NEW JERSEY REGISTER
VOLUME 35, NUMBER 5
MONDAY, MARCH 3, 2003
LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
ORTHOTICS AND PROSTHETICS BOARD OF EXAMINERS
RULES OF THE ORTHOTICS AND PROSTHETICS BOARD OF EXAMINERS
Proposed Readoption with Amendment: N.J.A.C.
Authorized By: Orthotics and Prosthetics Board
of Examiners, Laura Anderson, Executive Director.
Authority: N.J.S.A. 45:12B-26.
Calendar Reference: See Summary below for explanation of exception
to calendar requirement.
Proposal Number: PRN 2003-83.
Submit written comments by May 2, 2003 to:
Laura Anderson, Executive Director
Orthotics and Prosthetics Board of Examiners
124 Halsey Street
PO Box 45034
Newark, NJ 07101
The agency proposal follows:
The Orthotics and Prosthetics Board of Examiners
(the Board) proposes to readopt N.J.A.C. 13:44H with an amendment.
These rules are scheduled to expire on February 2, 2003. The
expiration date of the rules is extended to August 1, 2003
pursuant to N.J.S.A. 52:14B-5.1c by the filing of this proposed
readoption with the Office of Administrative Law.
The Board has undertaken a review of the existing
provisions of N.J.A.C. 13:44H in order to determine their
necessity and reasonableness. The Board believes that the
rules proposed for readoption, as amended, are necessary,
reasonable, understandable and responsive for the purpose
for which they were originally promulgated. The following
summarizes each subchapter in N.J.A.C. 13:44H and amendments
proposed to the existing rules.
N.J.A.C. 13:44H-1.1 sets forth the purpose and
scope of the rules in Chapter 44H. The rule states that the
chapter implements the provisions of the Orthotist and Prosthetist
Licensing Act (the Act) and that the chapter applies, except
as subsection (c) outlines, to all individuals who practice
orthotics and prosthetics in New Jersey, as well as those
pedorthists who chose to obtain licensure. Subsection (c)
lists those individuals to whom the rules do not apply, pursuant
to N.J.S.A. 45:12B-18. This list includes any person licensed
to practice medicine and surgery, dentistry or podiatry in
New Jersey; a college student in orthotics or prosthetics
program who is supervised by a licensee; a student prosthetist
assistant, a student orthotist assistant or a student prosthetist-orthotist
assistant; a licensed occupational therapist or licensed physical
therapist who fabricates or applies upper extremity adaptive
equipment, finger splints or hand splints; a licensed physical
therapist who provides corsets, soft cervical collars or lower
extremity orthotics made of fabric, canvas, neoprene or elastic;
a licensed physical therapist who provides lower extremity,
low temperature splint or ankle foot orthotics that are provided
for the evaluation or treatment of an adult patient for less
than three months or a pediatric patient for less than one
year when these braces do not become the patient's property;
a licensed physical therapist who provides any off-the-shelf
ankle foot orthosis made of fabric, canvas, neoprene or elastic
and any low temperature posterior leaf ankle foot orthosis;
a licensed physical therapist who provides any high temperature
posterior leaf ankle foot orthosis when the licensed physical
therapist is conducting research at a college or university;
a licensed physical therapist who manages lower extremity
prosthetic volumetric changes, provided that the physical
therapist consults with a prosthetist prior to addressing
any non-reversible changes; or a certified pedorthist who
is limited to the practice of orthotics and prosthetics to
the ankle and below.
N.J.A.C. 13:44H-1.2 sets forth definitions
of words and terms used in the chapter such as "orthotist,"
"orthotist assistant," "pedorthist," "prosthetist," "prosthetist
assistant," "prosthetist-orthotist" and "prosthetist-orthotist
Subchapter 2 sets forth the scope of practice
for licensees. N.J.A.C. 13:44H-2.1 sets forth the scope of
practice for licensed orthotists and a licensed orthotist
assistants. Orthotist scope of practice includes the evaluation
for, and manufacture and fitting of, orthotic devices prescribed
for the correction or alleviation of musculoskeletal diseases,
injuries or deformities. A licensed orthotist may employ a
licensed orthotist assistant to mold, paint, cut, mix, grind,
polish, sew, laminate, glue, screw, rivet, fasten or vacuum
form an orthotic appliance or orthosis. Orthotist assistants
must be supervised by a licensed orthotist pursuant to N.J.A.C.
