CCLE California Chiropractic Law Exam 2026/2027 | Verified Questions & Answers | 100% Correct Solutions

CCLE California Chiropractic Law Exam 2026/2027 | Verified Questions & Answers | 100% Correct Solutions Q: What is a chiropractor allowed to adjust? Answer A duly licensed chiropractor may manipulate and adjust the spinal column and other joints of the human body and in the process thereof a chiropractor may manipulate the muscle and connective tissue related thereto. Q: T or F a duly licensed chiropractor may treat any condition, disease, or injury in any patient, including a pregnant woman, and may diagnose Answer T …so long as such methods and treatment DO NOT constitute the practice of medicine by exceeding the legal scope of chiropractic practice… Q: A duly licensed chiropractor may employ the use of ___________ (3), or proprietary medicines Answer - vitamins Q: What is required for a chiropractor to use Vitamins, food, supplements, foods for special dietary use, or proprietary medicines? Answer They must NOT be included in materia Medica and treatment must be within the scope of practice Q: How are chiropractors allowed to use X-ray? Thermography? Diagnostic ultrasound? Answer X-ray & thermography: diagnosis but NOT for the purposes of treatment diagnostic ultrasound: neuromuscular skeletal diagnosis. Q: Can a chiropractor use the term "physical therapy" in advertising? Answer - A chiropractor MAY NOT hold himself or herself out as being licensed as anything other than a chiropractor or as holding any other healing arts license or as practicing physical therapy or use the term “physical therapy” in advertising unless he or she holds another such license. Q: A chiropractor is not allowed to hold himself or herself out as being licensed as a physical therapist, Unless they hold another such license. HOWEVER are they allowed to practice physical therapy techniques? Answer As part of a course of chiropractic treatment, a duly licensed chiropractor may use all necessary mechanical, hygienic, and sanitary measures incident to the care of the body, including, but not limited to, air, cold, diet, exercise, heat, light, massage, physical culture, rest, ultrasound, water, and physical therapy techniques in the course of chiropractic manipulations and/or adjustments. Q: What is the consequence for a chiropractor who uses the term physical therapy without holding the appropriate license? A) $750 and/or up to 6 months imprisonment B) $1000 fine and/or up to 6 months imprisonment C) up to $2500 fine and/or up to 6 months imprisonment D) up to $5000 fine for each offence E) fine of $100-600 and/or up to 6 months imprisonment Answer A) $750 and/or up to 6 months imprisonment Q: What does the term "board" refer to? Answer The term “board” means the State Board of Chiropractic Examiners Q: What does the term "act" mean? Answer The term “act” means the Chiropractic Initiative Act of California as amended. Q: The term "duly licensed chiropractor" means...? Answer any chiropractor in the State of California holding an unrevoked certificate to practice chiropractic Q: Who is allowed to use a laser in the chiropractic clinic? Answer A duly licensed CHIROPRACTOR AND ANY PERSON under their direct or indirect SUPERVISION Q: What does “Immediate and direct supervision” mean in reference to the licensed Doctor of Chiropractic? Answer - …Shall be at all times on the premises when the examinations are being conducted. - The licensed Doctor of Chiropractic shall be responsible for the verification of the recorded findings, and solely responsible for rendering a conclusion based on the findings Q: What does "Adequate and indirect supervision" mean in reference to the licensed Doctor of Chiropractic? Answer - The doctor shall be present in the same chiropractic facility with the unlicensed individual at least 50% of any work week or portion thereof the said individual is on duty unless this requirement has been waived by the board. - The doctor shall be readily available to the said individual at all other times for advice, assistance and instruction. Q: What organization has to approve the use of Laser to use it in a chiropractic clinic? Answer Any laser in the practice of chiropractic has to be properly approved or cleared by the United States Food and Drug Administration (FDA). Q: Which of the following can a chiropractor use laser for? a) laser treatment of allergies b) laser ablation c) surgical procedures d) none of the above Answer d) none of the above Q: Each person holding a license to practice chiropractic in the State of California under any and all laws administered by the board shall file his proper and current place of practice address of his principal office and, where appropriate, each and every sub-office, with the board at its office in __________ Answer Sacramento Q: When filing an address to the board, what must you provide and what is the time span allotted to you? Answer shall immediately notify the board at its said office of any and all changes of place of practice address, giving both his old and his new address within 30 days of change. Q: The revocation, suspension, or other discipline by another state of a license or certificate to practice chiropractic, or any other health care profession for which a license or certificate is required, shall constitute... what? Answer grounds for disciplinary action against a chiropractic licensee or grounds for the denial of chiropractic licensure of an applicant in this state. Q: If a person, not a regular employee of the board, is hired or is under contract to provide expertise or to perform investigations for the Board of Chiropractic Examiners in the evaluation of the conduct of a licensee or administration of a board examination, and such person is named as a _____________________ Answer defendant in a civil action The board shall not be liable for any judgment rendered against that person. The Attorney General shall be utilized in those civil actions. What are the roles of the Attorney General? Answer Legal Defense in Civil Cases - If an independent contractor hired by the Board of Chiropractic Examiners is sued for their professional work (e.g., investigations, expert opinions, testimony), the Attorney General provides legal representation in the lawsuit. - The Board itself is not responsible for any financial judgments against the contractor. Enforcement & Disciplinary Proceedings - When a chiropractor violates regulations, the Board can order them to pay for the costs of investigation and enforcement. - These costs include fees for the Attorney General’s services, which may be assessed during disciplinary proceedings. Legal & Financial Oversight - The Attorney General’s involvement ensures that enforcement actions comply with legal standards and that costs related to disciplinary actions are fairly assessed. - If costs are unpaid, the Board has the right to enforce payment through legal means, with the Attorney General playing a role in upholding these decisions. When can the board or its designee may inspect the physical premises of any chiropractic office? Answer During regular business hours When can there be a