ARIZONA HOUSE OF REPRESENTATIVES

57th Legislature, 2nd Regular Session

Majority Research Staff

 

☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal Note

HB 2227: chiropractic board; complaints; training; authority.

Sponsor: Representative Blackman, LD 7

Committee on Government

Overview

Revises the regulation of chiropractic doctors by expanding and modifying the list of grounds for disciplinary action, outlining referrals of criminal complaints to law enforcement, establishing conflict of interest training and outlining causes for termination of the Board of Chiropractic Examiners' (Board) Executive Director.

History

Established in 1921, the Board was created to protect the health, welfare and safety of the public through the enforcement of the laws governing the practice of chiropractic. The Board accomplishes this by investigating complaints, administering disciplinary actions and establishing education and training standards for the profession (A.R.S. § 32-904).

Statute describes the actions that constitute grounds for disciplinary action of a Doctor of Chiropractic (DC) by the Board. Upon the Board's own motion or on receipt of a complaint, it is authorized to 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 as to the content of the complaint as soon as is reasonable. Any person who reports or provides information to the Board in good faith is not subject to civil damages as a result of that action. The Board may require a licensee under investigation to be interviewed by the Board or its representatives and require a licensee to undergo, at the licensee's expense, any combination of medical, physical or mental examinations that the Board finds necessary to determine the licensee's competence (A.R.S. § 32-924).

Provisions

Unprofessional Conduct

1.   Constitutes the following, whether occurring in Arizona or elsewhere, as unprofessional conduct, for the purposes of disciplining a DC:

a.   failing to disclose in writing to a patient or a third-party payor that the licensee has a financial interest in a referred diagnostic or treatment facility, test, good or service when alternatives are available from other health care providers, with the exception of referrals within a group practice;

b.   knowingly making a false or misleading statement to a patient or a third-party payor;

c. knowingly making and providing false or misleading information or omitting material information in oral or written communication to the Board, Board staff or representative or on a form required by the Board;

d.   knowingly filing an application or document that contains false or misleading information to the Board;

e. failing to create complete patient records that include health history, clinical impressions, exam findings, diagnostic results, imaging, treatment plans, visit notes and billing records with statutorily required information;

f. failing to maintain patient records for at least six years after the last treatment date or six years after a minor turns 18 years old;

g.   failing to provide written notice to the Board with instructions and minimum information on how to access patient records for a closed chiropractic practice;

h.   failing to properly release patient records, diagnostic imaging or billing records free of charge to eligible individuals within specified time frames after a request;

i. claiming certifications, specialties, academic degrees or professional credentials not held;

j.   failing to provide a patient with documentation of credentials when requested;

k.   practicing or billing for services under a name not registered with the Board without first notifying the Board in writing;

l. suggesting or having sexual contact with a patient, during their treatment or three months after their last professional interaction, with whom a consensual sexual relationship did not exist prior to the DC-patient relationship;

m. intentionally viewing a disrobed patient in the course of an examination or treatment if the viewing is unrelated to diagnosis or treatment under current practice standards;

n.   intentionally misrepresenting the effectiveness of a treatment, diagnostic test or device;

o. using rectal probes to administer an ultrasound, diathermy or other modality;

p.   improperly using ionizing radiation;

q.   using diagnostic testing or treatment for research purposes without properly obtaining written informed consent, disclosing research contracts and conforming to generally accepted research criteria;

r. having a professional connection with illegal practitioners or individuals falsely claiming Board affiliation;

s. violating the Health Insurance Portability and Accountability Act;

t. habitually using or having used alcohol, narcotics or stimulants to the extent that it impairs professional duties;

u.   being convicted by a court of competent jurisdiction of a Class 1, 2, 3, 4 or 5 felony;

v.   having disciplinary action taken against in another jurisdiction for unprofessional conduct;

w. fee splitting or improper referral arrangements with the exception for lawful business  entities;

x.   violating federal or Arizona law, rule or regulation that applies to the chiropractic practice; and

y.   filing an anonymous complaint against another licensee. (Sec. 2)

2.   Prohibits the Board from adopting rules that alter unprofessional conduct as it is statutorily written. (Sec. 2)

 

 

Board Regulations

3.   Directs the Board to develop policies and procedures for determining when a licensee should undergo psychosexual evaluation and how the Board will use evaluation results. (Sec. 3)

4.   Requires the Board to terminate the Board's Executive Director for any of the following:

a.   subpoenaing information unrelated to a complaint allegation;

b.   failing to refer to the appropriate law enforcement agency information that indicates a licensee or certificate holder may have committed a misdemeanor or felony within two business days of receiving the information; and

c. advocating in support or against a legislative proposal in their official capacity prior to the Board taking a formal position in a public meeting. (Sec. 3)

Board's Conflict of Interest Training

5.   Instructs all Board members and employees to complete an annual conflict-of-interest disclosure form that attests that no conflict exists. (Sec. 4)

