THE HISTORY OF THE ORIENTAL MEDICINE SCOPE OF PRACTICE IN NEW MEXICO

This document was created with an appreciation for all the doctors of oriental medicine in New Mexico whose vision of evolving a truly integrated, holistic system of medicine is an inspiration for all medical professionals who hope to provide better healthcare for their patients. With a firm foundation in the ancient wisdom and proven effectiveness of traditional oriental medicine, the evolution of this system of health care is embracing the best of medical knowledge, skill and insight from around the world. This evolution has been guided by an imperative consideration for inclusion, cooperation, consensus building and freedom of choice. It is an acknowledgement of all that oriental medicine was meant to be – real medicine.

This document is an accurate, factual resource for those who come after. Members of regulatory agencies and professional associations, as well as healthcare professionals and consumers who were not involved at the time these events occurred will have a dependable history to which they may refer.

SYNOPSIS

07/01/81 The first Acupuncture Practice Act (The Practice Act) became law which created the independent Acupuncture Board (The Board) and authorized the practice of acupuncture by licensed acupuncturists without supervision or a referral requirement.

07/01/89 The definition of “acupuncture” in The Practice Act was expanded to include “all allied techniques of oriental medicine both traditional and modern” thus authorizing licensed acupuncturists to practice the full scope of oriental medicine rather than just acupuncture. Other classes of licensed health care professionals were forbidden to “hold themselves out to the public or any private group or business by using any title or description of services that includes the terms acupuncture, acupuncturist, or oriental medicine.”

05/22/91 Based on the recommendations made by the profession after an inclusive consensus gathering process, the Board of Acupuncture approved changes to Rule 11 - Scope of Practice that expanded the scope of practice beyond only acupuncture. It was later discovered that the Board’s administrator neglected to appropriately file the amended rule approved by The Board.

10/07/92 With support from Governor Bruce King, the Board approved and officially filed the previously approved changes to Rule 11 – Scope of Practice from 05/22/91. “Subcutaneous or intramuscular injection therapy” was specified as were “physical examination procedures like muscle testing or extremity testing for strength, dexterity, and stamina, or the ordering of x-rays, CT scans, MRI images, bone densitometry studies, and other diagnostic tests.” “Routine venipuncture for collection of specimen(s) and/or the ordering of diagnostic tests by medical laboratories” was specified. Manual therapy of the joints was specified and it was understood that this involved manipulation or adjustment of the spine and joints since the CPT code for this procedure was also specified in the rule. This is the official beginning of injection therapy for doctors of oriental medicine in New Mexico. Since this date, vitamins, minerals, homeopathic medicines and other injectable natural substances were legally being used and officially considered part of the scope of practice for all licensed acupuncturists in New Mexico.

07/01/93 The Acupuncture Practice Act was changed to the Acupuncture and Oriental Medicine Practice Act (The Practice Act), The Board was renamed the Board of Acupuncture and Oriental Medicine (BAOM) and the license title was changed from licensed acupuncturist to doctor of oriental medicine and D.O.M.s were defined as physicians. The education requirement for licensure was increased to a post college, four year program in oriental medicine. A separate definition of oriental medicine was added to The Practice Act which defined oriental medicine as “a distinct system of primary health care that uses all allied techniques of oriental medicine both traditional and modern.” The definition also specified the authority to diagnose and treat “any disease, illness, injury, pain or other physical or mental condition” and also to prescribe or administer a list of specified substances. The prescription or administration of the following substances was authorized: herbal medicines, homeopathic medicines, vitamins, minerals, enzymes, glandular supplements, and nutritional supplements. “Administration” of the substances was not limited in any way in The Practice Act and included all forms of injection of the specified substances. Note that any substance used for injection is automatically categorized, by New Mexico law, as a dangerous drug requiring a prescription.

12/07/94 The Scope of Practice Rule was further modified.

12/03/95 The Acupuncture and Oriental Medicine Association of New Mexico (The Association) organized a course named “Injection Therapy for New Mexico Doctors of Oriental Medicine.” Injection therapy was also taught at New Mexico schools of oriental medicine and was practiced by D.O.M.s licensed in New Mexico as authorized by BAOM rule.
1996 The Board of Pharmacy informed the BAOM that the prescriptive authority for any substance used for injection (all injected substances are categorized by law as dangerous drugs requiring a prescription) was not well defined in The Practice Act and questioned that authority. They recommended that this be more clearly defined in The Practice Act by legislative change.

07/01/97 The Changes to The Practice Act clarifying the prescriptive authority became effective. Doctors of oriental medicine were also defined as primary care providers and were also included in the definition of “provider” in the Drug, Device and Cosmetic Act. The prescriptive authority for D.O.M.s was clearly defined and the oriental medicine prescriptive authority clearly authorized the prescription or administration of a limited list of specified dangerous drugs. D.O.M.s who chose to be certified to use these dangerous drugs were required to successfully complete additional training prior to certification. With additional BAOM approved education and certification, the prescriptive authority included the prescribing and administering of the following substances if classified at any time as dangerous drugs: sterile water, sterile saline, sarapin or its generic, vapocoolants, topical naturally occurring hormones, therapeutic serum as defined in the New Mexico Drug, Device and Cosmetic Act, herbal medicines, homeopathic medicines, vitamins, minerals, amino acids, enzymes, glandular products, dietary and nutritional supplements, cosmetics as defined in the New Mexico Drug, Device and Cosmetic Act, and over the counter drugs as defined in the New Mexico Drug, Device and Cosmetic Act. The language “if at any time these substances or drugs are classified as dangerous drugs” was first added to the Practice Act at this time in 1997. As used in oriental medicine, sterile water (for injection), sterile saline (for injection), sarapin, vapocoolants and topical natural hormones are classified as dangerous drugs and require a prescription. Some substances, like testosterone a topical natural hormone, are additionally classified as controlled substances and require a DEA number to prescribe. The other specified substances, such as vitamins, minerals, etc., are not classified as dangerous drugs or controlled substances unless they are intended for injection, in which case they are automatically classified as dangerous drugs and require a prescription. Therefore, the Practice Act contained distinct lists with the clear authorization that substances that were available without a prescription in one list (vitamins, minerals, etc.) would be included in the list requiring a prescription (dangerous drugs and controlled substances) when appropriate or in other words “if at any time these substances or drugs are classified as dangerous drugs.” The prescription or administration of devices, restricted devices and prescription devices, as those devices are defined in the New Mexico Drug, Device and Cosmetic Act was also authorized.

05/29/98 The BAOM approved the first Extended Prescriptive Authority rule at 16.2.2.10 NMAC. This rule required a minimum of 15 hours of education prior to extended prescriptive authority certification by the BAOM. The rule stated “The education shall include a minimum of five (5) hours on the pharmacology and use of Sarapin, a minimum of five (5) hours on the pharmacology and use of vopocoolants and a minimum of three (3) hours on the pharmacology and use of topical natural hormones and a minimum of two hours on the pharmacology and use of cosmetics, therapeutic serum and over the counter drugs.”

07/01/00 Changes to The Practice Act became effective that authorized the extended prescriptive authority and the expanded prescriptive authority certifications that authorized the use of specified drugs, dangerous drugs and controlled substances. Doctors of oriental medicine were added to the definition of practitioner in the Controlled Substances Act. Prescriptive authority for caffeine, procaine, oxygen, epinephrine and all bioidentical hormones was added with a requirement that the rules for additional training in these five substances be determined by the board of pharmacy. These five substances were only authorized for use by D.O.M.s certified for expanded prescriptive authority. The topical application of naturally occurring hormones, which were previously specified in the Practice Act and authorized under the extended prescriptive authority were not specified but natural substances were added. Other substances, in addition to natural substances, added to the prescriptive authority for all D.O.M.s were: protomorphogens, live cell products, gerovital and biological products. D.O.M.s who chose to be so certified, were required to successfully complete additional training.

08/29/00 The BAOM approved amendments to the Extended Prescriptive Authority rule. The education necessary for extended prescriptive authority certification was increased to 54 hours.

07/10/01 The BAOM approved the “Extended Prescriptive Authority Certification Curriculum” submitted by the Academy of Advanced Integrative Medicine LLC (AAIM).

08/13/01 The Board of Pharmacy voted to approve all rules proposed by the BAOM for expanded prescriptive authority certification. This rule also contained the requirements for training in the use of caffeine, procaine, oxygen, epinephrine and bioidentical hormones as required by The Practice Act.

09/17/01 The BAOM approved the new Expanded Prescriptive Authority Certification rule at 16.2.2.10 NMAC exactly as approved by the Board of Pharmacy on 08/13/01. (Note that this Expanded Prescriptive Authority section of Part 2 of the BAOM Rules was originally numbered as 16.2.2.10 NMAC but was subsequently renumbered as 16.2.2.11 NMAC.) It replaced the extended prescriptive authority rule. At that time, the amended rule specified that new certifications in extended prescriptive authority would not be available after 02/28/02 but that current certifications in extended prescriptive authority would continue to be valid until final expiration of all extended prescriptive authority certifications on 12/31/11. To be certified in Expanded Prescriptive Authority, this rule required a D.O.M. to successfully complete 144 hours of BAOM approved education in the specified categories of injection therapy, intravenous therapy and bioidentical hormone therapy.

12/10/01 The BAOM approved the amended “Extended Prescriptive Authority Certification Curriculum” submitted by the Academy of Advanced Integrative Medicine LLC. This course provided the education required for D.O.M.s to be certified for extended prescriptive authority. The BAOM also approved the “Expanded Prescriptive Authority Certification Curriculum” submitted by the Academy of Advanced Integrative Medicine LLC. This BAOM approved course provided the education required for D.O.M.s to be certified for expanded prescriptive authority. This educational program specifically included the use of human growth hormone, insulin and many other commonly used bio-identical hormones.

03/28/03 The BAOM adopted as administrative directives the documents titled “Prescriptive Authority Explanation for New Mexico Doctors of Oriental Medicine” and “Prescriptive Authority Summary for New Mexico Doctors of Oriental Medicine by Dr. Glenn Wilcox. These documents were posted on the BAOM website.

07/21/03 The BAOM approved the “Expanded Prescriptive Authority Formulary Authorized for Use by DOMs Certified for the Expanded Prescriptive Authority.” In this BAOM approved formulary, all bioidentical hormones were within the prescriptive authority of a D.O.M. certified for expanded prescriptive authority as mandated by the Acupuncture and Oriental Medicine Practice Act. Insulin and human growth hormone were specified as were neurotransmitters. All natural substances were included. This formulary was posted on the BAOM Website until superseded on 02/15/05 by an amended formulary added to Part 2 Scope of Practice at 16.2.2.13 NMAC. On 07/21/03, the BAOM also approved the document titled “NMBAOM Guidelines for Biomedical Competencies and Skills” which was posted on the BAOM website.

08/13/04 The BAOM approved amendments to 16.2.2 NMAC, the Scope of Practice Rule. The extended prescriptive authority certification was reinstated at 16.2.2.10 NMAC and the total required education was increased, from the 54 hours previously required in 2001 prior to eliminating this certification, to 60 hours. At this time, intravenous injection and infusion therapy which had previously been included in the extended prescriptive authority, was specifically excluded from the extended prescriptive authority and only authorized under the expanded prescriptive authority. The extended prescriptive authority education was made a prerequisite for the expanded prescriptive authority education. The total expanded prescriptive authority education at 16.2.2.11 NMAC, including the 60 hours of prerequisite extended prescriptive authority education, was increased from 144 hours to 145 hours (60 hours + 95 hours). A new section at 16.2.2.13 NMAC was added for the “Prescriptive Authority Formulary.” This “Prescriptive Authority Formulary” section of the rule was posted on the BAOM website on 03/02/05. For the first time the formulary was formalized in a rule. Insulin, atropine and neurotransmitters were deleted from the formulary approved by the BAOM on 07/21/03. Human growth hormone was not specified but anterior pituitary hormones were included. Human growth hormone is a type of anterior pituitary hormone and therefore was included under that general category. Also on 08/13/04, the definition of bioidentical hormones and natural substances in 16.2.1 NMAC was approved by the BAOM.

11/17/05 The BAOM approved the 60 hour Rx1 Extended Prescriptive Authority Course.

08/28/06 The BAOM approved the Rx2 Expanded Prescriptive Authority Educational Program. This course was 134 hours. Either prior extended prescriptive authority certification or the 60 hour Rx1 Extended Prescriptive Authority Course approved on 11/17/05 were required as a prerequisite.

07/01/07 The Expanded Practice and Prescriptive Authority Certification became law creating four expanded practice and prescriptive authority certifications for D.O.M.s who successfully complete additional training. This replaced the two previously authorized certifications – the extended prescriptive authority certification (basic injection therapy) and the expanded prescriptive authority certification (injection therapy, intravenous therapy and bioidentical hormone therapy). The four new certification categories created were: 1) basic injection therapy; 2) injection therapy; 3) intravenous therapy; and 4) bioidentical hormone therapy. The requirement for Board of Pharmacy determination, with BAOM input, of the rule defining the training necessary for use of caffeine, procaine, oxygen, epinephrine and bioidentical hormones remained the same as it was previously. There is no requirement for Board of Pharmacy determination of education or continuing education for any other substances and no requirement for the Board of Pharmacy to approve the individual oriental medicine expanded practice course curricula and teachers required for certification or continuing education. The Practice Act authorized the BAOM to approve these. In addition to the authority to prescribe and administer the authorized substances, the authority to compound and dispense was specified. Although there was no expansion of the prescriptive authority, four new substance categories were specified which had previously been included under other substance categories. These were proteins, carbohydrates, lipids, and natural medicines.

From the Spring of 2007 when Governor Richardson signed SB 353 to October 2007 there were 11 meetings, many of them joint meetings, involving the BAOM and its Committees and The Association and its Committees to draft appropriate rule proposals to insure safe and effective oriental medicine expanded practice. Those proposals were approved by BAOM Rx Committee and the AOMANM Expanded Practice Committee on 06/13/07, the BAOM Rules Committee on 06/29/07 and the AOMANM Board of Directors on 08/25/07 and presented to the AOMANM general membership at the annual meeting on 09/29/07.

As of 2008, some categories of oriental medicine expanded practice, such as injection therapy, have been included in the oriental medicine scope of practice for 16 years and the BAOM has certified 30 D.O.M.s for extended prescriptive authority (Rx1) and 31 D.O.M.s for expanded prescriptive authority (Rx2). The extended prescriptive authority has been authorized since 1997 and the expanded prescriptive authority has been authorized since 2000. There has never been any disciplinary action against any D.O.M. certified for extended or expanded prescriptive authority.

To summarize, the oriental medicine expanded practice scope of practice has evolved significantly over the past 20 years and has become more clearly defined with each revision. The oriental medicine expanded practice prescriptive authority, as defined in the Acupuncture and Oriental Medicine Practice Act, includes an appropriate, limited list of substances. It is also a list that has been articulated in such a way that it allows for the evolution of the approved formulary, as oriental medicine expanded practice evolves. And, it is important to state that this list, along with the complete expanded practice and prescriptive authority section of the Practice Act at 61-14A-8.1, was approved by the oriental medical profession and the AOMANM after much dialogue. It was then reviewed by the BAOM, the Medical Society, the Medical Board, the Pharmacy Association and the Board of Pharmacy before it was twice passed by the New Mexico Legislature (2000 and 2007) and signed into law on two occasions, first by Governor Gary Johnson in 2000 and again by Governor Bill Richardson in 2007. A similar rigorous process resulted in the adoption of the rules relating to oriental medicine expanded practice and prescriptive authority certification. For 10 years, from 1997 to 2007, BAOM Assistant Attorney General Corliss Thalley worked closely with the Board of Acupuncture and Oriental Medicine throughout the process which involved the Board of Pharmacy, The Oriental Medicine Association and the D.O.M.s certified for expanded practice.

FULL HISTORY

In 1981, the original Acupuncture Practice Act was signed into law and created the independent Board of Acupuncture. It authorized the practice of acupuncture by a licensed acupuncturist (L.Ac.), without supervision or the need for referral from another healthcare professional. This law was initiated by Sensei Masahilo Nakazono, who, in 1978, started the first school of acupuncture and oriental medicine in New Mexico called the Kototama Institute School of Natural Life Medicine. His students and a few others created the Acupuncture Association of New Mexico which is now called the Acupuncture and Oriental Medicine Association of New Mexico (The Association). Sensei Nakazono loaned a group of ten of his students $10,000.00 to hire a lobbyist with the goal of creating a law that would provide for the licensed practice of acupuncture. Each of those ten students agreed to repay Sensei Nakazono $1,000.00. Those people were Tom Duckworth, Sarai Saporta, Paul Sowanick, Sandra Spies, Lou Talento Link Tate, and Glenn Wilcox. (If anyone reading this remembers who the other three original contributors were, please contact Dr. Glenn Wilcox at 505-235-0101 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it .) Stuart Watts, who later founded Southwest Acupuncture College, was also involved in this legislative effort and represented a different perspective on acupuncture and oriental medicine from that of those from the Kototama Institute. He encouraged Governor King to appoint a neutral Acupuncture Board.
Signed by: Governor Bruce King
Drafted by: The Association and Legislative Council Service
Sponsored by: Senator Tito Chavez
Initiated by: Sensei Masahilo Nakazono and The Association
Professional Lobbyist: Peter Mallery
Lobbied by: Tom Duckworth

In 1989, Senate Bill 88 changed the definition of “acupuncture” in The Acupuncture Practice Act to include “all allied techniques of oriental medicine both traditional and modern.” This change authorized licensed acupuncturists to practice the full scope of oriental medicine rather than just acupuncture. Other classes of licensed health care professionals were forbidden to “hold themselves out to the public or any private group or business by using any title or description of services that includes the terms acupuncture, acupuncturist, or oriental medicine.” For the first time, the services of licensed acupuncturists were covered by indemnity health insurance and licensed acupuncturists were defined as “practitioners of the healing arts” along with medical doctors, osteopaths and dentists.
Signed by: Governor Gary Carruthers
Sponsored by: Senator Tito Chavez
Drafted by: Dr. Glenn Wilcox
Initiated by: Dr. Angelique Cook-Lowry, Dr. Lou Talento and Dr. Glenn Wilcox
Professional Lobbyist: None
Lobbied by: Dr. Angelique Cook-Lowry, Dr. Lou Talento and Dr. Glenn Wilcox

Governor Carruthers, when he signed SB 88 into law, requested that the Acupuncture Board clearly define the scope of practice by rule. The Acupuncture Board's chairman, Lou Talento, initiated a Scope of Practice Committee with the task of determining the full scope of practice of traditional and modern oriental medicine from all traditions worldwide and developing language to present to the Acupuncture Board so that the scope of practice could be defined by rule, as requested by the Governor. An inclusive group of committees were formed to discuss the scope of practice of oriental medicine. It was up to a broad array of experienced practitioners to come together, discuss among themselves, and begin to define the scope of practice. A series of consensus gathering meetings were held, making sure to at least include senior practitioners from all schools of thought, from all types of training and points of view. Out of that consensus process, over a two year period, emerged a document that defined the scope of practice of licensed acupuncturists in New Mexico. On May 1, 1991 the Board held a rule hearing on the proposed changes to Rule 11 - Scope of Practice, based on this process. On May 22, 1991 the Board met and approved the changes to Rule 11. Rule 11 has since been renamed and renumbered as Part 2 – Scope of Practice (16.2.2 NMAC.)

