Defending a Complaint before the North Carolina Chiropractic Board

If you have been contacted by an investigator or received a letter from the North Carolina Chiropractic Board of Examiners about a complaint, you may be uncertain about what to do next, what the procedures are, and what the results may be.  You may also be trying to decide whether you need to retain an attorney.  Our firm represents chiropractors (hereafter, “licensees”) in responding to the Chiropractic Board and defending against allegations of misconduct.

In the sections below, we attempt to address some of the questions you may have and explain the general process, procedures, and possible results.

North Carolina Chiropractic Board of Examiners

As background, the North Carolina Chiropractic Board of Examiners was established by the General Assembly to regulate chiropractic practice.  The Board consists of 8 members appointed by the Governor and General Assembly, six of whom are practicing chiropractors who have actively practiced for at least eight consecutive years.  The Board meets on a quarterly basis or when otherwise warranted.

How Complaints are Handled

When a complaint is received, the secretary of the Chiropractic Board reviews the complaint to determine whether a major or minor violation has been alleged. If the secretary determines that the alleged violation is minor, s/he attempts to resolve the complaint by informal communications with the complainant and the chiropractor. If the secretary determines that the alleged violation is major, s/he assists the complainant in filing a formal complaint.

A formal complaint is executed in writing under oath on a form provided by the secretary. It specifies the statute or rule allegedly violated and contains a short statement of the acts or omissions constituting the alleged violation, including the dates of said acts or omissions.  Formal complaints are investigated by the Chiropractic Review Committee which is composed of the secretary, the attorney for the Chiropractic Board and a licensed chiropractor selected by the secretary who was a candidate for board membership, but not elected.

Probable Cause Hearing and Possible Outcomes

The Chiropractic Review Committee determines if probable cause exists to believe a violation of the laws governing chiropractors has occurred.  The respondent chiropractor receives notice of the probable cause hearing at least 15 days in advance of the probable cause hearing.  Because the probable cause hearing is considered informal, the secretary can establish procedures s/he believes are necessary to assist in examination of evidence, and the Review Committee can consider evidence that would not be admissible if offered at a hearing in a contested case.

After examining the evidence, the Review Committee may:

(1)  Determine that no probable cause exists to believe that a violation has occurred and dismiss the charge;

(2)  Direct the licensee to cease and desist from commission of the following acts which violate G.S. 90-154, if the licensee admits the charge;

(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 N.C.G.S. 90-154.2.

(5)  Negligence, incompetence, or malpractice in the practice of chiropractic medicine.

(6)  Not rendering acceptable care in the practice of the profession as defined in G.S. 90-154.3.

(7)  Lewd or immoral conduct toward a patient.

(8)  Committing or attempting to commit fraud, deception, or misrepresentation.

(9)  Offering to waive a patient’s obligation to pay any deductible or copayment   required by the patient’s insurer.

(10) Failing to honor promptly a patient’s request for a copy of any claim form submitted to the patient’s insurer.

(11) 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.

(12) Advertising any free or reduced rate service without prominently stating in the advertisement the usual fee for that service.

(13) 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.

(14) Charging an insurer or other third-party payor a fee greater than the advertised fee for the same service.

(15) Violating the provisions of G.S. 90-154.1.

(16) Physical, mental, or emotional infirmity of such severity as to impair the ability to practice safely.

(17) Violating the provisions of G.S. 90-151 regarding the extent and limitation of license.

(18) Concealing information from the Board or failing to respond truthfully and completely to an inquiry from the Board concerning any matter affecting licensure.

(19) Failing to comply with a decision of the Board that is final.

(20) Committing an act on or after October 1, 2007, which demonstrates a lack of good moral character which would have been a basis for denying a license under G.S. 90-143(b)(1), had it been committed before application for a license.

(3)  If probable cause is found and (a) the charge is denied or (b) the charge is admitted and is deemed serious as to make the imposition of punitive sanctions appropriate, the complaint is presented to the Board for a decision on the merits in accordance with statutes governing contested cases.

Formal Hearing for Contested Cases and Possible Outcomes

Disciplinary proceedings to enforce the behavior listed above are considered contested cases, and the licensee has a right to a hearing.  The hearing is conducted by a majority of the board, and the president normally serves as the presiding officer.

When the Board finds that a chiropractor or applicant is guilty of any offense described above, it may:

(1)  Permanently revoke the license;

(2)  Suspend the license;

(3)  Refuse to grant a license;

(4)  Censure the chiropractor;

(5)  Issue a letter of reprimand;

(6)  Place the chiropractor on probationary status.

Impact of Decision of Whether to Retain an Experienced Law Firm

If you have received a letter from the Board staff or have a pending formal hearing, you should consider retaining a firm like ours that has experience representing licensees before the N.C. Chiropractic Board of Examiners.  Disciplinary action could have a significant and permanent impact on your license(s) in NC and other states, which also can substantially affect you financially and personally.  Hiring an experienced law firm can be an investment in your professional future as a chiropractor.