland, to perform acupuncture in connection with the practice of dentistry, or A veterinarian licensed under the Agriculture Article, Title 2, Subtitle 3, Annotated Code of Maryland, who performs acupuncture on animals in connection with the practice of veterinary medicine. In this chapter, the following terms have the meanings indicated. Terms Defined. “ABAA” means the American Board of Animal Acupuncture. “ACAHM” means the Accreditation Commission for Acupuncture and Herbal Medicine. “Acupoint injection therapy” means a form of acupuncture that stimulates acupuncture points by subcutaneous, intramuscular, and intradermal injection with approved sterile substances, specifically manufactured for non-intravenous injection. “Acupuncture” means a form of health care based on East Asian medical theories of energetic physiology that describe the interrelationship of the body organs and functions of a human or animal. “Applicant” means an individual who has applied to the Board for a license to practice acupuncture in this State. “Auricular detoxification” means an acupuncture technique that involves needling the external auricle of the human ear to assist individuals undergoing detoxification from addictive substances and restore health. “Board” means the State Board of Acupuncture. “CCAHM” means the Council of Colleges of Acupuncture and Herbal Medicine. “License” means a license issued by the Board to practice acupuncture in this State. “NADA” means the National Acupuncture Detoxification Association. “NCCAOM” means the National Commission for the Certification of Acupuncture and Oriental Medicine. “Practice acupuncture” means the use of East Asian medical therapies for the purpose of normalizing energetic physiological functions including pain control, and for the promotion, maintenance, and restoration of health including, but not limited to: Stimulation of a human or animal body by the insertion of needles; The application of moxibustion; and Manual, mechanical, thermal, or electrical therapies only when performed in accordance with the principles of] East Asian medical theories. “Pro bono work” means work provided within the scope of practice of the licensee: Without financial reimbursement; or Without direct financial gain. “TOEFL” means the Test of English as a Foreign Language. To qualify for a license, an applicant shall: Submit a completed application in the format provided by the Board; Provide at the applicant's expense, in English, all documentation required by §§B and C of this regulation or copies of original documents with English translations; Pay the necessary fees established in COMAR 10.26.01.03; Submit a current copy of a: Government-issued photographic identification; or Passport-size photograph; and Meet with the Board to review the application if requested by the Board. To prove that the applicant is 18 years old or older, the applicant shall provide a certified copy of an official government or institutional record, if requested by the Board. The applicant shall provide documentary evidence of having met one of the following standards for education, training, or demonstrated experience: Graduation with a master’s degree from an accredited educational institution with a practice relevant course of training that is equivalent to or exceeds at least 1,800 hours in acupuncture, including 300 clinical hours, that is: Approved by the Maryland Higher Education Commission; Accredited by the ACAHM; or Found by the Board to be equivalent to a course approved or accredited by the authority listed under §C(1)(a) or (b) of this regulation; or Achievement of a: Diplomate in Acupuncture from the NCCAOM; or Passing score on an examination that is determined by the Board to be equivalent to the examination given by the NCCAOM. An applicant shall demonstrate proof of proficiency in the written and oral communication of the English language by providing documentary evidence that the applicant has: Completed at least 30 classroom credits from: An English-speaking undergraduate school; An English-speaking professional school; A community college; or An undergraduate or graduate program at a college or university; Achieved a passing score on the TOEFL within the 2 years preceding license application; or Provided proof of passing scores on the NCCAOM written and practical examination components in English. The Board shall determine whether an application is complete as received, with all required documentation enclosed. Within 90 days of its receipt of a completed application and required information or documentation, the Board shall approve or deny the application. The Board may close an incomplete application when the information needed to complete the application is not received within 120 days of the submission date. Upon approval of an application, the Board shall issue a document authorizing the applicant to practice acupuncture in this State in accordance with Health Occupations Article, §1A-304, Annotated Code of Maryland, and the regulations in this chapter. Except with approval of the Board, an applicant may not withdraw an application while under investigation or after having received a notice of denial of licensure. Unless renewed, the term of a license is valid through the expiration date. Renewal. At least 1 month before a license expires, the Board shall send to the licensee a renewal notice that states the: Date on which the current license expires; Date by which the renewal application is to be received by the Board for the renewal to be issued and mailed before the license expires; and Amount of the renewal fee. Before a license expires, the licensee may renew if the licensee: Submits to the Board a completed renewal application in the format required by the Board along with documentation that the licensee meets the requirements for a license; Pays the renewal fee specified in COMAR 10.26.01.03; and If requested, submits to the Board documentation that the licensee has complied with the continuing education requirements established under COMAR 10.26.06. A licensee shall keep the Board apprised of the licensee's current address and telephone number or shall pay a fee as specified in COMAR 10.26.01.03. A licensee has a grace period of 30 days after the licensee's license expires to renew retroactively if the licensee: Otherwise is entitled to have the license renewed; and Pays to the Board the renewal fee and late fee set by the Board. If the applicant’s license expires, an applicant may not practice acupuncture in the State until the renewal application is approved by the Board. Reinstatement. Thirty-one days after the expiration date of a license, a licensee whose license has expired without seeking inactive status may have the license reinstated upon meeting all of the following: Submission of a completed reinstatement application in the format required by the Board; Payment of the reinstatement fee, and renewal fee, specified in COMAR 10.26.01.03; and One of the following: Thirty hours of continuing education within the 2 years that are most recent to the requested reinstatement date; or Passage of the acupuncture exam given by the NCCAOM within 4 years from the date of reinstatement. Inactive Status. The Board shall place a licensee on inactive status for a maximum period of 6 years if the licensee submits to the Board within 30 days after the expiration of a license: An application for inactive status in the format required by the Board; and The inactive status application fee specified in COMAR 10.26.01.03. To reactivate a license from inactive status, the applicant shall: Satisfy the renewal requirements in §B(2)(a) and (b) of this regulation that exist at the time the individual changes from inactive to active status; and Complete 30 hours of continuing education as specified under COMAR 10.26.06. The licensee shall renew inactive status every 2 years, but not to exceed 6 years, in the format required by the Board and pay the fee as set forth in COMAR 10.26.01.03. Continuing Education. A licensee applying for renewal shall complete 30 hours of relevant continuing education during the 2-year period preceding the expiration of the license which include the following: At least 20 hours in formally organized programs which are relevant to the practice of acupuncture and Oriental medicine and are approved by the Board or sponsored by, but not limited to, the following organizations and their member organizations: American Academy of Medical Acupuncture; American Association of Acupuncture and Oriental Medicine (AAAOM); Council of Colleges of Acupuncture and Oriental Medicine (CCAOM); Colleges and universities accredited by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM); National Commission for the Certification of Acupuncture and Oriental Medicine (NCCAOM); Society for Acupuncture Research; or The National Acupuncture Detoxification Association; Not more than 10 hours of formally organized training programs in Western science and medical practices, medical ethics, medical research, or cardiopulmonary resuscitation which are relevant to the practice of acupuncture and are sponsored by, but not limited to, organizations listed in §F(1)(a) of this regulation and the following organizations: World Health Organization (WHO); National Institutes of Health (NIH); American Medical Association (AMA); American Nurses Association (ANA); American Psychiatric Association (APA); Red Cross; Local colleges; or Local hospitals; Not more than 10 hours of training in approved programs which will assist a licensee to carry out the licensee's professional responsibilities, including, but not limited to: Management courses for a school administrator; Foreign language training for translators of relevant texts; Educational methodology for teachers of acupuncture; Not more than 10 hours teaching acupuncture and related Oriental medical therapies in an accredited school or in a program approved for acupuncture continuing education; Not more than 7 hours of pro bono work as outlined in §F(3) of this regulation; or Not more than 7 hours in published writing or articles in acupuncture and Oriental medicine that are: Peer-reviewed research or peer-reviewed clinically relevant articles in acupuncture and Oriental medicine; and Limited to 4 hours per article. Pro Bono Work. Pro bono work shall earn 1 credit hour for each 3 hours of pro bono activity up to a maximum of 7 credit hours per renewal cycle. Pro bono work shall be for the provision of acupuncture services provided through an organization offering humanitarian services such as, but not limited to: Domestic or international victims in an emergency situation or disaster area; Low income or underserved areas or populations; Special needs populations; or United States military personnel. Upon completion of the pro bono work, the licensee shall obtain from the facility written documentation of completion of pro bono hours including: The name of the facility; The address where the pro bono work was provided; The type of work that was done; The number of hours of actual work provided for which the licensee desires credit hours; and A statement guaranteeing that the work provided no financial benefit to licensee. Licensees shall maintain the documentation of their continuing education credits for 4 years from the date of their acupuncture renewal. If requested by the Board, a licensee shall provide proof of continuing education attendance by providing documentation of: Name of the program; Date of the program; Number of continuing education hours earned; and Name of the sponsoring organization. Change of Mailing Address, Legal Name, or Email Address. A licensee shall give the Board written notice within 30 days of a change of: Mailing address; Legal name; or Email address if the licensee has previously submitted an email address to the Board. Failure to notify the Board of any change of mailing address, legal name, or email address within 30 days of the change may result in a fee as set forth under COMAR 10.26.01.03. To obtain certification from the Board as qualified to practice acupuncture on animals, an applicant shall: Possess a current active license to practice acupuncture in Maryland; Successfully complete a Board-approved specialty training program in animal acupuncture from a school accredited by ABAA, ACAHM, or approved by the Maryland Higher Education Commission that consists of a minimum of 135 