refund of the license application fees? The board is NOT authorized or permitted by law to return any portion of the license application fee of a qualified applicant. Each person holding a license shall display a current active license in a __________ in the licensee's _______ or _________ Each person holding a license shall display a current active license in a conspicuous place in the licensee’s principal office or primary place of practice. Any licensed Doctor of Chiropractic with more than one place of practice shall obtain from the Board a ______ for each additional place of practice. Said certificate must be renewed _______. Satellite Office Certificate annually A licensed Doctor of Chiropractic must display in a ___________ a current active Satellite Office Certificate at the office for which it was issued. conspicuous place T or F You can display a chiropractic license if it is inactive F No licensed Doctor of Chiropractic shall display any chiropractic license, certificate or registration, which is not currently active and valid. What does the term "community based organization" mean? “Community-based organization” means a public or private nonprofit organization that is representative of a community or a significant segment of a community, and is engaged in meeting human, educational, environmental, or public safety community needs. What does the term "Out-of-state practitioner" mean? “Out-of-state practitioner” means a person who is not licensed in California to engage in the practice of chiropractic but who holds a current, active and valid license in good standing in another state, district, or territory of the United States to practice chiropractic. What does the term "in good standing" mean (3)? No Active Investigations or Charges They are not under investigation by any government agency and have not been charged with an offense related to chiropractic practice. No Disciplinary Agreements or Restrictions They have not agreed to any consent orders or been subject to administrative decisions that impose restrictions on their practice, including voluntarily surrendering their license. No History of Serious Malpractice or Negligence They have not had an adverse judgment against them due to chiropractic practice that suggests a pattern of incompetence or negligence, as determined by the Board. A sponsoring entity that wishes to provide, or arrange for the provision of, health care services at a sponsored event. What are the steps for this? - At Least 90 Days Before the Event – Register with the Board - Submit Form 901-A ("Registration of Sponsoring Entity Under Business & Professions Code Section 901"). - The Board (or its delegate) will review the form and respond within 15 days of receiving the form - If deficiencies are found, they must be corrected at least 30 days before the event, or registration will be rejected. Once a sponsored event is approved, and it now occurs, what must the sponsoring entity do in terms of record keeping? - Maintain event-specific records on-site for inspection upon request at the physical location of the sponsored event until that event has ended. - The sponsoring entity shall maintain these records for a period of at least 5 years after the date on which a sponsored event ended. - Keep copies of all records required by Business & Professions Code Section 901 at a physical location in California. - The records may be maintained in either paper or electronic form After the sponsored event takes place, other than maintaining the records of the event what must the sponsoring entity do? Within 15 Days After the Event provide a report to the Board including: - Date(s) of event - Event location(s) - Types of health care services provided - List of approved out-of-state practitioners and their license numbers What are the steps for an out-of-state practitioner to be authorized to participate in a sponsored event? - An out-of-state practitioner must submit Form 901-B ("Request for Authorization to Practice Without a License at a Registered Free Health Care Event"). - A $59 non-refundable processing fee must be included. - First-time applicants must provide fingerprints or a Live Scan for a criminal history check, covering all associated costs. - Within 20 calendar days of the event, the board will notify the participant if the request is approved or denied. The board shall (automatic) deny a request for authorization to participate if (6)? 1) Incomplete application not corrected within 7 days of the board request for additional information 2) No valid, active license in good standing. 3) Violation of requirements or grounds for license denial under Business & Professions Code §480. 4) Drug or alcohol-related physical or mental impairment. 5) Graduation from a non-approved chiropractic college. 6) Failure to obtain a timely criminal history check report. The board may (discretionary) deny a request for authorization to participate if (3)? 1) Application submitted less than 20 days before the event. 2) Prior request for authorization was denied. 3) Previous authorization to participate was revoked. Can an out-of-state practitioner appeal, a denial to participate in a sponsored event? YES An applicant requesting authorization to participate in a sponsored event may appeal the denial of such request by following the procedures set forth in Business and Professions Code section 309.3 What constitutes "grounds for termination" of an out-of-state practitioner's authorization to participate in a sponsored event (3)? - Non-compliance with any applicable laws, regulations, or practice requirements. - Committing an act that would warrant discipline if performed by a licensed chiropractor. - Receiving a credible complaint that suggests the practitioner is unfit or poses a danger to patients If the board decides to terminate a out-of-state practitioner from being able to participate in a sponsored event, How will the notice of termination be carried out? - The Board must provide written notice to both the sponsoring entity and the practitioner, explaining the reason for termination. -If termination occurs during an event, notice may be given to an event representative on-site. What are the consequences of termination of an out-of-state practitioners from being able to participate in a sponsored event? - The practitioner must immediately stop providing care at the event. - Termination is considered a disciplinary measure and will be reported to national practitioner databases. - The Board will notify all jurisdictions where the practitioner holds a license with a written notice If an out-of-state practitioner wishes to make an appeal to the board's decision to terminate their authorization for the sponsored event, what is the request for the appeal considered? The appeal is treated as a request for an informal hearing under the Administrative Procedure Act. In addition to requesting a hearing, the out-of-state practitioner may request an informal conference with the ________ regarding the reasons for the termination of authorization to participate. - The practitioner may also request an informal conference with the Executive Officer within 30 