Chapter 4734-9 Discipline

4734-9-01 Fine schedules.

The board shall consider the factors in rule 4734-8-06 of the Administrative Code when imposing a civil fine in accordance with the following schedule of fines:

(A) For a first offense, a minimum fine of five hundred dollars and a maximum fine of three thousand dollars.

(B) For a second offense, a minimum fine of one thousand five hundred dollars and a maximum fine of five thousand dollars.

(C) For a third or subsequent offense, a minimum fine of three thousand dollars and a maximum fine of five thousand dollars.

Replaces: 4734-9-01

Effective: 1/1/2019
Five Year Review (FYR) Dates: 01/01/2024
Promulgated Under: 119.03
Statutory Authority: 4734.31(B)(4), 4734.10
Rule Amplifies: 4734.31
Prior Effective Dates: 05/02/2003

4734-9-02 Advertising and solicitation.

(A) This rule applies to all forms of chiropractic and acupuncture advertising and solicitation. All advertisements and solicitations shall comply with the provisions of this rule.

(B) Advertising and solicitation means any communication disseminated by any means with the intent, either directly or indirectly, of offering or selling professional services, or offering to perform professional services, or inducing individuals to enter into any obligation relating to professional services or care or goods related thereto. Advertising includes business cards.

(C) No chiropractic physician shall disseminate or cause to be disseminated any advertisement or solicitation that is in any way false, fraudulent, deceptive, or misleading.

(D) Excluding a free consultation, any advertisement or solicitation which offers free or discounted goods or services shall include a disclaimer. The disclaimer shall clearly state specifically what goods or services are discounted or free and what goods or services are not included with the free or discounted services offered. If the advertisement is visual, the disclaimer shall be contained therein. If the advertisement is aural, the disclaimer shall be read. A copy of the disclaimer shall be provided to each patient who responds to an offer prior to the rendering of care and a copy shall be maintained in the patient's file. Additional goods or services that are subject to a charge that are rendered on the same date as free or discounted goods or services are offered shall not be rendered until such charges are disclosed in writing and acknowledged by signature of the patient. A copy of such signed disclosure shall be provided to the patient prior to rendering care and a copy shall be maintained in the patient's file.

(E) All advertisements and solicitations shall include therein the first and last name of a designated chiropractic physician who holds a valid Ohio chiropractic license, who has reviewed and approved the content of the advertisement or solicitation.

(F) All advertisements and solicitations shall clearly reveal that the advertisement and/or solicitation is being made on behalf of a chiropractic physician(s).

(G) All advertisements and solicitations shall contain therein one of these exact terms: chiropractic, chiropractor, doctor of chiropractic or chiropractic physician and in at least ten point font or its equivalent if the advertisement or solicitation is visual.

(H) No chiropractic physician who holds a certificate to practice acupuncture issued under Chapter 4734. of the Revised Code may advertise or represent to the public that he or she is engaged in the practice of oriental medicine or utilize any of the titles in section 4762.08 of the Revised Code.

(I) Any trade or fictitious names utilized in connection with the practice of chiropractic and/or acupuncture shall be duly registered with the Ohio secretary of state.

(J) No chiropractic physician shall advertise that he or she will waive the payment of all or any part of a deductible or copayment that a patient, pursuant to a health insurance or health care policy, contract, or plan that covers the chiropractor's services, otherwise would be required to pay, unless the waiver is made:

(1) In compliance with the health benefit plan that expressly allows a practice of that nature. Waiver of the deductibles or copayments shall be made only with the full knowledge and consent of the plan purchaser, payer, and third-party administrator. Documentation of the consent shall be made available to the board upon request, or;

(2) For professional services rendered to any other person licensed pursuant to this chapter, to the extent allowed by this chapter and the rules of the board.

(K) All advertisements and solicitations that claim specific physical illnesses, ailments, conditions, or symptoms are alleviated by chiropractic care must be supported by clinical or scientific literature generally recognized by the chiropractic profession.

(L) Chiropractic physicians who solicit via any telecommunication method or device shall maintain a record of the names of the individuals called, their telephone number, and a copy of the exact solicitation script(s) used for six months from the date of last use. Failure to maintain the names of the individuals called, their telephone number, and a copy of the exact solicitation script(s) used for six months from the date of last use constitutes a violation of this rule.