N.J.A.C. 13:44H-2.2 sets forth the scope of
practice for licensed prosthetists and licensed prosthetist
assistants. Prosthetist scope of practice includes the evaluation
for, and manufacture and fitting of, upper and lower extremity
prosthetic appliances. A licensed prosthetist may employ a
licensed prosthetist assistant to mold, paint, cut, mix, grind,
polish, sew, laminate, glue, screw, rivet, fasten or vacuum
form upper and lower extremity prosthetic appliances. Licensed
prosthetist assistants must be supervised by a licensed prosthetist
pursuant to N.J.A.C. 13:44H-3.6.
N.J.A.C. 13:44H-2.3 sets forth the limitations
for the practice of pedorthists. Licensed pedorthists are
limited to the design, manufacture, fit and modification of
shoes and related foot appliances which extend from the ankle
and below, which are prescribed for the amelioration of painful
or disabling conditions of the foot.
N.J.A.C. 13:44H-2.4 outlines prohibited practices.
The rule prohibits any person from practicing orthotics or
prosthetics, or acting as an orthotist assistant, prosthetist
assistant or prosthetist-orthotist assistant, without obtaining
a license pursuant to N.J.S.A. 45:12B-1 et seq. and this chapter.
No licensed orthotist, prosthetist, prosthetist or prosthetist-orthotist
may employ a person to act as an orthotist, prosthetist, prosthetist-orthotist,
orthotist assistant, prosthetist assistant or prosthetist-orthotist
assistant unless that person has been licensed by the Board.
Subchapter 3 sets forth requirements for licensure.
N.J.A.C. 13:44H-3.1 deals with application requirements for
licensure as an orthotist, prosthetist or prosthetist-orthotist.
The rule requires applicants for licensure as an orthotist,
prosthetist, prosthetist-orthotist to pass the American Board
for Certification in Orthotics and Prosthetics examination.
An applicant for licensure as an orthotist, prosthetist, or
prosthetist-orthotist also must submit to the Board: a completed
application which includes documentation indicating that the
applicant received a bachelor's degree and has completed a
clinical internship of at least 1,900 hours; the application
fee set forth in N.J.A.C. 13:44H-10.1; and proof that the
applicant has successfully completed the licensing examination.
The rule provides separate requirements for applicants who
apply for licensure by June 17, 2007. Such an applicant has
to show that he or she has earned an associates degree, with
course work in biology, anatomy and physiology, physics and
chemistry. The applicant is also required to complete a 1,900
hour internship, successfully pass the licensing examination
and pay the licensing fee required by N.J.A.C. 13:44H-10.1.
Any applicant who applies by June 17, 2003 is allowed to complete
the 1,900 hours of clinical practice under the supervision
of an unlicensed person if the applicant can show that the
supervisor would qualify for licensure pursuant to N.J.A.C.
13:44H-3.3. Subsection (e) of the rule requires a foreign-trained
applicant to obtain an evaluation of his or her professional
educational and professional experience credentials from a
credentialing agency recognized by the American Board for
Certification in Orthotics and Prosthetics or the International
Society of Prosthetists and Orthotists. The Board will review
this evaluation to determine if the applicant's education
and experience is equivalent to the requirements of the Board.
Subsection (e) is proposed for amendment to correct a cite
to the Board's application requirements. The subsection currently
cites to a non-existent "(a)1 above," and is amended to cite
to paragraph "(b)1 above."
N.J.A.C. 13:44H-3.2 requires applicants for
licensure as a pedorthist to submit to the Board: a completed
and notarized application; the application fee set forth in
N.J.A.C. 13:44H-10.1; and proof of certification by the American
Board for Certification of Pedorthists.