days. - After the conference, the Executive Officer can affirm or dismiss the termination and must provide a written decision within 10 days. - If the termination is dismissed, the practitioner’s request for a formal hearing is automatically withdrawn. What are additional practice requirements for out-of-state practitioners authorized to participate in sponsored free healthcare events? - Each out-of-state practitioner must post a notice in at least 48-point Arial font at every patient station at the event. - The notice must be clearly visible to all patients or prospective patients. What must a licensee do if they wish to change their name? Within 10 days of such change, reregister his name with the Executive Officer of the board by submitting to the board office a: 1) written statement of the change 2) evidence of legal documentation 3) nonrefundable fee of $25.00 Is a licensee entitled to replace their original license if it is lost, stolen, or mangled? What must they do if this is the case? Each request for a replacement license must be accompanied by: 1) a nonrefundable fee of $25.00 2) signed written statement as to the circumstances of loss of said license, or the return to the board office of the mangled license What is the proper use of title when advertising to practice chiropractic? “doctor” “chiropractor” And using the letters, prefixes or suffixes “Dr.” and “D.C.” title or letters indicating or implying that he or she is engaged in the practice of chiropractic, or who represents or holds himself or herself out as a doctor of chiropractic without having, at the time of so doing, a valid, unrevoked, or unsurrendered license, is in violation of the Chiropractic Initiative Act. What are the disciplinary penalties for "advertising which contains misstatements, falsehoods, misrepresentations, distorted, sensational or fabulous statements, or which is intended or has a tendency to deceive the public or impose upon credulous or ignorant persons"? 1) Suspension of the right to practice in this State for a period not exceeding one year. 2) Probation. 3) Taking such other action, excepting the revocation of said licensee's license, in relation to disciplining said licensee as the board in its discretion may deem proper. An individual was caught for the 2nd time advertising using misrepresentations. What is the disciplinary penalty that may be bestowed upon them? A) Suspension and $5K fine B) Revocation and $5K fine C) Suspension and $10K fine D) Revocation and $10K fine A) Suspension and $5K fine Because a fine ordered by the executive officer can not exceed $5,000, and advertisement penalties can be any “action, excepting the revocation of said licensee’s license” For purposes of the Department of Industrial Relations' Qualified Medical Evaluator Eligibility regulations, the board recognizes only those specialty boards that are recognized by the _______________ or the ____________________ American Chiropractic Association (ACA) or the International Chiropractors Association (ICA) Chiropractors who treat animals in California must follow specific regulations. These regulations include (3)? 1) Working under the direct supervision of a veterinarian 2) Consulting with the veterinarian after an initial examination or treatment 3) Terminating treatment if the veterinarian ends their relationship with the chiropractor What is an “unlicensed individual”, and what are they not permitted to do? Are there any exceptions? any person, including a student or graduate of a chiropractic institution, who does not hold a valid California chiropractic license (EXCEPTION = student doctors participating in board approved preceptorship program) What can "unlicensed individuals" NOT do (4)? - Diagnose - Analyze - Perform chiropractic adjustments - Conduct examinations requiring diagnostic or analytic interpretations (heart & lung sounds) What can "unlicensed individuals" do (5)? - Take patient history (separate from consultation). conclusions UNDER “immediate and direct supervision” - Administer physical therapy UNDER adequate supervision - Mark X-ray films (measurements only, no diagnostic conclusions). - Develop X-ray films (only if that’s their sole radiologic task). What supervision is required for "unlicensed individuals"? Immediate & direct supervision for exams (licensed chiropractor must be on-site). Adequate supervision for physical therapy: - Chiropractor present 50% of the workweek unless waived, and shall be readily available at all times - Initial exam + written treatment plan required to be made by DC BEFORE therapy begins with “unlicensed individual” - “Periodic Reevaluation” of patient by DC every 30 days - DC will perform and record an evaluation of the patient and his or her response to treatment at the termination thereof What are "unlicensed individuals" allowed to do in regards to x-rays? What are they not allowed to do? Marking X-ray Films (draw, measure, and make angular/linear measurements on X-ray films) Make any diagnostic conclusions or chiropractic analytical listings. Administering X-rays = Position patient, Set up X-ray machine, Press button taking X-ray. EXCEPTIONS: Can administer X-rays (w/ X-ray technician certificate or department of health services program) Can develop X-ray films if that is their ONLY radiologic responsibility. T or F The unlicensed individual is responsible for ensuring markings do not obstruct pathological findings. F the licensed doctor is responsible for any pathological entities covered or obstructed by the markings. Unlicensed individuals who exceed the permitted scope of practice set forth in this regulation shall be in violation of Section 15 of the Chiropractic Act and shall be ....? prohibited from applying for a California chiropractic license for such time as may be determined by the board T or F Student doctors participating in board approved preceptorship programs are not to be considered "unlicensed individuals" when working in said program. T What can an "unlicensed individual" own in a chiropractic practice? facilities in which the practice is conducted equipment provided PROHIBITED from: making and/or influencing decisions relating to diagnosis, or treatment of patients own a chiropractic practice regardless of the form in which the practice is established (individual ownership, partnership, corporation, etc.). In the event of the death of a chiropractic licensee, or the legal declaration of the mental incompetency of the licensee to practice, the unlicensed heirs or trustees of the chiropractor must dispose of the practice within: a) 4 months b) 6 months c) 9 months d) 12 months b) 6 months T or F At all times while the unlicensed heirs or trustees of a chiropractor are trying to dispose of a practice, the practice must be supervised by a licensed chiropractor T What period may the board extend the period for when disposing a practice after the death of chiropractor: a) 4 months b) 6 months c) 9 months d) 12 months a) 4 months Is promising a job to an unlicensed school allowed? - No licensee of chiropractic in the State of California shall offer or cause to be offered to a student or prospective student of chiropractic any