(M) Chiropractic physicians who solicit via any written medium, including but not limited to via the US mail, facsimile, or electronic mail, shall maintain a copy of the written solicitation and a record of the name, address, electronic mail address, or other location where the solicitation was sent, for six months from the last date of use. Failure to maintain a copy of the written solicitation and a record of the name, address, electronic mail address, or other location where the solicitation was sent for six months from the date of last use constitutes a violation of this rule. When the name and information are acquired from public documents, the written solicitation shall clearly state in at least ten point font or its equivalent "This is an advertisement. Your name and information were acquired from public documents. You are under no obligation to respond to this communication."

(N) Chiropractic physicians who solicit via in-person shall maintain a record of the names of the individuals contacted, including their address and telephone number, and copies of any documents or materials provided to the individual for a period of six months. Failure to maintain a record of the names of the individuals contacted, including their address and telephone number and copies of any documents or materials provided to the individual for a period of six months constitutes a violation of this rule.

(O) Each of the following constitutes an act of abusive solicitation and is in violation of this rule:

(1) Use of threats, intimidation, or profane or obscene language;

(2) Contacting an individual repeatedly or continuously, or after being advised that there is no interest in receiving chiropractic and/or acupuncture services;

(3) Contacting an individual when that person has previously stated that he or she does not wish to receive an outbound telephone call or in person solicitation made by or on behalf of the seller whose goods or services are being offered. Every chiropractic physician who solicits via telephone is to maintain a "do not call" list;

(4) Contacting an individual at any time other than between eight a.m. and nine p.m. local time;

(5) Requiring an immediate response from an individual to any offer made during the solicitation or making a one time only offer and/or not permitting the individual to consider the offer and reply at a later time;

(6) Failure to disclose within the first sixty seconds of the solicitation, the solicitor's identity and the identity and practice name of the chiropractic physician on whose behalf the solicitation is being made; the purpose of the solicitation; and a statement of the goods or services being offered;

(7) Failure to provide the practice telephone number of the chiropractic physician on whose behalf the solicitation is being made;

(8) Misrepresenting an affiliation with, or endorsement by, any government or third-party organization;

(9) Communicating with an individual in a way that invades privacy of the individual, or interferes with an existing doctor/patient relationship;

(10) Leaving a recorded message for the prospect that does not comply with this rule;

(11) Failing to advise the prospect how his or her name and information were acquired and that the prospect is under no obligation to respond to the offer made during the solicitation;

(12) Contacting a minor child under eighteen years of age;

(13) Offering cash, gift cards, gift certificates or cash equivalents to patients or potential patients as a referral fee or as an inducement to enter into or to continue care or offering a promotional item that violates paragraph (I) of rule 4734-9-07 of the Administrative Code.

(14) Blocking or otherwise concealing or disguising the true identification of the origin of the solicitation.

(P) Chiropractic physicians are responsible for the solicitations made by others on his or her behalf.

(Q) A licensee may utilize testimonials if the patient giving the testimonial has given written consent as to the exact wording and proposed use of the testimonial. A copy of such consent and testimonial shall be retained by the chiropractic physician who holds a valid Ohio license for one year from the last date of publication. Testimonials shall be true and shall not be false, fraudulent, deceptive or misleading.

Five Year Review (FYR) Dates: 4/30/2019 and 04/30/2024
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.31, 4734.285
Prior Effective Dates: 05/02/2003, 08/01/2007, 11/15/2007, 04/05/2009, 08/14/2014

4734-9-03 Signage and display of license and certificate.

(A) Chiropractic physicians may not utilize signs which include any false, fraudulent, deceptive or misleading information.

(B) One of the following terms must be included on all signs utilized in connection with the practice of chiropractic or otherwise prominently displayed unless the chiropractic physician practices under a trade or fictitious name and complies with paragraph (C) of this rule:

(1) Chiropractic,

(2) Chiropractor,

(3) Doctor of chiropractic,

(4) Chiropractic physician,

(5) Or the initials "D.C." with the use of the chiropractic physician's name.

(C) If a chiropractic physician practices under a trade or fictitious (DBA) name , he or she shall display his or her first and last name with one of the exact terms: chiropractic, chiropractor, doctor of chiropractic, chiropractic physician, or the initials "D.C." at the public entrance of each practice location. Any trade or fictitious name utilized shall be registered with the Ohio secretary of state.

(D) Every licensee practicing in the state of Ohio shall publicly and prominently display his or her license to practice chiropractic in the state of Ohio or a copy thereof in all facilities in which the licensee practices and/or provides health related services.

(E) If a chiropractic physician holds an active certificate to practice acupuncture issued under Chapter 4734. of the Revised Code, the licensee shall publicly and prominently display his or her certificate to practice acupuncture or a copy thereof in all facilities in which the licensee practices and/or provides acupuncture services.