N.J.A.C. 13:44H-3.3 sets forth application requirements
for individuals who are currently working as orthotists or
prosthetists. A person will qualify for licensure if that
person applies by December 14, 2002 and has practiced as an
orthotist, prosthetist or prosthetist-orthotist for at least
1,750 hours a year during the three years prior to June 17,
2002. An applicant for licensure pursuant to N.J.A.C. 13:44H-3.3
shall submit to the Board: a completed application which includes
a certified statement from applicant documenting his or her
work history; notarized documentation from the employer of
the applicant's employment history; four Physician Reference
Forms completed by physicians who have medical rehabilitation
and/or orthopedic experience; a passport size photograph;
and the application fee set forth in N.J.A.C. 13:44H-10.1.
The Board is required to conduct an investigation of the applicant's
work history within six months of receiving the application
in order to determine whether the applicant has established
his or her qualifications for licensure.
N.J.A.C. 13:44H-3.4 sets forth requirements
for granting a temporary license to an applicant who is licensed
in another state. The Board may issue a temporary license
if the applicant is licensed in another state which has licensing
standards equivalent to those in New Jersey, the applicant's
license is in good standing in the other state and the applicant
has applied for licensure as an orthotist, prosthetist or
prosthetist-orthotist in New Jersey. A temporary license will
only permit its holder to practice in the field in which he
or she is licensed in the other state. For example, an orthotist
licensed in another state would only be allowed to practice
as an orthotist in this State pursuant to a temporary license.
The holder of a temporary license must be supervised by a
licensee pursuant to N.J.A.C. 13:44H-3.6. The temporary license
will be valid for one year and the holder of a temporary license
must take the first available licensing examination. The Board
may renew the temporary license if the holder shows good cause
for the renewal and the renewal would serve the well-being
and interests of the clients of the establishment in which
the holder works. An applicant who seeks to renew a temporary
license must send an application to the Board at least 90
days before the temporary license expires. The holder of a
renewed temporary license must take the next available examination
and the renewed temporary license will expire after the results
of that examination are issued. A person whose temporary license
has expired may no longer work as an orthotist, prosthetist
or prosthetist-orthotist but may continue to take the licensing
examination. If a person passes the licensing examination
after the temporary license has expired, he or she may apply
for licensure pursuant to N.J.A.C. 13:44H-3.1. N.J.A.C. 13:44H-3.5
outlines the application procedures for licensure as an orthotist
assistant, prosthetist assistant or prosthetist-orthotist
assistant. An applicant must submit to the Board an application
that includes proof that the applicant: is at least 18 years
old; has a high school diploma; has completed a 40-hour course
of training as an orthotist assistant or prosthetist assistant
or 80 hours of training as a prosthetist-orthotist assistant;
and has completed 1,900 hours of clinical practice. The applicant
must also submit proof that he or she has passed the licensing
examination and must submit the application fee. An individual
who applies by June 17, 2003 will qualify for licensure if
they have completed 1,900 hours of clinical practice under
the supervision of a person who would qualify for licensure
as an orthotist, a prosthetist or a prosthetist-orthotist
pursuant to N.J.A.C. 13:44H-3.3.
N.J.A.C. 13:44H-3.6 sets forth standards for
the supervision of orthotist assistants, prosthetist assistants,
prosthetist-orthotist assistants, students and holders of
temporary licenses. A licensed orthotist assistant, licensed
prosthetist assistant, licensed prosthetist-orthotist assistant,
student or holder of a temporary license may receive supervision
from either a licensed orthotist, licensed prosthetist, licensed
prosthetist-orthotist or by a person who has a pending application
for licensure as an orthotist, prosthetist or prosthetist-orthotist.
This provision only applies until June 17, 2003. After that
date only a licensed orthotist, licensed prosthetist or licensed
prosthetist-orthotist may provide supervision. An assistant,
student or holder of a temporary license must be supervised
by a licensee who practices in their field and cannot perform
laboratory or clinical work unless closely or routinely supervised
by a supervising licensee. The rule defines a supervising
licensee as a licensed orthotist, prosthetist or prosthetist-orthotist
who works in the same facility as an assistant, student or
holder of a temporary license and who provides direction to,
and close or routine supervision of, the assistant, student
or holder of a temporary license. Licensed orthotist assistants,
licensed prosthetist assistants, licensed prosthetist-orthotist
assistants and students must receive close supervision from
a supervising licensee. "Close supervision" requires daily,
face-to-face contact and observation of the performance of
laboratory and clinical work at the location where the supervisee's
services are being performed. The holder of a temporary license
must receive routine supervision from a supervising licensee.