hours of theory and clinical training and includes at a minimum in each of the following: 90 hours in diagnosis of energy dynamics and treatment of animals, 15 hours in comparative functional anatomy and physiology of animals, 15 hours in animal handling, restraints, and emergencies, and 20 hours in introduction to animal diseases and zoonotics that require the immediate attention of a veterinary practitioner; Complete and submit the application provided by the Board; and Pay the fee as specified in COMAR 10.26.01.03. To practice acupuncture on animals, the licensed acupuncturist: Shall possess certification for animal acupuncture from the Board; Shall cooperate and consult with a veterinarian licensed in the State by: Beginning acupuncture treatment on an animal only if the animal has been seen by a veterinary practitioner within the previous 14 days, Adhering to the terms and conditions of treatment decided by the veterinary practitioner, including the degree of communication and collaboration between the veterinary practitioner and the individual practicing acupuncture, and Reporting to the veterinary practitioner at the end of the animal's acupuncture treatment or at monthly intervals at the discretion of the veterinary practitioner; and May not practice acupuncture on an animal for which the licensed acupuncturist has not been appropriately trained in accordance with this regulation. Certification Renewal, Reinstatement, and Reactivation. The licensee may, as a part of the 30 continuing education unit renewal requirement, complete at least 5 continuing education units directly related to the certification of veterinary or animal related acupuncture. The licensee may, as a part of the 30 continuing education unit reinstatement requirement, complete at least 5 continuing education units directly related to the certification of veterinary or animal related acupuncture. The licensee may, as a part of the 30 continuing education unit reactivation requirement, complete at least 5 continuing education units directly related to the certification of veterinary or animal related acupuncture. The Board shall maintain a registry of all: Licensed acupuncturists certified by the Board as qualified to practice acupuncture on animals; and Animal acupuncture training programs that the Board approves. On or after the effective date of this regulation, unless the person is certified by the Board as qualified to practice acupuncture on animals, an individual may not: Represent to the public that the individual is an animal acupuncturist; and Practice acupuncture on animals. Exception to Certification. This regulation does not apply to an individual who practices acupuncture on an animal under a research protocol which has been approved by an Animal Use and Care Committee as provided in 9 CFR Ch. 1, Part 2, Subpart C, §§2.30—2.38. Violation of this regulation constitutes unprofessional conduct and may result in disciplinary action as set forth in Health Occupations Article, §4-315, Annotated Code of Maryland. Qualification. To qualify as an auricular detoxification specialist, an applicant shall be a certified or licensed practitioner in the State as one of the following health care professionals who works directly with chemically dependent clients of a chemical dependency program in the counseling or treatment of those clients: A certified professional counselor—alcohol and drug; A certified associate counselor—alcohol and drug; A supervised counselor—alcohol and drug; A licensed clinical alcohol and drug counselor; A licensed nurse; A licensed psychologist who works directly with chemically dependent clients of a chemical dependency program in the counseling or treatment of those clients; or A licensed certified social worker—clinical who works directly with the chemically dependent clients of a chemical dependency program in the counseling or treatment of those clients. A practitioner that is a medical doctor shall obtain a medical acupuncture certification specific to physicians in accordance with COMAR 10.32.15. Registration. The Board shall maintain a registry of all certified auricular detoxification specialists. To apply for certification with the Board as an auricular detoxification specialist, an applicant shall: Provide documentation of successful completion of a Board and NADA approved training program that consists of a minimum 70-hour basic training of which 40 hours are clinical training which includes the following training and subject matter: At least 5 treatments during a 10-minute period with good point location and techniques; The uses and limitations of the treatment; Communal treatment effect and maintaining an appropriate atmosphere; Clean needle technique; The limited scope of practice of auricular detoxification and other ethical principles; The implications of the role of auricular acupuncture for addition in the larger addition treatment context; Preparation of written chart notes regarding status, treatment given, and patient response; Adjunctive nature of auricular acupuncture for addiction and the importance of collaboration and communication with the treatment team; The psycho-spiritual nature of recovery and the ability to respect and support the client's individual beliefs and cognitive process; Methods to modify treatment appropriately and to respond to adverse clinical situations should they occur; Sensitivity, compassion, and respect for clients; and Understanding of addictions from the perspective of basic concepts of East Asian medicine; Complete an application provided by the Board; Provide the name and address of the acupuncturist licensed by the State who shall supervise the applicant; Provide verification of active licensure in good standing in the State from the appropriate Health Occupations Board; Provide verification that an applicant works in a State-approved professional setting that specializes in the treatment of addiction; and Pay the registration fee in COMAR 10.26.01.03. Certification Renewal. A certified practitioner shall renew their certification every 2 years. As part of the renewal, the practitioner shall provide proof to the Board of: Licensure in the approved health profession; Employment working directly with chemically dependent clients of a chemical dependency program in the counseling or treatment of those clients; Employment working in a State-approved setting, working with chemically dependent patients of a chemical dependency program in the counseling or treatment of those patients; and Completion of three continuing education units relevant to the practice of auricular detoxification and the counseling or treatment of chemically dependent patients. At least 1 month before a certification expires, the Board shall send a renewal notice to an auricular detoxification specialist that states: The date the current certification expires; The date the renewal application is to be received by the Board for the renewal to be issued before the certification expires; and The amount of the renewal fee. Before a certification expires, a practitioner certified to perform auricular detoxification may renew the certification if the individual submits: A completed renewal application in the format required by the Board; and Verification from the appropriate Health Occupation Board under §A of this regulation, that confirms that the individual has a current certification or license in good standing; and The renewal fee specified in COMAR 10.26.01.03. An individual registered to perform auricular detoxification shall maintain a current address and telephone number with the Board. A practitioner listed on the registry to perform auricular detoxification: May not practice using any other name than the name on their certification; and Shall immediately inform the Board of any name change. Certification Reinstatement. An auricular detoxification specialist holding an expired certification may apply for reinstatement if the individual: Completes an application for reinstatement approved by the Board; Submits the auricular detoxification specialist registration reinstatement fee specified in COMAR 10.26.01.03; and Submits proof of completion of at least three continuing education units directly related to the certification. Supervision. The Board may approve a Maryland licensed acupuncturist for supervision of a practitioner on the registry to perform auricular detoxification if the licensee: Holds an active license in good standing to practice acupuncture in Maryland; Has completed a training program in auricular detoxification as set forth in §C of this regulation; and Submits to the Board a completed application in the format provided by the Board. Supervisor Responsibilities. A supervisor shall ensure that: Auricular detoxification specialists are sufficiently competent in the areas listed in §C(1) of this regulation; The supervised auricular detoxification specialist and the Board are notified if the supervisor cannot or is unwilling to fill the role of supervisor; and An on-site visit with the auricular detoxification specialist occurs at least once annually before renewal to: View the setting where services are being provided; and Observe at least five treatments, within an hour, performed according to the NADA group protocol. Setting. The clinical substance abuse program or professional setting where an individual performs auricular detoxification on patients with documented substance abuse concerns shall meet best practices within community healthcare standards. Complaints. The Board may investigate a complaint filed against an auricular detoxification specialist or the supervising licensed acupuncturist. The Board may withdraw the certification of the auricular detoxification specialist or take action against the license of the supervising acupuncturist if either individual violates an applicable law, regulation, or standard of practice while performing auricular detoxification. Registration. To obtain the required registration from the Board as qualified to practice acupoint injection therapy, an applicant shall: Possess an active license in good standing to practice acupuncture and East Asian medicine in the State; Successfully complete an NCCAOM, or other appropriate accreditation body endorsed specialty training program and assessment in acupoint injection therapy that consists of at least 60 hours including: A minimum of 40 hours of theoretical training in the required topics; A minimum of 20 hours of live face-to-face clinical practical experience; and Instruction that meets the requirements of §C of this regulation; Possess a current certification by the American Heart Association or approved equivalent in basic life support; Hold a current Clean Needle Technique Certificate through CCAHM or NCCAOM; If licensed in the State for less than 2 years, possess a valid license in good standing to practice acupuncture and East Asian medicine, in any state, for at least 2 years before applying to perform acupoint injection therapy in the State; and Complete and submit an application in the format provided by the Board. The Board shall accept the documentation from a licensee that has completed the training required to perform acupoint injection therapy prior to the effective date of this regulation if: The licensee provides a certificate, or other valid documentation, confirming successful completion of 60 hours of acupoint injection therapy training that complies with this regulation; or The previously completed training does not meet the requirements of this regulation, but the licensee provides documentation of completion of supplemental training that, together with the initial training, fulfills the coursework requirements of §C of this regulation. Training Program Curriculum. The curriculum for the acupoint injection therapy program shall include: 20 hours of clinical practice on a patient or patients; History and development of acupuncture injection therapy; Differential diagnosis; Definitions, concepts, and pathophysiology; The nature, function, channels entered, and contraindications of the substances stated in §F(2) of this regulation; Diseases amenable to treatment with acupuncture injection therapy and the substances appropriate to treat them; Identification of appropriate points for treatment, including palpatory diagnosis; A review of physical examination, anatomy, and referral zones; Universal precautions