GENERAL ASSEMBLY OF NORTH CAROLINA
1995 SESSION

CHAPTER 188
HOUSE BILL 829

AN ACT TO AMEND THE VARIOUS GROUNDS FOR DISCIPLINE OF PRACTITIONERS OF CHIROPRACTIC BY THE STATE BOARD OF CHIROPRACTIC EXAMINERS.

The General Assembly of North Carolina enacts:

Section 1.  G.S. 90-154(b) reads as rewritten:
"(b)	Any one of the following is grounds for disciplinary action by the Board under subsection (a):
(1)	Advertising services in a false or misleading manner.
(2)	Conviction of a felony or of a crime involving moral turpitude.
(3)	Addiction to or severe dependency upon alcohol or any other drug that impairs the ability to practice safely.
(4)	Unethical conduct as defined in G.S. 90-154.2.
(5)	Negligence, incompetence, or malpractice in the practice of chiropractic.
	(7)	Not rendering acceptable care in the practice of the profession as defined in G.S. 90-154.3.
(8)	Lewd or immoral conduct toward a patient.
(9)	Committing or attempting to commit fraud, deception, or misrepresentation.
(10)	Offering to waive a patient's obligation to pay any deductible or copayment required by the patient's insurer.
(11)	Failing to honor promptly a patient's request for a copy of any claim form submitted to the patient's insurer.
(12)	Rebating or offering to rebate to a patient any portion of the funds received from the patient's insurer, unless the sum rebated constitutes the refund of an overpayment to which the patient is lawfully entitled.
(13)	Advertising any free or reduced rate service without prominently stating in the advertisement the usual fee for that service.
(14)	Charging an insurer or other third-party payor a fee greater than a patient would be charged for the same service if the patient were paying directly.
(15)	Charging an insurer or other third-party payor a fee greater than the advertised fee for the same service.
(16)	Violating the provisions of G.S. 90-154.1.  
(17)	Physical, mental, or emotional infirmity of such severity as to impair the ability to practice safely.
(18)	Violating the provisions of G.S. 90-151 regarding the extent and limitation of license.
(19)	Concealing information from the Board or failing to respond truthfully and completely to an inquiry from the Board concerning any matter affecting licensure.
(20)	Failing to comply with a decision of the Board that is final."
Sec. 2.  G.S. 90-154.1 reads as rewritten:
"§ 90-154.1.  Collection of certain fees prohibited.
(a)	Any patient or any other person responsible for payment has the right to refuse to pay, cancel payment, or be reimbursed for payment for any service, examination, or treatment other than the advertised reduced rate service, examination or treatment which is performed as a result of and within 72 hours of responding to any advertisement for a free or reduced rate service, free or reduced rate examination, or free or reduced rate treatment. Any further treatment shall be agreed upon in writing and signed by both parties.
(b)	
Any chiropractic advertisement that offers a free or reduced rate service, examination or treatment shall contain the following notice to prospective patients:  'If you decide to purchase additional treatment, you have the legal right to change your mind within three days and receive a refund.'  If the advertisement is published in print, the foregoing notice shall appear in capital letters clearly distinguishable from the rest of the text.  If the advertisement is broadcast on radio or television, the foregoing notice shall be recited at the end of the advertisement.
	(d)	Any bill sent to a patient or any other person responsible for payment as a result of the patient responding to a chiropractic advertisement shall clearly contain the language of the first sentence of subsection (a) and have distinguished on its face the charge for the reduced rate services, including an itemization of free services, and the separate charge for any services, examinations or treatments other than the advertised free or reduced rate services, examinations, or treatments.  The reduced rate charges shall be labeled 'Free or Reduced Rate Charges' and any other charges shall be labeled 'Non-advertised Services, Examinations, or Treatments'.”
Sec. 3.  G.S. 90-154.3 reads as rewritten:
"§ 90-154.3.  Acceptable care in the practice of chiropractic.
	(a)	It shall be unlawful for a doctor of chiropractic to examine, treat, or render any professional service to a patient that does not conform to the standards of acceptable care.
(b)	For purposes of disciplinary action, the Board of Chiropractic Examiners may adopt rules that establish and define standards of acceptable care with respect to:
(1)	Examination and diagnosis;
(2)	The use of chiropractic adjustive procedures;
(3)	Physiological therapeutic agents;
(4)	Diagnostic radiology; 
.(5)	The maintenance of patient records; and 
	(6)	Sanitation, safety, and the adequacy of clinical equipment.
(c)	If the Board has not defined a standard of acceptable care by rule, then the standard of acceptable care shall be the usual and customary method as taught in the majority of recognized chiropractic colleges.
(d)	Nothing in this section shall alter the lawful scope of practice of chiropractic as defined in G.S. 90-143 or the limitation of license as defined in G.S. 90-151."
Sec. 4.  This act becomes effective October 1, 1995.
In the General Assembly read three times and ratified this the 6th day of June, 1995.

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Dennis A. Wicker
President of the Senate

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Harold J. Brubaker
Speaker of the House of Representatives