"Routine supervision" requires face-to-face contact with and
observation of the performance of the laboratory and clinical
work of the holder of a temporary license at least once a
week at the location at which services are being performed
by the holder of the temporary permit. The supervising licensee
is responsible for the laboratory and clinical work performed
by an assistant, student or holder of a temporary license
and may only supervise three assistants, students or holders
of a temporary license at one time. The supervising licensee
must by physically present during the initial evaluation of
the patient and the final provision of the orthotic or prosthetic
device so that he or she can determine the appropriateness
of the device for the patient's needs. The supervising licensee
must provide direction to the assistant, student or holder
of a temporary license. An assistant, student or holder of
a temporary license must maintain a daily record which is
initialed by the supervising licensee. The supervising licensee
must name another licensee to supervise the assistant, student
or holder of a temporary license whenever the supervising
licensee is absent.
N.J.A.C. 13:44H-3.7 requires an applicant who
has qualified for licensure to send in the licensing fee.
The rule also requires licensees to renew their licenses and
pay the license renewal fees every two years.
Subchapter 4 is reserved.
Subchapter 5 deals with established orthotic
and prosthetic facilities. N.J.A.C. 13:44H-5.1 requires every
established orthotic or prosthetic facility to possess specific
types of equipment. The rule also sets forth additionally
required equipment for orthotic facilities which engage in
on-site fabrication, prosthetic facilities which utilize centralized
fabrication services and prosthetic facilities which engage
in on-site fabrication. The rule requires that established
pedorthic facilities meet the facility accreditation requirements
set forth by the American Board for Certification in Pedorthics.
Subchapter 6 sets forth the obligations of licensees
and practices which are deemed unlicensed practice. N.J.A.C.
13:44H-6.1 requires licensees to notify the Board of their
office address and to notify the Board, in writing, within
30 days of any change in the office address. The rule states
that service of an administrative complaint at the licensee's
address on file with the Board is adequate notice for the
commencement of any inquiry or disciplinary proceeding against
the licensee. Also, licensees are required to cooperate in
any inquiry, inspection or investigation conducted by or on
behalf of the Board or the Director.
N.J.A.C. 13:44H-6.2 outlines what constitutes
unlicensed practice of orthotics, prosthetics and prosthetics-orthotics.
A person is engaged in the unlicensed practice if the person
offers or renders orthotics or prosthetics services and is
not a licensed orthotist, licensed prosthetist, licensed prosthetist-orthotist,
certified pedorthist, pedorthist licensed to the practice
of orthotics and prosthetics on the ankle and below, licensed
orthotist assistant, a licensed prosthetist, a licensed prosthetist-orthotist
assistant or a licensed professional acting exempt pursuant
to N.J.A.C. 13:44H-1.1(c). Any person, other than a licensed
orthotist, prosthetist or prosthetist-orthotist who uses a
title or designation which includes the words orthotist, prosthetist
or prosthetist-orthotist or the abbreviations L.O., L.P.,
L.P.O. or any similar abbreviations, is engaged in unlicensed
practice. The rule requires licensees to use only those titles
or designations that correspond to his or her licensure.
Subchapter 7 sets forth requirements for business
practices and professional conduct. N.J.A.C. 13:44H-7.1 requires
licensees to post two notices in their offices, one of which
notifies patients that any complaints regarding the licensee
can be sent to the Board, the second of which notifies patients
that information on professional fees is available from the
licensee's office upon request. N.J.A.C. 13:44H-7.2 prevents
a licensee from charging an excessive fee for professional
services. N.J.A.C. 13:44H-7.3 requires licensees to maintain
a list of fees for standard services and provide the list
upon request. N.J.A.C. 13:44H-7.4 requires licensees to advise
a patient as to the nature and purpose of services rendered
and the techniques for using a prescribed device. N.J.A.C.