including management of blood borne pathogens and hazardous waste; Procedures for injections, including preparing the substances, contraindications, and precautions; Administration techniques and equipment required; Administration of the prepackaged substances authorized for acupoint injection therapy, including aseptic technique, recordkeeping and storage of substances prepared and authorized for use in acupoint injection therapy; Safety and emergency procedures; and 2 hours of training in the use of intramuscular epinephrine and emergency oxygen which count toward the required theoretical and clinical training hours. Clinical Instructors. In addition to the requirements of NCCAOM, or other appropriate accreditation body, an instructor for acupoint injection therapy shall: Ensure that the curriculum meets the training requirements set forth under §C of this regulation; Be a licensed practitioner in acupuncture in good standing in the State and be registered to practice acupoint injection therapy in the State; Possess at least 5 years of experience in the practice of acupuncture that includes acupoint injection therapy; Retain proof of compliance as set forth under this section for as long as they provide acupoint injection therapy training; and Provide proof of compliance to the Board upon request. Training Programs. All training programs shall provide each successful student with: A certificate of successful completion of the program; A course syllabus outlining the schedule and curriculum of the program; and Testing requirements and the performance measure for successful completion. Practice. To practice acupoint injection therapy, the licensed acupuncturist shall: Possess a registration for acupoint injection therapy from the Board; Explain acupoint injection therapy to the patient in advance of treatment; Obtain written informed consent specific to acupoint injection therapy that shall be included in the patient’s medical record; Only perform subcutaneous, intradermal, or intramuscular injection in accordance with the principles of acupuncture; Have an adverse event or emergency plan in place for allergic reactions to injected substances; Maintain professional liability coverage for this procedure; and Only use prepackaged and sterile acupoint injectable therapeutic substances that are: Acquired from an appropriately licensed entity in compliance with federal and State law; and Stored securely and in accordance with manufacturer's specifications. In the practice of acupoint injection therapy, the licensed acupuncturist, provided they have been trained on utilization of the specific therapeutic substance, may only use the following therapeutic substances for acupoint injection therapy: Sterile and bacteriostatic water; Saline solution; Alkalizing agents such as sodium bicarbonate; Nutritional or dietary substances; Vitamins and minerals including B-12, B-complex, C, cyanocobalamin, hydroxocobalamin, and methylcobalamin; Proteins, enzymes, and amino acids including methionine, choline, inositol, and glutathione; Sugars including dextrose and glucose; Ozone; Procaine and lidocaine; Herbal and botanical extracts including astragalus and Sarapin; Biological products including hyaluronic acid and epinephrine; and Homeopathic substances including Traumeel and Zeel. A licensed acupuncturist in the practice of acupoint injection therapy may not: Administer substances other than those specified under §F(2) of this regulation; Administer substances that the licensed acupuncturist has not been appropriately trained in accordance with this regulation; Give an injectable substance to a patient for self-injection; or Administer intravenous injections. The Board shall maintain a list of all: Licensed acupuncturists registered by the Board as qualified to practice acupoint injection therapy; and Acupoint injection therapy training programs endorsed by the NCCAOM, or other appropriate accreditation body updated at least annually. On or after the effective date of this regulation, unless the person is registered by the Board as qualified to practice acupoint injection therapy, an individual may not: Practice acupoint injection therapy; or Represent to the public that the individual is an acupoint injection therapy registered acupuncturist. Violation of this regulation constitutes unprofessional conduct and may result in disciplinary action as set forth in Health Occupations Article, §4-315, Annotated Code of Maryland. A licensee shall be licensed to practice acupuncture only under the name indicated on the license. A licensee wishing to change the name under which the licensee practices shall obtain prior Board approval. The failure of a licensee to practice under the name on the license may: Result in a fine; or Be considered unprofessional conduct by the Board and constitute grounds for disciplinary action. Agriculture Article, §§2-301(g) and 2-304; Health Occupations Article, §§1-211, 1A-101, 1A-205, 1A-301, 1A-302, 1A-306, 1A-307, and 1A-316; Annotated Code of Maryland Effective date: Regulations .01—.05 adopted as an emergency provision effective February 22, 1996 (23:6 Md. R. 472); adopted permanently effective August 12, 1996 (23:16 Md. R. 1175) Regulation .02 amended effective October 1, 2001 (28:19 Md. R. 1685) Regulation .02B amended effective December 11, 2003 (30:24 Md. R. 1741); January 1, 2007 (33:26 Md. R. 1997) Regulation .03D amended effective March 9, 1998 (25:5 Md. R. 369); December 11, 2003 (30:24 Md. R. 1741) Regulation .03D, E amended effective October 1, 2001 (28:19 Md. R. 1685) Regulation .03E amended effective January 1, 2007 (33:26 Md. R. 1997) Regulation .03G adopted effective February 16, 2004 (31:3 Md. R. 207) Regulation .05 amended effective October 1, 2001 (28:19 Md. R. 1685); December 11, 2003 (30:24 Md. R. 1741) Regulation .05E amended effective April 11, 2005 (32:7 Md. R. 681) Regulation .05F amended effective January 1, 2007 (33:26 Md. R. 1997) Regulation .06 adopted as an emergency provision effective December 5, 1997 (24:26 Md. R. 1752); adopted permanently effective May 4, 1998 (25:9 Md. R. 680) Regulation .06A amended effective January 1, 2007 (33:26 Md. R. 1997) Regulation .06B amended effective February 22, 1999 (26:4 Md. R. 273) Regulation .07 adopted effective June 15, 1998 (25:12 Md. R. 947) Regulation .07A amended effective January 1, 2007 (33:26 Md. R. 1997) Regulation .08 adopted effective June 15, 1998 (25:12 Md. R. 947) Regulation .08A, D amended effective January 1, 2007 (33:26 Md. R. 1997) Regulation .09 adopted as an emergency provision effective December 7, 2001 (28:26 Md. R. 2270); emergency status expired June 4, 2002 Regulation .09 adopted as an emergency provision effective June 1, 2002 (29:12 Md. R. 924); adopted permanently effective August 5, 2002 (29:15 Md. R. 1142) Regulation .09 amended as an emergency provision effective January 19, 2005 (32:3 Md. R. 287); amended permanently effective April 11, 2005 (32:7 Md. R. 681) Regulation .09 amended effective November 7, 2005 (32:22 Md. R. 1756) Chapter revised effective April 20, 2009 (36:8 Md. R. 596) Regulation .02B amended effective December 28, 2009 (36:26 Md. R. 1995); October 16, 2023 (50:20 Md. R. 887); April 13, 2026 (53:7 Md. R 328) Regulation .03 amended effective April 13, 2026 (53:7 Md. R 328) Regulation .03D amended effective January 29, 2018 (45:2 Md. R. 69); October 16, 2023 (50:20 Md. R. 887) Regulation .03E amended effective October 16, 2023 (50:20 Md. R. 887) Regulation .03F repealed effective October 16, 2023 (50:20 Md. R. 887) Regulation .03G repealed effective January 29, 2018 (45:2 Md. R. 69) Regulation .04 amended effective April 13, 2026 (53:7 Md. R 328) Regulation .04E repealed effective October 16, 2023 (50:20 Md. R. 887) Regulation .05 amended effective February 20, 2012 (39:3 Md. R. 259); August 5, 2013 (40:15 Md. R. 1229); April 13, 2026 (53:7 Md. R 328) Regulation .05D amended effective May 12, 2014 (41:9 Md. R. 521) Regulation .05F amended effective December 28, 2009 (36:26 Md. R. 1995) Regulation .05F repealed effective October 16, 2023 (50:20 Md. R. 887) Regulation .06 amended effective April 13, 2026 (53:7 Md. R 328) Regulation .07 amended effective October 18, 2010 (37:21 Md. R. 1436); October 17, 2011 (38:21 Md. R. 1279); January 7, 2013 (39:26 Md. R. 1665); April 13, 2026 (53:7 Md. R 328) Regulation .08 adopted effective April 13, 2026 (53:7 Md. R 328) Regulation .09 effective April 13, 2026 (53:7 Md. R 328) This chapter does not apply to an individual who practices acupuncture on an animal under an animal research protocol which has been approved by an Animal Use and Care Committee as provided in 9 CFR §§2.30 — 2.38. In this chapter, the following term has the meaning indicated. Term Defined. “Board” means the State Board of Acupuncture. The licensee shall be concerned primarily with the welfare of the patient or client. A licensee who suffers from a physical, mental, or emotional impairment, including chemical abuse, which impacts the licensee's ability to practice acupuncture shall seek professional treatment and refrain from the practice of acupuncture until such time as the impairment no longer exists or reasonable accommodations can be made. A licensee shall: Use professional discretion and integrity in relationships with a member of the health care community; Be professional in conduct, with honesty, integrity, self-respect, and fairness; Remain free from a conflict of interest while fulfilling the objectives and maintaining the integrity of the acupuncture profession; Provide accurate fee information to the patient, the individual responsible for payment for treatment, and the insurer; At all times respect the patient's dignity, autonomy, and privacy; Practice acupuncture only as defined in the scope of practice set forth in Health Occupations Article, §1A-205, Annotated Code of Maryland; Cooperate with an investigation conducted by the Board, including: Furnishing information requested, Complying with a subpoena, Responding to a complaint at the request of the Board, and Providing meaningful and timely access to relevant patient records; and Report to the Board or other appropriate authority conduct in the practice of acupuncture that indicates a violation of: This chapter; Health Occupations Article, Title 1A, Annotated Code of Maryland; or Other federal or State laws. A licensee may not: Misrepresent the licensee's credentials, qualifications, or affiliations and shall attempt to correct others who misrepresent the licensee's credentials, qualifications, or affiliations; Knowingly engage in or condone behavior which is fraudulent, dishonest, or deceitful, or involves moral turpitude; Engage in a commercial activity which conflicts with the licensee's duties as a licensed acupuncturist; Perform acupuncture on a patient if the contraindication against acupuncture treatment exists; or Discriminate against a patient or a health care provider based on race, religion, age, gender, sexual orientation, national origin, or disability. A licensee shall: Use professional judgement in the use of evaluation and treatment procedures; Decline to administer treatment if the licensee believes that the treatment is contraindicated or unjustified; Terminate a professional relationship with patient in an appropriate manner, such as: Providing the patient with sufficient notice to permit the patient to obtain the services of another professional, Assisting the patient by providing referrals if appropriate, or Continuing to provide emergency treatment to the patient if treatment is required before a reasonable time has passed to allow the patient to obtain the services of another health care provider; Maintain a written record of treatment of the patient under the licensee's care for at least 5 years after the termination of treatment; Make the records available to the patient on request, in compliance with applicable laws for disclosure of medical records; Make arrangements for another professional to provide for the needs of the patient during an anticipated absence when the licensee is unavailable to a patient; Make a referral only to other qualified and duly licensed health care providers; Accurately inform a patient, a health care professional, and the public of the limitations of the practice of acupuncture and make a referral to an appropriate health care practitioner as needed; Adequately assess the patient to determine whether a