PART 15              CHIROPRACTIC ADVANCED PRACTICE CERTIFICATION REGISTRY               ISSUING AGENCY:  New Mexico Board of Chiropractic Examiners.

[ NMAC - N, 3/31/2009]               SCOPE:  All chiropractic practitioners who are certified for advanced practice or who are applicants for certification for advanced practice.

[ NMAC - N, 3/31/2009]               STATUTORY AUTHORITY:  This part is promulgated pursuant to the Chiropractic Examiners Practice Act Sections 61-4-2, 61-4-4, 61-4-6, 61-4-12 and 61-4-13 NMSA 1978.

[ NMAC - N, 3/31/2009]               DURATION:  Permanent.

[ NMAC - N, 3/31/2009]               EFFECTIVE DATE:  March 31, 2009, unless a later date is cited at the end of a section.

[ NMAC - N, 3/31/2009]               OBJECTIVE:  16.4.15 NMAC lists the requirements for advanced practice registration including course approval, formulary, continuing education, registration, application and fees.

[ NMAC - N, 3/31/2009]               DEFINITIONS:

                A.            “Chiropractic” means the science, art and philosophy of things natural, the science of locating and removing interference with the transmissions or expression of nerve forces in the human body by the correction of misalignments or subluxations of the articulations and adjacent structures, more especially those of the vertebral column and pelvis, for the purpose of restoring and maintaining health for treatment of human disease primarily by, but not limited to, adjustment and manipulation of the human structure. It shall include, but not be limited to, the prescription and administration of all natural agents in all forms to assist in the healing act, such as food, water, heat, light, cold, electricity, mechanical appliances, herbs, nutritional supplements, homeopathic remedies and any necessary diagnostic procedure, excluding invasive procedures, except as provided by the board by rule and regulation. It shall exclude operative surgery and prescription or use of controlled or dangerous drugs, except as provided by the board by rule and regulation.

                B.            “Certified advanced practice chiropractic physician” means advanced practice chiropractor who shall have prescriptive authority for therapeutic and diagnostic purposes as authorized by statute and stated by the board in NMAC.

                C.            “Chiropractic physician” includes doctor of chiropractic, chiropractor, doctor of chiropractic and medicine chiropractic physician and means a person who practices chiropractic as defined in the Chiropractic Physician Practice Act. Chiropractors are physicians that attempt to improve the quality of life, relieve pain and suffering and promote health and wellness with evidence-based and patient centered care as taught in their chiropractic educational institutions.  The chiropractic profession, through its institutions, professional associations, continuing educational providers and requirements teaches its health care professionals to use natural treatments, therapeutic interventions and patient education to promote health and wellness when indicated by the evidence and with other interventions as taught within chiropractic educational institutions and providers of approved continuing education instruction when necessary to safely treat individuals with disease, deformity, disability and neuromusculoskeletal maladies.

                D.            “Nationally recognized credentialing agency” means agency that has been recognized by the board and may be updated annually.  Any educational institution allowed to provide clinical and didactic programs credited toward advanced practice certification must have concurrent approval from the New Mexico medical board and the New Mexico board of chiropractic examiners.

                E.            “Chiropractic formulary” shall mean those substances that have been approved for use by the chiropractor registered in advanced practice by the chiropractic board and as by statute with consensus between the New Mexico medical board and New Mexico board of pharmacy.

[ NMAC - N, 3/31/2009; A, 7/23/2010; A, 1/30/15; A, 2/13/2015]               ADVANCED PRACTICE REGISTRATION GENERAL PROVISIONS:  Advanced practice registration is authorized by Subsection C of 61-4-9.1 NMSA 1978 of the act and defined in 61-4-9.2 NMSA 1978 and allows the use of approved substances through injection for therapeutic purposes.

                A.            A chiropractic physician shall have the prescriptive authority to administer through injection and prescribe the compounding of substances that are authorized in the advanced practice formulary.  Those with active registration are allowed prescription authority that is limited to the current formulary as agreed on by the New Mexico board of chiropractic examiners and as by statute, by the New Mexico board of pharmacy and the New Mexico medical board.  The New Mexico board of chiropractic examiners shall maintain a registry of all chiropractic physicians who are registered in advanced practice and shall notify the New Mexico board of pharmacy of all such current registered licensees no later than September 1st of each licensing period.

                B.            Chiropractic physicians applying for registry shall submit to the board:

                                (1)           documentation that the doctor has successfully completed a competency examination administered by a nationally recognized credentialing agency or after December 31, 2012 successfully completed a graduate degree in a chiropractic clinical practice specialty;

                                (2)           documentation that the chiropractic physician has successfully completed 90 clinical and didactic hours of education provided by an institution approved by the New Mexico medical board and the New Mexico board of chiropractic examiners;

                                (3)           an application provided by the board for registry of the advanced practice certification.

                C.            A chiropractic physician without advanced practice certification may administer, dispense and prescribe any natural substance that is to be used in an oral or topical manner so long as that substance is not considered a dangerous drug.

                D.            The board shall annually renew the advanced practice certification registration of a doctor of chiropractic medicine in good standing if the licensee has completed all continuing education required by 16.4.10 NMAC.

