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Chapter 9: CHIROPRACTORS
Subchapter 1: GENERAL PROVISIONS
§451. Definitions
1.
Chiropractic. "Chiropractic" means the art and science of
identification and correction of subluxation and the accompanying physiological
or mechanical abnormalities. The term subluxation, as utilized within the
chiropractic health care system, means a structural or functional impairment of
an intact articular unit. "Chiropractic" includes chiropractic
acupuncture. Chiropractic recognizes the inherent recuperative capability of
the human body as it relates to the spinal column, musculo-skeletal and nervous
system. [1999, c. 214, §1 (amd).]
1-A.
Chiropractic acupuncture. "Chiropractic acupuncture" means the
insertion of acupuncture needles through the skin at specific points. It is a
chiropractic methodology used for the correction of the soft tissue components
contributing to subluxation and the accompanying physiological or mechanical
abnormalities. Except as provided in section 502, chiropractic acupuncture may
only be practiced by a licensee who has received a chiropractic acupuncture
certification from the board. [1999, c. 214, §2 (new).]
2.
Chiropractic doctors. "Chiropractic doctors" are health care
providers functioning within their scope of practice as provided by this
chapter. [1983, c. 113, § 1 (new).]
3.
Chiropractic methodologies. "Chiropractic methodologies" utilized
for the identification or correction of subluxation and the accompanying
physiological or mechanical abnormalities include diagnostic, therapeutic,
adjustive or manipulative techniques utilized within the chiropractic
profession, excluding prescriptive medication or surgery. [1983, c. 113, § 1
(new).]
4.
Commissioner. "Commissioner" means the Commissioner of
Professional and Financial Regulation. [1989, c. 450, §8 (new).]
5.
Department. "Department" means the Department of Professional and
Financial Regulation. [1989, c. 450, §8 (new).]
§452. Application
of laws regarding reporting contagious diseases and deaths
All laws and rules regulating the
reporting of contagious diseases and deaths to the proper authorities and to
which the licensed practitioner of medicine is subject apply equally to the
practitioner of chiropractic. [1993, c. 600, Pt. A, §39 (amd).]
§453. Legally
licensed practitioners of other schools or professions not affected
This chapter may not be construed to:
restrain or restrict legally licensed physicians, surgeons, dentists,
osteopaths, physical therapists or nurses in the practice of their professions;
apply to masseurs in their particular sphere of labor who publicly represent
themselves as masseurs; apply to a commissioned medical officer in the United
States Army or Public Health Service in the performance of duties; or prohibit
gratuitous service or the rendering of assistance to emergency cases. [1993, c. 600, Pt. A,
§40 (amd).]
§454. Practicing
without license; fraudulent licenses
An individual who practices or attempts
to practice or use the science or system of chiropractic in treating diseases
of the human body; an individual who buys, sells or fraudulently obtains a
diploma, license or record to practice chiropractic, or who aids or abets in
that selling or fraudulent obtaining; ; an individual who practices
chiropractic, under cover of a diploma, license or record to practice
chiropractic, illegally obtained, or signed or issued unlawfully or under
fraudulent representations; or an individual who, after conviction of felony,
practices chiropractic, or who uses any of the forms of letters,
"Chiropractic," "Chiropractor," "Chiropractic
Practitioner," "Doctor of Chiropractic," "D.C." or any
other titles or letters, either alone or with qualifying words or phrases,
under circumstances that induce the belief that the individual who uses those
terms is engaged in the practice of chiropractic, without having complied with
this chapter, commits a Class E crime. This section may not be construed to
prohibit a lawfully qualified chiropractor in any other state meeting with a
licensed chiropractic practitioner in this State for consultation. [1993, c. 600, Pt. A,
§41 (amd).]
§455. Review
committee immunity
Any member of a peer review committee of
a state association composed of chiropractors licensed under this chapter, any
staff member of such an association assisting a peer review committee and any
witness or consultant appearing before or presenting information to the peer
review committee is immune from civil liability for, without malice, undertaking
or failing to undertake any act within the scope of the function of the
committee. [1987, c. 646, §7 (new).]