During the early 1990s there had been several errors and omissions in filing the Scope of Practice Rule by BAOM administrators. This resulted in much confusion and even a negative front page story and editorial about the D.O.M. scope of practice in the Albuquerque Journal that was initiated by an M.D. member of the BAOM who contributed to the confusion. Clarifying the situation required a week of research at the BAOM offices and New Mexico Records and Archives by Association president, Dr. Glenn Wilcox after which BAOM chair, Dr. Angelique Cook-Lowry, presented the material to Governor Bruce King. As a result, the Governor encouraged the BAOM to correct the errors in rule filing and in 1993 supported the elimination, in the Practice Act, of the requirement that two BAOM members be M.D.s.

After the administrative errors were corrected, Rule 11 – Scope of Practice went into effect on 10/07/92. “Routine venipuncture for collection of specimen(s) and/or the ordering of diagnostic tests by medical laboratories” was specified. “Subcutaneous or intramuscular injection therapy” was specified as was “physical examination procedures like muscle testing or extremity testing for strength, dexterity, and stamina, or the ordering of x-rays, CT scans, MRI images, bone densitometry studies, and other diagnostic tests.” Manual therapy of the joints was specified and it was understood that this involved manipulation or adjustment of the spine and joints since the CPT code for this procedure was also specified in the rule. This rule stated:
“11.1 SCOPE OF PRACTICE: Acupuncture means the use of needles inserted into the human body by piercing the skin and the use of all allied techniques of oriental medicine, both traditional and modern, for the diagnosis, prevention, cure or correction of any disease or pain by means of controlling and regulating the flow and balance of energy in the body so as to restore the body to its proper functioning and state of health. The scope of practice of acupuncture practitioners in New Mexico shall therefore cover all medical conditions, be they from internal or infectious illness or from injury, and the scope of practice may include but is not limited to the following services:
A. Acupuncture and related techniques
1. Percutaneous techniques
a) the temporary stimulation of acupuncture points using conventional needles
b) insertion and retention, for days or weeks, of intradermal needles, press tacks or suture therapy of acupuncture points
c) traditional therapeutic bleeding
d) routine venipuncture for collection of specimen(s) and/or the ordering of diagnostic tests by medical laboratories
e) ion-cord therapy linking acupuncture needles with wires
f) subcutaneous or intramuscular injection therapy
g) acupuncture analgesic techniques
2. Transcutaneous acupuncture techniques
a) non-penetrating surface stimulation with needles or related surface stimulation devices
b) surface stimulation with magnets, pieces of metal or seeds
c) cupping, the application of suction devices on the skin
B. Moxibustion and other treatments using heat, light, sound, electromagnetism and herbs
1. Burning of herbs on or near the skin
2. Warming with an electrical heating element held near the skin
3. Herbal poultices or compresses
4. Infrared therapy
5. Electromagnetic wave therapy
6. Ultraviolet therapy
7. Ultrasound therapy
8. Laser acupuncture
9. Hot and cold packs
C. Electrical stimulation for treatment, detection of acupuncture points, or diagnosis of energetic imbalances
1. Transcutaneous electrical stimulation without needles; for example:
a) TENS (transcutaneous electrical nerve stimulation)
b) piezo quartz electrical stimulation with needles
c) accuscope therapy
2. Percutaneous electrical stimulation with needles
3. Electroacupuncture systems and devices
4. Electomyography
D. Body treatment, including massage, traction, and manual therapy, for the correction of blockages and imbalances of Qi energy in the meridians of acupuncture and the surrounding tissue and joints, such as tui-na, shiatsu, acupressure, amma, ampuku, gwa-sha, jin shin jitsu, jin shin do, jin qi, polarity therapy, te-ate, palm healing, therapeutic touch, as well as physical examination procedures like muscle testing or extremity testing for strength, dexterity, and stamina, or the ordering of x-rays, CT scans, MRI images, bone densitometry studies, and other diagnostic tests
E. Therapeutic exercise and breathing techniques, such as qi-gong, tai-chi, pa-kua, martial arts, sotai, do-in; these and similar oriental techniques may also be referred to as gait training, neuromuscular re-education, kinetic activities to increase coordination, strength, and range of motion, functional activities, activities of daily living and diversional activities, etc.
F. The use of food and supplements therapeutically
G. Herbal and all homeopathically prepared substances
H. Stress reduction with meditation, relaxation techniques, etc.
I. Oriental life therapy/way of life counseling, advising people towards mental, emotional and spiritual balance in daily life
J. The scope of practice of licensed acupuncturists includes but is not limited to the following procedures as coded in CPT - Physicians' Current Procedural Terminology, 1992, by the American Medical Association: 16000, 16020, 36415, 64550, 64565, 90782, 90799, 90900, 90902, 90904, 90906, 90915, 95831, 95832, 95833, 95834, 95851, 95852, 95860, 95861, 95863, 95864, 95867, 95868, 95869, 95872, 95875, 95999, 97010, 97012, 97014, 97026, 97028, 97039, 97110, 97112, 97114, 97116, 97118, 97122, 97124, 97128, 97139, 97145, 97260, 97261, 97530, 97531, 97720, 97721, 97799, 99000, 99001, 99002, 99050, 99052, 99054, 99056, 99058, 99070, 99071, 99075, 99078, 99080, 99082, 99090, 99195, 99199, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99251, 99252, 99253, 99254, 99255, 99261, 99262, 99263, 99271, 99272, 99273, 99274, 99275, 99301, 99302, 99303, 99311, 99312, 99313, 99321, 99322, 99323, 99331, 99332, 99333, 99341, 99342, 99343, 99351, 99352, 99353, 99361, 99362, 99371, 99372, 99373, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99499.

In 1993, Senate Bill 178 renamed the Acupuncture Board as the Board of Acupuncture and Oriental Medicine (BAOM). It also changed the official licensure title from “licensed acupuncturist” to “doctor of oriental medicine” and defined D.O.M.s as physicians. The education requirement for licensure was increased to a post college, four year program in oriental medicine. It also created a separate definition of oriental medicine stating it is “a distinct system of primary health care that uses all allied techniques of oriental medicine both traditional and modern.” The definition also specified the authority to diagnose and treat “any disease, illness, injury, pain or other physical or mental condition” and also to prescribe or administer a list of specified substances. (The complete text of the Practice Act Definitions section as of 07/01/93 is included in the Addenda.)
Signed by: Governor Bruce King
Sponsored by: Senator Tito Chavez
Drafted by: Dr. Glenn Wilcox, Association President
Initiated by: The Association and The Acupuncture Board
Professional Lobbyist: Peter Mallery
Lobbied by: Dr. Angelique Cook-Lowry, Dr. Jonas Skardis, Dr. Lou Talento and Dr. Glenn Wilcox

Senate Bill 178 added the following definition of oriental medicine.
“F. ‘oriental medicine’ means the distinct system of primary health care that uses all allied techniques of oriental medicine, both traditional and modern, to diagnose, treat and prescribe, as defined in Subsection G of this section, for the prevention, cure or correction of any disease, illness, injury, pain or other physical or mental condition by controlling and regulating the flow and balance of energy and functioning of the person to restore and maintain health; and
G. ‘techniques of oriental’ medicine means the diagnostic and treatment techniques utilized in oriental medicine that include but are not limited to diagnostic procedures; acupuncture; moxibustion; manual therapy, also known as tui na; breathing and exercise techniques, dietary, nutritional and lifestyle counseling; and the prescription or administration of any herbal medicine, homeopathic medicine, vitamin, mineral, enzyme, glandular or nutritional supplement.”

Senate Bill 178 authorized the prescription or administration of the following substances:
1. Herbal medicines;
2. Homeopathic medicines;
3. Vitamins;
4. Minerals;
5. Enzymes;
6. Glandular supplements; and
7. Nutritional supplements.

After the 1993 changes made by Senate Bill 178 to the Acupuncture and Oriental Medicine Practice Act (The Practice Act) the last edition of the scope of practice document that was initiated in 1989 was published by the BAOM, chaired by Dr. Angelique Cook-Lowry. It was titled “Scope of Practice in New Mexico, Background Information on the Scope of Practice of Doctors of Oriental Medicine in the State of New Mexico, April 1993.” It was also distributed at national acupuncture and oriental medicine gatherings where it was recognized as an acknowledgement of what oriental medicine was meant to be. Herbal medicine was recognized as being within the oriental medicine scope of practice, as was homeopathic medicine. The ability to diagnose, using not only traditional oriental methods but also modern procedures developed by biomedicine, was included. Physical medicine modalities and procedures including manipulation or adjustment of the spine and other joints were included. And again, injection therapy was specified. At the time, “Acupuncture – A Comprehensive Text” contained a section on injection therapy. (This text, also known as the Shanghai Text, was one of the first textbooks about acupuncture and oriental medicine available in the West. It was published in 1981 by The Shanghai College of Tradition Medicine and was translated and edited by John O’Connor and Dan Bensky.) The Shanghai Text described injecting points, using hypodermic needles, with a number of substances such as “a 5-10% glucose solution; normal saline, distilled water, 25% magnesium sulfate, vitamin B1 or B12, 0.5-2% procaine hydrochloride, and certain, tissue fluids, as well as liquid extracts from herbs such as Angelica sinensis (danggui), Carthamus tinctoris (honghua) or Ligusticum wallichii (chuangxiong).”

On 12/07/94, as a result of the work summarized in “Scope of Practice in New Mexico,”the BAOM held a rule hearing and approved a new version of Rule 11 – Scope of Practice. Again, with this rule, the BAOM approved a scope of practice that included many diagnostic and therapeutic procedures and a formulary of substances that are now taken for granted to be part of the basic oriental medicine scope of practice, as well as others that are now included in what has become oriental medicine expanded practice. This new version of Rule 11 stated:
“11.1 SCOPE OF PRACTICE: Based on statutory language in NMSA 61-14A-3 the practice of oriental medicine in New Mexico is a distinct system of primary health care that includes all traditional and modern diagnostic, prescriptive and therapeutic methods utilized by practitioners of acupuncture and oriental medicine world wide for the prevention, cure, or correction of any disease, illness, injury, pain or other physical or mental condition. The scope of practice of Doctors of Oriental Medicine shall include but is not limited to:
A. Evaluation and management services
B. Examination and diagnostic testing
C. The ordering of radiological, laboratory or other diagnostic tests
D. The surgical procedures of acupuncture, injection therapy and other related procedures
E. The stimulation of points or areas of the body using needles, heat, cold, light, lasers, sound, vibration, magnetism, electricity, bleeding, suction, pressure, or other devices or means
F. Physical medicine modalities and procedures
G. Therapeutic exercise, breathing techniques, meditation, and the use of biofeedback and other devices that utilize color, light, sound, electromagnetic energy and other means therapeutically
H. Dietary and nutritional counseling and the administration of food, beverages and dietary supplements therapeutically
I. The prescription or administration of any herbal medicine, homeopathic medicine, or substances such as vitamins, minerals, enzymes, glandulars, amino acids and nutritional or dietary supplements
J. Counseling regarding physical, emotional and spiritual balance in lifestyle.”

On 12/03/95, The Association organized a course named “Injection Therapy for New Mexico Doctors of Oriental Medicine” that was taught by Rick Marinelli, N.D., L.Ac. and Jonas Skardis, D.O.M. Injection therapy was also taught at New Mexico schools of oriental medicine and was practiced by New Mexico licensed D.O.Ms as authorized by BAOM rule.

However, in 1996 the Board of Pharmacy approached the BAOM and informed the BAOM that, in their opinion, the prescriptive authority for the injection of dangerous drugs was not well defined in The Practice Act and recommended that the profession go to the legislature and change The Practice Act to more clearly define the prescriptive authority. (Note that any substance that is injected is automatically defined as a dangerous drug. All dangerous drugs require a prescription by a licensed practitioner legally authorized to prescribe or administer them.) After careful consideration within the profession it was decided that the best option was to go to the legislature to create a more clearly defined prescriptive authority as requested by the Board of Pharmacy. It was understood that there were risks involved in doing so, since success in the legislative process is never guaranteed.

In 1997, Senate Bill 272 defined D.O.M.s as primary care providers, clarified the prescriptive authority so that D.O.M.s who successfully completed additional BAOM approved education would be authorized to prescribe or administer specified dangerous drugs including topical natural hormones, vapocoolants and a number of substances used for injection therapy. (Refer to the list in next paragraph.). The prescription or administration of devices, restricted devices and prescription devices, as those devices are defined in the New Mexico Drug, Device and Cosmetic Act was authorized. Doctors of oriental medicine were also included in the definition of “provider” in the Drug, Device and Cosmetic Act. (The complete text of the Practice Act Definitions section as of 07/01/97 is included in the Addenda.)
Signed by: Governor Gary Johnson.
Sponsored by: Senator Michael Sanchez
Drafted by: Dr. Glenn Wilcox, BAOM Chairman
Initiated by: The Board of Acupuncture and Oriental Medicine and supported by The Association
Professional Lobbyist: Peter Mallery
Lobbied by: Dr. David Canzone and Dr. Glenn Wilcox

As of 07/01/97, when Senate Bill 272 became effective the prescriptive authority included the prescription or administration of the following substances by all D.O.M.s:
1. Herbal medicines;
2. Homeopathic medicines;
3. Vitamins;
4. Minerals;
5. Enzymes;
6. Glandular products;
7. Amino acids;
8. Dietary and nutritional supplements.

As of 07/01/97, the prescriptive authority also included the prescription or administration of the following dangerous drugs by D.O.M.s who completed additional training approved by the BAOM:
1. Sterile water;
2. Sterile saline;
3. Sarapin, or its generic;
4. Vapocoolants;
5. Topical application of naturally occurring hormones.

As of 07/01/97, the prescriptive authority also included the prescription or administration of the following substances “if at any time these substances or drugs are classified as dangerous drugs” (e.g. if administered by injection or infusion):
1. Herbal medicines;
2. Homeopathic medicines;
3. Vitamins;
4. Minerals;
5. Enzymes;
6. Glandular products;
7. Amino acids;
8. Dietary and nutritional supplements;
9. Cosmetics, as defined in the New Mexico Drug, Device and Cosmetic Act;
10. Therapeutic serum, as defined in the NM Drug, Device and Cosmetic Act; and
11. Over the counter drugs (other than herbal medicines, homeopathic medicines, vitamins, minerals, enzymes, glandular products, amino acids, dietary and nutritional supplements) as defined in the NM Drug, Device and Cosmetic Act.

On 05/29/98, the BAOM held a rule hearing that was followed by a BAOM meeting at which the first Extended Prescriptive Authority rule was approved at 16.2.2.10 NMAC. This rule was filed on 07/29/98, by BAOM chair Dr. Glenn Wilcox (As mentioned previously, there had been problems with BAOM administrators properly filing rules), and it became effective on 08/31/98. This and all subsequent rules were drafted by Dr. Glenn Wilcox, reviewed by the Association and adopted by BAOM after an appropriate rule hearing. This section stated:
“16.2.2.10 EXTENDED PRESCIPTIVE AUTHORITY: The Board shall register a Doctor of Oriental Medicine in good standing for Extended Prescriptive Authority as provided herein. [8-31-98]
10.1 The Doctor of Oriental Medicine shall file a completed and signed application form provided by the Board. [8-31-98]
10.2 The Doctor of Oriental Medicine shall submit proof of completion of a minimum of fifteen (15) hours of education satisfactory to the Board in the pharmacology and general use of the drugs authorized for use under the Extended Prescriptive Authority Provisions of Section 61-14A-3.H.(4) and (5) of the Act. The education shall include a minimum of five (5) hours on the pharmacology and use of Sarapin, a minimum of five (5) hours on the pharmacology and use of vopocoolants and a minimum of three (3) hours on the pharmacology and use of topical natural hormones and a minimum of two hours on the pharmacology and use of cosmetics, therapeutic serum and over the counter drugs. Such education shall have been earned in classes approved by the Board, shall be taught by qualified teachers as approved by the board, and shall be in addition to the education required to meet the minimum educational program requirements for licensure as a Doctor of Oriental Medicine. [8-31-98]”

On 08/29/00, the BAOM held a rule hearing that was followed by a BAOM meeting at which amendments to the Extended Prescriptive Authority rule were approved. The amended rule became effective on 10/15/00 and the education necessary for certification in extended prescriptive authority was increased to 54 hours. This section stated:
“16.2.2.10 EXTENDED PRESCRIPTIVE AUTHORITY: The Board shall certify a Doctor of Oriental Medicine in good standing for Extended Prescriptive Authority as provided herein.
A. The Doctor of Oriental Medicine shall file a completed and signed application form provided by the Board and shall pay the Administrative Fee for Extended Prescriptive Authority Application specified in 16.2.10 NMAC.
B. The Doctor of Oriental Medicine shall submit proof of completion of the following education, satisfactory to the Board, in the pharmacology and general use of the drugs authorized for use under the Extended Prescriptive Authority Provisions of Section 61-14A-3.H.(4) and (5) of the Act. Such education shall have been earned in classes pre-approved by the Board and shall be taught by qualified teachers as approved by the board. All pharmacology shall be taught by a licensed pharmacist, PharmD or a Ph.D. in pharmacology. The use of Sarapin, shall be taught by a licensed health care practitioner with appropriate training and a minimum of five years experience in trigger point and neural injection therapy and who is knowledgeable about Sarapin pharmacology. The use of vapocoolants shall be taught by a licensed health care practitioner with appropriate training and a minimum of five years experience in vapocoolant therapy and who is knowledgeable about vapocoolant pharmacology. The use of topical natural hormones shall be taught by a licensed health care practitioner with appropriate training and a minimum of five years experience in topical natural hormone therapy and who is knowledgeable about topical natural hormone pharmacology. The Board shall have final authority for approval of classes and teachers. All classes that do not require hands on training may be video recorded and transcribed for future presentation. Testing shall be administered to insure that the material presented in the classes has been learned. The entire educational program shall be completed in two (2) years. Doctors of oriental medicine who wish to be certified in the extended prescriptive authority shall be educated to such a level of knowledge, understanding and expertise that they shall be able to evaluate the material, have a deep grasp of the application of it in various settings, and be able to generate new thinking about the subject matter. They shall be required to demonstrate their skill in performing the necessary tasks and documenting the outcomes in writing. The above education shall be in addition to the education required to meet the minimum educational program requirements for licensure as a Doctor of Oriental Medicine. The education shall include a minimum of:
(1) 28 hours in the theory and practice of trigger point injection therapy, neural injection therapy including the injection of therapeutic serum, sterile water, sterile saline, Sarapin and all injectable forms of substances included in Section 61-14A-3.G. (2) of the Act with the exclusion of procaine, caffeine and epinephrine. The course shall include, but not be limited to: Anatomy, physiology, pathology, pharmacology, diagnostic methodology, clinical strategies, contraindications and safeguards as well as vapocoolants spray and stretch techniques.
(2) 21 hours in the theory and practice of transdermal bioidentical hormone replacement therapy. The course shall include, but not be limited to: Anatomy, physiology, endocrinology, pathology, pharmacology, the diagnostic use of blood and saliva testing, imaging diagnostics, clinical strategies, contraindications and safeguards as well as specialist referral.
(3) five hours in the pharmacology, application and clinical use of cosmetics and over-the-counter drugs.”

