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Minnesota Legislature

Office of the Revisor of Statutes

Key: (1) language to be deleted (2) new language

                            CHAPTER 121-S.F.No. 359 
                  An act relating to health occupations; modifying 
                  licensing requirements for the board of chiropractic 
                  examiners; modifying grounds for disciplinary action 
                  and penalties; allowing specified individuals to 
                  practice chiropractic in this state without being 
                  licensed in this state; amending Minnesota Statutes 
                  2000, sections 148.06, subdivision 1; 148.10, 
                  subdivisions 1 and 3; 148.104; 148.105, subdivision 2; 
                  and 148.106, subdivision 10; repealing Minnesota 
                  Statutes 2000, section 148.106, subdivisions 1, 2, 3, 
                  4, 5, 6, 7, 8, and 9. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  Minnesota Statutes 2000, section 148.06, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [LICENSE REQUIRED; QUALIFICATIONS.] No 
        person shall practice chiropractic in this state without first 
        being licensed by the state board of chiropractic examiners.  
        The applicant shall have earned at least one-half of all 
        academic credits required for awarding of a baccalaureate degree 
        from the University of Minnesota, or other university, college, 
        or community college of equal standing, in subject matter 
        determined by the board, and taken a four-year resident course 
        of at least eight months each in a school or college of 
        chiropractic or in a chiropractic program that is fully 
        accredited by the council on chiropractic education or fully 
        accredited by an agency approved by the United States Office of 
        Education or their successors as of January 1, 1988.  The board 
        may issue licenses to practice chiropractic without compliance 
        with prechiropractic or academic requirements listed above if in 
        the opinion of the board the applicant has the qualifications 
        equivalent to those required of other applicants, the applicant 
        satisfactorily passes written and practical examinations as 
        required by the board of chiropractic examiners, and the 
        applicant is a graduate of a college of chiropractic with a 
        reciprocal recognition agreement with the council on 
        chiropractic education as of January 1, 1988.  The board may 
        recommend a two-year prechiropractic course of instruction to 
        any university, college, or community college which in its 
        judgment would satisfy the academic prerequisite for licensure 
        as established by this section. 
           An examination for a license shall be in writing and shall 
        include testing in: 
           (a) The basic sciences including but not limited to 
        anatomy, physiology, bacteriology, pathology, hygiene, and 
        chemistry as related to the human body or mind; 
           (b) The clinical sciences including but not limited to the 
        science and art of chiropractic, chiropractic physiotherapy, 
        diagnosis, roentgenology, and nutrition; and 
           (c) Professional ethics and any other subjects that the 
        board may deem advisable. 
           The board may consider a valid certificate of examination 
        from the National Board of Chiropractic Examiners as evidence of 
        compliance with the written examination requirements of this 
        subdivision.  The applicant shall be required to give practical 
        demonstration in vertebral palpation, neurology, adjusting and 
        any other subject that the board may deem advisable.  A license, 
        countersigned by the members of the board and authenticated by 
        the seal thereof, shall be granted to each applicant who 
        correctly answers 75 percent of the questions propounded in each 
        of the subjects required by this subdivision and meets the 
        standards of practical demonstration established by the board.  
        Each application shall be accompanied by a fee set by the 
        board.  The fee shall not be returned but the applicant may, 
        within one year, apply for examination without the payment of an 
        additional fee.  The board may grant a license to an applicant 
        who holds a valid license to practice chiropractic issued by the 
        appropriate licensing board of another state, provided the 
        applicant meets the other requirements of this section and 
        satisfactorily passes a practical examination approved by the 
        board.  The burden of proof is on the applicant to demonstrate 
        these qualifications or satisfaction of these requirements. 