Subchapter 2: BOARD OF
CHIROPRACTIC LICENSURE (HEADING: PL 1993, c. 600, Pt. A, @42 (rpr))
§501. Membership;
qualifications; term; removal
The Board of Chiropractic Licensure, as
established by Title 5, section 12004-A, subsection 8, and in this chapter
called the "board," consists of 7 individuals appointed by the
Governor. These individuals must be residents of this State, 5 of whom must be
graduates of a legally chartered chiropractic school, college or university
having the power to confer degrees in chiropractic and must be, at the time of
their appointment, actively engaged in the practice of their profession for a
period of at least 3 years in this State. Two members must be representatives
of the public. Each appointment is for a period of 3 years. Appointments of
members must comply with section 60. A member of the board may be removed from
office for cause by the Governor. [1995, c. 397, §26 (amd).]
§502. Organization;
meetings; officers; seal; powers and duties
The board shall meet at least twice each
year at such times and places as its chair may designate to consider
applications, examine applicants and consider such other business as may
properly come before the board. At its first meeting in each calendar year, the
board shall elect one of its members as chair for a term of one year and one of
its members as secretary to hold office at the pleasure of the board. Special
meetings may be called at the pleasure of the chair and, in case of the death
or inability of the chair, the secretary may call special meetings. The board
shall keep correct records of all proceedings. The chair and secretary are
empowered to administer oaths in matters connected with the duties of the
board. The records, or duplicates of the records, must be open to inspection
and are prima facie evidence of all matters recorded in the records. Four
members of the board constitute a quorum for the transaction of business, but a
license to practice chiropractic may not be granted except on an affirmative
vote of at least 4 members of the board. The board has the power to make and
adopt rules and a code of ethics consistent with law necessary for the
enforcement of its authority, the performance of its duties and the governing
of the practice of chiropractic, but a rule or code of ethics may not be made
that is unreasonable or contravenes this chapter. The board shall adopt rules,
which are routine technical rules pursuant to Title 5, chapter 375, subchapter
II-A, authorizing and governing the use of chiropractic acupuncture by
certified licensees. The rules must set forth the requirements for chiropractic
acupuncture certification, which must include, but are not limited to, a
minimum number of classroom hours of education in acupuncture theory and
techniques; a component of supervised clinical acupuncture training or
documented clinical acupuncture experience for licensees practicing
chiropractic acupuncture prior to April 30, 1999; and instruction in exposure
control for blood-borne pathogens and registration as a biomedical waste
generator pursuant to Title 38, section 1319-O, subsection 3. Licensees who can
prove to the satisfaction of the board that they were engaged in the practice
of chiropractic acupuncture prior to April 30, 1999 may continue to practice
chiropractic acupuncture but must comply with all of the certification
requirements set forth in board rules within 2 years from the adoption of the
rules. In establishing the rules and code of ethics, the board must, in
addition to the standards set forth in this chapter, be guided by the following
standards setting forth conduct deemed unprofessional: [1999, c. 214, §3
(amd).]
1.
Fraud. The obtaining of any fee by fraud or misrepresentation, or the
practice of any deception or fraud upon a patient; [1973, c. 405, §3
(new).]
2.
Practice outside chiropractic. Offering health services outside the field
of chiropractic; [1973, c. 405, §3 (new).]
3.
Solicitation. [1977, c. 458, §1 (rp).]
4.
Advertising. Advertising in a false, misleading or deceptive manner. A rule
adopted pursuant to this section on advertising may not be inconsistent with a
rule adopted pursuant to Title 5, section 207, subsection 2; or [1993, c. 600, Pt. A,
§44 (amd).]
5.
Fee splitting. The splitting or dividing of a fee with an individual who is
not an associate licensed as a chiropractor. [1993, c. 600, Pt. A,
§45 (amd).]
§503. Complaints;
suspension or revocation of certificates (REPEALED)
§503-A. Disciplinary
actions
1.
Disciplinary proceedings and sanctions. The board shall investigate a
complaint, on its own motion or upon receipt of a written complaint filed with
the board, regarding noncompliance with or violation of this chapter or of a
rule adopted by the board. [1999, c. 547, Pt. B, §59 (amd); §80 (aff).]
The board shall notify the licensee of
the content of a complaint filed against the licensee as soon as possible. The
licensee shall respond within 30 days. If the licensee's response to the
complaint satisfies the board that the complaint does not merit further
investigation or action, the matter may be dismissed. [1999, c. 547, Pt. B,
§59 (amd); §80 (aff).]
