COLORADO STATE BOARD OF CHIROPRACTIC EXAMINERS
Adopted Rules Effective April 30, 2007

The Board of Chiropractic Examiners adopts the following amendments and rules pursuant to their rulemaking authority in 12-33-107(1)(a), C.R.S.

Rule 3  Professional Liability
A.	A chiropractor who qualifies for one of the following categories is exempt from the professional liability requirements outlined in §12-33-116.5, C.R.S.: 
1.	A chiropractor who performs chiropractic services exclusively as an employee of the United States government.
2.	A chiropractor who holds an inactive license.
3.	A chiropractor who provides uncompensated chiropractic care and who does not otherwise engage in any compensated patient care whatsoever.
4.	A chiropractor who holds an active license and does not engage in any patient care whatsoever in the state of Colorado.
5.	A chiropractor who provides services for the Olympic Training Center as long as the chiropractor is covered under professional liability required by the Olympic Training Center with the minimal amounts required for a chiropractor licensed in Colorado.
B.	The professional liability insurance must cover all acts within the entire legal scope of practice defined in §12-33-102, C.R.S.  Coverage is required for acupuncture and electrotherapy only if the licensee is authorized to perform such acts.
C.	Professional liability insurance shall remain in effect without a lapse in coverage.  Licensees shall notify the Board when professional liability insurance policy lapses, and immediately cease the practice of chiropractic until such time that professional liability insurance is reinstated or obtained.
	Rule 7  Scope of Practice
A.	Practices that are not within the scope of chiropractic practice and invoke the duty to refer provision in §12-33-117 (1)(bb), C.R.S. include, but are not limited to:
1.	Treatment of the disease cancer.  This does not preclude screening and diagnostic procedures for the prevention and early detection of cancer or the chiropractic treatment of other concomitant conditions that the patient may have.  In addition, a qualified chiropractor may collaboratively treat cancer in conjunction with, but not replacing, drugs, surgery, or chemotherapy.
2.	Obstetrics.
3.	Surgery.
4.	Administration of anesthetics, with the exception of topical or over-the-counter anesthetics.
5.	Prescription of drugs not referenced in Rule 7 C.
6.	Hypnosis unless used as a procedure to make the adjustment or manipulation more effective and unless the practitioner presents evidence to the Board of having obtained education in hypnosis from an accredited college.
B.	A chiropractor must have the knowledge, skill, ability, and documented competency to perform an act that is within the chiropractic scope of practice.  Procedures with specific clinical, didactic requirements, and qualifications include, but are not limited to: 
1.	Paraspinal Surface Electromyography (EMG) 
a.	Ten (10) hours of initial training with demonstrated competency.
b.	Procedures may be delegated to a qualified technician and must be supervised and interpreted by an on-site qualified and licensed doctor of chiropractic.
c.	Procedures must be performed in a manner consistent with generally accepted parameters, including any relevant standards of the Center for Communicable Diseases and meet safe and professional standards.
2.	Surface Electromyography excluding paraspinal, Nerve Conduction Velocity (NCV) and Needle Electromyography (EMG) 
a.	One hundred and twenty (120) hours of initial clinical and didactic training with demonstrated competency in electromyography (paraspinal surface electromyography excluded).
b.	Procedures may not be delegated to a technician and must be directly performed by a qualified and licensed doctor of chiropractic.
c.	Procedures must be performed in a manner consistent with generally accepted parameters, including clean needle techniques, and standards of the Center for Communicable Diseases and meet safe and professional standards.
3.	Electrocardiography (EKG/ECG)
a.	One hundred and twenty (120) hours of initial and related clinical with didactic training and demonstrated competency in cardiac medicine.
b.	Procedures may not be delegated to a technician and must be directly performed by a qualified and licensed doctor of chiropractic.
c.	Procedures must be performed in a manner consistent with generally accepted parameters, including any relevant standards of the Center for Communicable Diseases and meet safe and professional standards.
4.	Manipulation Under Anesthesia (MUA)
a.	Thirty six (36) hours of didactic and clinical training, successful completion of a competency examination, and nationally recognized certification.
b.	Professional liability insurance coverage to specifically include MUA. 
c.	Procedures must be performed in a manner consistent with generally accepted parameters and standards of practice. 
d.	Procedures shall be performed at either an ambulatory surgical center or outpatient hospital facility.
e.	The role of the chiropractor shall be limited to the scope of chiropractic practice as defined in § 12-33-102(1), C.R.S.
C.	Nutritional Remedial Measures as referenced in § 12-33-102(1), C.R.S., means that a doctor of chiropractic may administer, prescribe, recommend, compound, sell and distribute homeopathic and botanical medicines, vitamins, minerals, phytonutrients, antioxidants, enzymes, glandular extracts, non-prescription drugs, durable and non-durable medical goods and devices.

Rule 26  Sanitary and Hygienic Remedial Measures
Failure to utilize generally accepted standards of sanitary, hygienic, and public health measures may violate section 12-33-102(1), C.R.S., and be subject to disciplinary action under section 12-33-117(b) & (q), C.R.S.