(F) No chiropractic physician who holds a certificate to practice acupuncture issued under Chapter 4734. of the Revised Code shall utilize any title, initials or abbreviations contained in section 4762.08 of the Revised Code on any sign.

Five Year Review (FYR) Dates: 9/24/2018 and 09/24/2023
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.31, 4734.285
Prior Effective Dates: 05/02/2003, 08/01/2007, 11/15/2007, 10/06/2013

4734-9-04 Ownership of chiropractic practices.

(A) A chiropractic physician may practice chiropractic as an agent, employee, associate, owner, contractor, officer, shareholder, director, member or manager of a sole proprietorship, partnership, limited partnership, limited liability company, corporation, professional corporation, not for profit corporation, unincorporated association, or any other form of business legal in the state of Ohio. Without regard to what form of business in which a chiropractic practice is organized, all chiropractic practices shall have an Ohio licensed chiropractic physician who is responsible for any facet of the practice that deals with patient care, patient billing or advertising. Any unlicensed person with an ownership interest in a chiropractic practice may have access to financial data about the practice. However, the unlicensed owner shall keep any patient information confidential in accordance with and as required by law.

(B) Trusts: Any trust that owns or operates a chiropractic practice(s) must be operated by a trustee who is an Ohio licensed chiropractic physician.

Five Year Review (FYR) Dates: 9/24/2018 and 09/24/2023
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.17
Prior Effective Dates: 05/02/2003

4734-9-05 Confidentiality.

(A) Except when a release has been properly executed by a patient, every chiropractic physician shall maintain the confidentiality of patient information, except when otherwise required by law.

(B) Every chiropractic physician shall ensure that there is a system in place to protect the confidentiality of patient records and information, including instructing staff members and vendors on their legal obligations to safeguard confidential information.

(C) Every chiropractic physician shall comply with other applicable state and federal laws concerning the confidentiality of patient information.

Five Year Review (FYR) Dates: 9/24/2018 and 09/24/2023
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 2317.02, 4734.31
Prior Effective Dates: 01/10/2003

4734-9-06 Sexual misconduct.

(A) A patient is any person who is the recipient of a professional service rendered by a chiropractic physician. A doctor-patient relationship is any relationship between a chiropractic physician and a patient wherein the chiropractic physician provides professional services to the patient. An individual is considered a patient until thirty days have elapsed from the date the doctor-patient relationship was formally terminated in accordance with rule 4734-8-07 of the Administrative Code. An individual remains a patient until the doctor-patient relationship is terminated regardless if the individual is not actively receiving professional services from a chiropractic physician. Sexual contact between a chiropractic physician and a former patient after termination of the doctor-patient relationship may still constitute sexual misconduct if the contact is the result of the exploitation of trust, knowledge, or influence of emotions derived from the doctor-patient relationship.

(B) The doctor-patient relationship requires the chiropractic physician to exercise the utmost care that he or she will do nothing to exploit the trust and dependency of the patient. A chiropractic physician shall make every effort to avoid other types of relationships that impair his or her professional judgment or risk the possibility of exploiting the confidence placed in them by a patient.

(C) Sexual misconduct is any verbal or physical action or behavior, or expression of thoughts or feelings, or gestures that are sexual or that reasonably may be constured by a patient as sexual or conduct that exploits the doctor-patient relationship in a sexual manner, regardless of consent of the patient.

(D) Sexual misconduct includes, but is not limited to:

(1) Failure to provide privacy for disrobing and/or failure to provide proper gowns;

(2) Failure to explain the necessity of performing any procedure that involves exposure or contact with the pelvic area, genitals, rectum, male prostrate, or female breast. In the event the patient is a minor, the explanation shall be given to the parent or legal guardian. The chiropractic physician must ensure that the patient comprehends the necessity for such examination;

(3) Failure to have a third party present while performing any examination that involves exposure or contact with the pelvic area, genitals, rectum, male prostrate or female breast without the patient's signed consent;

(4) Subjecting a patient to exposure or contact with the pelvic area, genitals, rectum, male prostrate or female breast in the presence of a third party without the patient's consent;

(5) Examining or touching a patient's genitals without the use of gloves;

(6) Conduct that may reasonably be interpreted as intended for the sexual arousal or gratification of the chiropractic physician, patient, or both;

(7) Inappropriate sexual comments about or to a patient about the patient's body, underclothing, or sexual orientation;

