Committee approves substitute to expand dry-needling licensure to occupational therapists and clarify direct access

Representative Cutler introduced a first substitute to House Bill 188 adding trigger-point dry needling to the state’s regulated scope for occupational therapists and clarifying direct-access (nonreferral) practice for both physical and occupational therapists. Supporters including occupational therapists Sam DeLong and Trent Brown, and physical therapist and instructor Dr. Tyler (Ty) Robinson, described dry needling as a musculoskeletal therapeutic technique used to reduce pain, increase blood flow and improve function, and said it is recognized in many states.

The substitute keeps an active-practice requirement—applicants must typically have two years of active clinical practice before obtaining licensure in the specialized procedure—and clarifies that formal hands-on training and supervised clinical hours (presented in testimony as 54 hours of in-person instruction and several hundred supervised patient hours) are required for a certification pathway. Witnesses said training can begin before the two-year licensure threshold but that official subspecialty licensure is granted after the required practice time and supervised hours are completed.

Several committee members pressed speakers on whether the measure would affect insurance referral rules; witnesses and the sponsor said the statutory change clarifies that licensing does not require a physician referral from the state-licensing perspective, but it does not prevent private insurers or federal programs such as Medicare from requiring referrals for coverage. Representatives discussed patient protections and the experience requirement at length. The first substitute was adopted and the committee voted unanimously on a roll-call to favorably recommend HB 188 as substituted.