promise or inducement - This does NOT apply to students and doctors who participate in preceptorship programs sponsored by chiropractic institutions holding status It shall be the duty of every licensee to notify the ______________ or his or her designee of any violation of the act, or of these rules and regulations, in order that the board may take appropriate disciplinary action. Executive Officer Under what condition can the board require a psychiatric examination of a licensee? “When reasonable cause exists that a person holding a license under this Act is mentally ill to the extent that it may affect his ability to conduct with safety to the public” Who designates the psychiatrist(s) that evaluate the licensee's mental health? A) The licensee's employer B) The licensee's chosen physician C) The board D) The state medical director C What actions can the board take if a psychiatrist confirms that a licensee’s mental illness affects their ability to practice safely? (Select all that apply.) A) Place the licensee on probation B) Suspend the license for up to one year C) Suspend the license for up to two years D) Revoke the license A B D When can a suspended or revoked license be reinstated? A) If the board receives competent medical evidence that the condition is absent or controlled B) After one year, regardless of medical evaluation C) If the licensee files a legal appeal D) When the licensee personally declares they are fit to return to practice A T or F A psychiatric report used in board proceedings must be made available to the licensee. T T or F If a licensee is found to be mentally ill but not dangerous, the board must revoke their license. F If a chiropractor is mentally unable to practice, what is the board legally allowed to do (3)? - Probation - Physiciatry - Monitoring mental medication T or F A reinstated licensee may be required to undergo additional professional training and pass an examination. T A chiropractor is exhibiting erratic behavior, and multiple patients report concerns. The board orders a psychiatric evaluation, and the psychiatrist concludes that the chiropractor has an untreated condition impairing their ability to practice safely.What steps can the board take? (List at least three possible actions.) The board can: 1) Place them on probation 2) Suspend their right to practice for a year 3) Revoke their license The board may suspend a license for up to ___ year(s) if a psychiatrist determines the licensee's mental illness affects their ability to practice safely. 1 year T or F If a licensee disputes the results of a psychiatric evaluation, they may submit an additional evaluation from a physician of their choosing T Before reinstating a license, the board may require a licensee to pass an ___ or ___ examination to assess their current competency. oral or written According to the regulation, who is responsible for ensuring all conduct in a chiropractic practice complies with the law? A) Only the clinic manager B) Only the individual employees C) The licensee D) The state regulatory board C What is a licensee responsible for in their place of practice in terms of their employees? Ensuring all employees and supervised persons comply with laws and regulations Which of the following behaviors is NOT explicitly prohibited on premises where a chiropractic license is used? (Select all that apply.) A) Sexual stimulation involving patients or patrons B) Masturbation on the premises C) Prostitution on the premises D) Sexual contact between a licensed chiropractor and his/her spouse when the chiropractor provides professional treatment Which situation is NOT a violation? A) A licensee engaging in sexual activity with a patient B) A licensee permitting erotic behavior on their premises C) A licensed chiropractor providing professional treatment to their spouse D) A licensee engaging in a sexual relationship with a employee C What is the punishment for the 2nd offence for sexual solicitation? Revocation for 10 years T or F A licensee is only responsible for their own behavior, not that of employees or other supervised individuals. F Every licensee is responsible for the conduct of employees or other persons subject to his supervision in his place of practice, and shall insure that all such conduct in his place of practice conforms to the law and to the regulations herein. T or F Sexual relations with a patient, client, customer, or employee is considered unprofessional conduct. T T or F A chiropractor is allowed to engage in sexual contact with their spouse while providing professional treatment. T "... This section shall not apply to sexual contact between a licensed chiropractor and his or her spouse or person in an equivalent domestic relationship when that chiropractor provides professional treatment." A crime, professional misconduct, or act is considered substantially related to the qualifications, functions, or duties of a chiropractor if: A) It involves any interaction with a patient B) It demonstrates the person's unfitness to practice in a manner consistent with public health, safety, or welfare C) The chiropractor receives a minor penalty for the act D) It only involves a personal dispute and has no professional implications B When determining whether a crime is substantially related to chiropractic practice, the Board considers: (Select all that apply.) A) The nature and gravity of the offense B) The number of years since the offense occurred C) The nature and duties of a chiropractor D) The location where the crime was committed A, B, C Which of the following offenses is explicitly listed as substantially related to chiropractic qualifications? (Select all that apply.) A) Child abuse or elder abuse B) Conviction requiring sex offender registration C) Fraud or deceit D) Driving without a valid driver’s license A, B, C A chiropractor is convicted of a felony drug offense involving the sale of narcotics. How does this affect their license? A) The conviction is substantially related to chiropractic practice and may lead to denial, suspension, or revocation B) The conviction has no impact unless it occurs at the chiropractor's place of business C) The chiropractor is only fined and can continue practicing D) The Board cannot take action if the chiropractor completes probation A Which of the following would NOT be considered substantially related to chiropractic practice under this regulation? A) A conviction for driving under the influence (DUI) that endangers public safety B) A conviction for fraud involving patient billing C) A parking ticket for an expired meter D) A conviction requiring registration as a sex offender C) A parking ticket for an expired meter T or F A chiropractor who assists in violating a state or federal law related to chiropractic practice can face disciplinary action. T T or F The passage of time since an offense occurred has no bearing on whether it is considered substantially related. F "The number of years elapsed since the date of the offense" is taken into account T or F Convictions for violent crimes, including assault and battery, are considered substantially related to chiropractic practice. T T or F A chiropractor