           Sec. 2.  Minnesota Statutes 2000, section 148.10, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [GROUNDS.] (a) The state board of 
        chiropractic examiners may refuse to grant, or may revoke, 
        suspend, condition, limit, restrict or qualify a license to 
        practice chiropractic, or may cause the name of a person 
        licensed to be removed from the records in the office of the 
        court administrator of the district court for: 
           (1) Advertising that is false or misleading; that violates 
        a rule of the board; or that claims the cure of any condition or 
        disease. 
           (2) The employment of fraud or deception in applying for a 
        license or in passing the examination provided for in section 
        148.06 or conduct which subverts or attempts to subvert the 
        licensing examination process.  
           (3) The practice of chiropractic under a false or assumed 
        name or the impersonation of another practitioner of like or 
        different name.  
           (4) The conviction of a crime involving moral turpitude.  
           (5) The conviction, during the previous five years, of a 
        felony reasonably related to the practice of chiropractic.  
           (6) Habitual intemperance in the use of alcohol or drugs.  
           (7) Failure to pay the annual renewal license fee 
        Practicing under a license which has not been renewed.  
           (8) Advanced physical or mental disability.  
           (9) The revocation or suspension of a license to practice 
        chiropractic; or other disciplinary action against the licensee; 
        or the denial of an application for a license by the proper 
        licensing authority of another state, territory or country; or 
        failure to report to the board that charges regarding the 
        person's license have been brought in another state or 
        jurisdiction.  
           (10) The violation of, or failure to comply with, the 
        provisions of sections 148.01 to 148.105, the rules of the state 
        board of chiropractic examiners, or a lawful order of the board. 
           (11) Unprofessional conduct.  
           (12) Being unable to practice chiropractic with reasonable 
        skill and safety to patients by reason of illness, professional 
        incompetence, senility, drunkenness, use of drugs, narcotics, 
        chemicals or any other type of material, or as a result of any 
        mental or physical condition, including deterioration through 
        the aging process or loss of motor skills.  If the board has 
        probable cause to believe that a person comes within this 
        clause, it shall direct the person to submit to a mental or 
        physical examination.  For the purpose of this clause, every 
        person licensed under this chapter shall be deemed to have given 
        consent to submit to a mental or physical examination when 
        directed in writing by the board and further to have waived all 
        objections to the admissibility of the examining physicians' 
        testimony or examination reports on the ground that the same 
        constitute a privileged communication.  Failure of a person to 
        submit to such examination when directed shall constitute an 
        admission of the allegations, unless the failure was due to 
        circumstances beyond the person's control, in which case a 
        default and final order may be entered without the taking of 
        testimony or presentation of evidence.  A person affected under 
        this clause shall at reasonable intervals be afforded an 
        opportunity to demonstrate that the person can resume the 
        competent practice of chiropractic with reasonable skill and 
        safety to patients.  
           In addition to ordering a physical or mental examination, 
        the board may, notwithstanding section 13.42, 144.651, or any 
        other law limiting access to health data, obtain health data and 
        health records relating to a licensee or applicant without the 
        licensee's or applicant's consent if the board has probable 
        cause to believe that a doctor of chiropractic comes under this 
        clause.  The health data may be requested from a provider, as 
        defined in section 144.335, subdivision 1, paragraph (b), an 
        insurance company, or a government agency, including the 
        department of human services.  A provider, insurance company, or 
        government agency shall comply with any written request of the 
        board under this subdivision and is not liable in any action for 
        damages for releasing the data requested by the board if the 
        data are released pursuant to a written request under this 
        subdivision, unless the information is false and the provider or 
        entity giving the information knew, or had reason to believe, 
        the information was false.  Information obtained under this 
        subdivision is classified as private under sections 13.01 to 
        13.87.  
           In any proceeding under this clause, neither the record of 
        proceedings nor the orders entered by the board shall be used 
        against a person in any other proceeding.  
           (13) Aiding or abetting an unlicensed person in the 
        practice of chiropractic, except that it is not a violation of 
        this clause for a doctor of chiropractic to employ, supervise, 
        or delegate functions to a qualified person who may or may not 
        be required to obtain a license or registration to provide 
        health services if that person is practicing within the scope of 
        the license or registration or delegated authority.  