13:44H-7.5 prohibits a licensee from paying, offering to pay
or receiving any fee or other form of compensation for referral
of a client. A licensee is also prohibited from participating
in the division of fees for professional services outside
of a division among other licensees engaged in a bona fide
partnership, professional service corporation or employment
Subchapter 8 sets forth requirements on advertising
by licensees. N.J.A.C. 13:44H-8.1 sets forth definitions for
terms that are used in subchapter 8. N.J.A.C. 13:44H-8.2 sets
forth general requirements for licensees to follow when they
advertise. Licensees must be able to substantiate the truthfulness
of anything set forth in an advertisement. If a licensee is
a partner or officer of a firm identified in an advertisement
as offering services or goods, the licensee is responsible
for the form and content of any advertisement disseminated
by the firm. A licensee is required to ensure that any advertisement
he or she disseminates does not misrepresent, mislead, suppress,
deceive, omit or conceal a material fact. A licensee is prohibited
from improperly omitting, suppressing or concealing a material
fact or preventing a prospective client from making a full
and informed judgment on the basis of the information set
forth in the advertisement.
N.J.A.C. 13:44H-8.3 sets forth information licensees
are required to include in advertisements. A licensee must
include his or her name, field of licensure, license number
and the street address and telephone number of the practice
in all advertisements and professional representations.
N.J.A.C. 13:44H-8.4 outlines permissible use
of professional credentials. The rule requires a licensee
to accurately represent his or her competence, education,
training and experience. If a licensee includes information
about professional credentials in an advertisement, the advertisement
must contain the highest academic degree or certification
the licensee completed that is related to the practice of
orthotics or prosthetics. Any degree mentioned must be from
an academic institution accredited by a national or regional
accrediting agency recognized by the United States Department
of Education. Any advertisement which includes information
on an orthotic, prosthetic, prosthetic-orthotic or pedorthic
certification must include the full name of the agency conferring
the certification or the name, or abbreviation, of the certification.
Letters or abbreviations which a licensee uses adjacent to
his or her name must be limited to those representing either
the highest academic degree earned related to orthotics or
prosthetics or licenses or certifications issued by another
state or Federal agency. The rule does not preclude any truthful
and non-deceptive statement regarding the education or experience
a licensee has in a particular area of orthotics or prosthetics.
N.J.A.C. 13:44H-8.5 sets forth required disclosures
when a licensee advertises fees. The only fees that may be
advertised are fixed fees or a stated range of fees for specifically
described professional services. Any advertisement referring
to fees must include: everything which is ordinarily included
in the advertised services so that the fee will be clearly
understood by prospective clients; any additional services
contemplated and the fee to be charged for them; and the period
during which the advertised fee will remain in effect. The
rule states that the advertisement of a fee does not preclude
a licensee from adjusting a fee downward or waiving a fee.
N.J.A.C. 13:44H-8.6 outlines prohibited methods
of advertising. A licensee is prohibited from guaranteeing
that satisfaction or a cure will result from the performance
of professional services. A licensee is also prohibited from
offering a professional service which the licensee knows,
or should know, is beyond his or her ability to perform.
N.J.A.C. 13:44H-8.7 sets forth guidelines for
the use of testimonials. Any testimonial in an advertisement
must be based upon the personal knowledge or experience of
the person giving the testimonial, gained through a professional
relationship with the licensee. A licensee who uses a testimonial
must obtain a signed, notarized statement and release indicating
the person providing the testimonial is willing to have his
or her testimonial used in the advertisement. A layperson's
testimonial cannot attest to, or comment upon, any technical
matter beyond the layperson's competence. An expert testimonial
can only be rendered by an individual possessing expertise
relevant to the area in which he or she is giving the testimonial.
A licensee is required to be able to substantiate any statement
of fact appearing in a testimonial and to indicate that an
individual has been compensated for a testimonial in the advertisement,
if compensation is provided.
N.J.A.C. 13:44H-8.8 deals with the retention
of advertisements. A licensee must retain a copy of any advertisements
for three years from the date the advertisement was initially
published or disseminated. All advertisements a licensee retains
pursuant to this rule must indicate the date, name and place
of publication. Any documentation relating to the use of testimonials
must be maintained for three years from the date of the last
use of the testimonial.
Subchapter 9 deals with a licensee's records.