contraindication against acupuncture treatment exists before beginning treatment; Exercise independent professional judgement in the treatment and evaluation of a patient, regardless of whether the patient was referred by another health care provider; and Provide full notice to the patient that the patient would not reasonably be expected to benefit from the treatment. A licensee may not: Accept a client for treatment, or continue unnecessary treatment, when the patient cannot be reasonably expected to benefit from the treatment; Receive remuneration from, or split a fee for, either making or accepting a referral of the patient to another health care practitioner; Make a guarantee or promise about the efficacy of a particular treatment, the licensee's practice, or the result of a treatment unless supported by scientific principles accepted by the profession; or Exploit the professional relationship by: Continuing treatment unnecessarily; Charging for a service: Not provided, or Different from those actually provided. The licensee shall: Maintain professional boundaries, even when the patient initiates crossing the boundaries of the professional relationship; Respect and maintain professional boundaries and respect the patient's reasonable expectation of professional conduct; and If the licensee and the patient mutually desire a personal relationship, immediately terminate the professional relationship, make an appropriate referral to another health care practitioner, and wait before engaging in such a relationship for a time when it is reasonably certain that the professional relationship has no influence on the personal relationship. The licensee may not: Exploit a relationship with a patient for the licensee's personal advantage, including, but not limited to, a personal, sexual, romantic, or financial relationship; Engage in a sexually intimate act with a patient; or Engage in sexual misconduct which includes behavior in which a licensee has engaged in sexual behavior with a patient in the context of a professional evaluation, treatment, procedure, or other service to the patient, regardless of the setting in which the professional service is provided. A licensee shall: Respect and maintain the privacy and confidentiality of the patient; Disclose the patient's record or information about the patient only with the patient's consent or as required by law; Adequately safeguard confidential patient information, including storage and disposal of records; Provide sufficient information to a patient to allow the patient to make an informed decision regarding treatment, including: The purpose and nature of an evaluation or treatment regimen, Alternatives to treatment, Side effects and benefits of a treatment regimen proposed and alternatives to that treatment, The estimated cost of treatment and alternatives to treatment, The right of the patient to withdraw from treatment at any time, including the risks associated with withdrawing from treatment, and The patient's right to decline to participate in treatment if an aspect of the treatment will be recorded, documented, photographed, observed, or otherwise used in an educational program; Obtain the full informed consent of a patient participating in a human research program, without a direct or implied penalty for the patient's refusal to participate in the program, and with due regard for the patient's autonomy and dignity; Comply with applicable federal and State laws for human research programs; Maintain all patients' records in English; and If requested by the Board, provide an English language translation of the records by a Board approved translator, at the licensee's expense. The licensee shall: Recognize the licensee's limitations and qualifications and practice acupuncture within the limits of these limitations and qualifications; Obtain additional training, information, and supervision as needed to perform a new technique or service in a new specialty area or when employing a new treatment modality; and Be current in the licensee's qualifications to practice acupuncture, including meeting continuing education requirements established by the Board. The licensee may not perform a treatment or provide a service which the licensee is not qualified to perform or which is beyond the scope of the licensee's education, training, capabilities, experience, and scope of practice. A licensee may advertise services subject to the provisions of this regulation. A licensee may not use statements in an advertisement that: Contain a misrepresentation of facts; Are likely to mislead or deceive because, in context, the statement makes only a partial disclosure of relevant facts; Intend to or are likely to create a false or unjustified expectation of a favorable result; Relate to fees, other than a standard consultation fee or a range of fees for specific types of services, without fully disclosing all relevant variables so that the statement would not be misunderstood or be deceptive to a layman; Convey the impression that the licensee could improperly influence a public body, official, corporation, or a person on behalf of a patient; Contain a representation that the licensee is willing to perform a procedure which is illegal; or Contain a representation or implication that, in reasonable probability, can be expected to cause an ordinarily prudent person to misunderstand or be deceived. A licensee is accountable under this regulation if the licensee uses an agent, partnership, professional association, or health maintenance organization to implement an action prohibited by this regulation. The licensee may not construe the failure to specify a particular ethical, legal, or professional duty in this chapter as a denial of the existence of other ethical, legal, or professional duties or responsibilities that are equally as important and generally recognized in the profession. Health Occupations Article, §§1A-205 and 1A-206, Annotated Code of Maryland Effective date: October 18, 1999 (26:21 Md. R. 1630) Regulation .03C amended effective October 1, 2001 (28:19 Md. R. 1685); February 16, 2026 (53:3 Md. R. 122) Regulation .06G, H adopted effective April 11, 2005 (32:7 Md. R. 681); February 16, 2026 (53:3 Md. R. 122) This chapter governs procedures for disciplinary matters and hearings before the State Acupuncture Board and establishes the standards for use as a guide for the imposition of disciplinary sanctions against any Maryland licensed acupuncturist or any registered auricular detoxification specialist if, after a hearing, the Board finds that there are grounds under Health Occupations Article, §1A–309, Annotated Code of Maryland, to place a licensee or registered auricular detoxification specialist on probation, reprimand, suspend, fine, or revoke a license. The Board may consider aggravating and mitigating factors in determining sanctions. In this chapter, the following terms have the meanings indicated. Terms Defined. “Administrative law judge” means the hearing officer assigned to preside over a hearing in cases which the Board has delegated to the Office of Administrative Hearings. “Administrative Procedure Act” means State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland, which governs contested cases arising from charges brought by the Board. “Administrative prosecutor” means the attorney assigned by the Office of the Attorney General to prosecute disciplinary charges for the Board. “Advisory letter” means an informal action consisting of a nonpublic letter issued by the Board if the Board has a basis to charge the licensee with disciplinary violations, but closes the case by advising the licensee of the laws governing the practice of acupuncture. “Board” means the State Acupuncture Board. “Board counsel” means the attorney assigned by the Office of the Attorney General to provide legal advice to the Board, and to represent the Board in legal matters and suits filed against and on behalf of the Board. “Case resolution conference” means an informal, confidential meeting between the parties to a contested case and the Board's case resolution conference committee to discuss possible settlement of a disciplinary matter pending before the Board. “Case resolution conference committee” means a committee composed of members of the Board who make recommendations to the Board regarding settlement of disciplinary matters. “Cease and desist letter” means an informal action consisting of a nonpublic letter issued by the Board, ordering a licensee to cease from doing a specified activity or an unlicensed individual to cease the unauthorized practice of acupuncture. “Charging document” means a nonpublic document issued by the Board which: Alleges conduct by a licensee which the Board believes constitutes a violation under the Maryland Acupuncture Act; Sets forth sections of the Maryland Acupuncture Act the Board believes were violated; and Provides notice to the licensee of disciplinary proceedings before the Board. Complaint. “Complaint” means a written document received by the Board which sets out conduct by a licensee which may violate the Maryland Acupuncture Act and which may be grounds for an investigation or disciplinary action by the Board. “Complaint” includes, but is not limited to: A consumer complaint; A law enforcement report; A report from a hospital or related institution; A report from another state, country, or jurisdiction, or from the armed services of the United States; A report from an insurer; A malpractice insurance report; An advertisement; A news article or report; A webpage or other published content; A report from a professional association, peer review committee, rehabilitation committee, or medical review committee as defined in Health Occupations Article, §14-501, Annotated Code of Maryland; A report from another health occupation board or other State agency; A report from a court of this or another jurisdiction; An application filed with the Board; A written memorandum of the Board alleging conduct by a licensee; and Other information, from any other source, which warrants investigation. “Complaint review committee” means the committee composed of Board members, Board staff, Board counsel, the administrative prosecutor, and other individuals designated by the Board to: Review complaints; Recommend to the Board that a matter be referred for investigation; Recommend to the Board that a matter be closed; Recommend to the Board that a licensee be charged with a violation of the Maryland Acupuncture Act or of an order of the Board; Recommend to the Board that the Board solicit a response from a licensee or respondent before further action; and Make recommendations to the Board regarding any other disciplinary matter which has been delegated to the complaint review committee by the Board. “Consent agreement” means informal action taken by the Board consisting of a nonpublic document which has been negotiated and agreed to by both the licensee and the Board to resolve an administrative, nondisciplinary matter. “Consent order” means a public document issued by the Board which is a final order of the Board that has been negotiated and agreed to by both the licensee and the Board to resolve a disciplinary matter. “Contested case” means a proceeding conducted under State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland. “Disposition agreement” means a formal nonpublic agreement, entered into with an impaired licensee instead of formal disciplinary action, in which the licensee agrees to comply with certain conditions. “Final order” means a public document issued by the Board resolving a contested case either by consent or after an adjudication and which includes findings of fact, conclusions of law, and a disposition which: Denies a license; Sanctions by reprimand, probation, fine, or suspension or revocation of a license; Summarily suspends a license; Dismisses charges; Surrenders a license; or Takes any other action that the Board is authorized to do by law. “Imperatively requires emergency action” means a finding by the Board that an emergency action must be taken against a licensee under State Government Article, §10-226(c)(2), Annotated Code of Maryland, based on investigative facts that raise a substantial likelihood of risk of harm to the public health, safety, or welfare before a full evidentiary hearing can be held. “Informal action” means that the Board closes a case, without taking any