                E.            All advanced practice certification registrations shall automatically terminate when licensure as a doctor of chiropractic medicine

                                (1)           is placed on inactive status as stated in Paragraph (2) of Subsection A of NMAC; or

                                (2)           is suspended, revoked or terminated for any reason as stated in NMAC;

                                (3)           is not renewed prior to the annual renewal date (July 1).

                F.            All advanced practice certification registrations that were automatically terminated pursuant to Subsection E of NMAC shall be automatically reinstated when licensure as a chiropractic physician is reinstated, provided that:

                                (1)           all fees required by NMAC have been paid; and

                                (2)           all continuing education requirements stated in Subsection C of NMAC have been completed; and

                                (3)           any other reinstatement provisions, required by board rule, have been completed.

                G.            An advanced practice registration that is suspended or revoked by the board for any reason listed under NMAC, shall not be reinstated.  The chiropractic physician must reapply for advanced practice certification registration as a new applicant.

                H.            Each year the board may review the advanced practice formularies for necessary amendments. When new substances are added to a formulary, appropriate education in the use of the new substances may be approved and required by the board for chiropractic physician applying for registration or as continuing education for renewal of the applicable advanced practice registration.  All amendments to the formulary shall be made following consensus of the NM board of medicine, NM pharmacy board and the NM board of chiropractic examiners.

                I.             A chiropractic physician certified for advanced practice under NMAC that includes the use of controlled substances shall register with the federal DEA (drug enforcement agency) prior to obtaining, prescribing, administering, compounding the controlled substance.

                J.             A chiropractic physician registered in advanced practice, when prescribing, shall use prescription pads printed with his or her name, address, telephone number, license number and his or her advanced practice certification.  If a chiropractic physician is using a prescription pad printed with the names of more than one chiropractic physician the above information for each chiropractic physician shall be on the pad and the pad shall have a separate signature line for each chiropractic physician.  Each specific prescription shall indicate the name of the chiropractic physician for that prescription and shall be signed by the prescribing chiropractic physician.

[ NMAC - N, 3/31/2009; A, 7/23/2010; A, 1/30/15; A, 2/13/2015, A, 4/9/2022]               ADVANCED PRACTICE REGISTRATION - BOARD REQUIREMENTS:

                A.            The board shall have final authority for registration of all applicants.

                B.            The board shall notify the applicant in writing by mail postmarked no more than thirty (30) days after the receipt of the initial application as to whether the application is complete or incomplete and missing specified application documentation.

                C.            The board shall notify the applicant in writing by mail postmarked no more than thirty (30) days after the notice of receipt of the complete application sent out by the board, whether the application is approved or denied.

                D.            If the application is denied, the notice of denial shall state the reason the application was denied.

                E.            In the interim between regular board meetings the board’s chairman or an authorized representative of the board may certify a chiropractic physician into the advanced practice registry to an applicant who has filed with the board a complete application and complied with all requirements for advanced practice registration.

                F.            The board shall have the authority to deny, suspend, revoke or otherwise discipline an expanded practice certification, in accordance with the Uniform Licensing Act, 61-1-1 to 61-1-31 NMSA 1978, for reasons authorized in the act and clarified in Paragraph (24) of Subsection B of NMAC.

[ NMAC - N, 3/31/2009]             FEES, RENEWAL and CONTINUING EDUCATION:

                A.            A fee of $100 shall accompany the initial application.  When that application is approved a fee of $100 shall be submitted for registry of the advanced practice certification.

                B.            A fee of $100 shall be assessed for all renewal applications, in addition to the standard fee for renewal of the chiropractic license.

                C.            Chiropractic physicians seeking renewal of advanced practice certification registration shall have completed 10 hours of continuing education, in addition to the required number of continuing education hours for the general chiropractic licensure, from an approved institution as stated in 16.4.10 NMAC or as approved by the board.  The continuing education should include pharmacology, toxicology, medication administration or pharmacognosy appropriate to the current formulary and procedures authorized to be performed by the advanced practice chiropractic certification.

[ NMAC - N, 3/31/2009; A, 1/30/2015, A, 4/9/2022]             CHIROPRACTIC FORMULARY:

                A.            Hormones for topical, sublingual, oral use

                                (1)           estradiol

                                (2)           progesterone

                                (3)           testosterone

                                (4)           desicated thyroid

                B.            Muscle relaxers; cyclobenzaprine

                C.            NSAIDs - prescription strength

                                (1)           ibuprofen

                                (2)           naproxen

                D.            Prescription medications for topical use

                                (1)           NMDC Ca2  dextromethorphan

                                (2)           NSAIDSs

                                                (a)           ketoprofen

                                                (b)           piroxicam

                                                (c)           naproxen

                                                (d)           ibuprofen

                                                (e)           diclofenac

                                (3)           muscle relaxers; cyclobenzaprine

                                (4)           sodium chanel antagonist; lidocaine

                E.            Homeopathics requiring prescription

                F.            Other substances by injection

                                (1)           sterile water

                                (2)           sterile saline

                                (3)           sarapin or its generic

                                (4)           caffeine

                                (5)           procaine HCL

                                (6)           epinephrine

                                (7)           homeopathic for injection

                G.            Glutathione for inhalation

[ NMAC - N, 09/11/2009; A, 7/23/2010; A, 11/13/11; A, 04/30/2014]             [RESERVED]

[ NMAC - N, 11/13/11; Repealed, 1/30/2015