N.J.A.C. 13:44H-9.1 requires a licensee to maintain records
for each client. These records shall include: the client's
name, address and telephone number; the location and dates
of all treatments; the identity of the licensee providing
treatment and the supervisor, if any; the presenting situation;
the name and address of the referring physician, podiatrist
or dentist; any medications the client is taking; a treatment
or service plan; contemporaneous progress notes for each session;
fees charged and paid; and the name of the manufacturer of
any device not made by the licensee. The rule requires a licensee
to periodically review and update the treatment or service
plan and to maintain client records for at least seven years
from the date of the last entry. Licensees are required to
comply with this section regardless of an employer's recordkeeping
N.J.A.C. 13:44H-9.2 deals with the release of
client records. A licensee is required to provide a client
his or her record within 15 days of a request from the client
or the client's guardian. A licensee may require that a record
request be made in writing and may charge a fee for the reproduction
of records, which shall be no greater than $1.00 per page
or $100.00 for the entire record, whichever is less. A licensee
is prohibited from charging for the completion of health insurance
claim forms, however, a licensee is permitted to charge a
fee for completion of reports required for third-party reimbursement
of client treatment expenses or for use in judicial proceedings.
A licensee is prohibited from requiring advance payment prior
to releasing a report that is needed for the client's ongoing
care by another practitioner or for use in judicial proceedings.
A licensee may require advance payment for the release of
a report that is to be used by the licensee while acting as
an expert witness on behalf of the client.
Subchapter 10 sets forth the fees charged by
the Board. The Board has determined that the comment period
for this proposal shall be 60 days; therefore, pursuant to
N.J.A.C. 1:30-3.3(a)5, this proposal is excepted from the
rulemaking calendar requirement.
The rules proposed for readoption will continue
to ensure the proper practice of prosthetics and orthotics
by licensees in the State of New Jersey. The rules establish
practice standards and ensure that orthotists and prosthetists
remain accountable to the public and the Board. The rules
proposed for readoption benefit the Board and licensees by
providing procedures for the orderly administration of the
Board and by establishing clear practice guidelines.
Some of the rules proposed for readoption will
have an economic impact on applicants for licensure and licensees.
N.J.A.C. 13:44H-3.1 requires applicants for
licensure as orthotists, prosthetists or prosthetists-orthotists
to show that they have completed specific education requirements.
The rule requires applicants to complete a clinical internship
and the licensing examination. Additionally, the rule requires
that applicants who were educated in another country obtain
an evaluation of their education and professional experience
from a credentialing agency. N.J.A.C. 13:44H-3.2 requires
an applicant for licensure as a pedorthist to obtain certification
from the American Board for Certification of Pedorthists.
N.J.A.C. 13:44H-3.5 requires applicants for licensure as a
orthotist assistant, prosthetist assistant or prosthetist-orthotist
assistant to complete a training course and 1,900 hours of
clinical practice. An applicant is also required to pass the
licensing examination. All of these costs are borne by applicants.
N.J.A.C. 13:44H-5.1 sets forth basic equipment
that every established orthotic and prosthetic facility must
have. The cost of obtaining this equipment is borne by the
licensee. N.J.A.C. 13:44H-7.1 requires licensees to post certain
notifications in their offices. The cost of obtaining these
notifications is also borne by licensees.
N.J.A.C. 13:44H-8.3 requires that any advertisement
must include the licensee's name, area of licensure, license
number, street address and telephone number. N.J.A.C. 13:44H-8.4
requires that any advertisement that includes information
on certification must identify the full name of the agency
conferring the certification. N.J.A.C. 13:44H-8.5 requires
a licensee to include specific information when he or she
refers to fees in an advertisement. N.J.A.C. 13:44H-8.7 requires
that, when a licensee provides compensation for a testimonial
used in an advertisement, the licensee indicate that compensation
has been provided for the testimonial. The cost of including
this information in an advertisement is borne by the licensee.
N.J.A.C. 13:44H-9.1 requires all licensees to
maintain client records. The cost of creating and maintaining
these records is borne by licensees. N.J.A.C. 13:44H-10.1
sets forth the fees which the Board assesses for services
rendered to its licensees. The fee schedule has an economic
impact on licensees and applicants for licensure by establishing
fees that they must pay in order for the Board to be self-funding
and in compliance with N.J.S.A. 45:1-3.2.
Federal Standards Statement
A Federal standards statement is not required
because there are no Federal standards or requirements applicable
to the rules proposed for readoption.