(8) Requesting a date or romantic relationship with a patient;

(9) Initiating or participating in a conversation with a patient regarding the chiropractic physician's own sexuality, including sexual problems, preferences, or fantasies;

(10) Initiating conversation with, or requesting details of, a patient's sexuality, including history, sexual problems, sexual fantasies or sexual preferences that are unnecessary and/or not related to the patient's legitimate needs;

(11) Making sexual comments about a patient's body or underclothing, making sexualized or sexually demeaning comments to a patient, criticizing the patient's sexual orientation, or making comments about potential sexual performance;

(12) Participation in acts of sexual nature that is recorded on film, in print, or in an electronic medium;

(13) Kissing or fondling of a sexual nature;

(14) Touching any body part that has sexual connotation for the licensee or the patient for any purpose other than for the patient's legitimate health care need;

(15) Encouraging a patient to masturbate in the presence of the chiropractic physician or masturbation by the chiropractic physician in the presence of a patient;

(16) Sexual acts involving vaginal or anal intercourse, oral to genital, oral to anal, and/or oral to breast contact;

(17) Sexually demeaning conduct or conduct which demonstrates a lack of respect for the patient's privacy;

(18) Offering to provide or providing chiropractic or acupuncture services in exchange for any prohibited conduct outlined in this rule.

(E) The initiation of, consent to, or participation in sexual misconduct with a chiropractic physician by a patient does not change the nature of the conduct or negate the prohibitions contained in this rule.

(F) Sexually intimate acts and relationships that exist between life partners or in a marriage do not preclude the chiropractic physician from providing the partner or spouse with professional services.

Five Year Review (FYR) Dates: 9/24/2018 and 09/24/2023
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.31
Prior Effective Dates: 01/20/2003, 11/15/2007, 06/01/2013

4734-9-07 Billing practices.

(A) Chiropractic physicians who function as owners, operators, members, partners, shareholders, officers, directors, and/or managers of a chiropractic clinic shall be responsible for the policies, procedures and billings generated by the clinic.

(B) Chiropractic physicians who function only as clinical staff without any management or financial responsibilities are required to familiarize themselves with the clinic's billing practices to ensure that the services rendered are accurately reflected in the billings generated.

(C) Chiropractic physicians have a right to review and correct all billings submitted under their name and/or identifying number(s). Signature stamps and/or automatically generated signatures shall be utilized only with the authorization of the chiropractic physician whose name or signature is designated. Such authorization may be revoked at any time in writing by that individual.

(D) Chiropractic physicians shall accurately report the services rendered to a patient on all billing documents.

(E) Chiropractic physicians shall release copies of billing records upon a written request from a patient or a patient's authorized representative within thirty days of said request.

(F) Chiropractic physicians shall not knowingly:

(1) Increase charges when a patient utilizes a third-party payment program;

(2) Report incorrect dates or types of service on any billing documents;

(3) Report charges for services not rendered;

(4) Bill for services rendered which are not documented in a patient's file.

(G) No chiropractic physician shall waive the payment of all or any part of a deductible or copayment that a patient, pursuant to a health insurance or health care policy, contract, or plan that covers the chiropractor's services, otherwise would be required to pay if the waiver is used as an enticement to a patient or group of patients to receive health care services from that chiropractor, unless the waiver is made:

(1) In compliance with the health benefit plan that expressly allows a practice of that nature. Waiver of the deductibles or copayments shall be made only with the full knowledge and consent of the plan purchaser, payer, and third-party administrator. Documentation of the consent shall be made available to the board upon request, or;

(2) For professional services rendered to any other person licensed pursuant to this chapter, to the extent allowed by this chapter and the rules of the board.

(H) No chiropractic physician shall offer cash, gift cards, gift certificates or cash equivalents to patients or potential patients as a referral fee or an inducement to enter into or to continue care.

(I) Promotional items shall not be more than seventy-five dollars in retail value per year per patient. Professional services, product samples, literature, or refreshments served at events such as health fairs, open houses, educational lectures or health care orientations are not considered promotional items. Promotional items shall not be claimed directly or indirectly or otherwise shifted to any third party for reimbursement.

(J) Nothing in this rule shall prevent a chiropractic physician from providing a reasonable time of service discount.

Five Year Review (FYR) Dates: 4/30/2019 and 04/30/2024
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.31
Prior Effective Dates: 05/02/2003, 08/01/2007, 04/05/2009, 05/25/2014

4734-9-08 Professional ethics.