6.   Mandates the Board to retain all conflict-of-interest disclosure forms and make them available to the public on request. (Sec. 4)

7.   Requires all Board members and employees to annually complete an Attorney-General-approved training on the following:

a.   conflict-of-interest requirements, processes and disclosure forms that detail how they relate to their individual roles and responsibilities;

b.   open meeting law requirements; and

c. the Board's authority to investigate complaints and issue subpoenas. (Sec. 4)

Board's Executive Director

8.   Requires the Board's Executive Director to do all the following:

a.   ensure the Board follows all applicable law and rules and complies with all reporting requirements;

b.   advise the Board if any contemplated action is beyond their statutorily authorized scope and provide advice in executive session as outlined;

c. prepare and maintain a discipline matrix for the Board to ensure all licensees are treated consistently when a form of discipline is imposed; and

d.   classify each complaint that gets submitted to the Board in a way that prioritizes the allocation of Board resources, the investigation and adjudication of complaints. (Sec. 5)

9.   Outlines the material the discipline matrix must contain. (Sec. 5)

10.  Specifies that the discipline matrix must be available to any licensee, including their counsel, who has a complaint filed against them and a formal investigation has opened against them. (Sec. 5)

11.  Prohibits the Board's Executive Director from advocating in support or against a legislative proposal in their official capacity prior to the Board taking a formal position in a public meeting and encouraging licensees or the public to support or oppose any legislation. (Sec. 5)

 

 

 

Board Complaint Investigations

12.  Specifies the scope of an investigation based on a complaint the Board receives is limited to the information contained in the initial complaint or the information the Board has at the time of the Board's motion to investigate. (Sec. 8)

13.  Prohibits the Board from subpoenaing information related to a licensee's personal finances. (Sec. 8)

14.  Subjects the Board’s subpoena and record-access authority to existing limitations on obtaining a licensee’s personal financial information. (Sec. 10)

15.  Allows the Board to extend the time to investigate a licensee if either of the following applies:

a.   the complaint relates to improper sexual conduct of the licensee; or

b.   the licensee agrees to the proposed extension and the Board has diligently pursued the investigation within the allowed time frame. (Sec. 8)

16.  States that an investigation and initial review of a complaint must be completed within 90 days of a complaint being filed, unless the Board extends the time frame due to the outlined reasons. (Sec. 8)

17.  Directs the Board to make a final decision of a formal hearing within 220 days after a complaint is filed. (Sec. 8)

18.  Stipulates that a complaint is deemed administratively closed if the Board has not made a final decision on a complaint with a formal hearing after 220 days. (Sec. 8)

19.  Entitles a licensee to restitution for costs incurred through the course of an investigation and or formal hearing process if a court of competent jurisdiction finds that the Board acted capriciously against a licensee with merit and violated pertinent laws and rules. (Sec. 8)

20.  Removes the definition of solicitation. (Sec. 8)

Receiving Criminal Complaints

21.  Instructs the Board to refer information or complaints that indicate a licensee or certificate holder may have committed a misdemeanor or felony offense to the appropriate law enforcement agency within two business days after receiving said information or complaint. (Sec. 9)

22.  Mentions that the Board does not need the complainant's consent or for them to substantiate the complaint prior to referring the complaint to law enforcement. (Sec. 9)

23.  Allows the Board to restrict, limit or suspend an individual's license or certificate if the Board finds that the public health, safety or welfare requires emergency action while action is pending by a law enforcement agency. (Sec. 9)

24.  Directs the law enforcement agency that receives a criminal complaint or information to inform the Board of the investigation's outcome and whether charges are filed against a licensee or certificate holder. (Sec. 9)

25.  Permits the Board to investigate, concurrent with a law enforcement agency's investigation, whether a complaint constitutes a violation of unprofessional conduct. (Sec. 9)

 

Miscellaneous

26.  Requires, rather than allows, a DC applicant to submit to the Board a full set of fingerprints. (Sec. 6)

27.  Stipulates that a DC license is automatically suspended after 90 days of the renewal due date if a licensee fails to properly renew their license. (Sec. 7)

28.  Allows a licensee who completes their renewal within the 90 days after the renewal due date to have their license renewal backdated to the prior expiration date. (Sec. 7)

29.  Expands exemptions from chiropractic business entity registration requirements to include business entities that are majority-owned by a licensed chiropractor and allows exempt entities to submit bills under either the controlling licensee’s name or the business entity’s name without notifying the Board. (Sec. 11)

30.  Defines pertinent terms. (Sec. 1)

31.  Contains a legislative intent clause. (Sec. 12)

32.  Makes technical and conforming changes. (Sec. 1, 3, 5-8, 10, 11).

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36.  Initials ML                       HB 2227

37.  1/30/2026  Page 0 Government

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