Chiropractic care is considered a form of alternative medicine, so it is stringently regulated in California by the California Board of Chiropractic Examiners (BCE). The BCE upholds rules that all licensed chiropractors must follow to continue practicing their profession legally. That means that even a simple mistake that violates these rules can lead to you losing your license. You want to consult a lawyer as soon as you learn that the BCE is investigating your license.
At San Francisco License Lawyer, we represent chiropractors facing disciplinary action from the BCE. With our in-depth experience in license defense, we can help you protect your career and livelihood and ensure the best possible outcome for your case. Do not hesitate to call us if you are facing legal trouble.
Allegations Against Chiropractors
In addition to being board-licensed, chiropractors in California are mandated to complete a 4-year Doctor of Chiropractic degree. This is a process that requires years of meticulous study, stress, dedication, and, finally, the desire to assist others genuinely and alleviate their suffering. Regardless of all this, it takes only a single mistake or misstep to face disciplinary action by the BCE, which seeks to punish the license you have worked so tirelessly to acquire. Some of the reasons for which the BCE may seek to revoke your license include the following:
- Fraud, including insurance fraud, Medical or Medicare fraud,
- Improper or poor recordkeeping, or making intentional changes
- A criminal conviction or charge of a crime substantially related to chiropractic practice.
- Substance abuse or Impairment issues
- Sexual misconduct
- Unprofessional conduct
- Incompetence and negligence in client care and treatment
- Undisclosed criminal records
- Misleading, deceptive, or false advertising
- Unlicensed practice
- Failure to satisfy continuing education requirements
- Disciplinary action imposed by another state
- Practicing beyond the scope of your license
- Inability to practice chiropractic care with reasonable safety and skill
- Improper delegation of duties or failure to supervise
- Violations of medical records
- Performing services not authorized by a patient
The BCE classifies the above violations into four primary categories: categories I, II, III, and IV.
- Category I includes relatively minor wrongdoings. These include failure to supervise, failure to inform the board of a change of business address, failure to post your practice license correctly, and failure to give patients their medical records when requested.
- Category II contains somewhat serious violations, which show a significant disregard for ethics, public safety, or the law. Examples include breach of patient confidentiality and failure to attend your administrative proceedings for another violation.
- Category III includes severe violations. Examples are practicing beyond the scope of your license, sexual misconduct, negligence, substance abuse, a criminal conviction for a crime related to chiropractic practice, and failure to refer a patient to the appropriate medical provider when you should have.
- Category IV carries the most severe violations that almost always lead to license revocation. These violations are not different from those under Category III, but they are nevertheless more egregious.
The BCE Role In Chiropractic Care In California
The BCE is part of the Department of Consumer Affairs (DCA). It is the body that regulates the chiropractic profession in California. It protects the public from unlicensed and licensed individuals engaged in the negligent, incompetent, or fraudulent chiropractic practice. This board oversees about 14,000 license holders and nineteen chiropractic colleges and schools located in the U.S. and Canada.
The BCE is governed by a 7-member board appointed by the Governor. It comprises five licensed doctors of chiropractic and 2 members representing the general public. Members of the board serve 4-year terms. The BCE has an executive officer who leads a staff responsible for licensing, enforcement, administration, continuing education, and other regulatory responsibilities. That said, to regulate the practice of chiropractic care in California, the BCE has the following functions:
- Licensing qualified practitioners and denying licenses to those unqualified
- Enforcing professional standards via complaint investigation and discipline
- Setting educational standards for chiropractic schools and colleges, and enforcing continuing education to maintain licensure
- Administering the California Chiropractic Law Examination (CCLE) to ensure competence
- Permitting consumers to verify the license status of a chiropractor to ensure they are in good standing.
- Enforcing the California Code of Regulations, California Business & Professional Code, Chiropractic Initiative Act, and other relevant regulations and laws governing chiropractors.
Remember, as a chiropractor, the board is not on your side. Its mission is to protect public safety and health. So, should you find yourself in any trouble that jeopardizes your license, the board will not protect you. Instead, it will seek to revoke your license. When in this situation, you want to hire a healthcare license defense lawyer as soon as possible, since only they can help you.
The BCE Complaint Process
It is upon the BCE to act accordingly when it receives a formal complaint against a chiropractor or chiropractor applicant. A complaint against a chiropractor can come from any party, including a former or current patient, an employer, a law enforcement agency, a patient’s family member, another board, or anyone else with an issue against the chiropractor’s practice. When the BCE receives a complaint against you, it will review it to ensure it is relevant to the board’s jurisdiction. If so, it will send the complaint to the investigative division for further investigation.
When the board’s investigative division initiates an investigation into the complaint against you, the investigator will send you a notice of the complaint and of the investigation, accompanied by a request for an interview or information. Note that each case is unique. However, if the board investigator requests an interview with you or information, it is wise to consult a lawyer first before you respond.
Providing any evidence or documents, answering questions, or agreeing to do anything else the investigator wants without legal advice can jeopardize your license even more. As a license holder, you have essential constitutional and statutory rights, and promptly seeking counsel from a lawyer skilled in healthcare license defense helps safeguard your career and reputation.