If, in the opinion of the board, the
factual basis of the complaint is or may be true, and the complaint is of
sufficient gravity to warrant further action, the board may request an informal
conference with the licensee. The board shall provide the licensee with
adequate notice of the conference and of the issues to be discussed. The
conference must be conducted in executive session of the board, pursuant to
Title 1, section 405, unless otherwise requested by the licensee. Statements
made at the conference may not be introduced at a subsequent formal hearing
unless all parties consent. [1999, c. 547, Pt. B, §59 (amd); §80 (aff).]
If the board finds that the factual basis
of the complaint is true and is of sufficient gravity to warrant further
action, it may take any of the following actions it considers appropriate: [1999, c. 547, Pt. B,
§59 (amd); §80 (aff).]
A. With the consent of the licensee, enter into a consent
agreement that fixes the period and terms of probation best adapted to protect
the public health and safety and to rehabilitate or educate the licensee. A
consent agreement may be used to terminate a complaint investigation, if
entered into by the board, the licensee and the Attorney General's office;
[1993, c. 600, Pt. A, §46 (amd).]
B. In consideration for acceptance of a voluntary surrender of the
license, negotiate stipulations, including terms and conditions for
reinstatement, that ensure protection of the public health and safety and that
serve to rehabilitate or educate the licensee. These stipulations may be set
forth only in a consent agreement signed by the board, the licensee and the
Attorney General's office;
[1993, c. 600, Pt. A, §46 (amd).]
C. If the board concludes that modification or nonrenewal of the
license is in order, the board shall hold an adjudicatory hearing in accordance
with the provisions of the Maine Administrative Procedure Act, Title 5, chapter
375, subchapter IV; or
[1993, c. 600, Pt. A, §46 (amd).]
D. If the board concludes that suspension or revocation of the
license is in order, the board shall file a complaint in the District Court in
accordance with Title 4, chapter 5.
[1999, c. 547, Pt. B, §59 (amd); §80 (aff).]
2.
Grounds for discipline. The board may suspend or revoke a license pursuant
to Title 5, section 10004. The following are grounds for an action to refuse to
issue, modify, suspend, revoke or refuse to renew the license of an individual
licensed under this chapter: [1993, c. 600, Pt. A, §46 (amd).]
A. The practice of fraud or deceit in obtaining a license under
this chapter or in connection with service rendered within the scope of the
license issued;
[1983, c. 378, §4 (new).]
B. Habitual substance abuse that has resulted or is foreseeably
likely to result in the licensee performing services in a manner that endangers
the health or safety of patients;
[1993, c. 600, Pt. A, §46 (amd).]
C. A professional diagnosis of a mental or physical condition that
has resulted or may result in the licensee performing services in a manner that
endangers the health or safety of patients;
[1993, c. 600, Pt. A, §46 (amd).]
D. Aiding or abetting the practice of chiropractic by an
individual who is not licensed under this chapter and who claims to be legally
licensed;
[1993, c. 600, Pt. A, §46 (amd).]
E. Incompetence in the practice for which the licensee is
licensed. A licensee is considered incompetent in the practice if the licensee
has:
(1) Engaged in conduct that evidences a lack of ability or fitness
to discharge the duty owed by the licensee to a client or patient or the
general public; or
(2) Engaged in conduct that evidences a lack of knowledge or
inability to apply principles or skills to carry out the practice for which the
licensee is licensed;
[1993, c. 600, Pt. A, §46 (amd).]
F. Unprofessional conduct. A licensee is considered to have
engaged in unprofessional conduct if the licensee violates a standard of
professional behavior that has been established in the practice for which the
licensee is licensed;
[1993, c. 600, Pt. A, §46 (amd).]
G. Subject to the limitations of Title 5, chapter 341, conviction
of a crime that involves dishonesty or false statement or relates directly to
the practice for which the licensee is licensed, or conviction of a crime for
which incarceration for one year or more may be imposed;
[1993, c. 600, Pt. A, §46 (amd).]
H. A violation of this chapter or a rule adopted by the board; or
[1993, c. 600, Pt. A, §46 (amd).]
I. Engaging in false, misleading or deceptive advertising.
[1983, c. 378, §4 (new).]