found guilty of fiscal dishonesty, such as fraud, may have their license revoked. T Your wife owns an imaging centre, how do you disclose this information? Have this disclosed on written consent and posted legibly in the office (does not have to be advertised) A chiropractor is convicted of fraud for overbilling insurance companies. How does this impact their chiropractic license? Fraud is explicitly listed as a substantially related offense, meaning the chiropractor may face license denial, suspension, or revocation. A chiropractor was convicted of DUI five years ago but has since completed rehabilitation and has no further infractions. How does the Board determine if this crime is substantially related to their license? The Board will consider The Board will consider: - The nature and gravity of the offense - The number of years that have passed since the offense - The chiropractor’s professional duties and whether substance use endangers patients List three examples of crimes or acts that are explicitly considered substantially related to chiropractic practice - Child abuse or elder abuse - Sex offenses requiring registration - Fraud, theft, or fiscal dishonesty What actions can the Board take against a chiropractor found guilty of unprofessional conduct? A) Issue a warning B) Require additional coursework C) Suspend, revoke, or decline to issue a license D) Both B and C D Which of the following is NOT explicitly listed as unprofessional conduct? A) Gross negligence B) Assisting in or abetting the violation of chiropractic regulations C) Failing to report personal chiropractic treatments on insurance claims D) Knowingly making a false statement on a chiropractic-related document C Which of the following is considered unprofessional conduct related to drug or alcohol use? A) Administering a controlled substance to oneself in a dangerous manner B) Being convicted of multiple misdemeanors related to drug or alcohol use C) Violating laws regulating narcotics or dangerous drugs D) All of the above D A chiropractor is found guilty of a crime involving moral turpitude. What action can the Board take? A) Decline to issue or renew their license B) Suspend or revoke their license C) Determine the degree of discipline based on the surrounding circumstances D) All of the above D A chiropractor knowingly signs a document falsely representing patient information. This is an example of (select all that apply): A) Moral turpitude B) Fraud or misrepresentation C) Unprofessional conduct D) Incompetence A, B, C T or F A plea of "nolo contendere" (no contest) is considered a conviction under the Board's disciplinary provisions. T In what circumstance would the board decline the issuance of a license (8)? UNPROFESSIONAL CONDUCT: - gross negligence - repeated negligent acts physical violence or corruption The administration of treatment or the use of diagnostic procedures which are clearly excessive as determined by the customary practice and standards of the _____________ local community of licensees T or F The Board can take action against a chiropractor who impersonates an applicant during a licensing exam. T T or F A chiropractor may waive a patient's co-payment as an advertising strategy without informing the insurance company. F T or F The Board can discipline a chiropractor for failing to refer a patient to an appropriate healthcare provider when necessary. T Can you reward a patient to thank them for a referral? What is the punishment? NO • Punishment = unlawful referral = charged with misdemeanor = penalties up to $5000 for each offense • Multiple misdemeanors is grounds for license suspension T of F A chiropractor can be disciplined for participating in an information or referral bureau that does not comply with regulations. T A chiropractor fails to refer a patient to another healthcare provider even though they identify a condition outside their scope of practice. What are the possible consequences? This is considered unprofessional conduct, and the Board may take disciplinary action, including suspension or revocation of the license. A chiropractor advertises spinal manipulation as a substitute for vaccination. Is this considered unprofessional conduct? Yes, the regulation explicitly prohibits offering, advertising, or substituting spinal manipulation for vaccination. A chiropractor repeatedly administers excessive treatment beyond what is customary in their local community. What violation does this represent? This is considered unprofessional conduct under "repeated negligent acts" and "excessive treatment." A chiropractor waives a co-payment for marketing purposes without proper disclosure. What must they do to comply with regulations? The chiropractor must notify the insurance company in writing and include a specific disclosure on the insurance billing statement. A chiropractor uses a "capper" or "steerer" to obtain new patients. What is the Board’s stance on this? This is considered unprofessional conduct, and disciplinary action may be taken. The Board may discipline a chiropractor for repeated __________ acts that endanger public health, welfare, or safety. negligent A chiropractor convicted of __________, dishonesty, or corruption may have their license suspended or revoked. moral turpitude: involves dishonesty, fraud, or conduct contrary to community standards of justice, honesty, or good morals, and can lead to scrutiny and potential license revocation for chiropractors. Making or giving a false statement in connection with a license application is considered __________. unprofessional conduct Which of the following best defines Gross Negligence? A) A severe deviation from the standard of care, demonstrating reckless disregard for patient safety. B) Multiple instances of failing to meet the standard of care. C) A lack of skill, knowledge, or ability that prevents safe practice. D) Administering treatment beyond what is necessary based on clinical guidelines. A Which of the following best defines Repeated Negligent Acts? A) A severe deviation from the standard of care, demonstrating reckless disregard for patient safety. B) Multiple instances of failing to meet the standard of care. C) A lack of skill, knowledge, or ability that prevents safe practice. D) Negligent failure to provide food, shelter, or supervision, putting a child at risk. B Which of the following best defines Incompetence? A) A lack of skill, knowledge, or ability that prevents safe practice. B) A severe deviation from the standard of care, demonstrating reckless disregard for patient safety. C) Administering treatment beyond what is necessary based on clinical guidelines. D) Failure to provide adequate care, leading to a child's severe malnutrition. A Which of the following best defines Excessive Treatment? A) Multiple instances of failing to meet the standard of care. B) A severe deviation from the standard of care, demonstrating reckless disregard for patient safety. C) Administering treatment beyond what is necessary based on local community clinical guidelines. D) A lack of skill, knowledge, or ability that prevents safe practice. C Which of the following best defines Severe Neglect? A) Negligent