HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 1405 Acupuncture
SPONSOR(S): Healthcare Regulation Subcommittee, Altman
TIED BILLS: IDEN./SIM. BILLS: SB 614
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Healthcare Regulation Subcommittee 14 Y, 0 N, As CS Osborne McElroy
2) Health Care Appropriations Subcommittee
3) Health & Human Services Committee
SUMMARY ANALYSIS
Acupuncture is a form of health care based on traditional Chinese medical concepts and modern “oriental”
techniques for the purpose of the promotion, maintenance, and restoration of health and the prevention of
disease. Acupuncture involves the insertion of acupuncture needles and the application of moxibustion to
specific areas of the human body, as well as the use of electroacupuncture, Qi Gong, oriental massage, herbal
therapy, dietary guidelines, and other adjunctive therapies.
The Board of Acupuncture (Board), within the Department of Health (DOH), is responsible for the licensure and
regulation of acupuncturists in the state. There are 2,672 acupuncturists currently licensed to practice in
Florida.
CS/HB 1405 significantly revises the acupuncture practice act which regulates the practice and licensure of
acupuncture in Florida. The bill updates terminology throughout the practice act to use contemporary
terminology and creates a scope of practice for acupuncturists. The bill revises the educational requirements
for a person seeking initial licensure as an acupuncturist and adds practice management to the list of subjects
which may be included in continuing education courses for licensed acupuncturists.
The bill exempts a person acting in the capacity or guest instructor or in response to a declared disaster or
emergency from the prohibition on the unlicensed practice of acupuncture. The bill directs the Board to
establish rules to implement this provision.
The bill has an indeterminant, negative fiscal impact on DOH, and no impact on local government.
The bill provides an effective date of July 1, 2024.
This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives .
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DATE: 2/2/2024
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Licensure and Regulation of Acupuncture
Acupuncture is a form of health care based on traditional Chinese medical concepts and modern
“oriental” techniques for the purpose of the promotion, maintenance, and restoration of health and the
prevention of disease. Acupuncture involves the insertion of acupuncture needles and the application of
moxibustion1 to specific areas of the human body, as well as the use of electroacupuncture, Qi Gong,2
oriental massage, herbal therapy, dietary guidelines, and other adjunctive therapies. 3
There are 2,672 acupuncturists currently licensed to practice in Florida. 4
Board of Acupuncture
The Board of Acupuncture (Board), within the Department of Health (DOH), is responsible for the
licensure and regulation of acupuncturists. The Board consists of seven members appointed by the
Governor and confirmed by the Florida Senate. The board must include five licensed acupuncturists
and two laypersons who have never been acupuncturists or members of a closely related profession. 5
Licensure Requirements
To be licensed to practice acupuncture, a person must apply to DOH and meet all of the following
criteria:6
Be at least 21 years of age, have good moral character, and the ability to communicate in
English;
Have completed 60 college credits from an accredited post-secondary institution;
Have completed a four-year course of study in acupuncture and oriental medicine which meets
the standards set by the Board and includes, at a minimum, courses in western anatomy,
physiology, pathology, and biomedical terminology, first aid, and cardiopulmonary resuscitation
(CPR);7 and
Pay the required fees set by the Board.
In addition to meeting all of the criteria listed above, an applicant must also meet one of the following
requirements:8
Has successfully completed a board-approved national certification;
Is actively licensed to practice in a state with examination requirements that are substantially
equivalent to, or more stringent than, Florida’s requirements; or
1 Moxibustion is an external treatment based in traditional Chinese medicine. The practice involves the burning moxa, an herb, adjacent
to specific acupuncture points. See, Deng, H., & Shen, X. The mechanism of moxib ustion: ancient theory and modern research. (2013).
Evidence-based complementary and alternative medicine https://doi.org/10.1155/2013/379291
2 Qi Gong is the Chinese system of energy cultivation which uses posture, movement, exercises, breathin g, meditation, visualization,
and conscious intent to move, cleanse, or purify Qi (vital energy) to promote, maintain and restore health and to prevent dis ease. See,
Rule 64B1-4.006, F.A.C.
3 S. 457.102(1), F.S.
4 Department of Health, License Verification Look-up. Available at https://mqa-
internet.doh.state.fl.us/MQASearchServices/HealthCareProviders (last visited January 29, 2024).