           (14) Improper management of health records, including 
        failure to maintain adequate health records as described in 
        clause (18), to comply with a patient's request made under 
        section 144.335 or to furnish a health record or report required 
        by law.  
           (15) Failure to make reports required by section 148.102, 
        subdivisions 2 and 5, or to cooperate with an investigation of 
        the board as required by section 148.104, or the submission of a 
        knowingly false report against another doctor of chiropractic 
        under section 148.10, subdivision 3.  
           (16) Splitting fees, or promising to pay a portion of a fee 
        or a commission, or accepting a rebate.  
           (17) Revealing a privileged communication from or relating 
        to a patient, except when otherwise required or permitted by law.
           (18) Failing to keep written chiropractic records 
        justifying the course of treatment of the patient, including, 
        but not limited to, patient histories, examination results, test 
        results, and X-rays.  Unless otherwise required by law, written 
        records need not be retained for more than seven years and 
        X-rays need not be retained for more than four years.  
           (19) Exercising influence on the patient or client in such 
        a manner as to exploit the patient or client for financial gain 
        of the licensee or of a third party which shall include, but not 
        be limited to, the promotion or sale of services, goods, or 
        appliances.  
           (20) Gross or repeated malpractice or the failure to 
        practice chiropractic at a level of care, skill, and treatment 
        which is recognized by a reasonably prudent chiropractor as 
        being acceptable under similar conditions and circumstances.  
           (21) Delegating professional responsibilities to a person 
        when the licensee delegating such responsibilities knows or has 
        reason to know that the person is not qualified by training, 
        experience, or licensure to perform them.  
           (b) For the purposes of paragraph (a), clause (2), conduct 
        that subverts or attempts to subvert the licensing examination 
        process includes, but is not limited to:  (1) conduct that 
        violates the security of the examination materials, such as 
        removing examination materials from the examination room or 
        having unauthorized possession of any portion of a future, 
        current, or previously administered licensing examination; (2) 
        conduct that violates the standard of test administration, such 
        as communicating with another examinee during administration of 
        the examination, copying another examinee's answers, permitting 
        another examinee to copy one's answers, or possessing 
        unauthorized materials; or (3) impersonating an examinee or 
        permitting an impersonator to take the examination on one's own 
        behalf.  
           (c) For the purposes of paragraph (a), clauses (4) and (5), 
        conviction as used in these subdivisions includes a conviction 
        of an offense that if committed in this state would be deemed a 
        felony without regard to its designation elsewhere, or a 
        criminal proceeding where a finding or verdict of guilt is made 
        or returned but the adjudication of guilt is either withheld or 
        not entered. 
           (d) For the purposes of paragraph (a), clauses (4), (5), 
        and (6), a copy of the judgment or proceeding under seal of the 
        administrator of the court or of the administrative agency which 
        entered the same shall be admissible into evidence without 
        further authentication and shall constitute prima facie evidence 
        of its contents. 