In 2000, Senate Bill 117 authorized the BAOM to certify D.O.M.s in two categories - the extended prescriptive authority and expanded prescriptive authority. D.O.M.s who chose to be so certified were required to complete additional BAOM approved education. The prescription or administration of a limited list of drugs, dangerous drugs and controlled substances was authorized as listed below. The following substances were added to the prescriptive authority for all D.O.M.s: natural substances, protomorphogens, live cell products, gerovital and biological products. Doctors of oriental medicine were added to the definition of practitioner in the Controlled Substances Act. (The complete text of the Practice Act Definitions and Extended or Expanded Prescriptive Authority sections as of 07/01/00 is included in the Addenda.)
Signed by: Governor Gary Johnson.
Sponsored by: Senator Michael Sanchez
Drafted by: Dr. Glenn Wilcox, BAOM Chairman
Initiated by: The Board of Acupuncture and Oriental Medicine and supported by The Association
Professional Lobbyist: Peter Mallery
Lobbied by: Dr. David Canzone, Dr. Celeste Skardis and Dr. Glenn Wilcox

The Acupuncture and Oriental Medicine Practice Act, as a result of the changes from Senate Bill 117 made it clear that for certain, specific substances, and only for those substances, the Board of Pharmacy had the authority, after consulting with the BAOM, to determine the rules that define the training required for the use of those substances by D.O.M.s. The Acupuncture and Oriental Medicine Practice Act at 61-14A-8.1.A stated: “The board shall adopt the rules determined by the board of pharmacy for additional training required for the prescribing, administering, compounding or dispensing of caffeine, procaine, oxygen, epinephrine and bioidentical hormones. The board and the board of pharmacy shall consult as appropriate.” The Board of Pharmacy was only required, by the Practice Act, to determine the rules defining the training necessary for the use of the five specified substances and was not required to approve the individual curricula of the extended or expanded prescriptive authority courses required for certification in those two categories or for continuing education with regard to the use of the five specified substances or any other substances. The BAOM was authorized to approve individual course curricula and continuing education.

As of 07/01/00, when Senate Bill 117 became effective the base prescriptive authority included the prescription or administration of the following substances by all D.O.M.s:
1. Herbal medicines;
2. Homeopathic medicines;
3. Vitamins;
4. Minerals;
5. Enzymes;
6. Glandular products;
7. Natural substances;
8. Protomorphogens;
9. Live cell products;
10. Gerovital;
11. Amino acids; and
12. Dietary and nutritional supplements.

As of 07/01/00, the prescriptive authority also included the prescription or administration of the following dangerous drugs or controlled substances by D.O.M.s who completed additional training approved by the BAOM:
1. Sterile water;
2. Sterile saline;
3. Sarapin, or its generic;
4. Caffeine;
5. Oxygen;
6. Epinephrine;
4. Vapocoolants; and
5. Bioidentical hormones.

As of 07/01/00, the prescriptive authority also included the prescription or administration of the following substances “if at any time these substances or drugs are classified as dangerous drugs or controlled substances” (e.g. if administered by injection):
1. Herbal medicines;
2. Homeopathic medicines;
3. Vitamins;
4. Minerals;
5. Enzymes;
6. Glandular products;
7. Natural substances;
8. Protomorphogens;
9. Live cell products;
10. Gerovital;
11. Amino acids;
12. Dietary and nutritional supplements;
12. Cosmetics, as defined in the New Mexico Drug, Device and Cosmetic Act;
13. Biological products, including therapeutic serum, as defined in the New Mexico Drug, Device and Cosmetic Act; and
11. Over the counter drugs (other than herbal medicines, homeopathic medicines, vitamins, minerals, enzymes, glandular products, natural substances, protomorhogens, live cell products, gerovital, amino acids, dietary and nutritional supplements) as defined in the NM Drug, Device and Cosmetic Act.

After Governor Johnson signed Senate Bill 117, Dr. Glenn Wilcox, BAOM Chairman, sent a “Request for Feedback” with regard a BAOM “Expanded/Extended Prescriptive Authority Implementation Proposal” to Association President Dr. Alix Bjorklund on 04/25/00, with a request to present the document to the profession for consideration. This document specifically listed insulin as one of the bioidentical hormones to be included and is the first official reference to insulin in an official BAOM document.

On 04/17/01, the BAOM approved a draft proposal for the creation of a rule detailing the training and certification requirements that D.O.M.s must complete to be certified for expanded prescriptive authority. This proposal included the required training for the use of caffeine, procaine, oxygen, epinephrine and bioidentical hormones. (The minutes of that meeting and the draft proposal are available at the BAOM office.)

On 06/05/01, Dr. Glenn Wilcox, BAOM Chairman, presented the above referenced draft proposal to the Board of Pharmacy and was asked to return with changes and to allow for further consideration by the Board of Pharmacy. (The relevant excerpt from the Board of Pharmacy minutes is copied below. The complete minutes are available on the Board of Pharmacy website at www.rld.state.nm.us/Pharmacy.)
Minutes of The New Mexico Board of Pharmacy Regular Board Meeting
June 4 - 5, 2001
“GELNN WILCOX - NM BOARD OF ACCUPUNCTURE AND ORIENTAL MEDICINE:
Dr. Wilcox presented to the Board a plan for expanded prescriptive authority for people licensed by his Board. He stated that the legislature passed an addition to the practice act of the Board of Acupuncture and Oriental Medicine with extended or expanded prescriptive authority. He presented the education that doctors of oriental medicine would have to take in order to receive certification for the expanded prescriptive authority. Further brief discussion was held regarding this matter. The Board decided that Mr. Wilcox should bring before the Board a more in depth program and the Board will discuss the classes again at that time.”

On 06/11/01, the BAOM approved the draft proposal, with amendments made to the 04/17/01 proposal, for presentation to the Board of Pharmacy. This BAOM approved proposal, drafted in the style appropriate for inclusion in the BAOM rules, detailed the training and certification requirements that D.O.M.s must complete to be certified for expanded prescriptive authority and included the training for use of caffeine, procaine, oxygen, epinephrine and bioidentical hormones. (The minutes of that meeting are available at the BAOM office. The draft proposal approved by the BAOM on 06/11/01 is available at the BAOM office and is copied below.)

“TITLE 16 OCCUPATIONAL AND PROFESSIONAL LICENSING

CHAPTER 2 ACUPUNCTURE AND ORIENTAL MEDICINE
PART 2 SCOPE OF PRACTICE

NEW SECTION TO REPLACE 16.2.2.10

16.2.2.10 EXPANDED PRESCRIPTIVE AUTHORITY: The Board shall certify a Doctor of Oriental Medicine in good standing for Expanded Prescriptive Authority as provided herein.
A. The Doctor of Oriental Medicine shall file a completed and signed application form provided by the Board and shall pay the Administrative Fee for Expanded Prescriptive Authority Application specified in 16.2.10 NMAC (Part 10 of the Rules).
B. The Doctor of Oriental Medicine shall submit proof of completion of the following education, satisfactory to the Board, in the pharmacology and general use of the drugs authorized for use under the Expanded Prescriptive Authority Provisions of Section 61-14A-3.G.(4) and (5) and Section 61-14A-8.1 of the Act. Such education shall have been earned in classes pre-approved by the Board and shall be taught by qualified teachers as approved by the Board. All pharmacology shall be taught by a licensed pharmacist, PharmD or a Ph.D. in pharmacology. The education in the therapeutic use of the drugs shall be taught by a licensed health care practitioner with appropriate training and a minimum of five years experience using the drugs. The Board shall have final authority for approval of classes and teachers. All classes may be video recorded and transcribed for future presentation. Testing shall be administered to insure that the material presented in the classes has been learned. The entire educational program shall be completed within two (2) years. Doctors of Oriental Medicine who wish to be certified in the Expanded Prescriptive Authority shall be educated to such a level of knowledge, understanding, skill and expertise that they shall be able to evaluate the material, have a deep grasp of the application of it in various settings, and be able to generate new thinking about the subject matter. They shall be required to demonstrate their skill in performing the necessary tasks and documenting the outcomes in writing. The above education shall be in addition to the education required to meet the minimum Educational Program requirements for licensure as a Doctor of Oriental Medicine. The education shall include a minimum of one hundred forty-three (143) hours in the following areas:
(1) Forty (40) hours in the theory and practice of injection therapy such as trigger point injection therapy, neural injection therapy, prolo therapy, and intravenous therapy, including the injection of therapeutic biological products, therapeutic serum, sterile water, sterile saline, Sarapin or its generic, caffeine, procaine, epinephrine, and all injectable forms of any herbal medicine, homeopathic medicine, vitamins, minerals, enzymes, glandular products, natural substances, protomorphogens, live cell products, gerovital, amino acids, dietary and nutritional supplements. The course shall include classes in: anatomy, physiology, pathology, pharmacology, diagnostic methodology, clinical strategies, contraindications and safeguards as well as vapocoolant spray and stretch techniques.
(2) Fourteen (14) hours in orthopedic and neurological evaluation.
(3) Fourteen (14) hours in the use of oxygen therapeutically.
(4) Fourteen (14) hours in chelation therapy using vitamins, natural substances and amino acids.
(5) Thirty (30) hours in the theory and practice of bioidentical hormone therapy. The course shall include classes in: anatomy, physiology, endocrinology, pathology, pharmacology, diagnostic imaging, clinical strategies, contraindications, safeguards, and specialist referral.
(6) Twelve (12) hours in blood and saliva hormone diagnostic testing and evaluation.
(7) Fourteen (14) hours in biomedical differential diagnosis relative to the prescription or administration of the authorized drugs.
(8) Five (5) hours in the pharmacology, application and clinical use of cosmetics and over-the-counter drugs.
C. The fifty four (54) hours of education and training completed by a doctor of oriental medicine who is certified for Extended Prescriptive Authority may be credited towards the education required for Expanded Prescriptive Authority Certification.
D. Certification for Extended Prescriptive Authority will not be available after February 28, 2002. However, those Doctors of Oriental Medicine who have been certified for Extended Prescriptive Authority may continue to prescribe or administer the drugs authorized by the Extended Prescriptive Authority until December 31, 2011, but they may not prescribe or administer caffeine, procaine, oxygen, epinephrine or ingested bioidentical hormones. All Extended Prescriptive Authority certifications will expire on December 31, 2011.
E. The Board shall notify the applicant in writing by mail postmarked no more than thirty (30) days after the receipt of the complete application whether the application is accepted or rejected. If the application is rejected, the notice of rejection shall state the reason the application was rejected.
F. The Expanded Prescriptive Authority certification shall automatically terminate when the license lapses, is suspended, revoked or terminated for any reason.
G. A Doctor of Oriental Medicine certified for Expanded Prescriptive Authority shall be designated as such by the addition of “Rx” after his or her license number. The board shall issue a wallet size license card to each Doctor of Oriental Medicine that shall contain the licensee’s name, and license number followed by “Rx” if applicable. The board shall maintain a list of each Doctor of Oriental Medicine who is certified for Expanded Prescriptive Authority and shall notify the New Mexico Board of Pharmacy of all licensees certified for Expanded Prescriptive authority.
H. A Doctor of Oriental Medicine certified with the Expanded Prescriptive Authority shall register with the Federal DEA (Drug Enforcement Agency) to authorize the use of testosterone, a controlled substance, and any other drug that is currently, or in the future, classified as a controlled substance and that is within the prescriptive authority of a doctor of oriental medicine as defined in the Act and this Rule.
Draft for the Board of Pharmacy - Approved by the Board of Acupuncture & Oriental Medicine 6-11-01”

On 07/01/01 House Bill 394 went into effect. HB 394 added “initiates referrals to other health care practitioners and maintains the continuity of care when appropriate” to the definition of “primary care provider” in The Practice Act and increased the BAOM fee ceilings. Senate Bill 536, sponsored by Senator Michael Sanchez, was the same as the House Bill but did not change fees. Both were signed by Governor Johnson but since House Bill 394 was signed last, it became law. (The complete text of the Practice Act Definitions section as of 07/01/01 is included in the Addenda.)
Signed by: Governor Bill Richardson.
Sponsored by: Representative Rick Miera
Drafted by: Dr. Glenn Wilcox
Initiated by: The BAOM and supported by the Association.
Professional Lobbyist: Peter Mallery
Lobbied by: Drs. David Canzone and Glenn Wilcox.

On 07/10/01, the BAOM approved the “Extended Prescriptive Authority Certification Curriculum” submitted by the Academy of Advanced Integrative Medicine LLC (AAIM). AAIM was created by Drs. Martin Manrique and Glenn Wilcox. They developed the curriculum and hired the best, nationally respected teachers from around the country and brought them to New Mexico for the course. This course provided the education required for D.O.M.s to be certified for extended prescriptive authority. There were 22 D.O.M.s who completed this course and were certified for expanded prescriptive authority by the BAOM.

On 08/13/01, Dr. Glenn Wilcox, BAOM Chairman, presented the above draft proposal, approved by the BAOM on 06/11/01, to the Board of Pharmacy. During this Board of Pharmacy meeting, it was agreed that a one hour legal update course by the Pharmacy Board inspectors would be added to the required training and a motion was unanimously passed by the Board of Pharmacy to approve the BAOM proposed regulation for expanded prescriptive authority certification, as presented and amended. (The relevant excerpt from the Board of Pharmacy minutes is copied below. The complete minutes are available on the Board of Pharmacy website at www.rld.state.nm.us/Pharmacy. The complete approved proposal is copied below and a hard copy of it is available in the BAOM file at the Board of Pharmacy offices.)
Minutes of The New Mexico Board of Pharmacy Regular Board Meeting
August 13 & 14, 2001
“BOARD OF ACUPUNCTURE AND ORIENTAL MEDICINE - Dr. Glenn Wilcox:
Dr. Wilcox stated that the only pertinent sections with regard to the Board are the sections regarding training. He would like to know if the Board is comfortable with the amount of training that will be necessary for prescription authority and expanded prescription authority. Dr. Wilcox stated that he would like the Board's approval of this regulation so that the Board of Acupuncture and Oriental
Medicine can schedule a regulation hearing and get these regulations put into effect. Dr. Wilcox went into detail about the training needed in order to be qualified for prescriptive authority and expanded prescriptive authority. Mr. Harvey stated that the one- hour legal update course put on by the Board inspectors should be added to required training. Dr. Wilcox stated that the legal update would be very helpful and he will get it put in the regulation. Mr. Carreno stated that he would like the Attorney General's Office to look into this regulation, but he has no problem with the regulation being noticed for hearing.
MOTION: A motion was made by Mr. Cato, seconded by Mr. Reece to approve the proposed regulation for prescriptive authority as presented by the Acupuncture and Oriental Medicine Board.
The vote was unanimous. Motion passed.”
The above is the only voted upon action taken by the Board of Pharmacy with regard to the requirement in the Acupuncture and Oriental Medicine Practice Act, at 61-14A-8.1.A., that states “the board (BAOM) shall adopt the rules determined by the board of pharmacy for additional training required for the prescribing, administering, compounding or dispensing of caffeine, procaine, oxygen, epinephrine and bioidentical hormones.” As of 08/08/08, it has been the only voted upon action taken by the Board of Pharmacy, since 08/13/01, with respect to anything relating to oriental medicine or D.O.M.s.

On 09/17/01, the BAOM held a rule hearing that was followed by a BAOM meeting at which the new Expanded Prescriptive Authority rule was approved. It replaced the extended prescriptive authority rule. At that time, the amended rule specified that new certifications in extended prescriptive authority would not be available after 02/28/02 but that current certifications in extended prescriptive authority would continue to be valid until final expiration of all extended prescriptive authority certifications on 12/31/11. The wording of this approved Expanded Prescriptive Authority section of the rule was exactly the same as is copied above, as was approved by the BAOM on 06/11/01, except that the total number of hours was increased from 143 to 144 hours and the Board of Pharmacy request for a one hour legal class was added at 16.2.2.10.B.(9) which stated:
“(9) One (1) hour of pharmaceutical law as provided by the New Mexico Board of Pharmacy.”

The above rule change, approved by the BAOM on 09/17/01, was filed with New Mexico Records and Archives and became effective on 11/26/01. Minor changes have been made to this BAOM Rule since then, but no changes have been made to reduce the training required for the substances for which the Board of Pharmacy has oversight. Note that this Expanded Prescriptive Authority section of Part 2 of the BAOM Rules was originally numbered as 16.2.2.10 NMAC but was subsequently renumbered as 16.2.2.11 NMAC.