§504. Annual
reports
The board shall annually on or before the
first day of July in each year make a report to the Commissioner of
Professional and Financial Regulation containing a full and complete account of
all its official acts during the preceding year, and a statement of its
receipts or suggestions as it may deem essential. [1985, c. 748, § 42
(amd).]
§505. Liaison;
limitations
The commissioner shall act as a liaison
between the board and the Governor. [1977, c. 604, § 12 (new).]
The commissioner shall not have the
authority to exercise or interfere with the exercise of discretionary,
regulatory or licensing authority granted by statute to the board. [1977, c. 604, § 12
(new).]
§506. License
expiration
All licenses expire biennially, beginning
on December 31, 1992 or at any other time the commissioner designates. [1995, c. 397, §27
(amd).]
Subchapter 3: LICENSURE
(HEADING: PL 1991, c. 392, @6 (rpr))
§551. Examination
and licensure
An individual, before engaging in the
practice of chiropractic in this State, shall make application for a license to
practice chiropractic to the board on a form prescribed by the board. The
application must be filed with the clerk of the board at least 30 days before
the date of examination, together with an application and examination fee. The
application fee is not refundable if an application is denied. Each applicant
must be at least 18 years of age and present proof of 2 years' satisfactory
attendance at a college of liberal arts. A candidate for licensure shall
present a transcript from an accredited college or university certifying that
the candidate has completed 2 years of preprofessional work, 2 subjects of
which must be English and biology, or otherwise satisfy the members of the
board that the candidate has acquired sufficient prior academic education. The
applicant shall present a diploma granted by a legally chartered chiropractic
college, school or university in good standing and having the power to confer
degrees in chiropractic, which diploma must show that it was granted on
personal attendance of the applicant and completion of a course of 4 school
years of not less than 8 months each and of a total of 4,400 60-minute school
hours. If an applicant matriculated in a chiropractic college on or after
January 1, 1984, the diploma must show that it was granted by a chiropractic
college accredited by a chiropractic educational accrediting agency approved by
the United States Department of Education or its successor agency or, if no
accrediting agency exists, approved by the board, or the applicant must have
evidence of having successfully passed a licensing procedure from another state
having similar requirements. If an applicant matriculated in a chiropractic
college before January 1, 1984, the diploma must show that it was granted by a
chiropractic college accredited as set out in this section, or the applicant
must present evidence of having become a diplomat of the National Board of
Chiropractic Examiners or of having successfully passed a licensing procedure
from another state having similar requirements. Each applicant must present a
certificate of good moral character signed by a reputable individual and any
other reasonable and proper facts the board may require in its application
form.
[1993, c. 600, Pt. A, §48 (amd).]
§552. Examination
of applicants; subjects included; license; license without examination
The board shall require the applicant to
submit to an examination that demonstrates qualifications for the practice of
chiropractic. The examination must include the subjects of anatomy, physiology,
symptomatology, hygiene, sanitation, chemistry, pathology, electrotherapy,
hydrotherapy, dietetics, bacteriology, chiropractic analysis, the principles
and practice of chiropractic as taught in reputable chiropractic schools and
colleges and any other subjects the board determines necessary. If the
examination is passed in a manner satisfactory to the board, the board shall
issue to the applicant a license granting that individual the right to practice
chiropractic in this State. [1993, c. 600, Pt. A, §49 (amd).]
An individual licensed by a chiropractic
board of any other state or territory having a standard equal to that of this
State may be licensed without examination upon the payment of a fee of $225 and
submission of a chiropractic diploma and proof of licensure in that other
state. The board may, in its discretion, require an examination of the
applicant. [1993, c. 600, Pt. A, §49 (amd).]
§553. Fees;
compensation and expenses (REPEALED)
§553-A. Licenses
renewal procedure; continuing education and fees
1.
Renewal procedure. The board shall notify every licensed chiropractor of
the expiration date of the chiropractic license and indicate the amount of the
fee required for biennial renewal. Notice must be mailed to each licensee's
last known address at least 30 days before the expiration date of that license.
