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Minnesota
Board |
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Minnesota
Board |
What's New . . .
(Updated February 1, 2012)
AG AND BOARD JOIN IN FRAUD CIVIL SUITS RE: HEALTH CARE CREDIT CARD USE
AUTHORITY OF CHIROPRACTORS TO PERFORM CERTAIN PHYSICAL EXAMS
The Board has adopted rules for the establishment and maintenance of "Pre-Pay," plans for chiropractic care. To summarize, the rules require:
This only applies to accounts where the doctor accepts $1000 or more as advance payment from one or more patients;
The doctor must provide a written plan with a copy to the patient;
The plan must include a written description of reimbursement policies;
The plan requires notification to the patient when funds for their plan have been exhausted;
Each plan must be limited to 50 visits, although the plan may be renewed as often as necessary;
A doctor using such plans must have a separate escrow account into which these monies must be deposited, and must keep an accounting of disbursements;
The doctor can only move money from the escrow account into their operating accounts as the services are actually rendered. In other words, the doctor may not spend money that has not actually been earned by the provision of clinical services;
There is a 3 day right of recission for any person entering into such a plan.
This should not be considered an exhaustive list of the requirements. For the actual language of the prepay rules, please click on the link. (For a copy of the most current set of statutes and rules related to chiropractic, please click on the Statutes and Rules link and select those of interest to you.) If you have questions regarding the rules, you are encouraged to discuss them with your own private counsel.
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The Minnesota Office of Enterprise Technology (OET) recently sponsored and the Minnesota Legislature passed legislation requiring a 10% surcharge of no less than $5.00 and no more than $150 on EACH business, commercial, professional, or occupational license. The funding from this will go to OET, which will establish an electronic licensing system for the state.
THIS SURCHARGE IS NOT A LICENSE FEE, HAS NOTHING TO DO WITH THE BOARD OF CHIROPRACTIC, AND IS NOT MANAGED BY THE BOARD EXCEPT FOR ITS COLLECTION. Additionally, this surcharge applies ONLY to licenses, and does not apply to registrations, such as Professional Firms, Acupuncture, Animal Chiropractic, Independent Examiners, etc.
Also, THIS FEE WILL BE CHARGED WHETHER YOU RENEW ONLINE OR BY PAPER RENEWAL.
If
you have any questions regarding this surcharge,
please call OET at 651-296-8888.
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CAN DOCTORS OF CHIROPRACTIC UTILIZE MOBILE MRI's?
Recently, the Board has been asked multiple questions regarding the permissibility of performance of Mobile MRI’s for patients of doctors of chiropractic. The difficulty in answering such questions lies not in the general notion of whether mobile MRI’s are authorized, but in the very many permutations under which this may occur. It is not necessarily the performance of an MRI from a mobile location which may be impermissible, but any of a number of other variables which may render such activity as improper. Therefore, the Board takes no general position on the permissibility of the performance of mobile MRI’s. Rather, when considering a complaint, the Board would consider all such issues on the merits of the individual situation.
Those doctors who may be using mobile MRI’s may ask themselves the following questions as a guide to whether they may be treading into dangerous territory:
Might your use of the mobile MRI facility in any way influence whether or not you order such procedures for your patients? In other words, are you ordering more procedures than you would ordinarily, just because the facility is mobile?
Does the mobile facility require that you have a certain number of patients before they will come to your location?
Does the facility pay you, or in any manner provide you with a
financial or other benefit by coming to your location?
>> Are they giving you a certain
dollar amount for each patient eAre they paying you “rent” for the parking lot
space?
***
If they are, do you
even have authority to rent parking lot space? In other words, to you own the
building/parking lot?
>> Are they paying you
“rent” for any other office space or staff services?
***
If so, on what basis did you make the calculations to determine the
fair market value of this rental?
What is the demonstrable benefit of using the mobile MRI over using another community location?
Is there a local facility available which would perform MRI’s for you?
This is not meant to be an exhaustive list of questions you should be pursuing. These are simply the more common issues seen by the Board. You are strongly advised to seek legal consultation in any situation in which you may be considering such an option.
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FELONY LEVEL CRIMINAL SEXUAL CONDUCT CONVICTIONS
The 2010 Legislature established new language for either applicants, or currently licensed doctors of chiropractic who have been convicted of criminal sexual conduct. In short, if such behavior occurred with a patient, this chiropractor must be revoked and may never be reinstated. If such conduct occurred with a non patient, they may have an opportunity to reinstate their license provided certain conditions are met. The language of the bill may be found here.
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AG and Board Join in Fraud Civil Suit
On August 12, 2009 and on November 24, 2009, the Attorney General and the Board jointly filed civil suits in the District Court of the First Judicial District, for what is deemed to be the improper use of Health Care "Credit Cards." by two separate doctors of chiropractic. Please click here for a copy of the filing against Cory Couillard, DC, or against Erik Okeson, DC.
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Pursuant to new Legislation under the correct conditions, doctors of chiropractic may provide chiropractic services to animals. In short, those conditions are:
Must Register with the Board
Must have completed an approved course of at least 210 hours
Must have a referral from a Veterinarian
Must have a separate treatment room
Must complete 6 additional hours of continuing education in this subject every year
Additional information may be acquired by downloading and reading the statute.
Registration has begun, and Application forms may be acquired online.
Click here for a list of Registered Animal Chiropractors.
Click here for a list of approved courses on Animal Chiropractic.