On 12/10/01, the BAOM approved the amended “Extended Prescriptive Authority Certification Curriculum” submitted by the Academy of Advanced Integrative Medicine LLC. This course provided the education required for D.O.M.s to be certified for extended prescriptive authority. This course provided education in all clinically relevant transdermal natural hormone therapies. (As a result of Senate Bill 272 in 1997, transdermal natural hormones were authorized for prescription and administration under the extended prescriptive authority certification.) Human growth hormone was specifically listed in the approved curriculum. (The document titled “Academy of Advanced Integrative Medicine LLC – Extended Prescriptive Authority Certification Curriculum For New Mexico Doctors of Oriental Medicine” is on file at the BAOM office. Refer to page 3, bottom of the page under “Hormones” and page 9 under “Transdermal Bioidentical Hormones.”)

On 12/10/01, the BAOM approved the “Expanded Prescriptive Authority Certification Curriculum” submitted by the Academy of Advanced Integrative Medicine LLC. This course provided the education required for D.O.M.s to be certified for expanded prescriptive authority. This course provided education in all clinically relevant bioidentical hormone therapies; none were excluded. Twenty-two D.O.M.s completed this course and were certified for expanded prescriptive authority by the BAOM. (The document titled “Academy of Advanced Integrative Medicine Academy LLC – Expanded Prescriptive Authority Certification Curriculum For New Mexico Doctors of Oriental Medicine” is on file at the BAOM office. Refer to page 3 from the middle of the page to page 4.)

On 03/02/03, the BAOM approved increase in the expanded prescriptive authority certification educational requirement went into effect. The total hours of education was increased from 144 to 145 hours. One hour of education in oriental medicine scope of practice was added. Also, continuing education was mandated for D.O.M.s certified for extended or expanded prescriptive authority.

On 07/01/03 House Bill 679 went into effect. HB 679 authorized, under the Practice Act, BAOM certification of auricular detoxification specialists who were not D.O.M.s and also authorized BAOM registration of D.O.M.s as auricular detoxification specialist supervisors. HB 679 also authorized the BAOM to approve auricular detoxification specialist training programs.
Signed by: Governor Bill Richardson.
Sponsored by: Representative Ray Begaye
Drafted by: Dr. Glenn Wilcox
Initiated by: The Association
Professional Lobbyist: Peter Mallery
Lobbied by: Dr. Selah Chamberlain.

On 07/21/03, the BAOM approved the “Expanded Prescriptive Authority Formulary Authorized for Use by DOMs Certified for the Expanded Prescriptive Authority.” In this BAOM approved formulary, all bioidentical hormones were within the prescriptive authority of a D.O.M. certified for expanded prescriptive authority as mandated by the Acupuncture and Oriental Medicine Practice Act. Insulin and human growth hormone were specified. All natural substances were included. Neurotransmitters were specified. (The document titled “Board of Acupuncture & Oriental Medicine, Expanded Prescriptive Authority Formulary Authorized for Use by DOMs Certified for the Expanded Prescriptive Authority” is on file at the BAOM office. Refer to: page 3, number 7; page 6, number 24; and page 7 top of the page. (The complete text is included in the Addenda.))

This “Expanded Prescriptive Authority Formulary Authorized for Use by DOMs Certified for the Expanded Prescriptive Authority” was specifically approved by the BAOM as a working document. It was not approved as a draft document. This intent is clear in the BAOM minutes and has been checked and verified by Anna Hansen, who was BAOM Chair at the time, Dr. Glenn Wilcox who made the motion and Dr. Stuart Watts who seconded the motion. At this time the BAOM had not yet included a formulary in the rules. This formulary was approved by the BAOM so that D.O.M.s and pharmacists would have a formulary document to refer to. An excerpt from the approved minutes of the 07/21/03 BAOM meeting, from page 6, reads as follows: (The complete minutes are available at the BAOM office.)
“Dr. Wilcox MOVED to approve the Expanded Prescriptive Authority Formulary as a working document on page 33 of Addendum #2 and to amend it to add the following language after paragraph four (4), “All substances from threatened or endangered species as determined by the Convention on the International Trade in Endangered Species of Wild Fauna and Flora (CITES at www.cites.org) and the US Fish and Wildlife Service (http://endangered.fws.gov/) shall be automatically eliminated from this formulary. In addition to the above amendment, the following substances are to be removed from the formulary, Bear Gall Bladder, Musk Deer Gland Secretion, and Velvet of Young Deer Horn. Dr. Watts SECONDED the motion, which PASSED unanimously.”

Also on 07/21/03, the BAOM approved the document titled “NMBAOM Guidelines for Biomedical Competencies and Skills.” This document has been posted on the BAOM website since then and serves as an official guideline for all D.O.M.s. and is an especially important information resource for D.O.M.s certified for oriental medicine expanded practice. (The complete text is included in the Addenda.)

On 01/07/04, this “Expanded Prescriptive Authority Formulary Authorized for Use by DOMs Certified for the Expanded Prescriptive Authority” was again reviewed and the approval confirmed. An excerpt from the minutes of the 01/07/04 BAOM meeting, on page 3, reads as follows: (The complete minutes are available at the BAOM office.)
“Rx Formulary: Chair Hansen stated that the Committee will be going forward with the formulary. The Committee’s directive is to 1) Work towards defining ‘Natural Substances’ and ‘Bio-identical Hormones’, and 2) Criteria for Continuing Education for the Expanded Prescriptive Authority licensure level. Dr. Watts moved to approve the NMBAOM Expanded Prescriptive Authority Formulary. Dr. Duckworth SECONDED the motion for discussion purposes. Dr. Wilcox stated that the NMBAOM Expanded Prescriptive Authority Formulary was approved at the July 21, 2003 regular meeting. Ms. Ortiz read the motion from the approved minutes of the July 21, 2003 regular meeting confirming Dr. Wilcox’s statement. Motion was withdrawn as was the second.” [Please refer to the attached document “Board of Acupuncture & Oriental Medicine, Regular Meeting Draft Minutes January 7, 2004,” page 3.]

After 2003, Governor Richardson appointed all new members to the Board of Acupuncture and Oriental Medicine and to the Board of Pharmacy. During 2004, a Joint Committee of members from both Boards initiated a dialogue about the substances that should be listed in the Extended and Expanded Prescriptive Authority Formularies. No final official conclusion was arrived at by that Joint Committee and the Joint Committee discontinued meeting.

On 08/13/04, the BAOM held a rule hearing that was followed by a BAOM meeting at which substantial amendments to 16.2.2 NMAC, the Scope of Practice Rule, were approved. The amended rule was filed with New Mexico Records and Archives and became effective on 12/15/05. With this change, the extended prescriptive authority certification was reinstated at 16.2.2.10 NMAC and the total education required was increased, from the 54 hours previously required in 2001 prior to eliminating this certification, to 60 hours. Intravenous therapy, which had been practiced by some D.O.M.s certified for extended prescriptive authority, was specifically excluded from the extended prescriptive authority at this time. The extended prescriptive authority education was made a prerequisite for the expanded prescriptive authority education. The total expanded prescriptive authority education at 16.2.2.11 NMAC, including the 60 hours of prerequisite extended prescriptive authority education, was increased from 144 hours to 145 hours (60 hours + 95 hours). A new section at 16.2.2.13 NMAC was added for the “Prescriptive Authority Formulary.” For the first time the formulary was formalized in a rule. Insulin was deleted from the formulary approved by the BAOM on 07/21/03, as were atropine and neurotransmitters. Human growth hormone was not specified but anterior pituitary hormones were included. Human growth hormone is a type of anterior pituitary hormone and therefore was included under that general category. This rule was adopted almost a year after the BAOM approved the previous formulary that included all bioidentical hormones, atropine and neurotransmitters. Only one BAOM professional member remained at this time from those who had approved the previous formulary on 07/21/03. (The complete Part 2 Scope of Practice rule as approved by the BAOM on 08/13/04 is included in the Addenda of this document.)

Also on 08/13/04, a definition of bioidentical hormones was approved by the BAOM and added to Part 1 at 16.2.1.7.B(8) which reads:
“bioidentical hormones are hormones that are chemically identical to, or are analogues of hormones found in living entities or that have substantially identical physiological functions as hormones found in living entities.”
This is the only definition of bioidentical hormones in New Mexico law. This is likely the first and may currently be the only legal definition of bioidentical hormones in the United States. The FDA does not define bioidentical hormones.

On 11/17/05, the BAOM approved the 60 hour “Rx1 Extended Prescriptive Authority Course” offered by Adi Shakti Acupuncture Inc. which was created by Drs. Japa Khalsa and Mavrick Lobe. There were 23 D.O.M.s who successfully completed this course and were certified for extended prescriptive authority (Rx1) by the BAOM.

On 08/28/06, the BAOM Rx Committee, which had been previously authorized to do so by the BAOM on 04/05/06, approved the “Rx2 Expanded Prescriptive Authority Educational Program.” This course was 134 hours and the 60 hour Rx1 Extended Prescriptive Authority Course was completed as a prerequisite, making for a total of 194 hours. The course was organized by Dr. Maia Saranteas. There were 9 D.O.M.s who successfully completed this course and were certified for expanded prescriptive authority (Rx2) by the BAOM.

In 2007, Senate Bill 353 created four expanded practice and prescriptive authority certifications for D.O.M.s who successfully complete additional training, rather than the two previously authorized (extended prescriptive authority or Rx1 and expanded prescriptive authority certification or Rx2). The four categories created were: 1) basic injection therapy; 2) injection therapy; 3) intravenous therapy; and 4) bioidentical hormone therapy. In addition to the authority to prescribe and administer the authorized substances, the authority to compound and dispense was specified. Although there was no expansion of the prescriptive authority for D.O.M.s certified for expanded practice, four new substance categories were specified which had previously been included under the substance category of natural medicines. These new substance categories were proteins, carbohydrates, lipids, and natural medicines.
The requirement for Board of Pharmacy determination, with BAOM input, of the rule defining the training necessary for use of caffeine, procaine, oxygen, epinephrine and bioidentical hormones remained the same as it was previously. The Practice Act stated “the board shall adopt the rules determined by the board of pharmacy for additional training required for the prescribing, administering, compounding or dispensing of caffeine, procaine, oxygen, epinephrine and bioidentical hormones. The board and the board of pharmacy shall consult as appropriate.” As was the case previously, the Board of Pharmacy was only required, by the Practice Act, to determine the rules defining the training necessary for the use of the five specified substances and was not required to approve the individual curricula of the courses required for certification in the four categories of oriental medicine expanded practice or for continuing education with regard to the use of the five specified substances or any other substances. The BAOM was authorized to approve individual course curricula and continuing education. The base prescriptive authority for all D.O.M.s was expanded to include cosmetics as they are defined in the New Mexico Drug, Device and Cosmetic Act and nonprescription drugs as they are defined in the Pharmacy Act. Previously cosmetics and nonprescription drugs were only authorized for use by D.O.M.s who completed additional BAOM approved education. Also specified in the base prescriptive authority for all D.O.M.s were natural medicines which had previously been included under the natural substances category. (The complete text of the Practice Act Definitions and Expanded Practice sections as of 07/01/07 is included in the Addenda.)
Signed by: Governor Bill Richardson.
Sponsored by: Senator Michael Sanchez
Drafted by: Dr. Glenn Wilcox
Initiated by: The Association
Professional Lobbyist: Peter Mallery
Lobbied by: Dr. Cody Burch, Dr. Beth Gineris, Dr. Rob Skoog and Dr. Glenn Wilcox

As of 07/01/07, when Senate Bill 353 became effective the base prescriptive authority included the prescribing, administering, combining and providing of the following substances by all D.O.M.s:
1. Herbal medicines;
2. Homeopathic medicines;
3. Vitamins;
4. Minerals;
5. Enzymes;
6. Glandular products;
7. Natural substances;
8. Natural medicines;
9. Protomorphogens;
10. Live cell products;
11. Gerovital;
12. Amino acids;
13. Dietary and nutritional supplements;
14. Cosmetics as they are defined in the New Mexico Drug, Device and Cosmetic Act; and
15. nonprescription drugs as they are defined in the Pharmacy Act.

As of 07/01/07, the prescriptive authority also included the prescribing, administering, compounding and dispensing of the following dangerous drugs or controlled substances by D.O.M.s who completed additional training approved by the BAOM:
1. Sterile water;
2. Sterile saline;
3. Sarapin, or its generic;
4. Caffeine;
5. Oxygen;
6. Epinephrine;
7. Vapocoolants;
8. Bioidentical hormones; and
9. Biological products, including therapeutic serum.

As of 07/01/07, the prescriptive authority also included the prescribing, administering, compounding and dispensing of the following substances “if at any time these substances or drugs are classified as dangerous drugs or controlled substances” (e.g. if administered by injection):
1. Herbal medicines;
2. Homeopathic medicines;
3. Vitamins;
4. Minerals;
5. Amino acids;
6. Proteins;
7. Enzymes;
8. Carbohydrates;
9. Lipids;
10. Glandular products;
11. Natural substances;
12. Natural medicines;
8. Protomorphogens;
9. Live cell products;
10. Gerovital;
12. Dietary and nutritional supplements;
12. Cosmetics, as they are defined in the New Mexico Drug, Device and Cosmetic Act; and
13. Nonpresciption drugs as they are defined in the Pharmacy Act.

Again, as of 2008, the BAOM has certified 30 D.O.M.s for extended prescriptive authority (Rx1) and 31 D.O.M.s for expanded prescriptive authority (Rx2). The extended prescriptive authority has been authorized since 1997 and the expanded prescriptive authority has been authorized since 2000. There