At the end of the investigation, the board may take various actions based on the investigation outcome. If there is insufficient evidence to proceed with the case and prove that you committed a violation, the board may close the case, meaning you will be free to continue to practice. If the investigation shows you committed a violation, but it was only minor, the board may issue a citation and fine against you or any other lesser form of disciplinary action. And if the investigation finds you committed a severe violation and there is sufficient evidence to proceed, the board will refer the case to the California Office of the Attorney General for official disciplinary proceedings.
The Office of the Attorney General will seek to revoke your license if you are a licensee or to deny you one if you are a new applicant.
When your case reaches the Office of the Attorney General, a Deputy Attorney General or the Attorney General themself may bring an Accusation or Statement of Issues against you. An Accusation will apply if you already have a license, while a Statement of Issues is applicable if you are a chiropractic license applicant. Either of these documents initiates an official hearing process per the California Administrative Procedures Act. In addition to disciplining your license, the BCE will seek to recover all prosecution and Investigative costs.
Once the Attorney General’s Office files either of the mentioned documents, it will send you a notice. You have 15 days from the date you receive this notice to make your intentions of defending your license known. As such, you are required to respond to the notice by filing a Notice of Defense. This is a document that notifies the board and the Attorney General’s Office that you intend to challenge the allegations against you and retain your license. If you do not file it within 15 days, the board will take it that you do not intend to defend your license. Therefore, the board will issue a default order, which will lead to the automatic revocation of your chiropractic license.
On the other hand, if you show the intention to challenge the case against you, the Attorney General’s Office will schedule an administrative hearing in one of the Office of Administrative Hearings locations in Los Angeles, San Diego, Sacramento, or Oakland. Administrative hearings are conducted similarly to a criminal court trial. However, the jury is usually not present. An Administrative Law Judge (ALJ) conducts the hearings. You and the board, through the Attorney General, will present your cases, including submitting evidence and calling witnesses.
When the hearing concludes, the ALJ will have 30 days to send their proposed decision to the board. If you are guilty of the allegations against you, the decision will include a recommendation on the kind of discipline the judge thinks the board should impose. The board then has the authority to adopt, modify, or reject the judge’s recommendation and impose its own disciplinary action.
Board Disciplinary Actions Against Chiropractors
When determining what kind of disciplinary action to impose against a chiropractor found to have violated the law, the BCE considers various factors, including the following:
- Potential or actual harm caused to the general public
- Potential or actual harm to any consumers
- Previous warnings of record
- Past disciplinary record, including level of compliance with disciplinary orders
- Variety or number of present violations
- Severity and nature of the act, offense, or violation under consideration
- Evidence of rehabilitation
- Mitigating evidence
- Adherence to the terms of any criminal sentence
- General criminal record
- The time that has passed since the commission of the violation
- Whether the violation was negligent, intentional, demonstrated incompetence, or if you are being held to account for an act committed by someone else, whether you knew about or consciously participated in the act
- The financial gain you obtained from the misconduct
After considering all of the above factors, the board can impose various disciplinary actions. These include the following:
- License revocation. Here, you will lose your license indefinitely and will not be able to practice for the entire period. This is the severest form of discipline by the board.
- License suspension. In a license suspension, you will lose your practice license for a specific period. Once this period is over, the board can reinstate the license, and you can resume your practice.
- Interim suspension. This form of discipline is imposed during an investigation into your case. It bars you from practicing while the investigation is ongoing. The board usually imposes this disciplinary action if the allegations against a licensee are more severe and their continued practice will pose a threat to the public.
- License probation. If the board imposes a probation sentence, you can continue practicing provided you comply with the conditions.
- Public reprimand. A reprimand letter simply warns you not to continue or repeat the violation against you. However, it is a public record posted on the board’s website and may harm your career, as patients and employers can see it.
If you disagree with the outcome of the hearing, you can appeal to the Superior Court. If you do not agree with the Superior Court’s outcome, you can move to the Court of Appeal, and then to the California Supreme Court if you are still not satisfied with the outcome. Note that no new arguments or evidence are introduced during the appeal process. The judge reviews the ALJ’s ruling to determine whether the ALJ made any mistakes.
Find an Expert Healthcare License Defense Lawyer Near Me
If you are a chiropractor and receive notice of an investigation against your practice license from the BCE, you need a skilled healthcare license defense lawyer by your side. The consequences of a license investigation can be devastating, potentially resulting in an official Accusation seeking to revoke your license and criminal charges. You might think you can handle the investigation yourself or that ignoring the matter will make it go away. However, the situation may become more complicated, jeopardizing your license, practice, and livelihood even more. You want a lawyer to help defend your interests.
At San Francisco License Lawyer, we can determine the best course of action for your situation and provide an understanding, proactive approach to the allegations threatening your license. If you are being investigated or a formal Accusation has already been filed, please call us promptly at (415) 496-2811 for an expert defense.