           (e) For the purposes of paragraph (a), clause (11), 
        unprofessional conduct means any unethical, deceptive or 
        deleterious conduct or practice harmful to the public, any 
        departure from or the failure to conform to the minimal 
        standards of acceptable chiropractic practice, or a willful or 
        careless disregard for the health, welfare or safety of 
        patients, in any of which cases proof of actual injury need not 
        be established.  Unprofessional conduct shall include, but not 
        be limited to, the following acts of a chiropractor: 
           (1) gross ignorance of, or incompetence in, the practice of 
        chiropractic; 
           (2) engaging in conduct with a patient that is sexual or 
        may reasonably be interpreted by the patient as sexual, or in 
        any verbal behavior that is seductive or sexually demeaning to a 
        patient; 
           (3) performing unnecessary services; 
           (4) charging a patient an unconscionable fee or charging 
        for services not rendered; 
           (5) directly or indirectly engaging in threatening, 
        dishonest, or misleading fee collection techniques; 
           (6) perpetrating fraud upon patients, third-party payors, 
        or others, relating to the practice of chiropractic, including 
        violations of the Medicare or Medicaid laws or state medical 
        assistance laws; 
           (7) advertising that the licensee will accept for services 
        rendered assigned payments from any third-party payer as payment 
        in full, if the effect is to give the impression of eliminating 
        the need of payment by the patient of any required deductible or 
        copayment applicable in the patient's health benefit plan; or 
        advertising a fee or charge for a service or treatment different 
        from the fee or charge the licensee submits to a third-party 
        payer for that service or treatment.  As used in this clause, 
        "advertise" means solicitation by the licensee by means of 
        handbills, posters, circulars, motion pictures, radio, 
        newspapers, television, or in any other manner.  In addition to 
        the board's power to punish for violations of this clause, 
        violation of this clause is also a misdemeanor; 
           (8) accepting for services rendered assigned payments from 
        any third-party payer as payment in full, if the effect is to 
        eliminate the need of payment by the patient of any required 
        deductible or copayment applicable in the patient's health 
        benefit plan, except as hereinafter provided; or collecting a 
        fee or charge for a service or treatment different from the fee 
        or charge the licensee submits to a third-party payer for that 
        service or treatment, except as hereinafter provided.  This 
        clause is intended to prohibit offerings to the public of the 
        above listed practices and those actual practices as well, 
        except that in instances where the intent is not to collect an 
        excessive remuneration from the third-party payer but rather to 
        provide services at a reduced rate to a patient unable to afford 
        the deductible or copayment, the services may be performed for a 
        lesser charge or fee.  The burden of proof for establishing that 
        this is the case shall be on the licensee; and 
           (9) any other act that the board by rule may define.  
           Sec. 3.  Minnesota Statutes 2000, section 148.10, 
        subdivision 3, is amended to read: 
           Subd. 3.  [REPRIMAND; PENALTIES; PROBATION.] In addition to 
        the other powers granted to the board under this chapter, the 
        board may, in connection with any person whom the board, after a 
        hearing, adjudges unqualified or whom the board, after a 
        hearing, finds to have performed one or more of the acts 
        described in subdivision 1: 
           (1) publicly reprimand or censure the person; 
           (2) place the person on probation for the period and upon 
        the terms and conditions that the board may prescribe; and 
           (3) require payment of all costs of proceedings resulting 
        in the disciplinary action; and 
           (4) impose a civil penalty not exceeding $10,000 for each 
        separate violation, the amount of the civil penalty to be fixed 
        so as to deprive the doctor of chiropractic of any economic 
        advantage gained by reason of the violation charged or to 
        reimburse the board for the cost of the investigation and 
        proceeding.  For purposes of this section, the cost of the 
        investigation and proceeding may include, but is not limited to, 
        fees paid for services provided by the office of administrative 
        hearings, legal and investigative services provided by the 
        office of the attorney general, court reporters, witnesses, 
        reproduction of records, board members' per diem compensation, 
        board staff time, and travel costs and expenses incurred by 
        board staff and board members. 
           Sec. 4.  Minnesota Statutes 2000, section 148.104, is 
        amended to read: 
           148.104 [COOPERATION DURING INVESTIGATIONS.] 
           A doctor of chiropractic who is the subject of an 
        investigation by or on behalf of the board shall cooperate fully 
        with the investigation.  Cooperation includes appearing at 
        conferences, meetings, or hearings scheduled by the board and 
        for which the board provided notice in accordance with chapter 
        14; responding fully and promptly to any question raised by or 
        on behalf of the board relating to the subject of the 
        investigation; and providing copies of patient health records, 
        as reasonably requested by the board, to assist the board in its 
        investigation.  If the board does not have written consent from 
        a patient allowing the board access to the patient's health 
        records, a doctor of chiropractic shall delete any data in the 
        record which identifies the patient before providing the records 
        to the board. 