ADDENDA

Part 2 Scope of Practice – 16.2.2 NMAC
As of 09/15/09

TITLE 16 OCCUPATIONAL AND PROFESSIONAL LICENSING
CHAPTER 2 ACUPUNCTURE AND ORIENTAL MEDICINE PRACTITIONERS
PART 2 SCOPE OF PRACTICE
16.2.2.1 ISSUING AGENCY: New Mexico Board of Acupuncture and Oriental Medicine.
[16.2.2.1 NMAC - Rp, 16.2.2.1 NMAC, 02-15-05]
16.2.2.2 SCOPE: All licensed doctors of oriental medicine, all licensed doctors of oriental medicine certified for the extended (Rx1) or expanded (Rx2) prescriptive authority, temporary licensees engaging in only those activities authorized on the temporary license, externs engaging in only those activities authorized by the externship and students enrolled in an educational program in acupuncture and oriental medicine approved by the board working under the direct supervision of a teacher at the approved educational program as part of the educational program in which they are enrolled.
[16.2.2.2 NMAC - Rp, 16.2.2.2 NMAC, 02-15-05]
16.2.2.3 STATUTORY AUTHORITY: This part is promulgated pursuant to the Acupuncture and Oriental Medicine Practice Act, Sections 61-14A-3, 4, 6, 8 and 8.1 NMSA 1978.
[16.2.2.3 NMAC - Rp, 16.2.2.3 NMAC, 02-15-05]
16.2.2.4 DURATION: Permanent.
[16.2.2.4 NMAC - Rp, 16.2.2.4 NMAC, 02-15-05]
16.2.2.5 EFFECTIVE DATE: 02-15-05, unless a later date is cited at the end of a section.
[16.2.2.5 NMAC - Rp, 16.2.2.5 NMAC, 02-15-05]
16.2.2.6 OBJECTIVE: This part clarifies the scope of practice of doctors of oriental medicine, temporary licensees, externs and students and defines the requirements for extended (Rx1) and expanded (Rx2) prescriptive authority.
[16.2.2.6 NMAC - Rp, 16.2.2.6 NMAC, 02-15-05]
16.2.2.7 DEFINITIONS: Refer to definitions in 16.2.1.7 NMAC (Section 7 of Part 1 of the rules).
[16.2.2.7 NMAC - Rp, 16.2.2.7 NMAC, 02-15-05]
16.2.2.8 SCOPE OF PRACTICE: Pursuant to Section 61-14A-3 NMSA 1978, the practice of oriental medicine in New Mexico is a distinct system of primary health care with the goal of prevention, cure, or correction of any disease, illness, injury, pain or other physical or mental condition by controlling and regulating the flow and balance of energy and functioning of the person to restore and maintain health. Oriental medicine includes all traditional and modern diagnostic, prescriptive and therapeutic methods utilized by practitioners of acupuncture and oriental medicine worldwide. The scope of practice of doctors of oriental medicine shall include but is not limited to:
A. evaluation, management and treatment services;
B. diagnostic examination, testing and procedures;
C. the ordering of diagnostic imaging procedures and laboratory or other diagnostic tests;
D. the surgical procedures of acupuncture and other related procedures, as well as injection therapy; injection therapy may only be performed by a doctor of oriental medicine who is certified for the extended (Rx1) or expanded (Rx2) prescriptive authority pursuant to 16.2.2.10 and 16.2.2.11 NMAC (Sections 10 and 11 of Part 2 of the rules) or a temporary licensee for the purposes specified in Section 61-14A-12 of the act and 16.2.5 NMAC (Part 5 of the rules);
E. the stimulation of points, areas of the body or substances in the body using qi, needles, heat, cold, color, light, infrared and ultraviolet, lasers, sound, vibration, pressure, magnetism, electricity, electromagnetic energy, bleeding, suction, or other devices or means;
F. physical medicine modalities, procedures and devices; spray and stretch techniques using prescription vapocoolants may only be performed by a doctor of oriental medicine who is certified for the extended (Rx1) or expanded (Rx2) prescriptive authority pursuant to 16.2.2.10 NMAC (Section 10 of Part 2 of the rules) or a temporary licensee for the purposes specified in Section 61-14A-12 of the act and 16.2.5 NMAC (Part 5 of the rules);
G. therapeutic exercises, qi exercises, breathing techniques, meditation, and the use of biofeedback devices and other devices that utilize heat, cold, color, light, infrared and ultraviolet, lasers, sound, vibration, pressure, magnetism, electricity, electromagnetic energy and other means therapeutically;
H. dietary and nutritional counseling and the prescription or administration of food, beverages and dietary supplements therapeutically;
I. counseling and education regarding physical, emotional and spiritual balance in lifestyle;
J. the prescription or administration of any herbal medicine, homeopathic medicine, vitamins, minerals, enzymes, glandular products, natural substances, protomorphogens, live cell products, gerovital, amino acids and dietary and nutritional supplements; the injection of any of the above substances may only be performed by a doctor of oriental medicine who is certified for the extended (Rx1) or expanded (Rx2) prescriptive authority pursuant to 16.2.2.10 and 16.2.2.11 NMAC (Sections 10 and 11 of Part 2 of the rules) or a temporary licensee for the purposes specified in Section 61-14A-12 of the act and 16.2.5 NMAC (Part 5 of the rules);
K. the prescription or administration of cosmetics, biological products including therapeutic serum and over the counter drugs other than those enumerated in Section 61-14A-3.G.(2) of the act by a doctor of oriental medicine who is certified for the extended (Rx1) or expanded (Rx2) prescriptive authority pursuant to 16.2.2.10 and 16.2.2.11 NMAC (Sections 10 and 11 of Part 2 of the rules) or a temporary licensee for the purposes specified in Section 61-14A-12 of the act and 16.2.5 NMAC (Part 5 of the rules);
L. the prescription or administration of sterile water, sterile saline, sarapin or its generic and vapocoolants by a doctor of oriental medicine who is certified for the extended (Rx1) or expanded (Rx2) prescriptive authority pursuant to 16.2.2.10 and 11 NMAC (Sections 10 and 11 of Part 2 of the rules) or a temporary licensee for the purposes specified in Section 61-14A-12 of the act and 16.2.5 NMAC (Part 5 of the rules);
M. the prescription or administration of caffeine, procaine, oxygen, epinephrine, bioidentical hormones and those substances listed in the prescriptive authority formulary defined in 16.2.2.13 NMAC (Section 13 of Part 2 of the rules) by a doctor of oriental medicine who is certified for the expanded prescriptive authority (Rx2) pursuant to 16.2.2.11 NMAC (Section 11 of Part 2 of the rules) or a temporary licensee for the purposes specified in Section 61-14A-12 of the act and 16.2.5 NMAC (Part 5 of the rules);
N. the prescription or administration of devices, restricted devices and prescription devices as defined in the New Mexico Drug, Device and Cosmetic Act (Section 26-1-1 NMSA 1978) by a doctor of oriental medicine who meets the requirements of 16.2.2.9 NMAC (Section 9 of Part 2 of the rules).
[16.2.2.8 NMAC - Rp, 16.2.2.8 NMAC, 02-15-05]
16.2.2.9 DEVICES, RESTRICTED DEVICES AND PRESCRIPTION DEVICES: The board determines that devices, restricted devices and prescription devices as defined in the New Mexico Drug, Device and Cosmetic Act (Section 26-1-1 NMSA 1978) are necessary in the practice of oriental medicine. Doctors of oriental medicine who have the training recommended by the manufacturer of the device shall be authorized to prescribe or administer the device.
[16.2.2.9 NMAC - Rp, 16.2.2.9 NMAC, 02-15-05]
16.2.2.10 EXTENDED PRESCRIPTIVE AUTHORITY CERTIFICATION (RX1): The board shall certify a doctor of oriental medicine in good standing for extended prescriptive authority (Rx1) as provided herein.
A. The doctor of oriental medicine shall file a completed and signed application form provided by the board and shall pay the administrative fee for extended prescriptive authority (Rx1) application specified in 16.2.10 NMAC (Part 10 of the rules).
B. The doctor of oriental medicine shall submit proof of completion of the following education, satisfactory to the board, in the pharmacology and general use of the drugs authorized for use under the extended prescriptive authority (Rx1) provisions of Section 61-14A-3.G.(4) and (5) and Section 61-14A-8.1 of the act. Such education shall have been earned in classes pre-approved by the board and shall be taught by qualified teachers as approved by the board. All pharmacology shall be taught by a licensed pharmacist, PharmD or a Ph.D. in pharmacology. The education in the therapeutic use of the drugs shall be taught by a licensed health care practitioner with appropriate training and a minimum of five years experience using the drugs. The board shall have final authority for approval of classes and teachers. All classes may be video recorded and transcribed for approval by the board for future presentation of the class. Testing shall be administered as approved by the board to insure that the material presented in the classes has been learned. The entire educational program shall be completed within two (2) years. The above education shall be in addition to the education required to meet the minimum educational program requirements for licensure as a doctor of oriental medicine. The education shall include a minimum of sixty (60) hours in the following areas with one (1) hour of education equal to that defined by the accreditation commission for acupuncture and oriental medicine (ACAOM):
(1) twenty-eight (28) hours in the theory and practice of injection therapy such as trigger point injection therapy, neural injection therapy, prolo therapy, mesotherapy, endotherapy, nerve blocks and therapeutic injections using the authorized drugs in the prescriptive authority formulary defined in 16.2.2.13 (Section 13 of Part 2 of the rules) as well as vapocoolant spray and stretch techniques; intravenous injection and infusion therapy are not authorized under the extended prescriptive authority (Rx1) certification; the course shall include classes in: anatomy, physiology, pathology, biochemistry, pharmacology, diagnostic methodology, clinical strategies, contraindications and safeguards;
(2) fourteen (14) hours in orthopedic and neurological evaluation;
(3) seven (7) hours in biomedical differential diagnosis relative to the prescription or administration of the authorized drugs;
(4) five (5) hours in the pharmacology, application and clinical use of cosmetics and over-the-counter drugs;
(5) three (3) hours in the compounding of the authorized drugs intended for injection utilizing approved aseptic technique;
(6) one (1) hour in the proper record keeping, storage and dispensing of dangerous drugs;
(7) one (1) hour of pharmaceutical law as provided by the New Mexico board of pharmacy;
(8) one (1) hour in oriental medicine scope of practice relative to the authorized substances and techniques.
C. The education and training completed by a doctor of oriental medicine who is certified for extended prescriptive authority (Rx1) may be credited towards the education required for expanded prescriptive authority (Rx2) certification.
D. The board shall notify the applicant in writing by mail postmarked no more than thirty (30) days after the receipt of the complete application whether the application is accepted or rejected. If the application is rejected, the notice of rejection shall state the reason the application was rejected.
E. The extended prescriptive authority (Rx1) certification shall automatically terminate when the license lapses, is suspended, revoked or terminated for any reason.
F. A doctor of oriental medicine certified for extended prescriptive authority (Rx1) shall be designated as such by the addition of “Rx1” after his or her license number. The board shall maintain a list of each doctor of oriental medicine who is certified for extended prescriptive authority (Rx1) and shall notify the New Mexico board of pharmacy of all licensees certified for extended prescriptive authority (Rx1).
G. A doctor of oriental medicine certified for the extended prescriptive authority (Rx1) shall complete all continuing education required by 16.2.9 NMAC (Part 9 of the rules).
[16.2.2.10 NMAC - N, 02-15-05]
16.2.2.11 EXPANDED PRESCRIPTIVE AUTHORITY CERTIFICATION (RX2): The board shall certify a doctor of oriental medicine in good standing for expanded prescriptive authority (Rx2) as provided herein.
A. The doctor of oriental medicine shall file a completed and signed application form provided by the board and shall pay the administrative fee for expanded prescriptive authority (Rx2) application specified in 16.2.10 NMAC (Part 10 of the rules).
B. The education and training required for extended prescriptive authority (Rx1) certification defined in 16.2.2.10 NMAC (Section 10 of Part 2 of the rules) shall be a prerequisite for the education and training required for expanded prescriptive authority (Rx2) certification.
C The doctor of oriental medicine shall submit proof of completion of the following education, satisfactory to the board, in the pharmacology and general use of the drugs authorized for use under the expanded prescriptive authority (Rx2) provisions of Section 61-14A-3.G.(4) and (5) and Section 61-14A-8.1 of the act. Such education shall have been earned in classes pre-approved by the board and shall be taught by qualified teachers as approved by the board. All pharmacology shall be taught by a licensed pharmacist, PharmD or a Ph.D. in pharmacology. The education in the therapeutic use of the drugs shall be taught by a licensed health care practitioner with appropriate training and a minimum of five years experience using the drugs. The board shall have final authority for approval of classes and teachers. All classes may be video recorded and transcribed for approval by the board for future presentation of the class. Testing shall be administered as approved by the board to insure that the material presented in the classes has been learned. The entire educational program shall be completed within two (2) years. The above education shall be in addition to the education required to meet the minimum educational program requirements for licensure as a doctor of oriental medicine. The education shall include a minimum of ninety-five (95) hours in the following areas with one (1) hour of education equal to that defined by the accreditation commission for acupuncture and oriental medicine (ACAOM).
(1) Fourteen (14) hours in the theory and practice of injection therapy such as trigger point injection therapy, neural injection therapy, prolo therapy, mesotherapy, endotherapy, nerve blocks, therapeutic injections and intravenous therapy using the authorized drugs in the prescriptive authority formulary defined in 16.2.2.13 NMAC (Section 13 of Part 2 of the rules). The course shall include classes in: anatomy, physiology, pathology, biochemistry, pharmacology, diagnostic methodology, clinical strategies, contraindications and safeguards.
(2) Fourteen (14) hours in oxidative and ultraviolet medicine and the use of oxygen therapeutically.
(3) Fourteen (14) hours in metal detoxification and chelation therapy using vitamins, natural substances, amino acids and those substances used for chelation therapy listed in the prescriptive authority formulary defined in 16.2.2.13 NMAC (Section 13 of Part 2 of the rules).
(4) Thirty (30) hours in the theory and practice of bioidentical hormone therapy. The course shall include classes in: anatomy, physiology, endocrinology, pathology, biochemistry, pharmacology, diagnostic imaging, diagnostic procedures, clinical strategies, contraindications, safeguards, and specialist referral.
(5) Twelve (12) hours in blood, urine and saliva hormone diagnostic testing and evaluation.
(6) Seven (7) hours in biomedical differential diagnosis relative to the prescription or administration of the authorized drugs.
(7) Two (2) hours in the compounding of the authorized drugs intended for injection utilizing approved aseptic technique.
(8) One (1) hour in the proper record keeping, storage and dispensing of the dangerous drugs and controlled substances.
(9) One (1) hour in oriental medicine scope of practice.
D. The board shall notify the applicant in writing by mail postmarked no more than thirty (30) days after the receipt of the complete application whether the application is accepted or rejected. If the application is rejected, the notice of rejection shall state the reason the application was rejected.
E. The expanded (Rx2) prescriptive authority certification shall automatically terminate when the license lapses, is suspended, revoked or terminated for any reason.
F. A doctor of oriental medicine certified for expanded prescriptive authority (Rx2) shall be designated as such by the addition of “Rx2” after his or her license number. The board shall issue a wallet size license card to each doctor of oriental medicine that shall contain the licensee’s name, and license number followed by “Rx2” if applicable. The board shall maintain a list of each doctor of oriental medicine who is certified for expanded prescriptive authority (Rx2) and shall notify the New Mexico board of pharmacy of all licensees certified for expanded prescriptive authority (Rx2).
G. A doctor of oriental medicine certified for the expanded prescriptive authority (Rx2) shall register with the federal DEA (drug enforcement agency) to authorize the use of testosterone, a controlled substance, and any other drug that is classified as a controlled substance and that is within the prescriptive authority of a doctor of oriental medicine as defined in the act and this rule and as listed in the prescriptive authority formulary defined in 16.2.2.13 NMAC (Section 13 of Part 2 of the rules).
H. A doctor of oriental medicine certified for the expanded prescriptive authority (Rx2) shall complete all continuing education required by 16.2.9 NMAC (Part 9 of the rules).
[16.2.2.11 NMAC - Rp 16.2.2.10 NMAC, 02-15-05]
16.2.2.12 PRESCRIPTION PADS: A doctor of oriental medicine, when prescribing, shall use prescription pads imprinted with his/her name, address, telephone number and license number. If a doctor of oriental medicine is certified for the extended (Rx1) or expanded (Rx2) prescriptive authority, the “Rx1” or “Rx2” designation shall be included after the license number. If a doctor of oriental medicine is using a prescription pad printed with the names of more than one doctor of oriental medicine, each doctor of oriental medicine shall have a separate signature line indicating the name and license number followed by “Rx1” or “Rx2” designation if applicable. Each specific prescription shall indicate the name of the doctor of oriental medicine for that prescription.
[16.2.2.12 NMAC - Rp 16.2.2.11 NMAC, 02-15-05]
16.2.2.13 PRESCRIPTIVE AUTHORITY FORMULARY: A doctor of oriental medicine is authorized to prescribe, dispense or administer only the drugs not listed by the designation Rx after a specific substance in Subsections A to L of this prescriptive authority formulary (16.2.2.13 NMAC) and is not authorized to prescribe the drug if it is classified as a dangerous drug or controlled substance or administer the drug by injection. A doctor of oriental medicine certified for extended prescriptive authority (Rx1) is authorized to prescribe, dispense or administer only the drugs listed in Subsections A to S of this prescriptive authority formulary (16.2.2.13 NMAC) and is only authorized to administer them in compliance with the techniques defined in 16.2.2.10 NMAC (Section 10 of Part 2 of the rules), except that injection of gerovital (buffered procaine) is not authorized and intravenous injection or infusion therapy is not authorized. A doctor of oriental medicine certified for expanded prescriptive authority (Rx2) is authorized to prescribe, dispense or administer all drugs listed in this prescriptive authority formulary (16.2.2.13 NMAC). Drugs, dangerous drugs and controlled substances are defined in the New Mexico Drug, Device and Cosmetic Act and the New Mexico Controlled Substances Act. All drugs listed in this prescriptive authority formulary that at any time have been classified as dangerous drugs or controlled substances, including those intended for injection are within the prescriptive authority of a doctor of oriental medicine certified for the appropriate extended prescriptive authority (Rx1) or expanded (Rx2) prescriptive authority. A drug listed in this prescriptive authority formulary that at any time is classified as a schedule 1 controlled substance, as defined in the New Mexico Controlled Substances Act, is within the prescriptive authority of a doctor of oriental medicine certified for the appropriate extended prescriptive authority (Rx1) or expanded (Rx2) prescriptive authority if at any time that drug is authorized for research or use by prescription or administration by a practitioner. This prescriptive authority formulary is an evolving document. All substances from threatened or endangered species as determined by the convention on the international trade in endangered species of wild fauna and flora (CITES at www.cites.org) and the US fish and wildlife service (http://endangered.fws.gov/) shall be automatically eliminated from this prescriptive authority formulary. Definitions from the New Mexico Drug, Device and Cosmetic Act and the New Mexico Controlled Substances Act apply to the appropriate terms in this prescriptive authority formulary. Doctors of oriental medicine must comply with all federal and state laws pertaining to the obtaining, possession, prescription, compounding, administration or dispensing of any drug, dangerous drug or controlled substance. Any substances for injection or infusion shall only be approved for use if procured from a manufacturer or compounding pharmacy compliant with all federal and state laws. This prescriptive authority formulary does not supersede such laws. A doctor of oriental medicine certified for the extended prescriptive authority (Rx1) or expanded (Rx2) prescriptive authority, when diagnosing and treating a patient, shall possess and apply the knowledge and use the skill and care ordinarily used by other similarly certified doctors of oriental medicine.
A. All herbal medicines from around the world.
B. All homeopathic medicines.
C. All vitamins including their surrogates, isomers and analogues. Doctors of oriental medicine certified for the extended prescriptive authority (Rx1) are authorized to inject these substances except that intravenous injection therapy is not authorized under the extended prescriptive authority (Rx1) certification. Doctors of oriental medicine certified for the expanded prescriptive authority (Rx2) are authorized to administer these substances through any means including intravenous therapy.
D. All minerals from the periodic table including the salts of calcium and magnesium such as ammoniates, anhydrides, ascorbates, aspartates, chlorides, citrates, gluconates, fumarates, iodinates, sulfates, etc., except the injection of gold.
E. All enzymes except urokinase.
F. All glandular products.
G. Natural substances. The authorized natural substances are:
(1) adenosine triphosphate (ATP)
(2) alcohols
(3) acetylcysteine (mucomist) Rx
(4) bee venom (apis)
(5) benzyl alcohol
(6) carbohydrates
(7) colchicine Rx
(8) cytokines
(9) dextrose
(10) EDTA
(a) ethylenediamine tetraacetic acid
(b) disodium ethylenediamine tetraacetic acid
(c) trisodium ethylenediamine tetraacetic acid
(11) fatty acids
(12) flavonoids
(13) fructose
(14) gamaglobulin
(15) glucose
(16) glucosamine
(17) glutathione
(18) glycerine
(19) haemaglobulin
(20) heparin Rx
(21) hyaluronic acid
(22) hydrochloric acid
(23) hydrogen peroxide
(24) lipids
(25) ozone
(26) phenol (carbolic acid) Rx
(27) proteins
(28) pumice
(29) sodium hyaluronate
(30) sodium morrhuate (extract of cod liver oil)
(31) sulfur compounds. Examples are:
(a) DMPS (dimercaptopropane-1-sulphonate)
(b) DMSO (dimethyl sulfoxide)
(c) DMSA (dimercaptosuccinic acid) Rx
(d) MSM (methylsulfonyl methane)
(32) tetrohydropalmatine (extract of corydalis)
(33) all natural substances from the traditional natural medicines of the world
(34) all substances in the natural medicines comprehensive database.
H. All protomorphogens.
I. All live cell products.
J. Gerovital.
K. All amino acids.
L. All dietary and nutritional supplements.
M. All cosmetics as defined in the New Mexico Drug Device and Cosmetic Act.
N. All biological products including therapeutic serum. Biological products and therapeutic serum are defined in the New Mexico Drug, Device and Cosmetic Act.
O. All over the counter drugs available without a prescription. Drugs are defined in the New Mexico Drug Device and Cosmetic Act.
P. Sterile water.
Q. Sterile saline.
R. Sarapin (or its generic).
S. Vapocoolants.
(1) Ethyl chloride
(2) Fluori-methane
T. Caffeine.
U. Procaine.
V. Oxygen.
W. Epinephrine.
X. Bioidentical hormones. The authorized hormones are:
(1) adrenocortical hormones (adrenocorticosteroids; cortical hormones)
(a) androgens (17-ketosteroids, dehydroisoandrosterone, androstenedione, testosterone)
(b) estrogens
(c) glucocorticoids (hydrocortisone or cortisol, cortisone, corticosterone)
(d) mineralocorticoids (aldosterone, dehydroepiandrosterone DHEA)
(e) progesterone
(2) adrenomedullary hormones
(a) epinephrine
(b) norepinephrine
(3) anterior pituitary hormones
(4) sex hormones
(a) androstenedione
(b) androsterone
(c) estradiol (E2)
(d) estriol (E3)
(e) estrone (E1)
(f) progesterone
(g) testosterone
(5) thyroid hormones
(a) 3, 5-diiodothyronine (T2)
(b) calcitonin
(c) monoiodothyronine (T1)
(d) thyroxine; levothyroxine (T4)
(e) triiodothyronine; liothyronine (T3).
[16.2.2.13 NMAC - N, 02-15-05]
16.2.2.14 REVIEW OF THE PRESCRIPTIVE AUTHORITY FORMULARY: Each year the board may review the prescriptive authority formulary for necessary amendments. When new substances are added to the formulary, appropriate education in the use of the new substances shall be approved and required by the board for doctors of oriental medicine applying for new certification or continuing education for renewal in the extended (Rx1) or expanded (Rx2) prescriptive authority.
[16.2.2.14 NMAC - N, 02-15-05]