(A) A doctor-patient relationship is any relationship between a chiropractic physician and a patient wherein the chiropractic physician provides professional services to the patient. The doctor-patient relationship requires the chiropractic physician to exercise the utmost care that he or she will do nothing to exploit the trust and dependency of the patient. A chiropractic physician shall make every effort to avoid other types of relationships that impair his or her professional judgement or risk the possibility of exploiting the confidence placed in him or her by a patient. Clinical judgment and practices should be objective and exercised solely for the patient's benefit.

(B) Chiropractic physicians who are employees of unlicensed individuals, or who work in a multidisciplinary healthcare setting, must exercise independent professional judgment and act in the patient's best interest at all times.

(C) Every chiropractic physician shall:

(1) Maintain proper standards of safety, sanitation and cleanliness in their place of practice, to include properly utilizing and maintaining all equipment used in practice;

(2) Remain free of conflicts of interest and shall maintain the integrity of the chiropractic profession while fulfilling his or her duties and responsibilities as a chiropractic physician. If a conflict of interest does develop, the chiropractic physician shall promptly disclose such conflict of interest to the affected parties. Chiropractic physicians shall avoid any conflicts of interest with a patient which might impair professional judgment;

(3) Maintain professional boundaries when interacting with patients via the internet, electronic messaging, text messaging, or any other type of social networking;

(4) Maintain confidentiality and protection of privacy, security, and integrity of patient information;

(5) Cooperate with other health care providers who concurrently treat, or who subsequently treat their patients;

(6) Present their professional credentials in an accurate and dignified manner;

(7) Promote or endorse themselves in a manner that is true and not in a false, fraudulent, deceptive, or misleading manner;

(8) Consult with other health care professionals when such consultation would benefit the patient, or when the patient requests such consultation;

(9) Protect the public by bringing to the attention of the board any action of another chiropractic physician that appears to violate Chapter 4734. of the Revised Code and agency 4734 of the Administrative Code;

(10) Not offer financial incentives such as cash, gift cards, gift certificates or cash equivalents to patients or potential patients;

(11) Not receive a fee, rebate, rental payment, or any other form of remuneration for the referral of a patient to a clinic, laboratory or other health service entity;

(12) Not misrepresent their professional credentials, or present credentials in a misleading manner. Misleading credentials and/or misrepresentation of credentials includes advertising educational degrees not recognized by a national accrediting agency recognized by the secretary of the United States department of education or the equivalent for education earned outside the United States; and/or advertising specialty certifications or diplomates not issued by a duly recognized organization;

(13) Not guarantee a cure to any patient;

(14) Not take physical, emotional, or financial advantage of any patient;

(15) Not discriminate on the basis of race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, veteran status, or mental or physical challenge;

(16) Not communicate with an individual in a way that invades privacy of the individual, or interferes with an existing doctor-patient relationship;

(17) Not make claims of professional superiority over his or her fellow practitioners or other health care practitioners in an inaccurate or unidentified manner which cannot be properly substantiated;

(18) Not identify themselves as practicing in a certain specialty or as a specialist, unless they possess the recognized credentials issued by the proper authority.

Replaces: 4734-9-08

Effective: 1/1/2019
Five Year Review (FYR) Dates: 01/01/2024
Promulgated Under: 119.03
Statutory Authority: 4734.16, 4734.10
Rule Amplifies: 4734.16, 4734.31
Prior Effective Dates: 05/02/2003, 08/01/2007, 11/15/2007, 10/06/2013

4734-9-09 Fee splitting prohibited.

(A) A chiropractic physician shall not divide fees, charges, income, or collections or have any arrangement to share fees, charges, income, or collections with any other person, except those which reflect services performed or result from lawful ownership of a business organization, as described in RC section 4734.17.

The following situations are exceptions to the above rule:

(1) A chiropractic physician may have an agreement with his clinic, firm, partner, or associate to provide for the payment of money, over a reasonable period of time after his or her death, to the estate or to one or more specified persons;

(2) A chiropractic physician or chiropractic organization may include non-chiropractic physician employees in a retirement plan, even though the plan is based in whole or in part on a profit-sharing arrangement.

(B) A chiropractic physician may not predicate the payment of financial consideration to any individual or entity who solicits potential patients on behalf of the licensee's practice, that is based wholly on the number of patient referrals obtained, unless that individual is a doctor of chiropractic employed by the chiropractic physician.

Five Year Review (FYR) Dates: 9/24/2018 and 09/24/2023
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 3999.22, 4734.17, 4734.31
Prior Effective Dates: 01/10/2003

4734-9-10 Conduct following action against a license.