The Board does not believe that the rules proposed
for readoption will result in an increase or decrease in the
number of jobs in this State.
Agriculture Industry Impact
The Board does not believe that the rules proposed
for readoption will have any impact on the agriculture industry
of this State.
Regulatory Flexibility Analysis
The Regulatory Flexibility Act (the Act), N.J.S.A.
52:14B-16 et seq., requires the Board to give a description
of the types and an estimate of the number of small businesses
to which the proposal will apply. If, for the purposes of
the Act, the individuals who are licensed by the Board as
orthotists, prosthetists, prosthetist-orthotists, pedorthists,
orthotist assistants, prosthetist assistants or prosthetist-orthotist
assistants are considered small businesses, then the following
The Act requires the Board to set forth the
reporting, recordkeeping and other compliance requirements
of the rules proposed for readoption with amendment including
the kinds of professional services likely to be needed to
comply with the requirements. The Act further requires the
Board to estimate the initial and annual compliance costs
of the rules proposed for readoption with amendment with an
indication of the varying impact on small businesses of differing
types and sizes and to outline the manner in which it has
designed the rules to minimize any adverse economic impact
upon small businesses.
The costs imposed on small businesses by the
rules proposed for readoption with amendment are the same
costs that are imposed on all businesses as outlined above
in the Economic Impact.
The Board does not believe that licensees will
need to employ any professional services to comply with the
requirements of the rules proposed for readoption.
The rules proposed for readoption impose compliance,
recordkeeping and reporting requirements on licensees.
The rules proposed for readoption impose several
compliance requirements. N.J.A.C. 13:44H-2.4 prohibits a licensed
orthotist, prosthetist or prosthetist-orthotist from employing
an unlicensed assistant. N.J.A.C. 13:44H-3.4 requires that
a temporary license holder be supervised by a licensee and
that a temporary license holder take the first licensing examination
offered after the holder receives the temporary license. The
rule also requires the holder to cease working once the temporary
license expires. N.J.A.C. 13:44H-3.6 requires that licensed
orthotist assistants, licensed prosthetist assistants, licensed
prosthetist-orthotist assistants, students and holders of
temporary licenses obtain supervision from a licensed orthotist
or licensed prosthetist. A supervising licensee must provide
close supervision for assistants and students. A supervising
licensee must provide routine supervision for the holder of
a temporary license. A supervising licensee is personally
responsible for any laboratory work performed by the supervisee,
is required to provide direction to a supervisee, is prohibited
from providing supervision for more than three individuals
at a time and must be physically present during the initial
evaluation of a patient and the final provision of a device
by a supervisee. A supervising licensee is also required to
arrange for supervision whenever he or she is unable to provide
supervision. N.J.A.C. 13:44H-3.7 requires a licensee to renew
licensure biennially. N.J.A.C. 13:44H-5.1 sets forth equipment
that licensees must have in an established orthotic and prosthetic
N.J.A.C. 13:44H-6.1 requires licensees to cooperate
in any inquiry, inspection or investigation conducted by the
Board or the Director of the Division of Consumer Affairs.
N.J.A.C. 13:44H-6.2 requires a licensee to use only those
titles or designations that accurately reflect his or her
licensure. N.J.A.C. 13:44H-7.1 requires a licensee to post
notifications in an office regarding the Board and fees. N.J.A.C.
13:44H-7.2 prohibits a licensee from charging an excessive
fee. N.J.A.C. 13:44H-7.3 requires licensees to provide a list
of fees to patients upon request. N.J.A.C. 13:44H-7.4 requires
a licensee to advise a patient as to the nature and purpose
of the services rendered as well as the techniques for use
and care of a device. N.J.A.C. 13:44H-7.5 prohibits a licensee
from accepting or offering compensation for the referral of
a patient or from dividing a fee for professional services
outside of a partnership or other permissible business structure.