failure to provide food, shelter, or supervision, putting a child at risk B) Negligent failure to protect a child from severe malnutrition or medically diagnosed nonorganic failure to thrive. C) A severe deviation from the standard of care, demonstrating reckless disregard for patient safety. D) Multiple instances of failing to meet the standard of care. B Which of the following best defines General Neglect? A) Negligent failure to provide food, shelter, or supervision, putting a child at risk B) Negligent failure to protect a child from severe malnutrition or medically diagnosed nonorganic failure to thrive. C) A severe deviation from the standard of care, demonstrating reckless disregard for patient safety. D) Multiple instances of failing to meet the standard of care. A A chiropractor performs a high-velocity cervical manipulation on a patient with a known vertebral artery dissection risk, resulting in a stroke. What category does this fall under? A) Gross Negligence B) Repeated Negligent Acts C) Incompetence D) Excessive Treatment A A chiropractor repeatedly misdiagnoses disc herniations as muscle strains and fails to refer patients for imaging, leading to worsening nerve damage. What category does this fall under? A) Gross Negligence B) Repeated Negligent Acts C) Incompetence D) Excessive Treatment B A chiropractor uses an unapproved laser device to 'treat allergies' in patients, leading to skin burns. What category does this fall under? A) Gross Negligence B) Repeated Negligent Acts C) Incompetence D) Excessive Treatment C A chiropractor bills patients for six months of daily spinal adjustments despite mild symptoms that do not require long-term care. What category does this fall under? A) Gross Negligence B) Repeated Negligent Acts C) Incompetence D) Excessive Treatment D A parent fails to provide their child with enough food, leading to extreme malnutrition. What category does this fall under? A) Severe Neglect B) General Neglect C) Gross Negligence D) Incompetence A A parent fails to provide their child with basic shelter and medical care, though no physical injury has occurred yet. What category does this fall under? A) Severe Neglect B) General Neglect C) Gross Negligence D) Incompetence B How many chiropractors are required to form a chiropractic referral bureau? Can it be a family referral network? 5 Whom do NOT have an fiduciary relationship to one another What is the maximum percentage of a referral bureau's available practitioners that can come from the same office? 20% What must be submitted along with a referral service application To participate in a referral bureau? $25 application fee What must a referral service use for its telephone operations In a referral bureau? A separate answering service. What three criteria must be recorded for each referral In a referral bureau? 1) Date of referral 2) Name and address of the patient 3) Name and address of the doctor referred to Under what three circumstances can a referral bypass the standard rotation of a referral bureau? - Request for a specialist - Geographic considerations - Request for services in a language other than English What is required if a 24-hour emergency referral service is advertised in a referral bureau? At least one chiropractor from the group must be available at all times. If a referral bureau cannot meet the requirement of 5 chiropractors, what can they do? The board may consider extenuating circumstances to allow for an exception. A patient calls the referral service asking for a chiropractor who speaks Mandarin. How should the answering service handle the request? The service can bypass the standard rotation and refer the patient to a chiropractor who speaks Mandarin. A chiropractic referral bureau is found to be referring only to a select few members rather than following the required rotation. What potential consequences could they face? The bureau could face disciplinary action for failing to comply with referral regulations. A referral service operates without a separate phone line and instead uses an individual chiropractor’s office phone. Why is this a violation? Regulations require a separate answering service for referral bureaus to ensure fair distribution of patients. A patient calls a referral service late at night for an emergency chiropractor but nobody is available. What rule did the service violate? If a 24-hour emergency referral service is advertised, at least one chiropractor must always be available. A chiropractor owns 50% of the referral bureau's participating offices. Why is this not allowed? No single office may represent more than 20% of the available practitioners in a bureau. A referral bureau fails to keep records of their referrals. What issue does this create? The bureau is not in compliance with regulations and may face board penalties. A new chiropractic referral service is set up, but they do not submit an application to the board. What step did they miss? A board-approved application must be filed before the service can legally operate. Under what circumstances can the Board of Chiropractic Examiners require a licentiate to pay for investigation and enforcement costs? If the licentiate is found guilty of violating the Chiropractic Initiative Act in a disciplinary proceeding. What evidence does the board use to determine the reasonable costs of investigation and enforcement? A certified copy of actual costs or a good faith estimate signed by the board or its representative. What types of costs can be included in the enforcement costs (3)? - Investigative fees - Enforcement costs, - Charges imposed by the Attorney General. Who determines the reasonable cost amount in a disciplinary case? The administrative law judge, if requested by the board. What actions can the board take if a licentiate fails to pay the ordered costs? The board can enforce repayment in court in addition to any other penalties. How does failure to pay investigation and enforcement costs affect a licentiate's license renewal or reinstatement? The board will not renew or reinstate a license until all ordered costs are paid. Under what condition can a licentiate receive a conditional license renewal despite unpaid costs? If the licentiate demonstrates financial hardship and enters a repayment agreement with the board for up to one year. Each licensed chiropractor is required to maintain all active and inactive chiropractic patient records for _______ from the date of the doctor's last treatment of the patient unless state or federal laws require a longer period of retention 5 years & Records of MINORS must be keep for 1 year following their 18th birthday Active chiropractic records are all chiropractic records of patients treated within the last ________ 12 months since the date of the last patient treatment Chiropractic patient records shall be classified as inactive when there has elapsed a period of more than __________ since the date of the last patient treatment. 