Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Session Laws - 2001, Regular Session
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.
Official Publication of the State of Minnesota
Revisor of Statutes