LAW
Writer®
Ohio Laws and Rules
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) Patient safety offenses: For a violation of Chapter 4734. of the Revised Code or of any board rule involving conduct which directly threatens the health, welfare or safety of a patient, the board may impose a fine as follows:
(1) For a first offense, a minimum fine of $250.00 and a maximum fine of $5,000.00:
(2) For a second offense, a minimum fine of $1,000.00 and a maximum fine of $5,000.00.
(3) For a third or subsequent offense, a minimum fine of $2,000.00 and maximum fine of $5,000.00.
(B) Financial misconduct offenses: For a violation of Chapter 4734. of the Revised Code or of any board rule which involves fraud, false statements, improper billing, or other financial misconduct, the board may impose a fine as follows:
(1) For a first offense, a minimum fine of double the amount of the money involved or $500.00, whichever amount is lesser, to a maximum of $5,000.00;
(2) For a second offense, a minimum fine of triple the amount of the money involved or $1,000.00, whichever amount is lesser, to a maximum of $5,000.00.
(3) For a third or subsequent offense, a minimum fine of $2,000.00 and maximum fine of $5,000.00.
(C) Advertising / soliciting offenses: For a violation of Chapter 4734. of the Revised Code or of any board rule which involves advertising or soliciting for patients, the board may impose a fine as follows:
(1) For a first offense a maximum fine of $2,000.00;
(2) For a second offense, a minimum fine of $500.00 to a maximum of $5,000.00;
(3) For a third or subsequent offense, a minimum fine of $1000.00 to a maximum of $5,000.00.
(D) Other offenses: For a violation of Chapter 4734. of the Revised Code or of any board rule not otherwise specified above, the board may impose a fine as follows:
(1) For a first offense a maximum of $2,500.00;
(2) For a second offense, a minimum fine of $500.00 to a maximum fine of $5,000.00.
(3) For a third or subsequent offense, a minimum fine of $1,000.00 to a maximum fine of $5,000.00.
R.C. 119.032 review dates: 04/23/2008 and 04/23/2013
Promulgated Under: 119.03
Statutory Authority: 4734.10, 4734.31(B)(4)
Rule Amplifies: 4734.31
Prior Effective Dates: 5/2/2003
(A) This rule applies to all forms of advertising and solicitation.
(B) No chiropractic physician shall advertise or solicit for patronage in connection with the practice of chiropractic and/or acupuncture if any communication contained therein is false, fraudulent, deceptive, or misleading.
(C) Excluding a free consultation, any advertisement or solicitation which offers chiropractic and/or acupuncture services on a gratuitous basis shall include a disclaimer. If the advertisement is visual, the disclaimer shall be contained therein. If the advertisement is aural, the disclaimer shall be read. A written copy of the disclaimer shall be provided to every patient who responds to an offer, prior to the rendering of patient care. The disclaimer shall clearly state:
(1) Any exclusions, prohibitions, restrictions, limitations, conditions, or eligibility requirements which apply to the offer and;
(2) If additional services rendered on the same day which are associated with the offer but not provided free of charge.
(D) All advertisements and solicitations in connection with the practice of chiropractic and/or acupuncture shall include therein the first and last name of a designated chiropractic physician who holds a valid Ohio chiropractic license and who has reviewed and approved the content of the advertisement or solicitation. Said designated chiropractic physician shall be responsible for solicitation made by others on his or her behalf.
(E) All advertisements and solicitations in connection with the practice of chiropractic and/or acupuncture shall clearly reveal that the advertisement and/or solicitation is being made on behalf of a chiropractic physician(s).
(F) All advertisements and solicitations in connection with the practice of chiropractic shall contain therein one of these exact terms: chiropractic, chiropractor, doctor of chiropractic or chiropractic physician.
(G) All advertisements and solicitations in connection with the practice of acupuncture by a chiropractic physician who holds a certificate to practice acupuncture issued under Chapter 4734. of the Revised Code shall comply with the provisions of this rule. 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 the person is engaged in the practice of oriental medicine or utilize any of the titles listed in section 4762.08 of the Revised Code.
(H) 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.
(I) Telephonic solicitations shall conform to Chapter 4719. of the Revised Code.
(J) Chiropractic physicians who solicit patients 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.
(K) 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.
(L) Chiropractic physicians who solicit via in-person shall maintain a record of the names of the individuals contacted, including their address and telephone number for a period of six months. Failure to maintain a record of the names of the individuals contacted, including their address and telephone number for a period of six months constitutes a violation of this rule.
