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ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
chiropractic care; licensure; complaint investigations
Purpose
Outlines various actions that constitute unprofessional conduct for the purpose of disciplining a doctor of chiropractic (DC). Modifies the powers and duties of the Arizona Board of Chiropractic Examiners (Board) and the Executive Director of the Board when investigating and reviewing complaints of unprofessional conduct.
Background
The Board is
charged with protecting the health, welfare and safety of the public through
the enforcement of the laws governing chiropractic practice. The Board's duties
include:
1) adopting necessary rules to protect the public regarding chiropractic
practice; 2) determining the qualifications and regulation of chiropractic
assistants who are not otherwise licensed by law; and 3) reviewing the amount
of each authorized fee in a public hearing at least once each fiscal year and
before establishing the amount of a fee for the subsequent fiscal year (A.R.S.
§ 32-904).
Current statute outlines what actions constitute grounds for disciplinary action of a DC by the Board. The Board on its own motion, or on receipt of a complaint, may investigate any information that appears to show that a DC is or may be in violation of the laws and Board rules that govern the practice of chiropractic in Arizona, or that indicates the DC may be mentally or physically unable to safely engage in the practice of chiropractic. The Board must notify the licensee of the complaint as soon as is reasonable. If the Board believes the allegation is of such magnitude as to warrant suspension or revocation of the license, the Board must immediately initiate formal revocation or suspension proceedings. The Board must notify the licensee of the complaint and hearing by certified mail addressed to the licensee's last known address on record in the Board's files. The notice of the complaint and hearing is effective on the date of its deposit in the mail. The Board must then hold a formal hearing within 180 days after the date the notice is deposited in the mail. (A.R.S. § 32-924).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
Unprofessional Conduct
1. Prescribes the following actions, occurring in Arizona or elsewhere, that constitute unprofessional conduct for the purpose of disciplining a DC:
a) failure to disclose, in writing, to a patient or third-party payor that the DC has a financial interest in any facility, test, good or service when referring a patient for various services, as prescribed;
b) knowingly providing a false or misleading statement or information to a patient, third-party payor or the Board ,including staff or a representative of the Board;
c) failure to create and maintain, adequate patient records as prescribed;
d) failure to provide a copy of requested patient records, free of charge, to a patient, patient's authorized agent or a licensed physician;
e) misrepresentation of the DC's certification in a specialty area, academic or professional credentials;
f) failure to provide documentation of the DC's specialty certification, academic or professional credentials to a patient who requests such documentation;
g) suggesting or having sexual contact in the course of patient treatment, or within three months of the last chiropractic service, with an individual with whom a consensual sexual relationship did not exist prior to becoming a patient;
h) intentionally viewing a disrobed patient, not related to the patient's complaint, diagnoses or treatment;
i) performing prohibited diagnostic procedures as prescribed;
j) promoting or using diagnostic testing or treatment for research or experimental purposes without obtaining informed consent and conforming to generally accepted research or experimental criteria;
k) having a professional connection with an unlawful practitioner; misrepresenting oneself as current or past Board personnel or claiming superiority in the practice of chiropractic;
l) having an action taken against the DC's license in another jurisdiction or having a license renewal denied due to unprofessional conduct;
m) directly or indirectly dividing a professional fee for patient referrals as prescribed; and
n) violating any federal or state law, rule or regulation applicable to the practice of chiropractic.
2. Prohibits the Board from adopting any rule that may alter or amend unprofessional conduct, as outlined.
Executive Director Duties
3. Requires the Executive Director of the Board to:
a) ensure the Board follows all applicable laws and rules, and complies with all reporting requirements;
b) advise the Board of any contemplated actions that are outside of the Board's authority and to state the Director's concern in open session if the Board disregards the advice provided;
c) prepare and maintain a discipline matrix to ensure all licensees are treated consistently based on the specific allegations at issue; and
d) classify complaints pursuant to Board policies to prioritize the allocation of Board resources and the investigation and adjudication of complaints.
Board Investigations and Initial Review
4. Requires the Board to complete an investigation and initial review within 90 days of receiving a complaint that is not related to sexual misconduct of a licensee.
5. Requires a final decision regarding a complaint unrelated to sexual misconduct to be made within 220 days after the complaint is filed if a formal hearing is required.
6. Requires the Board to complete an investigation and initial review within 60 days of receiving a complaint from a patient relating to the improper sexual conduct of a licensee.
7. Requires a final decision regarding a complaint of sexual misconduct to be made within 180 days after the complaint is filed if a formal hearing is required.
8. Prohibits the Board from subpoenaing information related to a licensee's personal finances during an investigation.
9. Allows the Board to request an extension of time to investigate a licensee if:
a) the complaint relates to sexual misconduct of a licensee; or
b) the licensee agrees to the proposed extension and the Board has diligently pursued investigations within the allotted timeframe, as prescribed, for complaints involving allegations or violations of unprofessional conduct or malpractice that implicates patient safety.
10. Entitles a licensee to restitution for all costs incurred relating to an investigation and formal hearing process if the Board acted capriciously against the licensee.
Miscellaneous
11. Stipulates that, after 90 days, the Board must automatically suspend a license if the licensee does not submit a complete application for renewal and pay the renewal fee.
12. Requires the licensee's renewal license to be backdated to the expiration date of the license if the licensee completes the renewal application and pays the renewal fee within 90 days of the due date.
13. Allows a facility, business entity, partnership or other form of business in which the majority of ownership is owned by a licensed DC to submit bills under the controlling licensee's individual name or business name without notification to the Board.
14. Specifies that member includes a chiropractor who is licensed with, contracted or otherwise affiliated with another licensee.
15. Defines patient safety as the prevention of errors and adverse effects to chiropractic patients, not including business, billing, continuing education or other administrative matters.
16. Makes technical and conforming changes.
17. Becomes effective on the general effective date.
Prepared by Senate Research
February 2, 2024
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