AN ACT TO UPDATE VARIOUS LAWS OF THE PRACTICE AND LICENSURE OF CHIROPRACTIC. SL 2021-120. Enacted Aug. 30, 2021. Effective Oct. 1, 2021.
Bill Summaries: H415 UPDATE CHIROPRACTIC LAWS.
Summary date: Aug 31 2021 - View Summary
Summary date: Aug 4 2021 - View Summary
Senate committee substitute to the 2nd edition makes the following changes.
Further amends Article 8, GS Chapter 90, which regulates chiropractic licensure, as follows. Revises the powers and duties of the North Carolina State Board of Chiropractic Examiners (Board) to include establishing reasonable fees for licensure verification and continuing education, and more specifically authorizes establishing fees for other administrative services provided by the Board (was, other services). Eliminates the proposed power to establish certification standards for diagnostic imaging technicians. Eliminates a statutory cross-reference regarding the Board's disciplinary authority. More specifically authorizes the Board to order production, or inspection and copy, of any clinical care or patient records (was, records, generally) concerning the practice of chiropractic relevant to a complaint, inquiry or investigation. Specifies that the record retention requirement for licensees or establishment employing licensees applies to patient records (was, records, generally). Eliminates the proposed provisions which deemed the names and office addresses of Board members and licensees to be public record. Specifies that the personal email addresses of Board members and licensees are not public record (was, email addresses, generally). Maintains rather than removes as grounds for disciplinary action by the Board (1) violating GS 90-151 (concerning licensure limitations), and (2) committing an act on or after October 1, 2017, demonstrating a lack of good moral character which would have been the basis of denying a license if committed before licensed. Maintains rather than removes the existing parameters provided for the Board in adopting rules that establish and define standards of acceptable care.
Now authorizes the Board to assess a civil penalty of up to $500 for the violation of any section of the Article (was, per violation of the Article) or any rule adopted by the Board. Adds a maximum cumulative fine amount, set at $1,000, for licensees found responsible for multiple violations in the same disciplinary actions. Clarifies that the Board's authority to charge the costs of a disciplinary proceeding against a licensee applies to instances in which a licensee is found to have violated any provisions of the Article or any rule adopted by the Board (previously, applicable to licensees against whom proceedings are brought). Makes further technical and clarifying changes.
Summary date: May 11 2021 - View Summary
House committee substitute to the 1st edition makes the following changes.
Makes further conforming changes throughout Article 8, GS Chapter 90, which regulates chiropractic licensure, to refer to the North Carolina State Board of Chiropractic Examiners throughout (was, referred to as the State Board of Chiropractic Examiners and Board of Chiropractic Examiners), specifically amending the following statutes: GS 90-139; GS 90-141; GS 90-143.1; GS 90-143.2; GS 90-143.4; GS 90-144; GS 90-145; GS 90-146; GS 90-147; GS 90-148; GS 90-151; GS 90-154; GS 90-154.3; GS 90-155; and GS 90-156.
Revises the proposed changes to powers and duties of the NC State Board of Chiropractic Examiners in GS 90-142 to include establishing by rule a process to assess civil penalties pursuant to GS 90-157.4 (was, establishing a schedule and assessing such civil penalties).
Summary date: Mar 25 2021 - View Summary
Makes the following changes to Article 8, GS Chapter 90, which regulates chiropractic licensure.
Adds 12 powers and duties of the NC State Board of Chiropractic Examiners (Board) to those stated in GS 90-142, now totaling 13. Power and duties now include (1) the administration and enforcement of the Article's provisions; (2) adopt, amend, or repeal rules as necessary to carry out and enforce the Article's provisions; (3) issue position statements and interpretive guidelines; (4) establish reasonable fees for examinations, licensure and other Board services; (5) establish certification standards for diagnostic imaging technicians and chiropractic clinical assistants; (6) take disciplinary action; (7) establish a schedule and assess civil penalties; and (8) seek injunctive relief for Article violations.
Amends GS 90-144 to require licensure applicants to comply with GS 90-143, which provides for the Board to examine eligible applicants. No longer provides for the Board to determine at which meetings applicants must be examined under this statute.
Adds the following provisions to GS 90-148, governing records of the Board. Adds new authority for the Board to order that any records concerning the practice of chiropractic and relevant to a complaint received by the Board or an inquiry or investigation conducted by or on behalf of the Board to order production by the custodian of the records to the Board or for inspection and copy by representatives of or counsel of the Board. Adds a new requirement for licensed chiropractors or establishments employing licensed chiropractors to maintain records for at least seven years from the date the chiropractor terminates services to the patient and the patient services record is closed. Requires cooperation with the Board's inquiries or record investigations. Deems all records collected and compiled by or on behalf of the Board public records, with redaction of patient information as appropriate, as well as notices of charges, hearings, and hearing decisions public records, with redaction of patient information as appropriate. Deems records connected with certification, licensure or disciplinary matters to not be public records. Makes the name and office addresses of Board members and licensee public records, with home and email addresses not public record unless written consent is given.
Amends the provisions governing disciplinary action by the Board under GS 90-154 as follows. Adds civil penalties to authorized sanctions the Board can impose for any of the disciplinary grounds stated. Modifies disciplinary grounds to include engaging in any act or practice violative of the Article or rules and regulations adopted by the Board, or aiding, abetting, or assisting another in the violation of the Article (previously not included). No longer includes: (1) advertising services in a false or misleading manner; (2) unethical conduct; (3) not rendering acceptable care in the practice; (4) offering to waive a patient's obligation to pay any insurer required deductible or copayment; (5) failing to honor a patient's request for a copy of any claim form submitted to an insurer; (6) rebating funds received from the patient's insurer; (7) advertising any free or reduced rate service without stating the usual service fee; (8) charging an insurer or third party a fee greater than the fee charged to directly to patients or a fee greater than the advertised fee; (9) violating GS 90-154.1 (concerning collecting prohibited fees) or GS 90-151 (concerning licensure limitations); and (10) committing an act demonstrating a lack of good moral character which would have been the basis of denying a license if committed before licensed.
Repeals GS 90-154.1 which provides for required disclosures in service advertisements and patient billing, and prohibits the collection of certain fees derived from services performed beyond those advertised.
Amends GS 90-154.3 to remove the parameters provided for the Board in adopting rules that establish and define standards of acceptable care.
Repeals GS 90-154.4 which prohibits certain enticements and rebates if the chiropractor knows or has reason to believe the prospective patient's treatment expenses will be paid in whole or in party by an insurer or other third party payor, with four described marketing practices excepted.
Replaces the provisions of GS 90-155, regarding annual licensure fees, as follows. Requires licenses to be renewed annually on or before December 31 with accompany fee as set by the Board not to exceed $300, and evidence of completion of two days of Board-approved educational sessions or programs unless the Board waives the education requirement due to sickness or other hardship. Allows for licensees not actively practicing to direct the Board to place the licensee on inactive status. Provides for a $25 late fee, with those failing to renew by January 30 placed on inactive status. Provides for the Board's continued jurisdiction over inactive licensees. Provides for license reinstatement following an interview before the Board.
Enacts GS 90-157.4, authorizing the Board to access civil penalties up to $500 per violation of the Article or rules of the Board, with proceeds remitted to the Civil Penalty and Forfeiture Fund. Lists four factors the Board must consider before civil assessment, including whether the violation was willful and malicious. Authorizes the Board to charge costs of disciplinary proceedings to the respective licensee. Allows for petition for judicial review of civil penalties imposed.
Effective October 1, 2021.