5 S. 457.103, F.S.
6 S. 457.105, F.S.
7 Individuals who were enrolled in a course of study prior to August 1, 1997 were eligible for licensure upon completion of a t wo-year
course of study which adhered to Board-established standards. See, s. 457.105(2)(b), F.S.
8 S. 457.105, F.S.
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Passes an examination administered by DOH.9
Acupuncturists are required to renew their license to practice biennially. As a condition of licensure
renewal, a licensed acupuncturist is required to complete a minimum of 30 hours of continuing
education per biennium.10 Continuing education programs must be in acupuncture or oriental medicine
subjects, including, but not limited to, anatomy, biological sciences, adjunctive therapies, sanitation and
sterilization, emergency protocols, and diseases.11 The Board is responsible for evaluating and
approving all continuing education courses.12
Scope of Practice
Current law does not expressly outline a scope of practice for acupuncturists. Acupuncturists are
licensed to practice acupuncture, which is defined in current law as a form of primary health care,
based on traditional Chinese medical concepts and modern oriental medical techniques, that employs
acupuncture diagnosis and treatment, as well as adjunctive therapies and diagnos tic techniques, for
the promotion, maintenance, and restoration of health and the prevention of disease. 13
Acupuncture includes, but is not limited to, the insertion of acupuncture needles and the application of
moxibustion to specific areas of the human body and the use of electroacupuncture, Qi Gong, oriental
massage, herbal therapy, dietary guidelines, and other adjunctive therapies. Current law allows the
Board discretion in defining these terms.14
Current law describes an acupuncturist’s prescriptive authority which authorizes an acupuncturist to
prescribe, administer, and use needles and other devices used in the practice of acupuncture and
oriental medicine.15
Prohibited Acts
Current law prohibits the following in regard to the licensed practice of acupuncture:16
The practice acupuncture unless the person is licensed under the acupuncture practice act;
The use, in connection with his or her name or place of business, any title or description of
services which incorporates the words “acupuncture,” “acupuncturist,” “certified acupuncturist,”
“licensed acupuncturist,” “oriental medical practitioner”; the letters “L.Ac.,” “R.Ac.,” “A.P.,” or
“D.O.M.”; or any other words, letters, abbreviations, or insignia indicating or implying the
practice of acupuncture, unless the person is licensed under the acupuncture practice act;
Presenting as his or her own the license of another;
Knowingly giving false or forged evidence to the board or a member thereof;
The use or attempted use of a license that has been suspended, revoked, or placed on inactive
or delinquent status;
The employ of any person who is not licensed pursuant to the acupuncture practice act to
engage in the practice of acupuncture; or
The concealing of information relating to any violation of the acupuncture practice act.
A person who violates this section commits a misdemeanor of the second degree, punishable as
provided in ss. 775.082 and 775.083, F.S.17
9 The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) examination consisting of the Foundations
of Oriental Medicine Module, the Acupuncture with Point Location Module, the Biomedicine Module and the Chinese Herbology Mod ule
is the Board-approved licensure examination. See, 64B1-3.004, F.A.C.
10 S. 457.107, F.S., and Rule 64B1-7.0015, F.A.C.
11 S. 457.107, F.S.
12 Rule 64B1-6.005, F.A.C.
13 S. 457.102, F.S.
14 S. 457.102(1), F.S.; see also, 64B1-3.001, F.A.C.
15 S. 457.102(7), F.S.
16 S. 457.116, F.S.
17 S. 457.116(2), F.S.; The punishment for such a misdemeanor consists of up to 60 days of imprisonment and a fine up to $500; see,
ss. 775.082 and 775.083, F.S.
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Effect of the Bill
CS/HB 1405 significantly revises the acupuncture practice act which regulates the practice and
licensure of acupuncture in Florida.
Licensure Requirements
CS/HB 1405 revises the educational requirements for licensure as an acupuncturist. Effective July 1,
2032, the bill requires an individual complete a minimum of 90 semester credits leading to a bachelor’s
degree from a college or university which is accredited by an accrediting agency recognized and
approved by the US Department of Education, or a foreign college, university, or institution program.
The bill specifies that the required four-year course of study in acupuncture must be from an accredited
program, and effective July 30, 2036, such course of study must terminate with the completion of a
doctoral degree in acupuncture that is recognized and approved by the US Department of Education.18
The bill revises the licensure pathways for individuals who have completed a board-approved national
certification or have been licensed to practice acupuncture in another US state.