Oriental Medicine Expanded Practice And Prescriptive Authority Excerpt
From the Acupuncture & Oriental Medicine Practice Act
Effective 07/01/2007

61-14A-8.1. Expanded Practice and Prescriptive Authority, Certifications.
A. The board shall issue certifications, as determined by rule of the board, for expanded practice and prescriptive authority only for the substances enumerated in Paragraphs (1) and (2) of Subsection C of this section to a doctor of oriental medicine who has submitted completed forms provided by the board, paid the application fee for certification and submitted proof of successful completion of additional training required by rule of the board. The board shall adopt the rules determined by the board of pharmacy for additional training required for the prescribing, administering, compounding or dispensing of caffeine, procaine, oxygen, epinephrine and bioidentical hormones. The board and the board of pharmacy shall consult as appropriate.
B. The board shall issue certifications in the four expanded practices of basic injection therapy, injection therapy, intravenous therapy and bioidentical hormone therapy.
C. The expanded practice and prescriptive authority shall include:
(1) the prescribing, administering, compounding and dispensing of herbal medicines, homeopathic medicines, vitamins, minerals, amino acids, proteins, enzymes, carbohydrates, lipids, glandular products, natural substances, natural medicines, protomorphogens, live cell products, gerovital, dietary and nutritional supplements, cosmetics as they are defined in the New Mexico Drug, Device and Cosmetic Act and nonprescription drugs as they are defined in the Pharmacy Act; and
(2) the prescribing, administering, compounding and dispensing of the following dangerous drugs or controlled substances as they are defined in the New Mexico Drug, Device and Cosmetic Act, the Controlled Substances Act or the Pharmacy Act, if the prescribing doctor of oriental medicine has fulfilled the requirements for expanded practice and prescriptive authority in accordance with the rules promulgated by the board for the substances enumerated in this paragraph:
(a) sterile water;
(b) sterile saline;
(c) sarapin or its generic;
(d) caffeine;
(e) procaine;
(f) oxygen;
(g) epinephrine;
(h) vapocoolants;
(i) bioidentical hormones;
(j) biological products, including therapeutic serum; and
(k) any of the drugs or substances enumerated in Paragraph (1) of this subsection if at any time those drugs or substances are classified as dangerous drugs or controlled substances.
D. When compounding drugs for their patients, doctors of oriental medicine certified for expanded practice and prescriptive authority shall comply with the compounding requirements for licensed health care professionals in the United States pharmacopeia and national formulary.

Definitions Excerpt
From the Acupuncture & Oriental Medicine Practice Act
Effective 07/01/2007

61-14A-3. Definitions.
As used in the Acupuncture and Oriental Medicine Practice Act:
A. “acupuncture” means the surgical use of needles inserted into and removed from the body and the use of other devices, modalities and procedures at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition by controlling and regulating the flow and balance of energy and function to restore and maintain health;
B. “board” means the board of acupuncture and oriental medicine;
C. “doctor of oriental medicine” means a person licensed as a physician to practice acupuncture and oriental medicine with the ability to practice independently, serve as a primary care provider and as necessary collaborate with other health care providers;
D. “moxibustion” means the use of heat on or above specific locations, or on acupuncture needles at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition;
E. “oriental medicine” means the distinct system of primary health care that uses all allied techniques of oriental medicine, both traditional and modern, to diagnose, treat and prescribe for the prevention, cure or correction of any disease, illness, injury, pain or other physical or mental condition by controlling and regulating the flow and balance of energy, form and function to restore and maintain health;
F. “primary care provider” means a health care practitioner acting within the scope of the health care practitioner’s license who provides the first level of basic or general health care for a person’s health needs, including diagnostic and treatment services, initiates referrals to other health care practitioners and maintains the continuity of care when appropriate;
G. “techniques of oriental medicine” means:

1. the diagnostic and treatment techniques used in oriental medicine that include diagnostic procedures, acupuncture, moxibustion, manual therapy also known as tui na and other physical medicine modalities and therapeutic procedures, breathing and exercise techniques, dietary, nutritional and lifestyle counseling;
2. the prescribing, administering, combining and providing of herbal medicines, homeopathic medicines, vitamins, minerals, enzymes, glandular products, natural substances, natural medicines, protomorphogens, live cell products, gerovital, amino acids, dietary and nutritional supplements, cosmetics as they are defined in the New Mexico Drug, Device and Cosmetic Act and nonprescription drugs as they are defined in the Pharmacy Act; and
3. the prescribing, administering and providing of devices, restricted devices and prescription devices, as those devices are defined in the New Mexico Drug, Device and Cosmetic Act, if the board determines by rule that such devices are necessary in the practice of oriental medicine and if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board for the devices enumerated in this paragraph; and

H. “tutor” means a doctor of oriental medicine with at least ten years of clinical experience who is a teacher of acupuncture and oriental medicine.

Definitions Excerpt
From the Acupuncture & Oriental Medicine Practice Act
Effective 07/01/1993

61-14A-3. Definitions.
As used in the Acupuncture and Oriental Medicine Practice Act:
A. “acupuncture” means the use of needles inserted into the human body and the use of other modalities and procedures at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition by controlling and regulating the flow and balance of energy and functioning of the person to restore and maintain health;
B. “board” means the board of acupuncture and oriental medicine;
C. “department” means the regulation and licensing department;
D. “doctor of oriental medicine” means a physician licensed to practice acupuncture and oriental medicine and includes the terms “oriental medical physician”, “doctor of acupuncture”, “ acupuncture physician”, acupuncture practitioner” and “acupuncturist”;
E. “moxibustion” means the use of heat on or above specific locations, or on acupuncture needles at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition;
F. “oriental medicine” means the distinct system of primary health care that uses all allied techniques of oriental medicine, both traditional and modern, to diagnose, treat and prescribe, as defined in Subsection G of this section, for the prevention, cure or correction of any disease, illness, injury, pain or other physical or mental condition by controlling and regulating the flow and balance of energy and functioning of the person to restore and maintain health; and
G. “techniques of oriental medicine” means the diagnostic and treatment techniques utilized in oriental medicine that include but are not limited to diagnostic procedures, acupuncture; moxibustion; manual therapy also known as tui na; breathing and exercise techniques, dietary, nutritional and lifestyle counseling; and the prescription or administration of any herbal medicine, homeopathic medicine, vitamin, mineral, enzyme, glandular or nutritional supplement.

Definitions Excerpt
From the Acupuncture & Oriental Medicine Practice Act
Effective 07/01/1997

61-14A-3. Definitions.
As used in the Acupuncture and Oriental Medicine Practice Act:
A. “acupuncture” means the use of needles inserted into and removed from the human body and the use of other devices, modalities and procedures at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition by controlling and regulating the flow and balance of energy and functioning of the person to restore and maintain health;
B. “board” means the board of acupuncture and oriental medicine;
C. “department” means the regulation and licensing department;
D. “doctor of oriental medicine” means a person licensed as a physician to practice acupuncture and oriental medicine with the ability to practice independently, serve as a primary care provider and as necessary collaborate with other health care providers;
E. “moxibustion” means the use of heat on or above specific locations, or on acupuncture needles at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition;
F. “oriental medicine” means the distinct system of primary health care that uses all allied techniques of oriental medicine, both traditional and modern, to diagnose, treat and prescribe for the prevention, cure or correction of any disease, illness, injury, pain or other physical or mental condition by controlling and regulating the flow and balance of energy and functioning of the person to restore and maintain health;
G. “primary care provider” means a health care professional acting within the scope of his license who provides the first level of basic or general health care for an individual’s health needs, including diagnostic and treatment services; and
H. “techniques of oriental medicine” means:
(1) the diagnostic and treatment techniques used in oriental medicine that include diagnostic procedures, acupuncture, moxibustion, manual therapy also known as tui na and other physical medicine modalities and therapeutic procedures, breathing and exercise techniques, dietary, nutritional and lifestyle counseling;
(2) the prescription or administration of any herbal medicine, homeopathic medicine, vitamins, minerals, enzymes, glandular products, amino acids, dietary and nutritional supplements;
(3) the prescription or administration of devices, restricted devices and prescription devices, as those devices are defined in the New Mexico Drug, Device and Cosmetic Act, if the board determines by rule that such devices are necessary in the practice of oriental medicine and if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board for the devices enumerated in this paragraph;
(4) the prescription or administration of cosmetics, therapeutic serum and over the counter drugs, other than those enumerated in Paragraph (2) of this subsection, as those are defined in the New Mexico Drug, Device and Cosmetic Act, if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board, for the substances enumerated in this paragraph; and
(5) the prescription or administration of the following dangerous drugs as they are defined in the New Mexico Drug, Device and Cosmetic Act, if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board for the substances enumerated in this paragraph:
(a) sterile water;
(b) sterile saline;
(c) sarapin, or its generic;
(d) vapocoolants;
(e) topical application of naturally occurring hormones; and
(f) any of the drugs or substances enumerated in Paragraph (2) and (4) of this subsection if at any time these substances or drugs are classified as dangerous drugs.

Definitions & Extended and Expanded Prescriptive Authority Excerpt
From the Acupuncture & Oriental Medicine Practice Act
Effective 07/01/00

61-14A-3. Definitions.
As used in the Acupuncture and Oriental Medicine Practice Act:
A. “acupuncture” means the surgical use of needles inserted into and removed from the body and the use of other devices, modalities and procedures at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition by controlling and regulating the flow and balance of energy and function to restore and maintain health;
B. “board” means the board of acupuncture and oriental medicine;
C. “doctor of oriental medicine” means a person licensed as a physician to practice acupuncture and oriental medicine with the ability to practice independently, serve as a primary care provider and as necessary collaborate with other health care providers;
D. “moxibustion” means the use of heat on or above specific locations, or on acupuncture needles at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition;
E. “oriental medicine” means the distinct system of primary health care that uses all allied techniques of oriental medicine, both traditional and modern, to diagnose, treat and prescribe for the prevention, cure or correction of any disease, illness, injury, pain or other physical or mental condition by controlling and regulating the flow and balance of energy and function to restore and maintain health;
F. “primary care provider” means a health care professional acting within the scope of his license who provides the first level of basic or general health care for a person’s health needs, including diagnostic and treatment services;
G. “techniques of oriental medicine” means:

1. the diagnostic and treatment techniques used in oriental medicine that include diagnostic procedures, acupuncture, moxibustion, manual therapy also known as tui na and other physical medicine modalities and therapeutic procedures, breathing and exercise techniques, dietary, nutritional and lifestyle counseling;
2. the prescription or administration of any herbal medicine, homeopathic medicine, vitamins, minerals, enzymes, glandular products, natural substances, protomorphogens, live cell products, gerovital, amino acids and dietary and nutritional supplements;
3. the prescription or administration of devices, restricted devices and prescription devices, as those devices are defined in the New Mexico Drug, Device and Cosmetic Act, if the board determines by rule that such devices are necessary in the practice of oriental medicine and if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board for the devices enumerated in this paragraph;
4. the prescription or administration of cosmetics, biological products, including therapeutic serum and over the counter drugs, other than those enumerated in Paragraph (2) of this subsection, as those are defined in the New Mexico Drug, Device and Cosmetic Act, if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board, for the substances enumerated in this paragraph; and
5. the prescription or administration of the following dangerous drugs or controlled substances as they are defined in the New Mexico Drug, Device and Cosmetic Act, or the Controlled Substances Act, if the prescribing doctor of oriental medicine has fulfilled requirements for extended or expanded prescriptive authority in accordance with rules promulgated by the board for the substances enumerated in this paragraph:
6. sterile water;
7. sterile saline;
8. sarapin or its generic;
9. caffeine;
10. procaine;
11. oxygen;
12. epinephrine;
13. vapocoolants;
14. bioidentical hormones; and
15. any of the drugs or substances enumerated in Paragraph (2) and (4) of this subsection if at any time these substances or drugs are classified as dangerous drugs or controlled substances; and

H. “tutor” means a doctor of oriental medicine with at least ten years of clinical experience who is a teacher of acupuncture and oriental medicine.

61-14A-8.1. Extended or expanded prescriptive authority; certification.
A. The board may issue certification for extended prescriptive authority as defined by the board to a doctor of oriental medicine who has submitted completed forms provided by the board, paid the application fee for certification and submitted proof of successful completion of additional training required by rule of the board.
B. The board may issue certification for expanded prescriptive authority only for the substances listed in this section to a doctor of oriental medicine who has submitted completed forms provided by the board, paid the application fee for certification and submitted proof of successful completion of additional training required by rule of the board. The board shall adopt the rules determined by the board of pharmacy for additional training required for the prescription or administration of caffeine, procaine, oxygen, epinephrine and bioidentical hormones. The board and the board of pharmacy shall consult as appropriate.

Definitions Excerpt
From the Acupuncture & Oriental Medicine Practice Act
Effective 07/01/01

61-14A-3. Definitions.
As used in the Acupuncture and Oriental Medicine Practice Act:
A. “acupuncture” means the surgical use of needles inserted into and removed from the body and the use of other devices, modalities and procedures at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition by controlling and regulating the flow and balance of energy and function to restore and maintain health;
B. “board” means the board of acupuncture and oriental medicine;
C. “doctor of oriental medicine” means a person licensed as a physician to practice acupuncture and oriental medicine with the ability to practice independently, serve as a primary care provider and as necessary collaborate with other health care providers;
D. “moxibustion” means the use of heat on or above specific locations, or on acupuncture needles at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition;
E. “oriental medicine” means the distinct system of primary health care that uses all allied techniques of oriental medicine, both traditional and modern, to diagnose, treat and prescribe for the prevention, cure or correction of any disease, illness, injury, pain or other physical or mental condition by controlling and regulating the flow and balance of energy and function to restore and maintain health;
F. “primary care provider” means a health care practitioner acting within the scope of his license who provides the first level of basic or general health care for a person’s health needs, including diagnostic and treatment services, initiates referrals to other health care practitioners and maintains the continuity of care when appropriate;
G. “techniques of oriental medicine” means:

• the diagnostic and treatment techniques used in oriental medicine that include diagnostic procedures, acupuncture, moxibustion, manual therapy also known as tui na and other physical medicine modalities and therapeutic procedures, breathing and exercise techniques, dietary, nutritional and lifestyle counseling;
• the prescription or administration of any herbal medicine, homeopathic medicine, vitamins, minerals, enzymes, glandular products, natural substances, protomorphogens, live cell products, gerovital, amino acids and dietary and nutritional supplements;
• the prescription or administration of devices, restricted devices and prescription devices, as those devices are defined in the New Mexico Drug, Device and Cosmetic Act, if the board determines by rule that such devices are necessary in the practice of oriental medicine and if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board for the devices enumerated in this paragraph;
• the prescription or administration of cosmetics, biological products, including therapeutic serum and over the counter drugs, other than those enumerated in Paragraph (2) of this subsection, as those are defined in the New Mexico Drug, Device and Cosmetic Act, if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board, for the substances enumerated in this paragraph; and
• the prescription or administration of the following dangerous drugs or controlled substances as they are defined in the New Mexico Drug, Device and Cosmetic Act, or the Controlled Substances Act, if the prescribing doctor of oriental medicine has fulfilled requirements for extended or expanded prescriptive authority in accordance with rules promulgated by the board for the substances enumerated in this paragraph:
• sterile water;
• sterile saline;
• sarapin or its generic;
• caffeine;
• procaine;
• oxygen;
• epinephrine;
• vapocoolants;
• bioidentical hormones; and
• any of the drugs or substances enumerated in Paragraph (2) and (4) of this subsection if at any time these substances or drugs are classified as dangerous drugs or controlled substances; and

H. “tutor” means a doctor of oriental medicine with at least ten years of clinical experience who is a teacher of acupuncture and oriental medicine.

Expanded Prescriptive Authority Formulary
Approved by the BAOM 08/17/03 

EXPANDED PRESCRIPTIVE AUTHORITY FORMULARY
Authorized for Use by DOMs Certified for the Expanded Prescriptive Authority

Only DOMs, certified for Expanded Prescriptive Authority (the license number contains the suffix Rx), are authorized to prescribe, dispense and administer the following dangerous drugs/controlled substances.

All substances from the following list that at any time have been classified as dangerous drugs or controlled substances, including those intended for injection are within the prescriptive authority of a DOM certified for the Expanded Prescriptive Authority (DOM Rx).

All substances from the following list that are schedule 1 controlled substances are within the prescriptive authority of a DOM Rx if at any time that substance is authorized for use by prescription or administration by a practitioner.

This New Mexico Board of Acupuncture and Oriental Medicine approved Expanded Prescriptive Authority Formulary is an evolving document. The absence of a specific substance does not indicate that the substance is not within the prescriptive authority of a DOM Rx. Please contact the NMBAOM if you have questions about whether or not a specific substance, not listed in this document, is within the scope of practice of a DOM Rx.

All substances from threatened or endangered species as determined by the Convention on the International Trade in Endangered Species of Wild Fauna and Flora (CITES at www.cites.org) and the US Fish and Wildlife Service (http://endangered.fws.gov/) shall be automatically eliminated from this formulary.

Definitions from the New Mexico Drug, Device and Cosmetic Act are copied in the last section of the document.