formal disciplinary action or issuing a final order, by imposing a disciplinary sanction consisting of: A letter of education; An advisory letter; A letter of admonishment; A cease and desist letter; or A consent agreement. “Investigation” means the gathering of information about an applicant or after the Board receives a complaint against a licensee, which is necessary for the Board to determine whether there is reasonable cause to deny an application or charge a licensee with a violation of the Maryland Acupuncture Act. Letter of Admonishment. “Letter of admonishment” means informal action consisting of a nonpublic letter issued by the Board, either before or after charges have been issued, if the Board believes a licensee has engaged in conduct which violates the Maryland Acupuncture Act but closes the case by admonishing the licensee. “Letter of admonishment” may reflect agreement by the Board and the licensee that the licensee shall perform certain conditions instead of the Board taking formal disciplinary action. “Letter of education” means informal action consisting of a nonpublic letter: Issued by the Board if the Board does not believe that conduct rose to the level of a violation of the Maryland Acupuncture Act; and In which the Board educates the licensee of the laws and standards of the practice of acupuncture. “Letter of surrender” means a public letter accepted by the Board in which the licensee agrees to surrender licensure to practice acupuncture, and which may include conditions for the Board's acceptance of the surrender as a resolution of the case instead of the Board taking formal disciplinary action. “Licensee” means an individual who is licensed to practice acupuncture in Maryland. “Licensure” means the authority granted to an individual by the Board pursuant to the Board's authority under the Maryland Acupuncture Act to practice acupuncture in this State. “Maryland Acupuncture Act” means Health Occupations Article, Title 1A, Annotated Code of Maryland. “Notice of initial denial” means a nonpublic document issued by the Board: By which an applicant or licensee is notified that the Board intends to deny a license, or a change in licensure status, or some other benefit sought by the licensee, and of the statutory grounds or other reasons for the denial; and Which provides notice to the licensee of any proceedings scheduled before the Board. “Post-deprivation hearing” means a contested case hearing scheduled by the Board after the Board has issued an order for summary suspension under State Government Article, §10-226(c)(2), Annotated Code of Maryland, in which the licensee may challenge the Board's basis for issuing the order for summary suspension. “Predeprivation hearing” means a nonevidentiary, show cause hearing held before the Board at which the licensee has an opportunity to demonstrate to the Board why the Board should not: Issue an order for summary suspension under State Government Article, §10-226(c)(2), Annotated Code of Maryland; or Take some other action which the Board is authorized by law to take. “Preliminary investigation” means the gathering of information necessary for the Board to determine whether the Board should dismiss a complaint or conduct further investigation to determine if there is reasonable cause to charge a licensee with a violation of the Maryland Acupuncture Act. “Probation” means a sanction imposed by the Board in a public final order by which the public is notified that the licensee has violated the Maryland Acupuncture Act and the licensee is monitored by the Board for a period of time and must comply with certain conditions in order to avoid further disciplinary action. “Prohibited act” means any conduct specified in the Maryland Acupuncture Act which can result in sanctions or penalties. “Public document” means a document that the Board is permitted or required to disclose to the public under State Government Article, Title 10, Subtitle 6, Annotated Code of Maryland. “Recommended decision” means a nonpublic document issued to the Board by an administrative law judge which sets out proposed findings of fact, proposed conclusions of law, and a proposed sanction, or any combination of these. “Recusal” means the disqualification of a member of the Board to participate in a proceeding because of interest, bias, or another reason which may interfere with the Board member's participation in a case. “Registered auricular detoxification specialist” means an individual who has been registered by the Board for the purpose of assisting an individual who is undergoing detoxification to remove addictive substances from the body and to restore health. “Respondent” means a licensee, subject to the jurisdiction of the Board, who has been: Charged with a violation of Health Occupations Article, §1A-309, Annotated Code of Maryland; Notified that the Board intends to initially deny a license, change a licensee's status, or deny some other benefit sought by the licensee; Notified of a potential emergency suspension of the licensee's license; or Otherwise notified that the licensee has the opportunity to appear before the Board to respond to allegations by the Board in a contested case. “Reprimand” means a sanction imposed by the Board in a public final order if the Board determines that the licensee has violated the Maryland Acupuncture Act, which: Does not place the licensee on a period of probation; Permits the licensee to continue practicing without license suspension; and May be imposed in addition to any other sanctions authorized by the Act. “Revocation” means a sanction imposed by the Board in a public final order if the Board determines that the licensee has violated the Maryland Acupuncture Act, which terminates the licensee's authority to practice acupuncture and renders the licensee an unlicensed individual. “Sanction” means an action taken against a licensee by the Board in a public final order by which the public is notified that the licensee has violated the Maryland Acupuncture Act, and which may consist of a reprimand, probation, suspension or revocation of the license, or a fine. “Show cause hearing” means a nonevidentiary hearing held before the Board in which a licensee has an opportunity to demonstrate to the Board why the Board should not issue a proposed order or take an action that the Board is legally authorized to take. “Stay” means the withholding of an action ordered by the Board and which may be subject to certain conditions. “Stet” means the act of suspending all action in a proceeding, which may be subject to certain conditions, and which the Board has the discretion to reopen at a later time. “Summary suspension” means the indefinite suspension of a license under State Government Article, §10-226(c)(2), Annotated Code of Maryland, issued if the Board believes the action is necessary to protect the public health, safety, or welfare. “Surrender” means the voluntary relinquishing of a license to practice acupuncture which may be subject to certain conditions set by the Board. “Suspension” means a sanction imposed by the Board in a public final order if the Board determines that a licensee has violated the Maryland Acupuncture Act, which temporarily discontinues the licensee's authority to practice acupuncture for a specific period of time or until certain conditions are met. Except as otherwise provided by law, the proceedings of the Board are confidential. The confidentiality may not be waived by the parties. Office of Administrative Hearing proceedings involving the adjudication of a Board contested case and the administrative law judge's recommended decision are confidential, and the respondent may not waive the confidentiality of the proceedings or of the patients whose medical records or care are reflected in the record of the proceedings. To the extent possible, both before and after a final order is entered into by the Board, the parties shall refrain from revealing legal documents, oral statements, or information that would reveal the identity of any patients referred to in the Board's order. A respondent may be represented by counsel in any matter before the Board and at any stage of the proceedings. If the matter goes to a hearing, a respondent shall be represented by the respondent, or by an attorney who is admitted to the Maryland Bar or specially admitted to practice law pursuant to Maryland Rules, Rules Governing Admission to the Bar of Maryland, Rule 14, Annotated Code of Maryland. An administrative prosecutor assigned to the Board by the Office of the Attorney General shall prosecute disciplinary matters in Board proceedings. The Board may be represented by and obtain advice of counsel assigned to it by the Office of the Attorney General in all proceedings. Investigation of Complaints. The Board executive director may make a preliminary review of each complaint and may recommend to the Board that cases involving complaints over which the Board has no jurisdiction be closed. The Board's complaint review committee shall review complaints over which the Board has jurisdiction and make a recommendation to the Board as to the disposition of each complaint. The Board may send a copy of the complaint, either in its entirety or redacted, to the licensee who is the subject of the complaint to obtain a response to the allegations made in the complaint. Participation in review of complaints made to the Board is not ordinarily a basis for recusal of a Board member, Board counsel, or the administrative prosecutor from further proceedings in the case. The Board may issue subpoenas over the signature of the Board's executive director or a Board member. Prosecution of Complaint. For each complaint, after reviewing any completed investigative information or reports and considering the recommendation of the complaint review committee, the Board shall: Dismiss the complaint; Close the case; Refer the case to peer review for mediation; Close the case with informal action; Issue a cease and desist order; Refer the matter for further investigation; Refer the matter to the administrative prosecutor; or Vote to: Charge a licensee with a violation of Health Occupations Article, §1A-309, Annotated Code of Maryland; Consider the matter as a basis for summary suspension under State Government Article, §10-226(c)(2), Annotated Code of Maryland; Initially deny licensure or reinstatement of a license; or Accept the surrender of a license subject to conditions acceptable to the Board. The Board may refer a complaint or other disciplinary matter to the administrative prosecutor at any time, regardless of whether the Board has voted to charge a licensee with a violation of the Maryland Acupuncture Act. Charges and Notice of Initial Denial. If the Board issues charges or a notice of initial denial, the document shall be served upon the respondent. Service is completed when the document is: Sent by U.S. first-class mail; Sent by certified mail to the address the respondent is required to maintain with the Board; Hand delivered in-person or by courier; or Sent by electronic means with a read receipt. Charges or a notice of initial denial shall: Inform the respondent of the statutory basis for the charges or denial of licensure; Allege sufficient facts which the Board believes constitute either a basis for: Violation of the Maryland Acupuncture Act; or Denial of licensure; Notify the respondent of any proceedings scheduled before the Board or of an opportunity to request a hearing within a certain period of time and the consequences of failing to appear for those proceedings or to request a hearing; and Be accompanied by a letter of procedure notifying the respondent of the applicability of the Administrative Procedure Act to the Board's proceedings. If the respondent has not acknowledged receipt of the charges or notice of initial denial, the Board may nevertheless proceed in prosecuting the case if it has complied with §C(2) of this regulation. If the Board issues a notice of initial denial to an applicant for a license, the applicant may not withdraw the application without approval of the Board. Discovery. Discovery on Request. By written request served on the other party and filed with the Board or the Office of Administrative Hearings, as appropriate, a party may require another party to produce, within 15 days, the following: A list of the witnesses to be called; Copies of documents intended to be