An expired license may be reissued up to 90 days after the date of expiration
upon payment of a late fee of $10 in addition to the renewal fee. An individual
who submits an application for renewal more than 90 days after the license
expiration date is subject to all requirements governing new applicants under
this chapter, except that the board may, in its discretion and giving due
consideration to the protection of the public, waive examination if that
renewal application is made within 2 years from the date of that expiration.
The board may assess penalty fees for late renewals. [1993, c. 600, Pt. A,
§50 (amd).]
2.
Continuing education. The board shall require applicants for license
renewal to submit evidence of satisfactory completion of continuing education
in accordance with rules adopted by the board. [1991, c. 392, §10
(new).]
3.
Fees. Fees are established as follows: [1999, c. 386, Pt. E, §1 (amd).]
A. For the application, an amount set by the board not to exceed
$75;
[1999, c. 386, Pt. E, §1 (amd).]
B. For the examination, an amount set by the board not to exceed
$75;
[1999, c. 386, Pt. E, §1 (amd).]
C. For the initial license, an amount set by the board but no more
than $225; and
[1995, c. 502, Pt. H, §22 (amd).]
D. For the license renewal, biennially, an amount set by the board
but no more than $225.
[1995, c. 502, Pt. H, §22 (amd).]
All fees received by the board must be
paid to the Treasurer of State and used to carry out this chapter. Any balance
of these fees may not lapse but must be carried forward as a continuing account
to be expended for the same purposes in the following years. [1999, c. 386, Pt. E,
§1 (amd).]
§554. Display
of license; rights
When the board grants to an individual
the license mentioned in section 552, the license must designate the holder as
a doctor of chiropractic or a chiropractor and must be publicly displayed at
the individual's principal place of business so long as that individual
continues to practice chiropractic for gain or hire. The license entitles the
individual to whom it is granted to practice chiropractic in this State in all
of its branches of discipline, except obstetrics, so far as the same relates to
parturition,, the administering of drugs and the performance of surgical
operations with the use of instruments, except as allowed by law. This section
may not be construed to prohibit a legally licensed doctor of chiropractic in
this State from practicing surgery after having passed a satisfactory
examination before the State Board of Licensure in Medicine. [1993, c. 600, Pt. A,
§51 (amd).]
Subchapter 4: CHIROPRACTIC
ASSISTANTS (HEADING: PL 1991, c. 884, @1 (new))
§555. Assistants
This chapter does not prohibit an
individual from rendering ancillary diagnostic or therapeutic services as used
in chiropractic practice, other than the adjustive or manipulative techniques,
if those services are rendered under the supervision and control of a licensed
chiropractor as long as that individual has successfully completed a training
program recognized by the board. "Supervision and control" may not be
construed as requiring the personal presence of the supervising and controlling
chiropractor at the place where those services are rendered, unless physical
presence is necessary to provide patient care of the same quality as provided
by the chiropractor. This chapter does not prohibit a chiropractor from
delegating to an employee certain activities relating to the care and treatment
being performed by custom and usage when those activities are under the direct
control of and in the presence of the chiropractor. The chiropractor delegating
those activities to an employee, to a program graduate or to a participant in
an approved training program is legally liable for those activities performed
by such an individual and that individual is considered to be the
chiropractor's agent. [1993, c. 600, Pt. A, §52 (amd).]
§556. Certificates
An individual may not render ancillary
services under section 555 until that individual has applied for and obtained a
certificate of qualification or a temporary certificate issued by the board,
which must be renewed biennially. The board shall adopt rules regarding the
training and certification of individuals permitted to render ancillary
services under section 555. [1993, c. 600, Pt. A, §52 (amd).]
§557. Termination
of certificate
The sanctions of section 454 apply to
individuals who render any ancillary services under section 555 and who: [1991, c. 884, §1
(new).]
1.
Misrepresentation. Profess to be or permit themselves to be represented as
licensed chiropractors; [1991, c. 884, §1 (new).]
2.
Nonsupervision. Perform other than at the direction and under the
supervision of a chiropractor licensed by the board; or [1991, c. 884, §1
(new).]
3.
Inadequate training. Perform a task that they have not been trained or are
not clinically competent to perform. [1991, c. 884, §1 (new).]
§558. Fees
The board shall establish by rule an
application fee that is reasonable and necessary for its purpose and a biennial
certification renewal fee not to exceed $50. [1995, c. 502, Pt. H,
§23 (amd).]