• All Herbal Medicines from around the world including but not limited to those listed in the following:

• British Herbal Pharacopoeia
• Chinese Herbal Medicine Materia Medica by Bensky and Gamble
• The Energetics of Western Herbs – Integrating Western and Oriental Herbs by Peter Holmes
• Indian Herbology of North America by Alma R. Hutchens
• Los Remedios – Traditional Herbal Remedies of the Southwest by Michael Moore
• Medicinal Plants of the Mountain West by Michael Moore
• Medicinal Plants of the Desert and Canyon West by Michael Moore
• PDR for Herbal Medicines
• Planetary Herbology by Michael Tierra
• The Yoga of Herbs – An Ayurvedic Guide to Herbal Medicine by Dr. Vasant Lad & David Frawley

• All Homeopathic Medicines including but not limited to those listed in the following:

• Biotherapeutic Index Ordinatio Antihomotoxica et Materia Medica by Heel Biotherapeutics
• Dictionary of Practical Materia Medica by John Henry Clarke, MD
• Homeopathic Materia Medica
• Homeopathic Pharmacopoeia of the United States (HPUS)
• Kent Repertory
• Sanum Compendium

• All Vitamins including but not limited to the following:

• Ascorbic acid
• Cyanocobalamin/B12
• Dexpanthenol/B5
• Folic acid
• Hydroxocobalamin/B12
• Methycobalamin/B12
• Pyridoxine hydrochloride/B6
• Pyridoxal 5 phosphate
• Riboflavin-5’-Phosphate
• Thiamine hydrochloride
• Vitamin B-complex

• All Minerals from the periodic table including the salts of calcium and magnesium such as ammoniates, anhydrides, ascorbates, aspartates, chlorides, citrates, gluconates, fumarates, iodinates, sulfates, etc., and includes but is not limited to the following:

• Calcium gluconate
• Calcium intramuscular
• Chromium trace element
• Copper trace element
• Iodopen (iodine)
• Lugols solution (potassium idodide)
• Ammonium molybdate (molybdenum)
• Magnesium chloride hexahydrate
• Magnesium sulfate
• Magnesium sulfate
• Magnesium trace element
• Manganese
• Manganese trace element
• Molybdenum
• Multitrace-5 (zinc, copper, manganese, chromium, selenium)
• Multitrace-5 concentrate (zinc, copper, manganese, chromium, selenium)
• Multivitamin (for infusion)
• Potassium chloride
• Selenium trace element
• Sodium bicarbonate 8.4%
• Sodium chloride 0.9%
• Sodium chloride 0.45%
• Sodium chloride bacteriostatic 0.9%
• Zinc chloride
• Zinc trace element

• All Enzymes including but not limited to the following:

• Endozyme
• Hyalurinadase
• Lumbrokinase
• Nattokinase
• Pancreatic enzymes
• Plasmin
• Secretin
• Urokinase
• Wobenzyme

• All Glandular Products
• All Natural Substances

Natural substances are substances, including atoms, elements, molecules and chemical compounds that exist in nature or are created by natural forces, processes or entities and their preparations, extracts, derivatives, byproducts, refinements, metabolites and analogues. Natural substances include but are not limited to the following:

• Adenosine triphosphate (ATP)
• Alpha lipoic acid (thioctic Acid)
• Analcetalcysteine (Mucomist)
• Apis (bee venom)
• Atropine
• Colchicine
• Cyclic adenosine monophosphate (cAMP)
• Dextrose
• Essential fatty acids
• Essential oils
• Fructose 10%
• Gamaglobulin
• Glucose
• Glucosamine sulfate
• Glutathione
• Glycerine
• Growth factors
• Haemaglobulin
• Heparin
• Hyaluronic acid
• Hydrochloric acid
• Hydrogen peroxide
• Lactated ringers
• Lipids
• Neurotransmitters
• Ozone
• Pumice
• Phenol
• Quercetin
• Sodium hyaluronate
• Sodium morrhuate
  Sodium bicarbonate
• Sulphur compounds
  • DMPS (Dimercaptopropane-1-sulphonate)
  • DMSO (Dimethyl sulfoxide)
  • DMSA (Dimercaptosuccinic Acid)
  • MSM (Methylsulfonyl methane)
• Tetrohydropalmatine (extract of corydalis)

Examples of natural substances that are included in the traditional Chinese Herbal Medicine Materia Medica include, but are not limited to the following:

• Abalone shell
• Antelope horn
• Ash
• Bone
• Calcitum
• Centipede
• Chicken Gizzard Lining
• Cicada Molting
• Clam Shell
• Cockle Shell
• Cuttle-fish Bone
• Earthworm
• Gecko
• Gypsum
• Hornet Nest
• Land Tortise Shell
• Leech
• Macaque Gallstone
• Mirabilitum
• Oyster Shell
• Pearl
• Pipe Fish
• Praying Mantise Egg Case
• Pumice
• Scorpion
• Sea Horse
• Silkworm
• Snake Skin Slough
• Soft Shell Turtle Shell
• White Patterned Snake
• All Protomorphogens (extracts of glandular tissues)
• All Live Cell Products (Live cell products are living cells from glandular tissues and other tissues including stem cells.)
• Gerovital (buffered procaine)
• All Amino Acids including but not limited to the following:

Essential amino acids include:

• Cysteine
• Histidine
• Isoleucine
• Leucine
• Lysine
• Methionine
• Phenylalanine
• Threonine
• Tryptophan
• Tyrosine
• Valine

Nonessential amino acids include:

• Alanine
• Arginine
• Aspartic Acid
• Citrulline
• Glutamic Acid
• Glycine
• Hydroxyglutamic Acid
• Hydroxyproline
• Norleucine
• Proline
• Serine

Other amino acids include but are not limited to the following:

• EDTA Calcium Disodium

• All Dietary and Nutritional Supplements
• All Cosmetics
• All Biological Products Including Therapeutic Serum (As defined in the New Mexico Drug, Device and Cosmetic Act)
• All Over the Counter Drugs including but not limited to the following:

• Dyphenhydramine HCl (Benadryl)
• Epinephrine (Primatene Mist)
• Etc.

• Sterile Water
• Sterile Saline
• Sarapin (or its generic)
• Caffeine
• Procaine
• Oxygen
• Epinephrine
• Vapocoolants

• Ethyl Chloride
• Fuori-Methane

• All Bioidentical Hormones
• Adrenocortical Hormones
• Adrenocorticotropic Hormone (ACTH)
• Androsteindione
• Dopa
• Dopamine
• Dehydroepiandrosterone (DHEA)
• Epinephrine
• Estradiol (E2)
• Estriol (E3)
• Estrone (E1)
• Glucocorticoids
• Human Growth Hormone (HGH)
• Insulin
• Norepinephrine
• Progesterone (P4)
• Pregnenolone
• Testosterone
• Thyroid Stimulating Hormone (TSH)
• Thyroxine (T4)
• Triiodothyronine (T3)

Definitions from the New Mexico Drug, Device and Cosmetic Act

"biological product" means any virus, therapeutic serum, toxin, antitoxin or analogous product applicable to the prevention, treatment or cure of diseases or injuries of man and domestic animals and, as used within the meaning of this definition: 
(1) a "virus" is interpreted to be a product containing the minute living cause of an infectious disease and includes filterable viruses, bacteria, rickettsia, fungi and protozoa; 
(2) a "therapeutic serum" is a product obtained from blood by removing the clot or clot components and the blood cells; 
(3) a "toxin" is a product containing a soluble substance poisonous to laboratory animals or man in doses of one milliliter or less of the product and having the property, following the injection of nonfatal doses into an animal, or causing to be produced therein another soluble substance that specifically neutralizes the poisonous substance and that is demonstrable in the serum of the animal thus immunized; and
(4) an "antitoxin" is a product containing the soluble substance in serum or other body fluid of an immunized animal that specifically neutralizes the toxin against which the animal is immune;

"drug" means: 
(1) articles recognized in an official compendium;
(2) articles intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals and includes the domestic animal biological products regulated under the federal Virus-Serum-Toxin Act, 37 Stat 832-833, 21 U.S.C. 151-158 and the biological products applicable to man regulated under Federal 58 Stat 690, as amended, 42 U.S.C. 216, Section 351 [of Act July 1, 1944, ch. 373], 58 Stat 702, as amended, and 42 U.S.C. 262; 
(3) articles other than food that affect the structure or any function of the body of man or other animals; and 
(4) articles intended for use as a component of Paragraph (1), (2) or (3) of this subsection, but does not include devices or their component parts or accessories;

"controlled substance" means any drug, substance or immediate precursor enumerated in Schedules I through V of the Controlled Substances Act [30-31-1 NMSA 1978];

"cosmetic" means:
(1) articles intended to be rubbed, poured, sprinkled or sprayed on, introduced into or otherwise applied to the human body or any part thereof for cleansing, beautifying, promoting attractiveness or altering the appearance; and
(2) articles intended for use as a component of any articles enumerated in Paragraph (1) of this subsection, except that the term shall not include soap;

"dangerous drug" means a drug, other than a controlled substance enumerated in Schedule I of the Controlled Substances Act [30-31-1 NMSA 1978], that because of a potentiality for harmful effect or the method of its use or the collateral measures necessary to its use is not safe except under the supervision of a practitioner licensed by law to direct the use of such drug and hence for which adequate directions for use cannot be prepared. "Adequate directions for use" means directions under which the layman can use a drug or device safely and for the purposes for which it is intended. A drug shall be dispensed only upon the prescription of a practitioner licensed by law to administer or prescribe such drug if it: 
(1) is a habit-forming drug and contains any quantity of a narcotic or hypnotic substance or a chemical derivative of such substance that has been found under the federal act and the board to be habit forming;
(2) because of its toxicity or other potential for harmful effect or the method of its use or the collateral measures necessary to its use is not safe for use except under the supervision of a practitioner licensed by law to administer or prescribe the drug;
(3) is limited by an approved application by Section 505 of the federal act to the use under the professional supervision of a practitioner licensed by law to administer or prescribe the drug; 
(4) bears the legend: "Caution: federal law prohibits dispensing without prescription."; 
(5) bears the legend: "Caution: federal law restricts this drug to use by or on the order of a licensed veterinarian."; or 
(6) bears the legend "RX only";

"official compendium" means the official United States pharmacopoeia national formulary or the official homeopathic pharmacopoeia of the United States or any supplement to either of them;

"prescription" means an order given individually for the person for whom prescribed, either directly from the prescriber to the pharmacist or indirectly by means of a written order signed by the prescriber, and bearing the name and address of the prescriber, his license classification, the name and address of the patient, the name and quantity of the drug prescribed, directions for use and the date of issue. No person other than a practitioner shall prescribe or write a prescription;

"practitioner" means a physician, doctor of oriental medicine, dentist, veterinarian, certified nurse practitioner, clinical nurse specialist, pharmacist, pharmacist clinician, certified nurse-midwife, physician assistant, prescribing psychologist or other person licensed or certified to prescribe and administer drugs that are subject to the New Mexico Drug, Device and Cosmetic Act [Chapter 26, Article 1 NMSA 1978];

NMBAOM Expanded Prescriptive Authority Formulary
Approved 7/21/03

BAOM Guidelines for Biomedical Competencies and Skills
Approved by the BAOM on 07/21/03 

NMBAOM GUIDELINES FOR BIOMEDICAL COMPETENCIES AND SKILLS

A Doctor of Oriental Medicine licensed by the New Mexico Board of Acupuncture and Oriental Medicine must demonstrate a clinically relevant, complementary and integrative knowledge of biomedicine sufficient to perform the following tasks in the context of practicing Oriental Medicine in order to refer patients when appropriate. The following competencies and skills are at the entry level and meant to reflect the current Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) requirements for accredited Oriental Medicine programs.

Biomedical Competencies

A. Protocols, Diagnosis and Treatment

1. Perform a physical assessment encompassing a history, physical exam and diagnosis.
2. Recognize conditions, situations and complications that necessitate referral for additional diagnosis or treatment and determine to whom to refer.
3. Recognize emergency situations, determine appropriate care and provide it or arrange for it.
4. Receive and understand referrals.
5. Understand a biomedical diagnosis.
6. Understand and determine a biomedical diagnosis according to ICD-9.
7. Determine an appropriate treatment plan.
8. Provide appropriate dietary recommendations and prescribe appropriate nutritional supplements.
9. Understand the contraindications for, and avoid inappropriate interactions between or side effects of drugs, herbs, natural medicinal substances and nutritional supplements.
10. Understand and conform to the limits of scope of practice.

B. Communication

1. Counsel and communicate with patients about various approaches to their healthcare and condition.
2. Translate an Oriental Medical diagnosis into biomedical terminology.
3. Comply with appropriate charting practices.
4. Communicate and consult with appropriate healthcare providers.
5. Evaluate and counsel patients about psychological and lifestyle issues.
6. Participate in maintaining the continuity of care.

C. Public Health and Safety

1. Protect the health and safety of the patient, staff and health care provider with regard to infectious/contagious diseases.
2. Participate in the community healthcare network.

Biomedical Skills Relating To Biomedical Competencies

1. Utilize an understanding of anatomy and physiology.
2. Utilize an understanding of medical terminology.
3. Utilize an understanding of a medical history.
4. Utilize an understanding of pathology.
5. Utilize an understanding of psychology.
6. Utilize an understanding of diagnosis.
7. Utilize an understanding of nutrition.
8. Utilize an understanding of pharmacology.
9. Utilize an understanding of ICD-9 codes.
10. Utilize appropriate reference resources.
11. Understand the clinical relevance of biomedical history taking, physical examination, diagnostic lab and imaging tests and procedures
12. Utilize an understanding of diagnostic lab reports and imaging reports.
13. Utilize diagnostic lab and imaging reports.
14. Review all medications.
15. Review a medical history.
16. Evaluate a medical history.
17. Generate a medical history.
18. Take vital signs.
19. Perform an exam.
20. Perform a systems review.
21. Review physical assessments.
22. Recognize patterns of disease and symptoms.
23. Formulate a working differential diagnosis.
24. Determine treatment protocols.
25. Consider contraindications.
26. Determine a prognosis.
27. Utilize appropriate principles of clinical management.
28. Consider referral.
29. Understand the relevant, prevalent healthcare systems and therapies.
30. Recognize conditions, situations and complications that necessitate referral for additional diagnosis or treatment and determine to whom to refer.
31. Utilize an understanding of pain management.
32. Possess an ability to communicate with healthcare providers with an understanding of their healthcare system and the diagnostic procedures and therapies they use.
33. Communicate and consult with appropriate healthcare providers.
34. Understand how to access community healthcare resources.
35. Utilize appropriate public health resources.
36. Communicate and consult with appropriate healthcare providers and community healthcare personnel.
37. Utilize appropriate charting practices.
38. Utilize SOAP notes.
39. Comply with HIPAA requirements.
40. Comply with New Mexico Board of Acupuncture and Oriental Medicine charting requirements.
41. Comply with federal requirements for chart storage.
42. Perform basic life support and first aid.
43. Utilize appropriate emergency resources.
44. Recognize and understand infectious/contagious diseases, blood borne and surface pathogens.
45. Implement appropriate infectious/contagious disease precautions and procedures for patients, staff and providers.
46. Practice clean needle technique, asepsis and hygiene.
47. Utilize an understanding of appropriate sterilization technique.
48. Practice appropriate sharps and blood waste products disposal.
49. Utilize an understanding of OSHA requirements.
50. Understand macro and micro nutrition.
51. Explain how poor nutrition contributes to disease.
52. Explain how proper nutrition contributes to the prevention and treatment of health problems.
53. Evaluate when to refer for nutritional consultation.
54. Recognize psychological pathologies.
55. Understand the various types of counseling, psychotherapy and psychiatric services for appropriate referral.
56. Evaluate patients for conditions that may endanger themselves or others including domestic violence, depression, suicidal tendencies, hypomanic and manic behaviors and eating disorders.
57. Utilize resources for suicide, domestic violence, rape or other crisis hotlines and treatment centers and individual counselors.
58. Recognize and utilize appropriate types of counseling for identified conditions.
59. Counsel patients about health promoting behaviors and attitudes, stressful events of daily living and emotional symptoms that may accompany a physical illness.
60. Recommend appropriate stress reduction techniques. 

Definitions As Used in This Document

Biomedicine means the application of the principles of the natural sciences to clinical medicine.
Biomedical diagnosis means a diagnosis of a person’s medical status based on the commonly agreed upon guidelines of conventional biomedicine as classified in the most current edition or revision of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM).
Competencies (competence) are abilities and imply the possession of the required skill and knowledge to perform a task adequately and satisfactorily.
ICD-9 is the most current edition or revision of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM).

Prescriptive Authority Explanation
for New Mexico Doctors of Oriental Medicine

By Dr. Glenn Wilcox

Adopted by the New Mexico Board of Acupuncture and Oriental Medicine
as an administrative directive 3/28/03

Purpose and Use of the Document

This document reflects the opinion of the author and is not necessarily the opinion of the New Mexico Board of Acupuncture and Oriental Medicine or other entity of the State of New Mexico. This document is prepared to furnish the New Mexico Doctor of Oriental Medicine with a general discussion or description of specific issues arising in connection with certain statutes or regulations that pertain to the practice of acupuncture and oriental Medicine. This document is not a definitive expression of the law that may apply in a particular actual situation and does not address the broad range of legal or medical issues that could arise when engaged in the practice of acupuncture and oriental medicine. This document is to be used for general educational purposes. The author, the Board of Acupuncture and Oriental Medicine, and the State of New Mexico make no representation or warranty concerning the application of the legal principles discussed herein to any specific actual situation.

Disclaimer

This information is provided as a general description of certain New Mexico statutes and regulations that pertain to the practice of acupuncture and oriental medicine. Every effort is made to provide accurate information as of the date of publication. The statutory and regulatory references provided are not inclusive of all laws that relate to the practice of acupuncture and oriental medicine. Laws are subject to revision or repeal by subsequent legislative action and are subject to interpretation, modification, or limitation by courts or regulatory authorities. Other statutes or regulations not described herein may apply to a particular subject matter, practice area, or actual situation. This information is not intended as legal, medical, or other professional advice.

Suggestions

This document is intended to help the doctor of oriental medicine in New Mexico better understand his or her scope of practice, specifically in relation to prescriptive authority. It is suggested that having a copy of the definition section, 61-14A-3, of the Acupuncture and Oriental Medicine Practice Act (The Act) available to refer to while reading this document will facilitate understanding. Refer to the material under the “Sources” heading below for instructions on locating the Practice Act. For your convenience, the definition section is copied towards the end of this document. Also, definitions of terms from the New Mexico Drug, Device and Cosmetic Act are included at the end of this document.