produced at the hearing; or Both §D(1)(a) and (b) of this regulation. Mandatory Discovery. Each party shall provide to the other party not later than 15 days before the prehearing conference, if scheduled, or 45 days before the scheduled hearing date, whichever is earlier: The name and curriculum vitae of any expert witness who will testify at the hearing; and A detailed written report summarizing the expert's testimony, which includes the opinion offered and the factual basis and reasons underlying the opinion. If the Board or the Office of Administrative Hearings, as appropriate, finds that the report is not sufficiently specific, or otherwise fails to comply with the requirements of this section, the Board or the Office of Administrative Hearings, as appropriate, shall exclude from the hearing the testimony of the expert and any report of the expert. The Board or the Office of Administrative Hearings, as appropriate, shall consider and decide arguments regarding the sufficiency of the report: At the prehearing conference, if scheduled; or Immediately before the scheduled hearing. If an expert adopts a sufficiently specific charging document as the expert's report, that adoption shall satisfy the requirements set forth in this section. Parties are not entitled to discovery of items other than those listed in §D(1) and (2) of this regulation. Both parties have a continuing duty to supplement their disclosures of witnesses and documents. Absent unforeseen circumstances which would otherwise impose an extraordinary hardship on a party, witnesses or documents may not be added to the list after: The prehearing conference, if scheduled; or 15 days before the hearing, if no prehearing conference is scheduled. The prohibition against adding witnesses does not apply to witnesses or documents to be used for impeachment or rebuttal purposes. Construction. In hearings conducted by an administrative law judge of the Office of Administrative Hearings, this regulation shall, whenever possible, be construed as supplementing and consistent with COMAR 28.02.01; In the event of a conflict between this regulation and COMAR 28.02.01, this regulation applies. Case Resolution Conference. After service of charges or notice of initial denial, the Board shall offer a respondent the opportunity for a case resolution conference. At any other time during disciplinary proceedings, the Board may offer or the respondent may request a case resolution conference to discuss a disciplinary matter. The Board may deny a respondent's request for a case resolution conference except as provided in §E(1) of this regulation. Matters admitted, revealed, negotiated, or otherwise discussed at a case resolution conference are without prejudice and may not be used by the respondent, administrative prosecutor, or the Board in any subsequent proceedings, unless the information is otherwise discovered or available through another source. The Board is not bound by the recommendations of the case resolution conference committee and may: Modify a proposed settlement; Require additional conditions; or Reject the recommendation and require the respondent to proceed to a hearing. If the respondent and the administrative prosecutor are unable to reach an agreement for settlement that is recommended by the case resolution conference committee and ratified by the Board, the matter shall proceed to a hearing on the charges or notice of initial denial. If either the respondent or administrative prosecutor disagree with the recommendation of the case resolution conference committee, the respondent may elect to proceed to a hearing in the matter, regardless of whether the Board has ratified the recommendation of the case resolution conference committee. Participation in a case resolution conference is not ordinarily a basis for recusal of a Board member, Board counsel, or Board prosecutor from further proceedings in a case. Surrender of License. If a respondent offers to surrender licensure after the initiation of an investigation, before or after service of charges, or instead of any or further disciplinary action, the Board may require conditions for the surrender of the license. The Board may require conditions for surrender of a license, including, but not limited to: The admission of a violation of the Maryland Acupuncture Act; The admission of facts; A statement of the circumstances under which the surrender was offered or accepted; Restrictions on future licensure; Conditions for reinstatement of the license; or An agreement that the respondent may not again apply for reinstatement of the license. A letter of surrender is a final order of the Board and is a public record under State Government Article, §10-611, Annotated Code of Maryland, unless the Board determines that disclosure of the surrender is not in the public interest. Hearings on Charges or Notice of Initial Denial. Hearings shall be conducted under State Government Article, Title 10, Annotated Code of Maryland. The Board may delegate its authority to hear contested cases to the Office of Administrative Hearings. Proceedings of the Board delegated to the Office of Administrative Hearings shall be conducted under this chapter. Proceedings are not open to the public and all records, including the recommended decision, shall be treated as confidential and sealed. If a matter has been delegated to the Office of Administrative Hearings, the administrative law judge presiding over the proceedings shall issue to the Board a recommended decision containing: Proposed or final findings of fact; Proposed or final conclusions of law; A proposed sanction; or Any combination of §B(5)(a) — (c) of this regulation under the Board's delegation. In proceedings before the Board, the Board's counsel may advise the Board on issues of law in the course of the proceedings. Burden of Proof. A licensee against whom the Board has issued a notice of initial denial has the burden to demonstrate by a preponderance of the evidence that the licensee is entitled to licensure or to receive the benefit sought which the Board has initially denied. The Board has the burden to demonstrate by a preponderance of the evidence that the licensee has committed a violation or violations of the Maryland Acupuncture Act. Exceptions and Exceptions Hearing. If a matter has been delegated by the Board to the Office of Administrative Hearings, each party may file exceptions to the administrative law judge's proposed findings of fact, proposed conclusions of law, and proposed sanction, as set out in the recommended decision, before the Board makes a final decision. Within 15 days after the issuance of the recommended decision, or as otherwise specified by the administrative law judge in the recommended decision, either party may file written exceptions with the Board. Unless otherwise permitted by the Board, a party's written exceptions may not be longer than 25 double-spaced pages. The exceptions shall state with particularity: The findings of fact, conclusions of law, or other matter excepted to; and The relevant portions of the record supporting the party's exception. Within 10 days after a party's exceptions are filed with the Board, the opposing party may file an answer to exceptions. Unless otherwise permitted by the Board, a party's answer to exceptions may not be longer than 25 double-spaced pages, and shall state with particularity a response to an exception and the relevant portions of the record supporting that response. Unless otherwise permitted, the Board may not consider a party's response to an answer to exceptions. Unless otherwise agreed by the parties and permitted by the Board, an exceptions hearing shall be scheduled for the next meeting of the Board following receipt of the parties' exceptions and any answer to exceptions. Exceptions Hearing. An exceptions hearing shall be held before the Board. The hearing shall be a nonevidentiary hearing to provide the parties with an opportunity for oral argument on the exceptions and answers to exceptions. The Board member presiding over the hearing shall determine all procedural issues and may impose reasonable time limits on each party's oral argument. The presiding Board member shall make any rulings reasonably necessary to facilitate the effective and efficient operation of the hearing. The party who filed the exceptions shall proceed first and may reserve part of the allotted time for rebuttal. Unless otherwise agreed by the parties and permitted by the Board, the parties may not, in exceptions, any answer to exceptions, or in the hearing on exceptions, reference any document or other evidence or offer any exhibit that is outside the record of the evidentiary hearing before either the Board or the administrative law judge. If neither party files exceptions within the time specified in §D(2) of this regulation, the Board shall consider only the recommended decision of the administrative law judge and the record of the evidentiary hearing in making its final decision. Board Final Decision and Order. After review of the record and deliberation, the Board shall issue a final order consisting of findings of fact, conclusions of law, and the sanction or disposition to be imposed. If the hearing followed charges, the Board may order the dismissal of the charges, or, if it determines there has been a violation of the Maryland Acupuncture Act, the Board may order that the licensee be fined, reprimanded, placed on probation, or the license suspended or revoked. If the hearing followed a notice of initial denial of license, the Board may order the grant or denial of a license. Within 15 days after the Board issues a final order, either party may file a motion for reconsideration with the Board, which may be granted at the Board's discretion. There is no automatic right to a hearing on a party's motion for reconsideration, and the Board has the discretion to request a response to the motion from the opposing party. Under State Government Article, §10-226(c)(2), Annotated Code of Maryland, the Board may order the summary suspension of a license if it determines that there is a substantial likelihood that a licensee poses a risk of harm to the public health, safety, or welfare. Notice of Intent to Summarily Suspend. Based on information gathered in an investigation or otherwise provided to the Board, the Board may vote to issue: A notice of an intent to summarily suspend a license; or An order of summary suspension. If the Board votes to issue a notice of an intent to summarily suspend a license or an order of summary suspension, it shall refer the matter to the administrative prosecutor for prosecution. A notice of intent to summarily suspend a license shall include, but is not limited to: A proposed order of summary suspension which is unexecuted by the Board and which includes: The statutory authority on which the action has been taken; Allegations of fact which the Board believes demonstrate a substantial likelihood that the licensee poses a risk of harm to the public health, safety, or welfare; and Notice to the respondent of the right to request a full hearing on the merits of the summary suspension if the Board executes the proposed order of summary suspension; and An order or summons to appear before the Board to show cause why the Board should not execute the order of summary suspension and which notifies the respondent of the consequences of failing to appear. Service. The Board shall serve a respondent with a notice of intent to summarily suspend a license not later than 5 days before a predeprivation show cause hearing is scheduled before the Board. Service of the notice of intent to summarily suspend shall be made: Personally upon the respondent; By certified mail to the address the respondent is required to maintain with the Board; or By any other reasonable means to effect service. If the Board is unable to serve the notice of intent to summarily suspend a license upon the respondent as described in §B(4)(a) and (b) of this regulation, the Board may nevertheless proceed in prosecuting the case. Predeprivation Opportunity To Be Heard. If the Board issues a notice of intent to summarily suspend a license, the Board shall offer the respondent the opportunity to appear before the Board to show cause why the respondent's license should not be suspended before it executes the order of summary suspension. A Predeprivation Show Cause Hearing