The bill adds “practice management” to the list of subjects which may be included in Board-approved
continuing education courses. The bill defines “practice management” as the development or
mechanics of establishing and managing an office, including enhancement of patient care, risk
management, cybersecurity, cost containment, health care documentation, and insurance coding,
billing, and claims processing. The bill specifies that up to six hours of practice management continuing
education courses may be applied toward a licensee’s biennial continuing education requirement.
Scope of Practice
CS/HB 1405 creates a new section of statute outlining the scope of practice for acupuncturists . Under
the bill, the scope of practice for an acupuncturist includes, but is not limited to, the following:
Examination, evaluation and management, analysis, diagnosis, and treatment services;
The use and ordering of testing procedures, diagnostic imaging, and laboratory tests; and
The stimulation of points, areas of the body, and tissues within the body using acupuncture and
Eastern medicine, herbal medicine therapies, nutritional substances, point injection, sterile
solutions, qi, medical instruments, and other devices or means, as defined by Board rule.
The bill directs the Board to periodically revise the use of acupuncture point injection therapies in rule
based on national standards of practice.
The bill expands an acupuncturist’s prescriptive authority to include medical devices, the use of
diagnostic laboratory tests and imaging procedures, botanical and herbal medicines, nutritional
substances, and acupuncture point injection therapies which include the injection of sterile solutions
that are used in the practice of acupuncture and Eastern medicine.
Prohibited Acts
CS/HB 1405 exempts a person acting in the capacity or guest instructor or guest practitioner or in
response to a declared disaster or emergency from the prohibition on the unlicensed practice of
acupuncture. The bill directs the Board to establish rules to implement this provision, including
exemption for teaching approved courses and practicing acupuncture in response to a declared
disaster or emergency.
18The US Department of Education does not directly approve and recognize specific educational programs. Rather, the US Department
of Education recognizes accrediting agencies that evaluate and accredit specific programs. See, US Department of Education,
Accreditation in the United States. Available at https://www2.ed.gov/admins/finaid/accred/accreditation.html#Overview (last visited
January 30, 2024).
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Terminology
CS/HB 1405 revises the definition of acupuncture to align with modern nomenclature used to describe
the practice. The bill deletes references to “Chinese,” and “oriental,” medicine and replaces them with
“Eastern” medicine. The bill defines “Eastern medicine” as a primary health care system of medicine
that includes differential diagnoses and treatment principles, modalities, procedures, and techniques
employing acupuncture; traditional Chinese medicine; contemporary Eastern medicine; herbal
medicine; adjunctive therapies; biological sciences; and medical assessments, examinations, and
evaluations for the promotion, maintenance, and restoration of health and the prevention of human
disease. The bill makes conforming changes throughout the acupuncture practice act.
The bill provides an effective date of July 1, 2024.
B. SECTION DIRECTORY:
Section 1: Amends s. 457.102, F.S., relating to definitions.
Section 2: Amends s. 457.105, F.S., relating to licensure qualifications and fees.
Section 3: Creates s. 457.106, F.S., relating to scope of practice for acupuncturists and
acupuncture assistants.
Section 4: Amends s. 457.107, F.S., relating to renewal of licenses; continuing education.
Section 5: Amends s. 457.116, F.S., relating to prohibited acts; penalty.
Section 6: Provides an effective date of July 1, 2024.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
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Not Applicable. This bill does not appear to affect county or municipal governments
2. Other:
None.
B. RULE-MAKING AUTHORITY:
Sufficient rule-making authority exists to implement the provisions of the bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
The bill currently requires that the course of study in acupuncture be recognized and approved by the
US Department of Education, however, the US Department of Education does not recognize individual
course of study, and instead recognizes accrediting agencies which evaluate and accredit individual
programs.19
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
On February 1, 2024, the Healthcare Regulation Subcommittee adopted a strike-all amendment to HB
1405 and reported the bill favorably as a committee substitute. The amendment:
Defined the terms “Doctor of Acupuncture and Chinese Herbal Medicine” and “Doctor of
Acupuncture and Oriental Medicine;”
Revised the dates that new educational requirements for acupuncture licensure take effect;
Revised the scope of practice for acupuncturists to remove unnecessary references to
telehealth and the Florida Administrative Code; and
The analysis is drafted to the bill as amended by the Healthcare Regulation Subcommittee.
19See, US Department of Education, Accreditation in the United States. Available at
https://www2.ed.gov/admins/finaid/accred/accreditation.html#Overview (last visited Jan