Effective as of August 1, 2008, it will be illegal, and grounds for revocation, to make any direct contact “in person, by phone, or by other electronic means, with any person who has suffered an injury arising out of the maintenance or use of an automobile, for the purpose of influencing that person to receive treatment or to purchase any good or item from the licensee or anyone associated with the licenses...” This includes contact by the licensee or any third party operating on behalf of the licensee. For more information on this see the text of the Bill.
Several years ago, a law was enacted requiring that all health care providers list their 50 most common services and include the average allowable payments for those services, and to have this list readily available to consumers (patient). (M.S. 62J.052, Subd. 1) This law (shown below) was repealed in 2007 (Session Laws 2007 Ch. 147, Art. 15, Sec. 22)…accordingly, no such list is required any longer.
Sec. 21. Minnesota Statutes 2005 Supplement, section 62J.052, is amended to
read:
62J.052 PROVIDER COST DISCLOSURE.
Subdivision 1. Health care providers. (a)
Each health care provider, as defined by section
(1) the average allowable payment from private third-party payers for the
50 services or procedures most commonly performed;
(2) the average payment rates for those services and procedures for medical
assistance;
(3) the average charge for those services and procedures for individuals who
have no applicable private or public coverage; and
(4) the average charge for those services and procedures, including all
patients.
(b) This information shall be updated annually and be readily available at no
cost to
the public on site.
The Board has received a significant number of inquiries lately regarding decompression therapy. The Board has not currently taken a position with regard to this procedure. However, new on the scene is a superior court decision regarding the false advertising of this therapy, as well as a number of Board actions from other states. The Board will be reviewing these decisions and may incorporate them into any complaints received regarding such advertising. Follow links below to receive copies of the original decisions.
State of Oregon vs. Benjamin Altadonna, and Altadonna Communications Inc.
State of Oregon vs. Axiom Worldwide, Inc.
OWNERSHIP OF CHIROPRACTIC PRACTICES
Pursuant to a Minnesota Supreme Court decision, (September 15, 2005), the corporate ownership of chiropractic practices and employment of chiropractors MUST occur through a licensed chiropractor. This is known as the "Corporate Practice of Medicine Doctrine." There are certain exceptions, such as HMO's and hospitals.) In this decision, the Supreme Court cited a previous Iowa Supreme Court decision which discussed the notion of "learned professions." The Minnesota Supreme Court applied this concept to it's decision regarding the profession of chiropractic. (Interestingly, in this same decision, the Supreme Court also held that this doctrine did not apply to the professions of Physical Therapy, or Massage Therapy.) You may view or download the actual text of the decision.
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AUTHORITY OF CHIROPRACTORS TO PERFORM CERTAIN PHYSICAL EXAMS
In the mid 1990's, there was considerable controversy over the authority of doctors of chiropractic to perform certain types of examinations (e.g. truck driver physicals, bus driver physicals, and high school physicals.) This started with a narrowly focused opinion from an Attorney General representative giving an opinion to a state agency. The Board of Chiropractic Examiners took exception to this opinion, and requested a fully researched opinion (through Legislative research) to more fully explore this question. Over the next few years, this resulted in 3 opinions, all clarifying the broad authority of chiropractors to conduct these physical exam, with only a few, very narrow limitations (e.g. exams may not be done via invasive procedures, and X-rays were limited to the bones of the skeleton.) The three opinions were, in short, 1) the fully researched opinion by Robert Holley, Assistant Attorney General (2/21/1995); 2) a clarifying/confirming opinion by Lucinda Jesson, Deputy Attorney General, (4/28/1997); and finally a similar opinion regarding bus drivers physical exams from Alan Klein, Administrative Law Judge (Confirmed by Chief Administrative Law Judge Kenneth Nickolai) in January, 1998. Finally, Governor Jesse Ventura directed "the Departments of Transportation and Public Safety to follow the advice of the Attorney General and accept chiropractor's signatures." These opinions are available for review and download.
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As a result of a legislative error in 2007, a rule was deleted in it's entirety. The actual intent of this deletion was to allow doctors of chiropractic to accept any amounts in payment for their services as a result of another law that was passed. However, the Legislature inadvertently deleted the entire portion of the rule rather than just the relevent portion. Therefore, as a result of a Legislative repair in 2008, the following language has been reinstated:
Section 1. Minnesota Statutes 2006, section 148.10, is amended by adding a
subdivision to read:
Subd. 1a. Free or discounted examination or treatment. (a) Free or discounted
examinations must provide sufficient information to allow for a diagnosis and initiation
of treatment, with the exception of examinations clearly identified as for the purpose of
screening. Free or discounted chiropractic treatments shall be comparable to similar
nondiscounted chiropractic treatments.
(b) When using the word "free," or any other term with essentially the same meaning
in reference to delivering any service, examination, or treatment, the following statement
must be presented to the patient or guardian for signature and kept on file: "I understand
that one or more services provided have been or will be free of charge. Any subsequent
services provided will be provided at the fees that have been or will be explained to me."
This language replaces the former rule 2500.0500 and is effective immediately.
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Pursuant to Legislation occurring in the 2007 Legislative session, doctors of chiropractic may now accept any fee from persons or groups they deem appropriate under the circumstances. It appears that this means they can accept different fees from different persons even for the same services. This does not allow doctors of chiropractic to ignore or forgive payments related to insurance deductibles or co-pays. The text for this Legislation can be found in it's original form in Minnesota Session laws, 2007, Chapter 123, but is included with this link. It is most appropriately understood from the perspective of the language which was removed from the practice acts original language. (See strikeouts for removed language.) Please consult with your attorney if you have questions regarding this change.
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