32-1501

32-1501. Definitions

In this chapter, unless the context otherwise requires:

1. "Accepted therapeutic purpose" means treatment of a disease, injury, ailment or
infirmity that is competent and generally recognized as safe and effective.

2. "Active license" means a current valid license to practice naturopathic
medicine.

3. "Adequate medical records" means legible medical records containing, at a
minimum, sufficient information to identify the patient, support the diagnosis, describe
the treatment, accurately document the results, indicate advice and cautionary warning
provided to the patient and provide sufficient information for a similarly qualified
practitioner to assume continuity of the patient's care at any point in the course of
treatment.

4. "Approved clinical training program" or "clinical training program" means a
program for naturopathic medical students in which the training occurred or is being
conducted by or in conjunction with an approved school of naturopathic medicine.

5. "Approved internship program" or "internship" means that the program in which
the training occurred or is being conducted has been approved for internship training for
physicians or for graduates of a school of naturopathic medicine by the board or was
approved or accredited by an educational or professional association recognized by the
board or by another state's or country's licensing agency recognized by the board.

6. "Approved postdoctoral training" or "postdoctoral training" means that the
program in which the training occurred or is being conducted has been approved for
specialty training or for graduate medical education in naturopathic medicine by the
board or approved or accredited by an educational or professional association recognized
by the board or by another state's or country's licensing agency recognized by the board.

7. "Approved preceptorship program" or "preceptorship" means that the program in
which the training occurred or is being conducted has been approved for preceptorship
training for physicians or for graduates of a school of naturopathic medicine by the
board or was approved or accredited by an educational or professional association
recognized by the board or by another state's or country's licensing agency recognized by
the board.

8. "Approved school of naturopathic medicine" or "school of naturopathic medicine"
means a school or college determined by the board to have an educational program that
meets standards prescribed by the council on naturopathic medical education, or its
successor agency, and that offers a course of study that, on successful completion,
results in the awarding of the degree of doctor of naturopathic medicine and whose course
of study is either of the following:

(a) Accredited or a candidate for accreditation by an accrediting agency recognized
by the United States secretary of education as a specialized accrediting agency for
schools of naturopathic medicine or its successor.

(b) Accredited or a candidate for accreditation by an accrediting agency recognized
by the council for higher education accreditation or its successor.

9. "Board" means the naturopathic physicians medical board.

10. "Chelation therapy" means an experimental medical therapy to restore cellular
homeostasis through the use of intravenous, metal-binding and bioinorganic agents such as
ethylene diamine tetraacetic acid. Chelation therapy does not include experimental
therapy used to treat heavy metal poisoning.

11. "Completed application" means that the applicant paid the required fees and
supplied all documents and information as requested by the board and in a manner
acceptable to the board.

12. "Controlled substance" means a drug, substance or immediate precursor in
schedules I through V of title 36, chapter 27, article 2.

13. "Direct supervision" means that a physician who is licensed pursuant to this
chapter or chapter 13, 17 or 29 of this title:

(a) Is physically present and within sight or sound of the person supervised and is
available for consultation regarding procedures that the physician has authorized and for
which the physician remains responsible.

(b) Has designated a person licensed pursuant to this chapter or chapter 13, 17 or
29 of this title to provide direct supervision in the physician's absence.

14. "Doctor of naturopathic medicine" or "doctor" means a natural person licensed to
practice naturopathic medicine under this chapter.

15. "Drug" has the same meaning prescribed in section 32-1901 but does not include:

(a) Intravenous administration of legend drugs, except for:

(i) Vitamins, chelation therapy and drugs used in emergency resuscitation and
stabilization.

(ii) Minerals.

(b) Controlled substances listed as schedule I or II controlled substances as
defined in the federal controlled substances act of 1970 (21 United States Code section
802), except morphine and any homeopathic preparations that are also controlled
substances.

(d) Antipsychotics.

16. "General supervision" means that the physician is available for consultation
regarding procedures that the physician has authorized and for which the physician
remains responsible.

17. "Legend drug" means any drug defined by section 503(b) of the federal food, drug
and cosmetic act and under which definition its label is required to bear the statement
"Rx only".