before the Board. The hearing shall be a nonevidentiary hearing to provide the parties with an opportunity for oral argument on the proposed summary suspension. The Board member presiding over the hearing shall determine all procedural issues and may impose reasonable time limits on each party's oral argument. The presiding Board member shall make any rulings reasonably necessary to facilitate the effective and efficient operation of the hearing. The respondent and the administrative prosecutor shall each be limited to 30 minutes in which to present oral argument. The respondent shall proceed first and may reserve part of the allotted time for rebuttal. The Board member who presides over the hearing: May allow either the respondent or the administrative prosecutor to present documents or exhibits which are relevant and material to the proceedings and which are not unduly repetitious when the presiding Board member believes that the documents or exhibits are necessary in order for a fair hearing; and May not allow testimony by any witness unless agreed to by the parties and approved by the Board in advance of the hearing. The members of the Board may be recognized by the presiding member to ask questions of either party appearing before the Board. Summary Suspension of a License without Prior Notice or an Opportunity To Be Heard. In extraordinary circumstances, the Board may, after consultation with Board counsel, order the summary suspension of a license without first issuing a notice of intent to summarily suspend the license or providing a respondent with an opportunity for a predeprivation hearing if: The Board determines that the public health, safety, or welfare requires the immediate suspension of the license and that prior notice and an opportunity to be heard is not feasible; The order of summary suspension is served upon the respondent within 24 hours after its execution; and The respondent is provided with an opportunity for a hearing before the Board within 15 days after the effective date of the summary suspension. If the respondent requests a hearing under §D(1)(c) of this regulation, the hearing shall be conducted before the Board as provided in §C(2) of this regulation and shall provide the respondent with an opportunity to show cause why the Board should lift the summary suspension and reinstate the license. Burdens of Production and Persuasion. In a show cause proceeding under §C of this regulation, the respondent may present argument in opposition to the allegations presented in the order for summary suspension or which otherwise demonstrates that the public health, safety, or welfare is not at risk. The administrative prosecutor bears the burden of demonstrating by a preponderance of the evidence that the public health, safety, or welfare imperatively requires the Board to summarily suspend the respondent's license. Disposition. If the Board issues a notice of intent to summarily suspend a license before summarily suspending a license, the Board may, after the show cause hearing, vote to: Order a summary suspension; Deny the summary suspension; Enter into an order agreed upon by the parties; or Enter into any interim order warranted by the circumstances of the case, including one providing for a stay of the summary suspension subject to certain conditions. If the Board orders a summary suspension before a show cause hearing, it may, at the conclusion of the hearing, vote to: Affirm its order of summary suspension; Rescind the order for summary suspension; Enter into an order agreed upon by the parties; or Enter into any interim order warranted by the circumstances of the case, including one providing for a stay of the summary suspension subject to certain conditions. An order for summary suspension or any other order of the Board issued after the initiation of summary suspension proceedings are final orders of the Board and public records under State Government Article, §10-611, Annotated Code of Maryland. Post-Deprivation Opportunity for an Evidentiary Hearing. If the Board orders the summary suspension of a license under §C or D of this regulation, the respondent may have an evidentiary hearing before the Board or before an administrative law judge, if the Board delegates the matter to the Office of Administrative Hearings. The respondent may request an evidentiary hearing within 10 days after the Board issues the order of summary suspension. Unless otherwise agreed by the parties, a hearing shall be provided within 45 days after respondent's request. An evidentiary hearing may be consolidated with a hearing on charges issued by the Board which include the facts which form the basis for the summary suspension. An evidentiary hearing shall be conducted under the contested case provisions of State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland. If the Board has delegated the matter to the Office of Administrative Hearings, the administrative law judge shall issue to the Board a recommended decision with: Proposed or final findings of fact; Proposed or final conclusions of law; A proposed disposition; or Any combination of §G(6)(a) — (c) of this regulation under the Board's delegation of the matter to the Office of Administrative Hearings. If the hearing is one combined with charges, the administrative law judge's determination as to the merits of the summary suspension shall be based only on those parts of the record that were available to the Board at the time it voted for the summary suspension. The parties may file exceptions to the recommended decision as provided in State Government Article, §10-216, Annotated Code of Maryland. An order issued by the Board after a post-deprivation evidentiary hearing is a final order of the Board and is a public record under State Government Article, §10-611, Annotated Code of Maryland. If the Board imposes a period of probation as a sanction, the Board may impose conditions of probation which the Board determines to be appropriate, including: Reeducation or completion of approved courses; Payment of a fine; Donation to an approved institution providing acupuncture services for the poor, indigent, or handicapped; Providing free acupuncture services in a Board-approved program; Entering into and complying with a contract with an addiction treatment program; Practice supervision; Monitoring by the Board or by an individual or entity chosen or approved by the Board and periodic reporting to the Board; Periodic review of a licensee's clinical practice; Periodic review or audit, or both, of a licensee's billing practices; An examination by a physician or appropriate health care provider; Limitation of the licensee's practice; Achieving a passing score on an appropriate examination; or Any other condition the Board determines to be appropriate for the rehabilitation or retraining of a licensee. A term of probation may be defined by a specific period of time or the successful completion of certain conditions or acts by the licensee. A licensee seeking termination of probation shall do so only by petitioning the Board for probation: When the specific period of time has passed; or After the licensee has successfully completed the conditions or acts required for termination. If at any time the Board determines that the licensee is not in compliance with the conditions of probation, the Board shall: Charge the licensee with a violation of probation; Take any action provided for in the final order or consent order in the event of a violation of probation, including suspension of the license; Consider a summary suspension of the license; or Take any other action the Board considers appropriate and which it is authorized to do by law. Charges for Violation of Probation. If the Board issues charges for a violation of probation, the service shall be as provided for in Regulation .05C(1) and (3) of this chapter. The charging document for a violation of probation shall: Inform the respondent of the statutory provision, condition of probation, or provision of the Board's order which the Board believes has been violated; Allege facts which the Board believes constitute a basis for a violation of probation; and Notify the respondent of: Any proceedings scheduled before the Board or of an opportunity to request a hearing within a certain period of time; and The consequences of failing to appear for those proceedings or to request a hearing. If the respondent requests a hearing on the charge of a violation of probation, the Board shall, before the hearing, provide the respondent with a case resolution conference as provided in Regulation .05E of this chapter, to discuss settlement of the matter. Violation of Probation Hearing. Unless otherwise determined by the Board, a hearing for a violation of probation shall be held before the Board. The hearing shall be a nonevidentiary hearing to provide the parties with an opportunity for oral argument on the charge that the licensee has violated probation. The Board member presiding over the hearing shall determine all procedural issues and may impose reasonable time limits on each party's oral argument. The presiding Board member shall make any rulings reasonably necessary to facilitate the effective and efficient operation of the hearing. The respondent and the administrative prosecutor shall each be limited to 30 minutes in which to present oral argument. The respondent shall proceed first and may reserve part of the allotted time for rebuttal. The Board member who presides over the hearing: May allow either the respondent or the administrative prosecutor to present documents or exhibits which are relevant and material to the proceedings and which are not unduly repetitious when the Board member believes that the documents or exhibits are necessary in order for a fair hearing; and May not allow testimony by any witness, unless the parties agree and the Board approves before the hearing. The members of the Board may be recognized by the presiding member to ask questions of either party appearing before the Board. If the Board believes that the issues in the case warrant it, the Board may provide a respondent with an evidentiary hearing, either before the Board or an administrative law judge if the Board delegates the matter to Office of Administrative Hearings, which may be instead of or after a nonevidentiary violation of probation hearing held before the Board. The Board may consider the complexity of the case, the need for testimony or admission of other evidence, or any other factor it considers appropriate in determining whether to provide a respondent with an evidentiary violation of probation hearing. An evidentiary hearing shall be conducted under the contested case provisions of the Administrative Procedure Act. After a hearing, the Board shall issue a final order consisting of findings of fact, conclusions of law, and an order that is a public record under State Government Article, §10-611, Annotated Code of Maryland. If the Board determines that respondent has violated probation, the Board may: Take any action provided for in the consent order or final order in the event of a violation of probation; Impose additional conditions of probation; or Impose any sanction or take any other action that the Board considers appropriate and is authorized to do by law. Petition for Reinstatement. A licensee who seeks reinstatement after suspension, revocation, or surrender of a license, or whose reinstatement involves a disciplinary issue, shall petition the Board for reinstatement. The Board may not consider a petition for reinstatement after the revocation of a license before 1 year after the effective date of the revocation, unless otherwise specified in the final order. A licensee who petitions the Board for reinstatement under terms and conditions for reinstatement set out in a final order, letter of surrender, or other order of the Board shall apply for reinstatement only under those terms and conditions. A licensee whose license has been revoked or surrendered for 3 or more years before filing a petition for reinstatement is not eligible for reinstatement but may apply for an initial license. In addition to complying with any conditions for reinstatement ordered by the Board, an applicant for reinstatement shall: File an application for reinstatement with the Board; Meet the requirements for reinstatement set out in COMAR 10.26.02; and Maintain completion of required