Summary

Basic Prescriptive Authority: A New Mexico D.O.M is authorized to prescribe or administer any herbal medicine, homeopathic medicine, vitamins, minerals, enzymes, glandular products, natural substances, protomorphogens, live cell products, gerovital, amino acids and dietary and nutritional supplements. Injectable forms of the above substances are not included in the basic prescriptive authority. A New Mexico D.O.M. who is not certified for the Extended Prescriptive Authority or Expanded Prescriptive Authority is not authorized to do injection therapy.

Extended Prescriptive Authority: A New Mexico D.O.M. certified for the Extended Prescriptive Authority is authorized to prescribe or administer all the above substances in the Basic Prescriptive Authority and the injectable forms of the above drugs as well as cosmetics, biological products including therapeutic serum, over the counter drugs, sterile water, sterile saline, Sarapin or its generic and vapocoolants.

Expanded Prescriptive Authority: A New Mexico D.O.M. certified for the Expanded Prescriptive Authority is authorized to prescribe or administer all the above substances in both the Basic Prescriptive Authority and the Extended Prescriptive Authority as well as caffeine, procaine, oxygen, epinephrine and all forms of bioidentical hormones. The board approved Expanded Prescriptive Authority Formulary lists the substances authorized for use.

Devices: All doctors of oriental medicine are authorized to prescribe or administer devices, restricted devices and prescription devices after completing the training recommended by the manufacturer of the device.

Sources

The laws and rules discussed in this document relating to scope of practice and prescriptive authority for New Mexico Doctors of Oriental Medicine can be found at the BAOM (Board of Acupuncture and Oriental Medicine) website at: www.rld.state.nm.us/b&c/acupuncture/index.htm. Review Sections 61-14A-3 and 61-14A-8.1 of The Act (the Acupuncture and Oriental Medicine Practice Act), and Part 2 – Scope of Practice (16.2.2. NMAC) of the Rules of the BAOM.

The laws discussed in this document relating to drugs and devices can be found in the New Mexico Drug, Device and Cosmetic Act. It can be found at the Legislature’s website at: www.legis.state.nm.us. Click on “New Mexico Statutes”, then “Statutes”, then “New Mexico Statutes” and go to “26. Drugs & Cosmetics” and refer to 26-1- 2. Definitions. 

Explanation

Prescriptive authority is the definition of what “drugs” a health care provider is authorized by law to prescribe or administer. “Drug” is a very broad term defined in the New Mexico Drug, Device and Cosmetic Act. That act states “drug means… (2) articles intended for use in the diagnosis, cure, mitigation, treatment or prevention of diseases in man or animal; (3) articles, other than food, that affect the structure or any function of the body of man or animal…” Clearly the term “drug” is much broader than many people realize and by this definition includes herbs, homeopathic medicines and more. “Drugs” that are available without a prescription are called “over the counter” or “OTC” and include such drugs as Tylenol and Primatene Mist. In the past most OTC drugs were previously “patent” prescription drugs that had been reclassified because they were considered relatively safe for the average consumer to figure out how to use without problems. Herbs and other unconventional “drug” substances were not referred to as OTC drugs but that is changing. There is also a federal law, the DSHEA Act, that influences this issue but its implications will not be discussed here.

The basic prescriptive authority for all doctors of oriental medicine licensed in New Mexico is defined in The Act at Section 61-14A-3.G.(2) and includes “the prescription or administration of any herbal medicine, homeopathic medicine, vitamins, minerals, enzymes, glandular products, natural substances, protomorphogens, live cell products, gerovital, amino acids and dietary and nutritional supplements.” Generally these are not thought of as “drugs” but by the above definition of “drug” these substances can be considered “drugs” by the Board of Pharmacy. New Mexico D.O.M.s may only prescribe OTC drugs if they fulfil certain requirements in addition to those for basic licensure. However, the New Mexico Acupuncture and Oriental Medicine Practice Act specifically excludes the above substances in 61-14A-3.G.(2) from inclusion with OTC drugs. Section 61-14A-3.G.(4) of The Act states that the practice of Oriental Medicine in New Mexico includes “the prescription or administration of cosmetics, biological products, including therapeutic serum, and over the counter drugs, other than those enumerated in Paragraph (2) of this subsection [i.e. 61-14A-3.G.(2)], as those are defined in the New Mexico Drug, Device and Cosmetic Act, if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board, for the substances enumerated in this paragraph.” The additional requirements for prescriptive authority for cosmetics, biological products, including therapeutic serum and over the counter drugs are included with the requirements for the Expanded Prescriptive Authority certification described below and can be found in Section 10 of Part 2 Scope of Practice of the Rules of the New Mexico Board of Acupuncture and Oriental Medicine (16.2.2.10.B.8 NMAC).

Injectable forms of the above substances listed in Section 61-14A-3.G.(2) of The Act are not included in the basic prescriptive authority for a D.O.M. Injectable forms of these substances are classified as “dangerous drugs.” The New Mexico Drug, Device and Cosmetic Act states "dangerous drug means a drug, other than a controlled substance enumerated in Schedule I of the Controlled Substances Act, that because of a potentiality for harmful effect or the method of its use or the collateral measures necessary to its use is not safe except under the supervision of a practitioner licensed by law to direct the use of such drug and hence for which adequate directions for use cannot be prepared. “Adequate directions for use means directions under which the layman can use a drug or device safely and for the purposes for which it is intended.” What this means is that even sterile water is considered a “dangerous drug” by the Board of Pharmacy and the FDA if its intended or actual use is for injection, and therefore requires a prescription to buy it or an appropriately authorized license to administer it or direct the administration of it.

Doctors of oriental medicine who are certified for the Extended Prescriptive Authority (identified by Ex after the license number) and the Expanded Prescriptive Authority (identified by Rx after the license number) are additionally authorized to prescribe or administer the injectable forms of the above “drugs” such as herbal medicines, homeopathic medicines, vitamins, etc. from Section 61-14A-3.G.(2) of The Act, and cosmetics, biological products including therapeutic serum, and over the counter drugs from Section 61-14A-3.G.(4) of The Act, as well as sterile water, sterile saline, Sarapin or its generic and vapocoolants from Sections 61-14A-3.G.(5) and 61-14A-8.1.A of the Act.

Section 61-14A-3.G.(5) of the Act is very clear that a D.O.M. must be certified in the Extended Prescriptive Authority or the Expanded Prescriptive Authority to be authorized to prescribe or administer any “dangerous drug” (specifically paragraph (j) below). The Act states that:
“techniques of oriental medicine means: the prescription or administration of the following dangerous drugs or controlled substances as they are defined in the New Mexico Drug, Device and Cosmetic Act, or the Controlled Substances Act, if the prescribing doctor of oriental medicine has fulfilled requirements for extended or expanded prescriptive authority in accordance with rules promulgated by the board for the substances enumerated in this paragraph:

• sterile water;
• sterile saline;
• sarapin or its generic;
• caffeine;
• procaine;
• oxygen;
• epinephrine;
• vapocoolants;
• bioidentical hormones; and

(j) any of the drugs or substances enumerated in Paragraph (2) and (4) of this subsection if at any time these substances or drugs are classified as dangerous drugs or controlled substances.”
The last subparagraph (j) above was created to protect D.O.M.s into the future. The FDA determines what substances are dangerous drugs or controlled substances. Subparagraph (j) will insure that D.O.M.s in New Mexico, who are certified for the Extended Prescriptive Authority or the Expanded Prescriptive Authority, will continue to be able to prescribe and administerall of the substances that are currently in their prescriptive authority, even if the FDA classified any of these substances in the past or reclassifies any of them in the future as a dangerous drug or controlled substance.

Since all injectable substances are dangerous drugs, only D.O.M.s who are certified for the Extended Prescriptive Authority or the Expanded Prescriptive Authority may perform injection therapy. (Refer to the “Historical Note” at the end of the document.)

Doctors of oriental medicine who are certified for the Expanded Prescriptive Authority (identified by Rx after the license number) are authorized to prescribe or administer all the above substances as well as caffeine, procaine, oxygen, epinephrine and all bioidentical hormones according to Sections 61-14A-3.G.(5) and 61-14A-8.1.B of The Act. New Mexico law (Section 61-14A-8.1.B of The Act) required that the New Mexico Board of Pharmacy determine the language of the Expanded Prescriptive Authority rule for the BAOM after consulting with the BAOM.

All doctors of oriental medicine are authorized to prescribe or administer devices, restricted devices and prescription devices after completing the training recommended by the manufacturer of the device according to Section 61-14A-3.G.(3) of The Act and Section 9 of Part 2 - Scope of Practice of the Rules (16.2.2.9 NMAC).

Excerpts from the Acupuncture and Oriental Medicine Practice Act

61-14A-3. DEFINITIONS.
As used in the Acupuncture and Oriental Medicine Practice Act:
A. “acupuncture” means the surgical use of needles inserted into and removed from the body and the use of other devices, modalities and procedures at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition by controlling and regulating the flow and balance of energy and function to restore and maintain health;
B. “board” means the board of acupuncture and oriental medicine;
C. “doctor of oriental medicine” means a person licensed as a physician to practice acupuncture and oriental medicine with the ability to practice independently, serve as a primary care provider and as necessary collaborate with other health care providers;
D. “moxibustion” means the use of heat on or above specific locations, or on acupuncture needles at specific locations on the body for the prevention, cure, or correction of any disease, illness, injury, pain, or other condition;
E. “oriental medicine” means the distinct system of primary health care that uses all allied techniques of oriental medicine, both traditional and modern, to diagnose, treat and prescribe for the prevention, cure or correction of any disease, illness, injury, pain or other physical or mental condition by controlling and regulating the flow and balance of energy and function to restore and maintain health;
F. “primary care provider” means a health care practitioner acting within the scope of his license who provides the first level of basic or general health care for a person’s health needs, including diagnostic and treatment services, initiates referrals to other health care practitioners and maintains the continuity of care when appropriate;
G. “techniques of oriental medicine” means:
(1) the diagnostic and treatment techniques used in oriental medicine that include diagnostic procedures, acupuncture, moxibustion, manual therapy also known as tui na and other physical medicine modalities and therapeutic procedures, breathing and exercise techniques, dietary, nutritional and lifestyle counseling;
(2) the prescription or administration of any herbal medicine, homeopathic medicine, vitamins, minerals, enzymes, glandular products, natural substances, protomorphogens, live cell products, gerovital, amino acids, dietary and nutritional supplements;
(3) the prescription or administration of devices, restricted devices and prescription devices, as those devices are defined in the New Mexico Drug, Device and Cosmetic Act, if the board determines by rule that such devices are necessary in the practice of oriental medicine and if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board for the devices enumerated in this paragraph;
(4) the prescription or administration of cosmetics, biological products, including therapeutic serum, and over the counter drugs, other than those enumerated in Paragraph (2) of this subsection, as those are defined in the New Mexico Drug, Device and Cosmetic Act, if the prescribing doctor of oriental medicine has fulfilled requirements for prescriptive authority in accordance with rules promulgated by the board, for the substances enumerated in this paragraph; and
(5) the prescription or administration of the following dangerous drugs or controlled substances as they are defined in the New Mexico Drug, Device and Cosmetic Act or the Controlled Substances Act, if the prescribing doctor of oriental medicine has fulfilled requirements for extended or expanded prescriptive authority in accordance with rules promulgated by the board for the substances enumerated in this paragraph:
(a) sterile water;
(b) sterile saline;

• sarapin, or its generic;
• caffeine
• procaine
• oxygen
• epinephrine
• vapocoolants;
• bioidentical hormones; and
• any of the drugs or substances enumerated in Paragraph (2) and (4) of this subsection if at any time these substances or drugs are classified as dangerous drugs or controlled substances.

61-14A-8.1. EXTENDED OR EXPANDED PRESCRIPTIVE AUTHORITY - CERTIFICATION.

• The board may issue certification for extended prescriptive authority as defined by the board to a doctor of oriental medicine who has submitted completed forms provided by the board, paid the application fee for certification and submitted proof of successful completion of additional training required by rule of the board.
• The board may issue certification for expanded prescriptive authority only for the substances listed in this section to a doctor of oriental medicine who has submitted completed forms provided by the board, paid the application fee for certification and submitted proof of successful completion of additional training required by rule of the board. The board shall adopt the rules determined by the board of pharmacy for additional training required for the prescription or administration of caffeine, procaine, oxygen, epinephrine and bioidentical hormones. The board and the board of pharmacy shall consult as appropriate.

61-14A-17. DISCIPLINARY PROCEEDINGS; JUDICIAL REVIEW; APPLICATION OF UNIFORM LICENSING ACT.
A. In accordance with the procedures contained in the Uniform Licensing Act, the board may deny, revoke or suspend any permanent or temporary license held or applied for under the Acupuncture and Oriental Medicine Practice Act, upon findings by the board that the licensee or applicant:
(17) fails, when diagnosing and treating a patient, to possess or apply the knowledge, or to use the skill and care ordinarily used by reasonably well-qualified doctors of oriental medicine practicing under similar circumstances, giving due consideration to the locality involved.

Definitions from the New Mexico Drug Device and Cosmetic Act

26-1-2. DEFINITIONS

"biological product" means any virus, therapeutic serum, toxin, antitoxin or analogous product applicable to the prevention, treatment or cure of diseases or injuries of man and domestic animals and, as used within the meaning of this definition:
(1) a "virus" is interpreted to be a product containing the minute living cause of an infectious disease and includes filterable viruses, bacteria, rickettsia, fungi and protozoa;
(2) a "therapeutic serum" is a product obtained from blood by removing the clot or clot components and the blood cells;
(3) a "toxin" is a product containing a soluble substance poisonous to laboratory animals or man in doses of one milliliter or less of the product and having the property, following the injection of nonfatal doses into an animal, or causing to be produced therein another soluble substance that specifically neutralizes the poisonous substance and that is demonstrable in the serum of the animal thus immunized; and
(4) an "antitoxin" is a product containing the soluble substance in serum or other body fluid of an immunized animal that specifically neutralizes the toxin against which the animal is immune;
"controlled substance" means any drug, substance or immediate precursor enumerated in Schedules I through V of the Controlled Substances Act;
"drug" means:
(1) articles recognized in an official compendium;
(2) articles intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals and includes the domestic animal biological products regulated under the federal Virus-Serum-Toxin Act, 37 Stat 832-833, 21 U.S.C. 151-158 and the biological products applicable to man regulated under Federal 58 Stat 690, as amended, 42 U.S.C. 216, Section 351, 58 Stat 702, as amended, and 42 U.S.C. 262;
(3) articles other than food that affect the structure or any function of the body of man or other animals; and
(4) articles intended for use as a component of Paragraph (1), (2) or (3) of this subsection, but does not include devices or their component parts or accessories;
"dangerous drug" means a drug, other than a controlled substance enumerated in Schedule I of the Controlled Substances Act, that because of a potentiality for harmful effect or the method of its use or the collateral measures necessary to its use is not safe except under the supervision of a practitioner licensed by law to direct the use of such drug and hence for which adequate directions for use cannot be prepared. "Adequate directions for use" means directions under which the layman can use a drug or device safely and for the purposes for which it is intended. A drug shall be dispensed only upon the prescription of a practitioner licensed by law to administer or prescribe such drug if it:
(1) is a habit-forming drug and contains any quantity of a narcotic or hypnotic substance or a chemical derivative of such substance that has been found under the federal act and the board to be habit forming;
(2) because of its toxicity or other potential for harmful effect or the method of its use or the collateral measures necessary to its use is not safe for use except under the supervision of a practitioner licensed by law to administer or prescribe the drug;
(3) is limited by an approved application by Section 505 of the federal act to the use under the professional supervision of a practitioner licensed by law to administer or prescribe the drug;
(4) bears the legend: "Caution: federal law prohibits dispensing without prescription.";
(5) bears the legend: "Caution: federal law restricts this drug to use by or on the order of a licensed veterinarian."; or
(6) bears the legend "RX only";
"prescription" means an order given individually for the person for whom prescribed, either directly from the prescriber to the pharmacist or indirectly by means of a written order signed by the prescriber, and bearing the name and address of the prescriber, his license classification, the name and address of the patient, the name and quantity of the drug prescribed, directions for use and the date of issue. No person other than a practitioner shall prescribe or write a prescription;
"practitioner" means a physician, doctor of oriental medicine, dentist, veterinarian, certified nurse practitioner, clinical nurse specialist, pharmacist clinician, certified nurse-midwife or other person licensed or certified to prescribe and administer drugs that are subject to the New Mexico Drug, Device and Cosmetic Act;
"cosmetic" means:
1) articles intended to be rubbed, poured, sprinkled or sprayed on, introduced into or otherwise applied to the human body or any part thereof for cleansing, beautifying, promoting attractiveness or altering the appearance; and
2) articles intended for use as a component of any articles enumerated in Paragraph (1) of this subsection, except that the term shall not include soap;
"official compendium" means the official United States pharmacopoeia national formulary or the official homeopathic pharmacopoeia of the United States or any supplement to either of them;

Historical Note

The injection therapy provision in the law was created a few years back after discussion within and outside the profession. Although it requires that all D.O.M.s must get the additional education and training necessary for certification in the Extended Prescriptive Authority or Expanded Prescriptive Authority, to be authorized to perform injection therapy, it was generally felt that there was great advantage to the fact that the new language clearly defined that injection therapy was within our scope of practice in a way that was acceptable to the Board of Pharmacy. Also, since only a few schools in the country had been teaching injection therapy, it provided a responsible means for insuring that any D.O.M. who performed injection therapy was competent to do so. It must be remembered that while many D.O.M.s are comfortable with injection therapy as part of the scope of practice now, it was not long ago that injection therapy was very controversial. New Mexico D.O.M.s have the most mature scope of practice in the nation. That comes with an increased level of responsibility. Of course some may argue that these provisions do not suit their personal needs or they once thought that they could do injection therapy and now they realize that they cannot. However, the language of the Practice Act was the result of the interplay of many forces. It was created to provide the most benefit to the most D.O.M.s while insuring that the consumer is protected from the incompetent practice of Oriental Medicine.