           Sec. 5.  Minnesota Statutes 2000, section 148.105, 
        subdivision 2, is amended to read: 
           Subd. 2.  [EXCEPTIONS.] The following persons shall not be 
        in violation of subdivision 1: 
           (1) a student practicing under the direct supervision of a 
        preceptor while the student is enrolled in and regularly 
        attending a recognized chiropractic college or chiropractic 
        program; and 
           (2) a student who is in continuing training and performing 
        the duties of an intern or resident or engaged in postgraduate 
        work considered by the board to be the equivalent of an 
        internship or residency in any institution approved for training 
        by the board.; 
           (3) a doctor of chiropractic licensed in another state or 
        jurisdiction who is in actual consultation in Minnesota; 
           (4) a doctor of chiropractic licensed in another state or 
        jurisdiction who is in this state for the sole purpose of 
        providing chiropractic services at a competitive athletic 
        event.  The doctor of chiropractic may practice chiropractic 
        only on participants in the athletic event; 
           (5) a doctor of chiropractic licensed in another state or 
        jurisdiction whose duties are entirely of a research, public 
        health, or educational character and while directly engaged in 
        such duties, and who is employed in a scientific, sanitary, or 
        teaching capacity by:  (i) an accredited institution; (ii) a 
        public or private school, college, or other bona fide 
        educational institution; (iii) a nonprofit organization which 
        has tax-exempt status in accordance with the Internal Revenue 
        Code, section 501(c)(3), and is organized and operated primarily 
        for the purpose of conducting scientific research; or (iv) the 
        state department of health; 
           (6) a doctor of chiropractic licensed in another state or 
        jurisdiction who treats the doctor of chiropractic's home state 
        patients or other participating patients while the doctor of 
        chiropractic and those patients are participating together in 
        outdoor recreation in this state as defined by section 86A.03, 
        subdivision 3; and 
           (7) a person licensed in another state or jurisdiction who 
        is a commissioned officer of, a member of, or employed by the 
        armed forces of the United States, the United States Public 
        Health Service, the Veterans Administration, any federal 
        institution, or any federal agency while engaged in the 
        performance of official duties within this state. 
           Sec. 6.  Minnesota Statutes 2000, section 148.106, 
        subdivision 10, is amended to read: 
           Subd. 10.  [CONFIDENTIALITY OF PEER REVIEW RECORDS.] All 
        data and information acquired by the board or the peer review 
        committee before August 1, 2001, in the exercise of its duties 
        and functions in conducting peer reviews before August 1, 2001, 
        shall be subject to the same disclosure and confidentiality 
        protections as provided for data and information of other review 
        organizations under section 145.64.  This subdivision does not 
        limit or restrict the board or the peer review committee from 
        fully performing their prescribed peer review duties and 
        functions, nor does it apply to disciplinary and enforcement 
        proceedings under sections 14.57 to 14.62, 148.10, 148.105, 
        214.10, and 214.11.  The peer review committee shall file with 
        the board a complaint against a health care provider if it 
        determines that reasonable cause exists to believe the health 
        care provider has violated any portion of this chapter or rules 
        adopted under it, for which a licensed chiropractor may be 
        disciplined.  The peer review committee shall transmit all 
        complaint information it possesses to the board.  The data, 
        information, and records are classified as private data on 
        individuals for purposes of chapter 13.  The patient records 
        obtained by the board pursuant to this section must be used 
        solely for the purposes of the board relating to peer review or 
        the disciplinary process. 
           Sec. 7.  [REPEALER.] 
           Minnesota Statutes 2000, section 148.106, subdivisions 1, 
        2, 3, 4, 5, 6, 7, 8, and 9, are repealed. 
           Presented to the governor May 16, 2001 
           Signed by the governor May 18, 2001, 12:19 p.m.