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ARIZONA HOUSE OF REPRESENTATIVESFifty-seventh Legislature First Regular Session |
Senate: RAGE DP 4-1-2-0 | 3rd Read 16-11-3-0 |
SB
1588: naturopathic physicians; chiropractors; board; conduct
NOW: naturopathic physicians; chiropractors; board; conduct
Sponsor: Senator Shamp, LD 29
Committee on Appropriations
Overview
Establishes actions that constitute unprofessional conduct for a Doctor of Chiropractic (DC). Sets requirements and timeframes for the Arizona Board of Chiropractic Examiners (Board) and the Executive Director of the Board when investigating and reviewing complaints of unprofessional conduct. Requires the Board to fire the Executive Director if the Director takes specified actions and states that the Naturopathic Physicians Medical Board is not entitled to a naturopathic doctor's proprietary formula or trade to implement or enforce applicable state law.
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. §§ 32-901, 32-904, 32-921, 32-922, and 32-931).
Statute lists what actions constitute grounds for disciplinary action of a DC by the Board. Upon the Board's own motion or on receipt of a complaint, 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.
If the Board find's based on the information it receives that the public health, safety or welfare imperatively requires emergency action, and incorporates a finding to that effect in its order, the Board may order a summary suspension of a license pending proceedings for revocation or other action. If the Board takes this action, it must serve the licensee with a written notice that states the charges and that the licensee is entitled to a formal hearing within 60 days (A.R.S. § 32-324).
Provisions
Unprofessional Conduct
1. Deems the following acts, whether occurring in Arizona or elsewhere, as unprofessional conduct for 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 outlined;
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 outlined;
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) practicing or billing for services under any name other than the name by which the DC is licensed by the Board without first notifying the Board;
h) 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;
i) intentionally misrepresenting the effectiveness of a treatment, diagnostic test or device;
j) intentionally viewing a disrobed patient, not related to the patient's complaint, diagnosis or treatment;
k) performing prohibited diagnostic procedures as prescribed;
l) 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;
m) having a professional connection with an unlawful practitioner; misrepresenting oneself as current or past Board personnel or claiming superiority in the practice of chiropractic;
n) having an action taken against the DC's license in another jurisdiction or having a license renewal denied due to unprofessional conduct;
o) habitually using or having habitually used alcohol, narcotics or stimulants to the extent of incapacitating the DC when performing professional duties;
p) directly or indirectly dividing a professional fee for patient referrals as specified; and
q) violating any federal or state law, rule or regulation applicable to the practice of chiropractic. (Sec. 2)
2. Forbids the Board from adopting rules that alter or amend unprofessional conduct as set by statute. (Sec. 2)
Executive Director
3. Requires the Board to terminate their Executive Director (Executive Director) for:
a) subpoenaing information that is unrelated to a complaint allegation;
b) failing to refer a complaint or information indicating that a DC or certificate holder may have committed a crime to the appropriate law enforcement agency within two days after receiving the complaint or information; or
c) advocating in support of or against a legislative proposal in the Executive Director's official capacity before the Board has taken a formal position on the proposal in a public meeting. (Sec. 3)
4. Directs the Board to develop policies and procedures for determining when the Board will require a DC to undergo psychosexual evaluations and how the Board will use the evaluation results. (Sec. 3)
5. Tasks the Executive Director with:
a) ensuring that the Board follows all applicable laws and rules and complies with all reporting requirements;
b) classifying complaints submitted to the Board pursuant to Board policies to prioritize the allocation of Board resources and the investigation and adjudication of complaints;
c) advising the Board of any contemplated actions that are beyond the scope of the Board's authority and to state concerns in open session if the Board disregards the advice provided in executive session; and
d) preparing and maintaining a discipline matrix for Board use to ensure all DCs are treated consistently to the best of the Board's ability based on specific allegations at issue when the Board contemplates imposing any form of discipline. (Sec. 5)
6. Requires the matrix to briefly outline material facts of all past cases in which the discipline was imposed without identifying any specific DC or complainant other than by potential file number or other reference and to specify the level of discipline imposed. (Sec. 5)
7. Requires the matrix to be available to any DC against whom a complaint has been filed and a formal investigation has been opened, including the DC's counsel. (Sec. 5)
8. Prohibits the Executive Director from:
a) advocating in support of or against a legislative proposal in the Executive Director's official capacity before the Board has taken a formal position on the proposal in a public meeting;
