HB 165 — AN ACT TO AMEND TITLE 24 OF THE DELAWARE CODE RELATING TO DRY NEEDLING.

Uses a thin filiform needle to penetrate the skin and stimulate underlying muscular tissue, connective tissues, and myofascial trigger points for the management of neuromusculoskeletal pain and movement impairments.

b.

Is based upon Western medical concepts.

c.

Requires a practical nursing exam and diagnosis.

(v) “Trigger points” means hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers.

They can give rise to local or referred pain, autonomic phenomenon, and can cause limitations in range of motion and muscle activation.

§ 1939.

Dry needling practice;

referral.

(a) A certified nurse practitioner may perform dry needling, subject to the following restrictions:

(1) A nurse practitioner may not perform a dry needling procedure on a patient without first receiving a written physician referral specific to dry needling.

A referral may be transmitted by digital means.

(2) A nurse practitioner may not advertise or in any other way hold themself out as an acupuncturist unless the nurse practitioner is a licensed acupuncturist.

(b) The Board must establish, by rule and regulation, training and practice standards for dry needling by certified nurse practitioners.

Section 3.

Amend Chapter 20, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows and by redesignating accordingly:

§ 2002.

Definitions.

As used in this chapter:

(4) “Dry needling” means an intervention that meets the following criteria:

a.

Uses a thin filiform needle to penetrate the skin and stimulate underlying muscular tissue, connective tissues, and myofascial trigger points for the management of neuromusculoskeletal pain and movement impairments.

b.

Is based upon Western medical concepts.

c.

Requires an occupational therapy examination and diagnosis.

(8) (9) a.

“Occupational therapy services” includes any of the following:

12The monthsassessment, aftertreatment, itsand enactmenteducation intoof law.or consultation with an individual, family, or other persons.

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05/19/202605/15/2025 11:5912:18 AMPM SYNOPSIS3. This Amendment to House Bill No.

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325b. of this General Assembly, and changes references from "certified nurse practitioners" to "APRNs", allowing any APRN to perform dry needing, subject to the requirements of the Act.

This“Occupational Acttherapy alsoservices” removes a requirement for an APRN or physician“practice associateof tooccupational havetherapy” amay physicianrequire referralassessment beforeof performingthe dryneed needlingfor onuse aof patient,interventions such as neitherthe ofdesign, thesedevelopment, licenseadaptation, typesapplication, requireor referralstraining andin boththe areuse ableof toassistive writetechnology referralsdevices; for services.

This Amendment also changes the effectivedesign, datefabrication, from 6 months after enactment to 12 months or uponapplication notice in the Register of Regulationsrehabilitative thattechnology regulationssuch implementingas theselected Actorthotic havedevices; been adopted, whichever is earlier.

training in the use of assistive technology, orthotic or prosthetic devices;

the application of thermal agent modalities, including paraffin, hot and cold packs, and fluido therapy, as an adjunct to, or in preparation for, purposeful activity;

the use of ergonomic principles;

the adaptation of environments and processes to enhance functional performance;

dry needling;

or the promotion of health and wellness.

c.

[Repealed.] (9) (10) “Person” means a corporation, company, association,or association, partnership, or an individual.

(14) “Trigger points” means hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers.

They can give rise to local or referred pain, autonomic phenomenon, and can cause limitations in range of motion and muscle activation.

§ 2022.

Dry needling practice;

referral.

(a) An occupational therapist may perform dry needling subject to the following:

(1) An occupational therapist may not perform a dry needling procedure on a patient without first receiving a written physician referral specific to dry needling.

A referral may be transmitted by digital means.

(2) An occupational therapist may not advertise or in any other way hold themself out as an acupuncturist unless the occupational therapist is a licensed acupuncturist.

(b) The Board must establish, by rule and regulation, training and practice standards for dry needling.

Section 4.

This Act takes effect 6 months after its enactment into law.

SYNOPSIS This Act authorizes physician assistants, occupational therapists, and nurse practitioners to practice dry needling.

This Act sets forth requirements and limitations pertaining to the practice of dry needling.

Dry needling may not be performed without a physician referral, and physician assistants, nurse practitioners, and occupational therapists may not hold themselves out as acupuncturists unless they are licensed acupuncturists.

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