18. "Letter of concern" means a nondisciplinary advisory letter that is issued by
the board to a person who is regulated under this chapter and that states that while
there is insufficient evidence to support disciplinary action the board believes that the
person should modify or eliminate certain practices and that continuation of the
activities that led to the information being submitted to the board may result in action
against the person's license, certificate or registration.

19. "Letter of reprimand" means a disciplinary letter that is issued by the board
and that informs a person who is regulated under this chapter that the person's conduct
violates state or federal law but does not require the board to restrict the person's
license, certificate or registration because the person's conduct did not result in harm
to a patient or to the public.

20. "Limit" means taking a nondisciplinary action that alters the physician's
practice or professional activities if the board determines that there is evidence that
the physician is or may be mentally or physically unable to safely engage in the practice
of medicine.

21. "Medical assistant" or "naturopathic medical assistant" means a person who is
certified by the board as a medical assistant, who assists a doctor of naturopathic
medicine and who may perform delegated procedures that are commensurate with the
assistant's education and training under the direct supervision of a doctor of
naturopathic medicine and that do not include diagnosing, designing or modifying
established treatment programs or those procedures prohibited by the board or by this
chapter.

22. "Medically incompetent" means a person who is licensed, certified or registered
pursuant to this chapter and who lacks sufficient naturopathic medical knowledge or
skills, or both, to a degree that is likely to endanger the health of patients.

23. "Natural substance" means a homeopathic, botanical, nutritional or other
supplement that does not require a prescription pursuant to federal law before it is
prescribed, dispensed or otherwise furnished to a patient and that is prescribed by a
physician licensed pursuant to this chapter to enhance health, prevent disease or treat a
medical condition diagnosed by the physician.

24. "Naturopathic medical student" means a person who is enrolled in a course of
study at an approved school of naturopathic medicine.

25. "Naturopathic medicine" means medicine as taught in approved schools of
naturopathic medicine and in clinical, internship, preceptorship and postdoctoral
training programs approved by the board and practiced by a recipient of a degree of
doctor of naturopathic medicine licensed pursuant to this chapter.

26. "Nurse" means a person licensed pursuant to chapter 15 of this title.

27. "Physician" means a doctor of naturopathic medicine licensed pursuant to this
chapter.

28. "Practice of naturopathic medicine" means a medical system of diagnosing and
treating diseases, injuries, ailments, infirmities and other conditions of the human mind
and body including by natural means, drugless methods, drugs, nonsurgical methods,
devices, physical, electrical, hygienic and sanitary measures and all forms of physical
agents and modalities.

29. "Restrict" means taking a disciplinary action that alters the physician's
practice or professional activities if the board determines that there is evidence that
the physician is or may be medically incompetent or guilty of unprofessional conduct.

30. "Specialist" means a physician who has successfully completed approved
postdoctoral training, who is certified by a specialty board of examiners recognized by
the board and who is certified by the board to practice the specialty pursuant to this
chapter.

31. "Unprofessional conduct" includes the following, whether occurring in this state
or elsewhere:

(a) Intentionally disclosing a professional secret or intentionally disclosing a
privileged communication except as either of these may otherwise be required by law.

(b) Any dishonorable conduct reflecting unfavorably on the profession.

(c) Committing a felony, whether or not involving moral turpitude, or a misdemeanor
involving moral turpitude. In either case conviction by any court of competent
jurisdiction or a plea of no contest is conclusive evidence of the commission of the
felony or misdemeanor.

(d) Habitual intemperance in the use of alcohol or any substance abuse.

(e) The illegal use of any narcotic or hypnotic drugs, or illegal substances.

(f) Conduct that the board determines is gross malpractice, repeated malpractice or
any malpractice resulting in the death of a patient.

(g) Impersonating another doctor of naturopathic medicine or any other practitioner
of the healing arts.

(h) Falsely acting or assuming to act as a member, an employee or an authorized
agent of the board.

(i) Procuring or attempting to procure a license or a certificate pursuant to this
chapter by fraud, by misrepresentation or by knowingly taking advantage of the mistake of
another person or agency.

(j) Having professional connection with or lending one's name to enhance or
continue the activities of an illegal physician or an illegal practitioner of any healing
art.

(k) Representing that a manifestly incurable disease, injury, ailment or infirmity
can be permanently cured, or falsely or fraudulently representing that a curable disease,
injury, ailment or infirmity can be cured within a stated time.