b) encouraging licensees or the public to support or oppose and legislation. (Sec. 4)
Conflict of Interests
9. Requires each Board member and employee to complete a conflict-of-interest disclosure form on appointment or employment. (Sec. 4)
10. Directs the employee or Board member to annually update the disclose form. (Sec. 4)
11. Instructs the Board to retain all conflict-of-interest disclosure forms and to make the forms and meeting minutes available to the public upon request. (Sec. 4)
12. Directs each Board member and employee annually and on appointment or employment to complete a training approved by the Attorney General's Office on:
a) conflict-of-interest requirements, processes and disclosure forms;
b) open meeting law requirements; and
c) the Board's authority to investigate complaints and issue subpoenas. (Sec. 4)
Board Investigations and Initial Review
13. Enables the Board to extend the time to investigate a DC if:
a) the complaint relates to sexual misconduct of a DC; or
b) both of the following apply:
i. the DC agrees to the proposed extension; and
ii. the Board has diligently pursued investigations within the allotted timeframe, as outlined, for complaints involving allegations or violations of unprofessional conduct or malpractice that implicates patient safety. (Sec. 8)
14. Requires the Board to complete an investigation and initial review within 90 days of receiving a complaint without an extended investigation time. (Sec. 8)
15. Requires a final decision regarding a complaint without an extended investigation time to be made within 220 days after the complaint is filed if a formal hearing is required. (Sec. 8)
16. Specifies that if the Board has not made a final decision on a complaint after 220 days, the complaint is deemed administratively closed. (Sec. 8)
17. Limits the scope of a Board investigation to the information contained in the initial complaint or information that the Board has in its possession at the time of the Board's motion to investigate. (Sec. 8)
18. Directs the Board, if a disciplinary or nondisciplinary order requires a DC to complete continuing education requirements, to provide at least two choices of continuing education provider organizations, boards or associations. (Sec. 8)
19. Forbids the Board from subpoenaing information related to a DC's personal finances during an investigation. (Sec. 8)
20. Entitles a DC to restitution for all costs incurred relating to an investigation and formal hearing process if a court of competent jurisdiction finds that the Board acted capriciously against the DC. (Sec. 8)
Criminal Complaints
21. Requires the Board to refer a complaint or information indicating that a DC or certificate holder may have committed a crime to the appropriate law enforcement agency within two business days after receiving the complaint or information. (Sec. 9)
22. Specifies that the Board does not need to obtain the complaint's consent or to substantiate the complaint before referring the complaint to law enforcement. (Sec. 9)
23. Allows the Board to restrict, limit or order a summary suspension of the DC's license or certificate holder's certificate pending the action of the law enforcement agency if the Board finds that the public health, safety or welfare requires emergency action based on the complaint or information the Board referred to law enforcement. (Sec. 9)
24. Requires the law enforcement agency that receives the complaint or information to inform the Board of the outcome of the agency's investigation and whether charges are filed against the DC or certificate holder. (Sec. 9)
25. Authorizes the Board to investigate, concurrent with the law enforcement agency's investigation, whether the complaint or information that was referred to the law enforcement agency constitutes a violation of unprofessional conduct against the DC or certificate holder. (Sec. 9)
Naturopathic Physicians Medical Board
27. Specifies that a patient may still have access to the list of ingredients for any method of treatment provided to the patient. (Sec. 12)
28. Requires the Naturopathic Physicians Medical Board to conform its rules to be consistent with the requirements of this act. (Sec. 12)
Miscellaneous
29. Requires, rather than allows the Board to require applicants to submit a full set of fingerprints to the Board in order to determine their eligibility for examination and licensure. (Sec. 6)
30. Requires the Board to automatically suspend a license after 90 days if the DC does not submit a complete application for renewal and pay the renewal license fee. (Sec. 7)
31. Requires the DC's renewal license, if the DC does not complete the renewal application and pays the renewal fee within 90 days, to be backdated to the expiration date of the license. (Sec. 7)
32. Repeals acts that are grounds for disciplinary actions for DCs. (Sec. 8)
33. Permits 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. (Sec. 11)
34. Specifies that the registration requirements and medical records protocols for business entities wishing to offer chiropractic services do not apply to a business entity, partnership or other form of business, the majority ownership of which is owned by a DC. (Sec. 11)
35. Contains a legislative intent clause. (Sec. 13)
36. Defines terms. (Sec. 1)
37. Makes technical and conforming changes. (Sec. 1, 3, 5, 6-8, 10, 11)
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41. SB 1588
42. Initials JB Page 0 Appropriations
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