(M) 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 seller of goods or services 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 the solicitor’s identity and the identity of the chiropractic physician and practice on whose behalf the solicitation is being made; the purpose of the solicitation; a statement of the goods or services being offered; and that no purchase or payment is necessary to participate in a promotion if a promotion is offered;
(7) Misrepresenting an affiliation with, or endorsement by, any government or third-party organization;
(8) Communicating with an individual in a way that invades privacy of the individual, or interferes with an existing doctor/patient relationship.
(N) 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.
Effective: 11/15/2007
R.C. 119.032 review dates: 08/20/2007 and 11/15/2012
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.31, 4734.285
Prior Effective Dates: 5/2/2003, 8/1/2007
(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:
(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 name other than his or her own, he or she shall display his or her first and last name with the initials “D.C.” at the front or main entrance of each practice location.
(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.
Effective: 11/15/2007
R.C. 119.032 review dates: 08/20/2007 and 11/15/2012
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.31, 4734.285
Prior Effective Dates: 5/2/2003, 8/1/2007
(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.
R.C. 119.032 review dates: 04/23/2008 and 04/23/2013
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.17, 4734.31
Prior Effective Dates: 5/2/2003
(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.
R.C. 119.032 review dates: 04/23/2008 and 04/23/2013
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 2317.02, 4734.31
Prior Effective Dates: 1/10/2003
(A) A patient is any person who is the recipient of a professional service rendered by a chiropractic physician. 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) A doctor-patient relationship is any relationship between a chiropractic physician and a patient wherein the chiropractic physician provides professional services to the patient.
(C) 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.
(D) Sexual misconduct is any verbal or physical action or behavior, or expression of thoughts or feelings, or gestures that exploits the doctor-patient relationship in a sexual manner, regardless of consent of the patient.
(E) Sexual misconduct includes:
(1) Failure to provide privacy for disrobing;
(2) Failure to explain the necessity of performing any procedure that involves exposure or contact with the genitalia, anus, 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 genitalia, anus or female breast without the patient’s signed consent;
(4) Subjecting a patient to exposure or contact with the genitalia, anus or female breast in the presence of a third party without the patient’s consent;
(5) Examining or touching a patient’s genitals or anus 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;
(9) Initiating 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, or preferences that are unnecessary and/or not related to the patient’s legitimate needs;
(11) Participation in acts of sexual nature that is recorded on film, in print, or in an electronic medium;
(12) Kissing or fondling of a sexual nature;
(13) Intentionally touching a patient’s breasts, genitalia or anus for non-diagnostic or non-therapeutic purposes;
(14) Encouraging a patient to masturbate in the presence of the chiropractic physician or masturbation by the chiropractic physician in the presence of a patient;
(15) Sexual acts involving vaginal or anal intercourse, oral to genital, oral to anal, and/or oral to breast contact;
(16) Offering to provide or providing chiropractic services in exchange for any prohibited conduct outlined in this rule.
(F) 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.
(G) 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.
Replaces: 4734-9-06
Effective: 11/15/2007
R.C. 119.032 review dates: 11/15/2012
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.31
Prior Effective Dates: 1/10/2003,
(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) Nothing in this rule shall prevent a chiropractic physician from providing a reasonable time of service discount.
Effective: 08/01/2007
R.C. 119.032 review dates: 01/19/2007 and 08/01/2012
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.31
Prior Effective Dates: 5/2/2003
(A) In order to provide the best possible care to patients, chiropractic physicians shall cooperate with other licensed practitioners who are concurrently treating his or her patients, or who subsequently treat his or her patients. Cooperation shall include, as authorized by the patient, making patient records available, reporting his or her diagnosis and/or treatment, and otherwise ensuring continuity of patient care.
(B) No chiropractic physician shall 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.
(C) A chiropractic physician shall present his or her professional credentials in an accurate and dignified manner. He or she shall not misrepresent his or her professional credentials, or present credentials in a misleading manner. The term “board” shall only be used in regard to the state chiropractic board, unless the full name of the entity other than the state chiropractic board is used.
(D) Chiropractic physicians may not identify themselves as practicing in a certain specialty or as a specialist, unless they possess the recognized credentials issued by the proper authority.
(E) A chiropractic physician shall maintain proper standards of safety, sanitation and cleanliness in his or her place of practice. This includes properly utilizing and maintaining all equipment used in chiropractic practice.
(F) A chiropractic physician shall remain free of conflicts of interest and shall maintain the integrity of the chiropractic profession while fulfilling their 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.
(G) A chiropractic physician who identifies him or herself as such in an endorsement, shall promote or endorse only in a manner that is true and that is not false, fraudulent, deceptive, or misleading.
(H) Chiropractic physicians shall not practice, condone, facilitate, or collaborate with any form of discrimination on the basis of race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, veteran status, or mental or physical challenge.