continuing education credits as if the licensee had been continually licensed. Notice of Intent to Deny Reinstatement and Opportunity for a Hearing. If the Board issues a notice of intent to deny reinstatement, service shall be as provided for in Regulation .05C(1) and (3) of this chapter. A notice of intent to deny reinstatement shall: Inform the applicant of the Board's legal basis for the Board's belief that the respondent is not qualified for reinstatement, including any applicable statutory provision; Allege any facts which the Board believes supports the Board's reasons for denying reinstatement; and Notify the respondent of: Any proceedings scheduled before the Board or of an opportunity to request a hearing within a certain period of time; and The consequences of failing to appear for those proceedings or to request a hearing. If the applicant requests a hearing on the notice of intent to deny reinstatement, the Board shall, before the hearing, provide the applicant with a case resolution conference to discuss settlement of the matter as provided in Regulation .05E of this chapter. A hearing on the notice of denial of reinstatement shall be held before the Board or be delegated to an administrative law judge and conducted under the contested case provisions of the Administrative Procedure Act. If the Board grants reinstatement of a license, the Board may impose any restrictions or conditions on the license or the licensee's practice that the Board considers appropriate. General Application. This regulation shall be used by the Board as a guide for sanctioning licensees pursuant to its authority under Health Occupations Article, §§1A-205 and 1A-309, Annotated Code of Maryland, for violations of the Acupuncture Act and the Board's regulations. The Board is not required to make findings of fact with respect to any of the factors for determining the sanction indicated by the sanctioning guidelines. A departure from the sanctioning guidelines alone is not a ground for any hearing or appeal of a Board action. Notwithstanding these sanctioning guidelines, in order to resolve a disciplinary matter, the Board and the licensee or registered detoxification specialist may agree to surrender a license or registration or to a Consent Order with terms, conditions, and sanctions agreed upon. In a case where there are multiple and distinct violations, the Board may impose a sanction greater than the maximum indicated by the sanctioning guidelines for each individual violation. If probation is imposed, the Board may impose appropriate terms and conditions of probation, and, if a licensee or registration holder violates the terms or conditions of probation, the Board may take further disciplinary action against the individual. In the event a violation does not fall within the sanction range, the Board shall so indicate and use its best judgment to determine the appropriate sanction and shall consider, to the extent possible, the factors in the sanctioning guidelines. Range of Sanctions. Mitigating and Aggravating Factors. Depending on the facts and circumstances of each case, and to the extent that they apply, the Board may consider the following mitigating and aggravating factors in determining whether the sanction in a particular case should fall outside of the range of sanctions established by the guidelines. These factors may include, but are not limited to the following: Mitigating Factors: Absence of a prior disciplinary record; The licensee reported the violation to the Board; The licensee voluntarily admitted violation, provided full disclosure to the Board, and cooperated during Board proceedings; The licensee implemented remedial measures to correct or mitigate harm arising from the violation; The licensee made a timely good-faith effort to make restitution or otherwise rectify the consequences of the violation; Evidence of rehabilitation or potential for rehabilitation; Absence of premeditation to commit the violation; Absence of potential harm to or adverse impact on the public; Isolated incident and not likely to recur; and The licensee’s prior community service and present value to the community. Aggravating Factors: Previous criminal or administrative disciplinary history; The violation was committed deliberately or with gross negligence or recklessness; The violation had the potential for, or caused, serious patient harm; The violation was part of a pattern of detrimental conduct; The licensee was motivated to perform the violation by his or her financial gain; The vulnerability of the patient; The licensee attempted to conceal the violation, falsified or destroyed evidence, or presented false testimony or evidence; The licensee failed to cooperate with the Board’s investigation; and Previous attempts at rehabilitation were unsuccessful. A final order of the Board is subject to judicial review as provided in Health Occupations Article, §1A-311, and State Government Article, §10-222, Annotated Code of Maryland. The Board may impose a civil monetary penalty instead of or in addition to a disciplinary sanction authorized by Health Occupations Article, §1A-309, Annotated Code of Maryland. Practicing on an Expired License. The Board may impose a civil fine against an acupuncturist who practices acupuncture on an expired license in the amount of $100 per day not to exceed $5,000. The Board may not impose a fine under §B(1) of this regulation against an acupuncturist for practicing acupuncture on an expired license if the acupuncturist’s license is reinstated within 30 calendar days of the expiration date of the license and the licensee complies with COMAR 10.26.02.05D. Practicing Without a License or Misrepresentation. The Board may impose a civil fine of no less than $5,000 and no more than $50,000 against an individual who practices acupuncture without a license or represents to the public, by description of services, methods, or procedures, or otherwise, that the individual is authorized to practice acupuncture in this State. Factors determining the amount of the fine include, but are not limited to, the following: The extent to which the individual derived any financial benefit from the unauthorized practice; The willfulness of the unauthorized practice; Actual or potential harm caused by the unauthorized practice; The length of time in which the individual engaged in the unauthorized practice; and The cost of any Board investigation. In any matter governed by this chapter, the Board may consider or take official notice, or both, of any information contained in the Board's files. If, after a hearing, a licensee is found to have violated provisions of Health Occupations Article, §1A-309, Annotated Code of Maryland, the Board shall impose a fee on the licensee that shall approximate the Board's cost of bringing the proceedings against the licensee. The hearing costs may include any or all of the following expense items: Services rendered by court reporters; Transcriptions of the hearing record by court reporters; Expenses related to witnesses appearing for the State; Obtaining or reproducing documents, exhibits, or other evidentiary items; Hearing-related per diems and expenses for Board members; or Any other expenses directly related to the investigation and prosecution of the disciplinary action against the licensee. Health Occupations Article, §§1A-205, 1A-309, 1A-310, and 1A-314;State Government Article, §10-206; Annotated Code of Maryland Effective date: July 22, 2002 (29:14 Md. R. 1075) Chapter revised effective February 20, 2012 (39:3 Md. R. 259) Regulation .02B amended effective February 16, 2026 (53:3 Md. R. 122) Regulation .05C amended effective February 16, 2026 (53:3 Md. R. 122) Regulation .10B amended effective February 16, 2026 (53:3 Md. R. 122) Regulation .12 amended effective April 13, 2015 (42:7 Md. R. 569) The Board may find that a compelling public purpose warrants disclosure of information in a certification, licensing, or investigative file, regardless of whether there has been a request for the information, if the information concerns: Possible criminal activity, and is disclosed to a federal, state, or local law enforcement or prosecutorial official or authority; A possible violation of law, and is disclosed to a federal, state, or local authority that has jurisdiction over the individual whose conduct may be a violation, and the information disclosed is limited to information relevant to the possible violation by that individual; or Conduct by an individual which the Board reasonably believes may pose a risk to the public health, safety, or welfare, and is disclosed to a law enforcement authority, administrative official or agency that regulates the individual, or to a hospital or other health care facility where the individual has privileges. This chapter does not prohibit or limit the ability of the Board to disclose general licensing information as provided in State Government Article, §10-617(h), Annotated Code of Maryland, or any information which the Board may otherwise disclose by law. State Government Article, §10-617(h)(3), Annotated Code of Maryland Effective date: October 1, 2001 (28:19 Md. R. 1685) This regulation governs all acupuncturists licensed to practice in the State of Maryland. In this chapter, the following term has the meaning indicated. Term Defined. “Board” means the State Board of Acupuncture. A licensee applying for renewal shall complete 30 hours of relevant continuing education during the 2-year period preceding the expiration of the license which include the following: At least 20 hours in formally organized programs approved by the Board which are relevant to the practice of acupuncture and East Asian medicine; Not more than 10 hours of formally organized training programs in Western science and medical practices, medical ethics, medical research, or cardiopulmonary resuscitation which are relevant to the practice of acupuncture and East Asian medicine; Not more than 10 hours of training in approved programs which will assist a licensee to carry out the licensee’s professional responsibilities, including, but not limited to: Management courses for a school administrator; Foreign language training for translators of relevant texts; or Educational methodology for teachers of acupuncture; Not more than 10 hours teaching acupuncture and related East Asian medical therapies in an accredited school or in a program approved for acupuncture continuing education; Not more than 7 hours of pro bono work as outlined in §B of this regulation; Not more than 7 hours in published writing or articles in acupuncture and East Asian medicine that are: Peer-reviewed research or peer-reviewed clinically relevant articles in acupuncture and East Asian medicine; and Limited to 4 hours per article; Not more than 20 hours for passage of the NCCAOM exam within the 2-year period preceding the expiration of the license; or Not more than 10 hours serving on a professional board involving: Acupuncture; or East Asian medicine. Pro Bono Work. Pro bono work shall: Earn 1 credit hour for each 3 hours of pro bono activity up to a maximum of 7 credit hours per renewal cycle; and Be for the provision of acupuncture services provided through an organization offering humanitarian services such as, but not limited to: Domestic or international victims in an emergency situation or disaster area; Low-income or underserved areas or populations; Special needs populations; or United States military personnel. Upon completion of the pro bono work, the licensee shall obtain from the facility written documentation of completion of pro bono hours, including: The name of the facility; The address where the pro bono work was provided; The type of work that was done; The number of hours of actual work provided for which the licensee desires credit hours; and A statement guaranteeing that the work provided no financial benefit to the licensee. Licensees shall maintain the documentation of their continuing education credits for 4 years from the date of their acupuncture renewal. If requested by the Board, a licensee shall provide proof of continuing education attendance by providing documentation of: Name of the program; Date of the program; Number of continuing education hours earned; and Name of the sponsoring organization. Health Occupations Article, §§1A-205 and 1A-306, Annotated Code of Maryland Effective date: October 16, 2023 (50:20 Md. R. 887)