12 months All chiropractic patient records shall be available to any representative of the Board upon presentation of (2)? patient's written consent OR a valid legal order. If a representative of the board at a chiropractic office requests active patient records, how long do you have to give them? What about inactive records? What about the location of inactive records? - Active patient records must be immediately available upon request - Inactive patient records must be provided within 10 days upon request. - The location of inactive records must be reported immediately if requested by the Board. If a patient asks for their records, how many days do you have to provide them? What about if they ask for copies of the records? - need to be provided within 5 days - you have 15 days to prepare copies If a patient makes a written request to review their file, They must be given access within _______ working days and have up to ______ days to inspect the file - given access with 5 working days - have up to 5 days to inspect the file What information must be included in both active and inactive chiropractic patient records to ensure compliance with regulations (8)? 1) Patient’s full name, DOB, and SSN (if available). 2) Patient’s gender, height, and weight (estimated if necessary). 3) Patient history, complaint, diagnosis/analysis, and treatment, signed by the primary treating doctor. 4) Signatures or initials of any other treating doctors for subsequent treatments. 5) Patient’s signature 6) Date of each patient visit. 7) All chiropractic X-rays or documentation of their transfer. 8) Signed written informed consent If any required patient record information is found to be missing or incomplete, the chiropractor must correct or complete the records within ___ days after the discovery of the omission. 30 days Who must be present during a Manipulation Under Anesthesia (MUA) procedure, and what are their respective roles? 2 licensed chiropractors must perform the procedure: - primary chiropractor formulates the treatment plan and performs manipulation - second chiropractor ensures patient care and safety and assists when necessary. Anesthesia must be administered by a California-licensed physician, surgeon, or other legally authorized provider. The chiropractors CANNOT interfere with anesthesia administration or patient discharge. Where can MUA be offered? MUA may only be performed in: - A licensed hospital - A licensed ambulatory surgery center MUA CANNOT be performed in a mobile van. Can chiropractors charge for free or discounted services? Chiropractors may advertise free or discounted services, but they cannot charge for any additional services or products during the same visit unless: - The patient is informed of the cost beforehand, and - The patient agrees to pay for those additional services. Is a Free Massage for a Referral Allowed? No, offering a free one-hour massage in exchange for a referral is not allowed because it is considered capping or steering, which is prohibited. Key Regulations: - Chiropractors cannot reward patients for bringing in new clients. - Unlawful referrals (such as incentives for patient recruitment) can result in misdemeanor charges and penalties up to $5,000 per offense. - Multiple offenses can lead to license suspension. This means that while chiropractors can advertise free or discounted services, they cannot offer them as a reward for referrals, as it would violate chiropractic regulations. Does informed consent have to be given to the patient orally or in written form? BOTH "A licensed doctor of chiropractic shall verbally and in writing inform each patient of the material risks of proposed care" T or F California will permit A temporary license or permit in certain circumstances F The California law does not provide for the granting of temporary permits or licenses. To apply for a chiropractic license, an applicant must submit the application with a nonrefundable fee of $___, verification of ___ prechiropractic college credits, and file it with the Board of Chiropractic Examiners in ___. $371.00 60 Sacramento Who Must Submit Fingerprints (3)? 1) New applicants for licensure. 2) Petitioners for reinstatement of a revoked or canceled license. 3) Current licensees who have not previously submitted fingerprints, were licensed before January 1, 1997, or have no record of electronic fingerprint submission. Who pays for fingerprinting? the licensee Licensees shall retain, for at least ________ years, either a receipt showing that he or she has electronically transmitted his or her fingerprint images to the Department of Justice or, for those licensees who did not use an electronic fingerprinting system, a receipt evidencing that the licensee's fingerprints were taken. 3 years No applicant under the age of ________ years of age shall be admitted to examination before the board for licensure to practice chiropractic in California. 21 years old What educational requirement must an applicant meet to qualify for reciprocity in California? What type of examination must an applicant pass to qualify for reciprocity? - Graduation from a board-approved chiropractic college and completion of the minimum required hours and per California law at the time their original license was issued. - The applicant must have successfully completed an equivalent examination in each subject examined in California during the same year their original license was issued. What licensing requirement must an applicant meet in their current state before applying for reciprocity in California? - The applicant must hold a valid and up-to-date license from the state they are applying from. - The state from which the applicant is licensed must offer reciprocity with California. What fees must an applicant pay when applying for reciprocity? A nonrefundable application fee of $25.00, plus an additional fee set forth in Section 5 of the Act if licensure is granted. How many years of chiropractic practice must an applicant have to qualify for reciprocity? 5 years A person whose application for licensure was denied may reapply for licensure _____ from the effective date of the decision. 2 years The following represents the fee for Annual license renewal for active and inactive licenses: a) double the annual renewal fee b) $500 c) $250 d) $371 C) $250 The following represents the fee for License restoration for forfeited and cancelled licenses: a) double the annual renewal fee b) $500 c) $250 d) $371 A & B (annual renewal is $250, which would make this $500) The following represents the fee for Inactive to active status license renewal: a) double the annual renewal fee b) $500 c) $250 d) $371 C A license shall expire _________ annually on the last day of the licensee's birth month What is a "License in forfeiture"? "License in forfeiture" is a license that has not been renewed within 60 days following its expiration date. What is a "Canceleld license"? "Cancelled license" is a license that has been expired for a period of three (3) consecutive years. How many CE credits are required annually? 