(A) A chiropractic physician who has had his or her chiropractic license and/or acupuncture certificate disciplined shall provide a copy of the board's action to all employers and entities that contract with the chiropractic physician to provide chiropractic and/or acupuncture services via a method that provides written confirmation of delivery within fifteen days of the action. The delivery evidence shall be maintained for two years.

(B) Immediately upon the effective date of an active suspension or revocation, and for the time period specified, a chiropractic physician shall not:

(1) Display his or her license to practice chiropractic and/or certificate to practice acupuncture or copies of any current proof of renewal of the license or certificate;

(2) Occupy, share or use office space in which another licensee practices chiropractic and/or acupuncture;

(3) Practice of chiropractic and/or acupuncture in any form either as a principal or employee or agent of another and shall not furnish chiropractic and/or acupuncture services. The affected chiropractic physician may respond to inquiries from patients, third party payors and/or health care practitioners regarding his or her prior services provided to a patient and may provide reports regarding his or her previous services provided to a patient;

(4) Hold him or herself forth as a chiropractic physician and/or the holder of an acupuncture certificate or someone who may legally practice chiropractic and/ or acupuncture;

(5) Advertise or claim to be a chiropractor, doctor of chiropractic, or chiropractic physician, or use the initials "DC" in connection with the person's name. The licensee shall notify in writing publishers of any professional advertising (including online listings) in which the chiropractic physician's name appears to remove any such listing;

(C) If a chiropractic physician's office will be closed during an active suspension or revocation, the chiropractic physician shall, within fifteen days of the action, notify in writing all patients who have been under the chiropractic physician's care within the preceding six months of his or her inability to provide chiropractic and/or acupuncture services. Notification shall include advising patients in writing as to the location of their files and what arrangements have been made to permit them to access their files, as well as a method for them to seek chiropractic care elsewhere.

(D) Chiropractic physicians actively suspended or revoked for thirty days or greater shall deliver to the board the original chiropractic license and/or acupuncture certificate within fifteen days of the effective date of the action.

(E) If an individual's license has been actively suspended or revoked for two or more years, the board may require as a condition of reinstatement that the individual complete training or testing as specified by the board.

(F) Within thirty days of the effective date of the discipline, the chiropractic physician shall file with the board a detailed sworn affidavit specifying how he or she has or will comply with this rule.

(G) Licensees shall not be prohibited from collecting accounts receivable for services rendered previously or from collecting reasonable and customary rental and equipment leases during the period of any active suspension and/or revocation.

Replaces: 4734-9-10

Effective: 1/1/2019
Five Year Review (FYR) Dates: 01/01/2024
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.14, 4734.31
Prior Effective Dates: 02/05/1991, 02/05/1993, 07/29/2002, 11/15/2007, 12/26/2013

4734-9-11 Prepayment plans.

A chiropractic physician who offers prepayment for chiropractic and/or acupuncture services shall:

(A) Require the patient to sign and date a written prepayment plan that incorporates all policies, conditions and descriptions of the plan. The plan shall include at least the following:

(1) The duration of the plan;

(2) The proposed treatment plan, the diagnosis and condition being treated;

(3) A list of all services, goods, and appliances covered by the plan and the fees related to such services, goods and appliances;

(4) A list of all separate or distinct fees for services, goods or appliances not covered by the prepayment plan;

(5) An explanation of any policy modifying the plan in the event of a new diagnosis, new condition, or new injury, such as an auto or worker's compensation injury;

(6) An explanation of how any unused portion of funds are calculated or prorated should the patient complete care early or discontinue care. The explanation of the refund policy shall be clearly indicated in the plan and written in plain language;

(7) A statement of an accounting of all funds used at the time of a request from a patient shall be provided to the patient within fourteen days of a written request.

(B) The patient shall receive a refund within fourteen business days for any unused funds upon request. The refund shall be calculated based on the method defined in the written prepayment policy in accordance with paragraph (A)(6) of this rule.

(C) Upon execution of the agreement, the patient shall be provided a copy of the signed prepayment plan.

(D) A copy of the dated prepayment plan signed by both the patient and an employee witness shall be maintained in the patient's file in accordance with the retention schedule outlined in Chapter 4734-8-04 of the Administrative Code.

(E) No prepayment plan shall exceed twelve months in duration.

Effective: 1/1/2019
Five Year Review (FYR) Dates: 9/24/2018 and 01/01/2024
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.10
Prior Effective Dates: 10/06/2013