(l) Offering, undertaking or agreeing to cure or treat a disease, injury, ailment
or infirmity by a secret means, method, treatment, medicine, substance, device or
instrumentality.

(m) Refusing to divulge to the board on demand the means, method, treatment,
medicine, substance, device or instrumentality used in the treatment of a disease,
injury, ailment or infirmity.

(n) Giving or receiving, or aiding or abetting the giving or receiving of, rebates,
either directly or indirectly.

(o) Knowingly making any false or fraudulent statement, written or oral, in
connection with the practice of naturopathic medicine or any naturopathic treatment
method.

(p) Immorality or misconduct that tends to discredit the naturopathic profession.

(q) Refusal, revocation or suspension of a license by any other state, district or
territory of the United States or any other country, unless it can be shown that this
action was not due to reasons that relate to the ability to safely and skillfully
practice as a doctor of naturopathic medicine or to any act of unprofessional conduct in
this paragraph.

(r) Any conduct or practice that is contrary to recognized standards of ethics of
the naturopathic profession, any conduct or practice that does or might constitute a
danger to the health, welfare or safety of the patient or the public, or any conduct,
practice or condition that does or might impair the ability to safely and skillfully
practice as a doctor of naturopathic medicine.

(s) Failure to observe any federal, state, county or municipal law relating to
public health as a physician in this state.

(t) Violating or attempting to violate, directly or indirectly, or assisting in or
abetting the violation of, or conspiring to violate this chapter or board rules.

(u) False, fraudulent, deceptive or misleading advertising or advertising the
quality of a medical or health care service by a physician or by the physician's staff,
employer or representative.

(v) Failing or refusing to maintain adequate medical records on a patient or
failing or refusing to make medical records in the physician's possession promptly
available to another physician or health care provider who is licensed pursuant to
chapter 7, 8, 13, 15, 17 or 29 of this title on request and receipt of proper
authorization to do so from the patient, a minor patient's parent, the patient's legal
guardian or the patient's authorized representative or failing to comply with title 12,
chapter 13, article 7.1.

(w) Referring a patient to a diagnostic or treatment facility or prescribing goods
and services without disclosing in writing to the patient that the physician has a
pecuniary interest in the facility, goods or services to which the patient is referred or
prescribed. This subdivision does not apply to a referral by one physician or
practitioner to another physician or practitioner within a group of physicians or
practitioners practicing together.

(x) Sexual intimacies with a patient in the course of direct treatment.

(y) Failing to dispense drugs and devices in compliance with article 4 of this
chapter.

(z) Administering, dispensing or prescribing any drug or a device for other than an
accepted therapeutic purpose.

(aa) Falsely representing or holding oneself out as being a specialist or
representation by a doctor of naturopathic medicine or the doctor's staff, employer or
representative that the doctor is boarded or board certified if this is not true or that
standing is not current.

(bb) Delegating professional duties and responsibilities to a person if the person
has not been approved or qualified by licensure or by certification to perform these
duties or responsibilities.

(cc) Failing to appropriately supervise a naturopathic medical student, a nurse, a
medical assistant, a health care provider or a technician employed by or assigned to the
physician during the performance of delegated professional duties and responsibilities.

(dd) Using experimental forms of diagnosis or treatment without adequate informed
consent of the patient or the patient's legal guardian and without conforming to
experimental criteria including protocols, detailed records, periodic analysis of results
and periodic review by a medical peer review committee as approved by the federal food
and drug administration or its successor agency.

(ee) Failing to furnish information in a timely manner to the board or
investigators or representatives of the board if this information is legally requested by
the board and failing to allow properly authorized board personnel on demand to examine
and have access to documents, reports and records maintained by the physician that relate
to the physician's medical practice or medically related activities.

(ff) Failing to report in writing to the board evidence that a person licensed,
certified or registered pursuant to this chapter is or may be medically incompetent,
guilty of unprofessional conduct or mentally or physically unable to safely practice or
assist in the practice of naturopathic medicine.

(gg) Conducting or engaging in an internship, preceptorship or clinical training
program in naturopathic medicine without being approved and registered by the board for
that internship, preceptorship or clinical training program.

(hh) Signing a blank, undated or predated prescription form.

(ii) Conduct that the board determines is gross negligence, repeated negligence or
negligence resulting in harm or death to a patient.