24 Can you compare and contrast license restoration for the following 3 scenarios: License in forfeiture, Inactive license, and canceled license - What forms do you need to submit for each one to be restored? - What fee must you pay? - What are the continuing education requirements? T or F A licensee who holds a license on inactive status is required to complete continuing education on an annual basis F "A licensee who holds a license on inactive status is NOT required to complete continuing education on an annual basis; however, they must provide proof of completion of the required" To restore an inactive license to active status, what needs to be done? - complete and submit an " Inactive to active status application" - Pay $250 for a renewal fee (same as active & inactive licenses) - Complete continuing education equivalent to that required for a single licensee renewal period (24 credits = 1 year) _________, or his or her designee, may issue a letter of admonishment to a licensee for failure to comply with any provision of the Act, statute or regulations governing the practice of chiropractic. The Executive Officer ___________ of the board or his or her designee may issue a citation containing an order to pay a fine between $100 and $5,000 and an order of abatement against a licensee for any violation of the Act or the California Code of Regulations or any laws governing the practice of chiropractors. The Executive Officer Each citation issued to a chiropractor by the executive officer shall be issued in what form? each violation specified in the citation, including a reference to the law or regulation alleged to have been violated. - The citation shall be served upon the cited person either personally or by certified United States mail. If a chiropractor is legally disqualified, how long do they have to sell the shares? A) 30 days B) 45 days C) 90 days D) 100 days C) 90 days If a chiropractor is declared incompetent, how long do they have to sell the shares of their practice? * Death & Dementia (after they have been found UNFIT) they have 6 months * To be found UNFIT they need a psychiatric evaluation from a board approved physician T or F any medical professional can own shares in a chiropractic corporation T In California, shares in a chiropractic corporation can be owned by licensed chiropractors and, up to 49%, by other licensed healthcare professionals like physicians, podiatrists, psychologists, and nurses, among others. The chiropractor is a part of a medical corporation What percentage of the shares are they allowed to own? For a MEDICAL corporation 51% of shares MUST be owned by a physician or surgeon, and up to 49% by other licensed professionals (e.g. chiropractor) Who has the authority to issue a citation against an unlicensed person acting as a licensee under the board's jurisdiction, and what penalties may be imposed? A) Only the Board of Chiropractic Examiners; the fine may not exceed $10,000 per violation. B) Only law enforcement agencies; penalties include a fine of $2,500 per violation. C) The Executive Officer or their designee; the fine may not exceed $5,000 per violation, and an order of abatement may be issued. D) Any licensed chiropractor; penalties include license suspension and a fine of $1,000 per violation. C) The Executive Officer or their designee; the fine may not exceed $5,000 per violation, and an order of abatement may be issued. If a licensee wishes to contest a citation, how many calendar days do they have to request a hearing? A) 10 days from the date of issuance B) 14 days from the date of issuance C) 30 days from the date of issuance D) 60 days from the date of issuance C) 30 days from the date of issuance In addition to requesting a hearing, how long does a cited person have to request an informal conference with the Executive Officer? A) 7 days after service of the citation B) 14 days after service of the citation C) 30 days after service of the citation D) 60 days after service of the citation B) 14 days after service of the citation How soon must the Executive Officer or their designee hold an informal conference after receiving a written request? A) 7 calendar days B) 14 calendar days C) 30 calendar days D) 60 calendar days C) 30 calendar days In a California professional medical corporation, at least ______% of the shares must be owned by a licensed physician or surgeon, and only up to ____% of the outstanding and issued shares may be held by a - doctor of podiatric medicine - psychologist - registered nurse - optometrist - marriage, family, and child counselor - clinical social worker - physician assistant For a MEDICAL corporation - 51% of shares MUST be owned by a physician or surgeon - up to 49% by other licensed professionals (e.g. chiropractor) In what instances can a chiropractor's license be automatically suspended? Upon conviction of felonies involving fraud related to worker's compensation or Medi-Cal benefits, and may also be suspended or revoked for other acts of unprofessional conduct as defined by California regulations. - moral turpitude, dishonesty, physical violence, corruption, as well as any conduct endangering the health, welfare, or safety of the public. What electronic safeguard storage is required to keep patient records safe? offsite backup storage system Is a DC allowed to sign death certificates? Yes How many CE hours of ethics and law are required by a chiropractor annually? 2 The what types of information cannot be disclosed without specific patient authorization? - Substance abuse treatment records (drugs & alcohol history and usage) - HIV/AIDS status - Mental health treatment records - Certain communicable diseases, including Hepatitis and Mononucleosis If it has been 2 years since a chiropractor's license has been active how many CE hours are needed, and what is the associated fine? - 48 CE hours (24 hours of CE per year of inactivity) - The restoration fee is double the annual renewal fee (for a fortified license which a license that has not been paid for 60 days following its expiration date) Be careful of the wording this is not saying That the license is inactive! It is saying it has been two years since it has been active!!! (AKA fortified) What is the punishment for a second offence of sexual solicitation? Revocation for 10 years When does a chiropractor have to renew their license? Annually by the last day of their birth month How many months can a chiropractor be suspended for false advertising? 6 months = 180 days What is the proper way to handle a situation where an error occurs in a patient's file and they want to correct it? The patient can add a 250 word addendum to each mistake which becomes part of their record permanently What is considered a homeless child under California reporting requirements? A homeless child or unaccompanied youth is not sufficient basis for reporting child abuse What consequences does a chiropractor face if they adjust and collect fees as normal for a workers compensation case? A fine up to 3 times the amount unlawfully collected When a patient's primary language is not English, what is the chiropractor required to do? Document the language in the patient's file What is the definition of an impairment rating in Worker' Compensation cases? A percentage estimate of how much normal use of your injured body parts you've lost What is the cap on chiropractic visits for worker compensation cases with an injury date of January 1, 2004 or later? 24 visits