N.J.A.C. 13:44H-8.2 requires licensees to be
able to substantiate the truthfulness of any representation
made in an advertisement. A licensee who is a partner or officer
in a firm is responsible for the form and content of an advertisement
made by the firm. A licensee is required to ensure that an
advertisement is not misleading and does not omit or suppress
material facts. N.J.A.C. 13:44H-8.3 requires advertisements
to include the name, area of licensure, license number, street
address and telephone number of the licensee. N.J.A.C. 13:44H-8.4
requires licensees to accurately represent his or her competence,
education and experience. A licensee is also required to include
in an advertisement the highest academic degree obtained from
an academic institution accredited by a national or regional
accrediting agency or certification attained when the advertisement
includes information on professional credentials. Any advertisement
which includes information on certification must include the
full name of the agency conferring the certification or the
name or abbreviation of the certification. Any letters or
abbreviations appearing adjacent to the name of a licensee
shall be limited to those that represent the highest academic
degrees earned related to the practice of orthotics or prosthetics
or licenses issued by another state or Federal agency. N.J.A.C.
13:44H-8.5 limits advertisement of fees to those which contain
a fixed range of fees. N.J.A.C. 13:44H-8.6 prohibit a licensee
from guaranteeing that satisfaction or a cure will result
from professional services. A licensee is also prohibited
from offering services which are beyond the licensees ability
to perform. N.J.A.C. 13:44H-8.7 requires that any testimonial
in an advertisement be based on information the individual
giving the testimonial gained from a professional relationship
with the licensee. A licensee is required to obtain a signed,
notarized release allowing the use of the testimonial in an
advertisement by the individual giving the testimonial. A
licensee is prohibited from using a testimonial given by a
layperson which attests to a technical matter beyond the layperson's
ability to comment on and a licensee can only use an expert
testimonial from an expert in the field. A licensee is required
to be able to substantiate any statement of fact appearing
in a testimonial. If a licensee provides compensation for
a testimonial, an advertisement that uses the testimonial
must disclose that compensation was provided. N.J.A.C. 13:44H-9.2
requires licensees to provide records to clients within 15
days of a request. A licensee is prohibited from charging
more than $100.00 for the reproduction of records. A licensee
is also prohibited from charging for the completion of health
insurance claim forms and for records needed to enable a client
to receive ongoing care by another practitioner.
The rules proposed for readoption also impose
reporting and recordkeeping requirements on licensees. Orthotist
assistants, prosthetist assistants, prosthetist-orthotist
assistants and holders of temporary licenses are required
to maintain a daily record of services performed and the supervising
licensee is required to initial this record. N.J.A.C. 13:44H-6.1
requires licensees to notify the Board in writing within 30
days of a change in the office address on file with the Board.
N.J.A.C. 13:44H-7.3 requires licensees to maintain a record
of the fees for standard services. N.J.A.C. 13:44H-8.8 requires
licensees to retain copies of advertisements for three years
from the last date of dissemination. The rule also requires
licensees to maintain documentation relating to testimonials
for three years from the date of the last use of the testimonial.
N.J.A.C. 13:44H-9.1 requires licensees to maintain client
records. These records must be maintained for at least seven
years from the date of the last entry.
As the compliance, reporting and recordkeeping
requirements contained in the rules proposed for readoption
with amendment as discussed above are necessary to adequately
regulate licensees and protect consumers who use their services,
the Board believes that the rules must be uniformly applied
to all licensees and no exemptions are provided based on the
size of the licensee's business.
Smart Growth Impact
The Board does not anticipate that the rules
proposed for readoption with amendment will have any impact
on the achievement of smart growth and implementation of the
State Development and Redevelopment Plan, otherwise known
as the State Plan.
Full text of the proposed readoption may be
found in the New Jersey Administrative Code at N.J.A.C. 13:44H.
Full text of the proposed amendment follows:
<< NJ ADC 13:44H-3.1 >>
13:44H-3.1 Requirements for orthotists, prosthetists
and prosthetists- orthotists
(a)-(d) (No change.)
(e) Foreign-trained applicants shall obtain
an evaluation of their professional educational and professional
experience credentials from a credentialing agency recognized
by the American Board for Certification in Orthotics and Prosthetics,
its successor or the International Society of Prosthetists
and Orthotists. The Board shall accept only an evaluation
which is sent to the Board by the credentialing agency. Upon
receipt of the evaluation by the Board, the Board shall review
the evaluation and determine whether the applicant's education
and experience credentials are substantially equivalent to
those required in <<-(a)1->><<+(b)1+>> above.