(jj) Knowingly making a false or misleading statement in oral testimony to the
board on a form required by the board or in written correspondence to the board,
including attachments to that correspondence.

(kk) The failure of a physician who is the chief medical officer, the executive
officer or the chief of staff of an internship, a preceptorship or a clinical training
program to report in writing to the board that the privileges of a doctor of naturopathic
medicine, a naturopathic medical student or a medical assistant have been denied,
limited, revoked or suspended because that doctor's, student's or assistant's actions
appear to indicate that the person is or may be medically incompetent, is or may be
guilty of unprofessional conduct or is or may be unable to safely engage or assist in the
practice of naturopathic medicine.

(ll) Action taken against a doctor of naturopathic medicine by a licensing or
regulatory board in another jurisdiction due to that doctor's mental or physical
inability to engage safely in the practice of naturopathic medicine or the doctor's
medical incompetence or for unprofessional conduct as defined by that licensing or
regulatory board and that corresponds directly or indirectly to an act of unprofessional
conduct prescribed by this paragraph. The action taken may include refusing, denying,
revoking or suspending a license, otherwise limiting, restricting or monitoring a
licensee or placing a licensee on probation by that licensing or regulatory board.

(mm) Sanctions imposed by an agency of the federal government, including
restricting, suspending, limiting or removing a person from the practice of naturopathic
medicine or restricting that person's ability to obtain financial remuneration.

(nn) Violating any formal order, probation, consent agreement or stipulation issued
or entered into by the board pursuant to this chapter.

(oo) Refusing to submit to a body fluid examination pursuant to a board
investigation of alleged substance abuse by a doctor of naturopathic medicine.

(pp) Charging a fee for services not rendered or dividing a professional fee for
patient referrals among health care providers or health care institutions or between
these providers and institutions or a contractual arrangement that has this effect.

(qq) Obtaining a fee by fraud, deceit or misrepresentation.

(rr) Charging or collecting a clearly excessive fee. In determining if a fee is
clearly excessive the board shall consider the fee or range of fees customarily charged
in this state for similar services, in light of modifying factors such as the time
required, the complexity of the service and the skill required to perform the service
properly. This subdivision does not apply if there is a clear written contract for a
fixed fee between the physician and the patient that was entered into before the service
was provided.

(ss) With the exception of heavy metal poisoning, using chelation therapy in the
treatment of arteriosclerosis or as any other form of therapy without adequate informed
patient consent and without conforming to generally accepted experimental criteria,
including protocols, detailed records, periodic analysis of results and periodic review
by a medical peer review committee.

(tt) Using a controlled substance unless it is prescribed by another physician for
use during a prescribed course of treatment.

(uu) Prescribing, dispensing or administering anabolic androgenic steroids for
other than therapeutic purposes.

(vv) Except in an emergency or urgent care situation, prescribing or dispensing a
controlled substance to a member of the naturopathic physician's immediate family.

(ww) Prescribing, dispensing or furnishing a prescription medication or a
prescription-only device as defined in section 32-1901 to a person unless the licensee
first conducts a physical examination of that person or has previously established a
doctor-patient relationship. This subdivision does not apply to:

(i) A licensee who provides temporary patient supervision on behalf of the
patient's regular treating licensed health care professional.

(ii) An emergency medical situation as defined in section 41-1831.

(iii) Prescriptions written to prepare a patient for a medical examination.

(iv) Prescriptions written or prescription medications issued for use by a county
or tribal public health department for immunization programs or emergency treatment or in
response to an infectious disease investigation, a public health emergency, an infectious
disease outbreak or an act of bioterrorism. For the purposes of this item, "bioterrorism"
has the same meaning prescribed in section 36-781.

(v) Prescriptions written or antimicrobials dispensed to a contact as defined in
section 36-661 who is believed to have had significant exposure risk as defined in
section 36-661 with another person who has been diagnosed with a communicable disease as
defined in section 36-661 by the prescribing or dispensing physician.

(xx) If medical treatment is considered experimental or investigational, failing to
include in a patient's record a consent to treatment document that is signed by the
patient or the patient's parent or legal guardian and that indicates that the patient or
the patient's parent or legal guardian has been informed of the risk of any treatment to
be provided and the expected cost of that treatment.