(I) Chiropractic physicians shall endeavor to practice with the highest degree of professional competency in the care of patients. Clinical judgment and practices should be objective and exercised solely for the patient’s benefit.
(J) Chiropractic physicians shall consult with other health care professionals when such consultation would benefit the patient, or when the patient requests such consultation.
(K) Chiropractic physicians shall 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.
(L) A chiropractic physician shall 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.
(M) A chiropractic physician shall not guarantee a cure to any patient.
(N) A chiropractic physician shall not take physical, emotional, or financial advantage of any patient.
(O) Upon receipt of a written request, a chiropractic physician shall release the patient’s records to the patient, or to whom the patient designates to receive the records.
Effective: 11/15/2007
R.C. 119.032 review dates: 08/20/2007 and 11/15/2012
Promulgated Under: 119.03
Statutory Authority: 4734.10, 4734.16
Rule Amplifies: 4734.16, 4734.31
Prior Effective Dates: 5/2/2003, 8/1/2007
(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.
R.C. 119.032 review dates: 04/23/2008 and 04/23/2013
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 3999.22, 4734.17, 4734.31
Prior Effective Dates: 1/10/2003
(A) A chiropractic physician who has had his or her chiropractic license and/or acupuncture certificate disciplined shall:
(1) Within fifteen days of the board’s order, disclose in writing the details of the board’s action to any employer, and to any entity which contracts with the chiropractic physician to provide chiropractic and/or acupuncture services. For any and all written notices required pursuant to this rule, the chiropractic physician shall transmit the notice via a method which provides written confirmation of delivery. This evidence shall be kept by the chiropractic physician for two years.
(2) Comply with any restrictions, conditions, or limitations placed on his or her chiropractic license and/or acupuncture certificate by the board’s order.
(B) In addition to the preceding, a chiropractic physician who has had his or her chiropractic license and/or acupuncture certificate suspended or revoked, during the time period specified in the board’s order shall:
(1) Not display his or her license to practice chiropractic and/or certificate to practice acupuncture or current year’s renewal card(s);
(2) Not occupy, share or use office space in which another licensee practices chiropractic and/or acupuncture;
(3) Desist and refrain from the practice of chiropractic and/or the practice of acupuncture in any form either as a principal or employee or agent of another and shall not furnish chiropractic and/or acupuncture services. However, the affected chiropractic physician may respond to inquiries from patients, third party payors and/or health care practitioners regarding his or her prior examination and/or treatment of a patient and may provide reports regarding his or her previous examination and/or treatment of a patient;
(4) Not advertise, announce or otherwise hold him or herself forth as a chiropractic physician and/or the holder of an acupuncture certificate issued under Chapter 4734. of the Revised Code or someone who may legally practice chiropractic and/or acupuncture;
(5) Advise the board of any changes in employment or residence addresses or telephone numbers within fifteen days of any such change;
(6) If the board’s action includes revocation or active suspension for thirty days or greater, promptly notify in writing all patients who have been under such chiropractic physician’s care within the preceding six months of his or her inability to provide further chiropractic and/or acupuncture services. The chiropractic physician shall notify the patients in the 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. For suspensions of shorter duration, the chiropractic physician shall take reasonable measures to ensure his or her patients have continuity of care and access to their records.
(7) Not share in any fee for chiropractic and/or acupuncture services performed by any other chiropractic physician during the revocation or suspension. This provision will not prohibit the chiropractic physician from collecting accounts receivable for services rendered previously or from collecting rental payments or payments for equipment leases;
(8) If revoked or actively suspended for six months or greater, within thirty days of the effective date of the action deliver to the board the original chiropractic license and/or acupuncture certificate and current year’s renewal card(s);
(9) If revoked or actively suspended for a period of one year or more, within fifteen days notify in writing publishers of any telephone directory, professional directory and any other professional listing (including online listings) in which such chiropractic physician’s name appears, to remove any such listing;
(10) Within thirty days after the effective date of the chiropractic physician’s revocation, file with the board a detailed sworn affidavit specifying how such person has fully complied with this rule;
(11) For those suspended, complete the mandatory continuing education required to renew a chiropractic license and/or acupuncture certificate, plus any additional hours ordered by the board;
(12) If revoked or suspended actively for more than one year, the chiropractic physician may be required to take an examination prior to reinstatement of his or her license to good standing.
Effective: 11/15/2007
R.C. 119.032 review dates: 08/20/2007 and 11/15/2012
Promulgated Under: 119.03
Statutory Authority: 4734.10
Rule Amplifies: 4734.14, 4734.31
Prior Effective Dates: 2/5/1991, 2/5/1993, 7/29/2002