AGENDA - District Meeting - Federation of Chiropractic ...

Arrive at your leisure. Optional University of Western States Tour and Reception - 5 PM, transportation provided. Return for dinner on your own.

Friday, September 20, 2013 - 8:00 AM Breakfast

8:30 AM GREETINGS AND OPENING REMARKS - FCLB Directors

Tell your story! INTRODUCTIONS AND INDIVIDUAL BOARD REPORTS# Recent achievements and current concerns

PowerPointPresentation

FCLB BOARD REPORTOVERVIEW OF YOUR FEDERATION

About Your FederationFCLB ServicesFinancial ReportUpcoming Meeting: Myrtle Beach – 2014

ROUNDTABLE DISCUSSIONS - BY TOPIC

1. DISCIPLINARY TOPICS - small group breakouts, focus on your areas of interest

1 # Tracking felony convictions - how do you know?

2 # Publishing disciplinary actions - active distribution vs. posting

3 # Car accidents: kickbacks, patient solicitation, staged accidents

4 # Does intent matter?

5 # FDA and discipline: human chorionic gonadotropin (hCG) / other hormonal ornutraceutical programs, failure to deliver results as promised

6 # Misrepresentation of chiropractic efficacy / one size fits all treatment programs

7 # Investigative files: HIPAA and patient confidentiality

8 # Injunctions against practice without a license: neurological balance technician

9 # Notification of malpractice settlements

10 # Social media - licensee guidance and enforcement

Discussion: Hot Issues in Chiropractic Regulation & Professional Governance

3:00 - 9:00 PM: Exclusive Top Oregon Wineries tour and dinner, $85 per person. Your host: Dr. Daniel Côté

09/16/2013 AGENDA 2013 Districts I & IV Regional Meeting

Federation of Chiropractic Licensing BoardsRegistration fee: $295 per person

Agenda subject to change

2013 FCLB Regional Meeting Agenda - p. 1 of 3

Saturday, September 21, 2013 - 8:00 AM Breakfast / 8:30 AM Meeting Begins

Discussion Hot Issues in Chiropractic Regulation Continues & Professional Governance

2. GENERAL REGULATORY ISSUES - Breakouts

1 # Regulation of Chiropractic Assistants - use of the CCCA - see Brochure

2 # What constitutes proper supervision of clinical assistants?

3 # Social legislation - the board as a hammer

4 # International Mobility: Role of the accrediting bodies

5 # Confidence in other countries’ discipline

6 # Rehabilitative options

7 # Informed consent

8 # Scope issues: dry needling, MUA, animal care

9 # Military service and regulation

10 # Cultural competency

11 # June 2013 OIG Report - Chiropractors prescribing schedule drugs

12 # Advertising requirements: Minnesota’s constitutional challenge

3. BOARD OPERATIONS: IS YOUR BOARD THRIVING OR SURVIVING? - Breakouts

1 # Managing the public comments section of the board meeting

2 # Who speaks officially for the board? Clear policies?

3 # Managing the cost of appeals

4 # Does the board have adequate administrative support?

5 # Training and continued development of board members

6 # Best practices in website information and management

7 # Public accountability - not just for Sunset

8 # Creating a useful long range plan

9 # Building healthy relationships with associations


REPORTS FROM OTHER ORGANIZATIONS & COMMITTEES 4. FCLB Model Practice Act Task Force

# Presentation - Dr. LeRoy Otto, FCLB President

5. NATIONAL BOARD OF CHIROPRACTIC EXAMINERS

# Presentation - NBCE Directors: Drs. Daniel Côté & Ron Tripp

6. ACCREDITATION

# Update

7. CHIROPRACTIC BOARD ADMINISTRATORS

# Current Initiatives

8. FEDERATION OF ASSOCIATIONS OF REGULATORY BOARDS (FARB)

# What is FARB? Programs and Resources - Report from Donna Liewer

9. COUNCIL ON CHIROPRACTIC GUIDELINES & PRACTICE PARAMETERS (CCGPP)

# Report from Dr. Albert Stabile (NJ), FCLB Appointee

10. US NATIONAL DATABANKS - NPDB, HIPDB

# Report from Donna Liewer, FCLB Representative on NPDB Executive Committee

11. INTERNATIONAL PERSPECTIVES

# What’s happening with our member boards around the world?

REGULATION IN THE NEWS # Interesting articles - read these at your leisure

NEW BUSINESS

FUTURE FCLB EDUCATIONAL MEETINGS

# ANNUAL CONFERENCE:

Spring 2014 – Myrtle Beach, South Carolina - April 30 - May 4, 2014Spring 2015 – New Orleans, Louisiana

# DISTRICT REGIONAL MEETINGS:

Fall 2014 – __________________________________

Fall 2015 – __________________________________

UPCOMING MEETINGS / AFFILIATED ASSOCIATIONS & ORGANIZATIONS

Refer tolast pages

# Alphabet Soup - our popular reference of other organizations and their scheduled meetings


Membership OverviewThis section is designed to help you understand some of the basics involved in Federation membership. Please feel free to contact any member of the Federation's Board of Directors or staff with any questions.

What is the purpose of the Federation?

As the only international professional association ofchiropractic regulatory boards, the FCLB wasestablished in 1926 to provide education,networking, and informational support for itsmembers.

The Certificate of Incorporation outlines the purposesin detail. Our mission statement further defines theorganization:

Protecting the public by promoting excellence

in chiropractic regulation through service to our member boards

How does the governing structure of theFederation work?

The board of directors totals ten people.

There are five district directors and four officers(President, Vice President, Treasurer and ImmediatePast President).

The Executive Committee consists of the electedBoard Chair (one of the five district directors) and thefour officers.

Beginning in 2002, the membership also added a seat for a board administrator (Administrative FellowDirector) elected by the membership as a wholeduring the annual business meeting.

Elections for the district directors are held at theSaturday morning breakfast caucus of the districts atthe spring conference. The officers andAdministrative Fellow director are elected by themembership at large during the annual businessmeeting at the spring conference.

District directors serve for up to two three-yearterms. The President, Vice President and Treasurermay serve for one two-year term in that office. TheAdministrative Fellow Director may serve up to twothree-year terms.

Who are the members? Who votes?

Each member licensing board has one vote, to becast by either the delegate (or in that person'sabsence, the alternate). Boards designate theirdelegate and alternate at least 30 days prior to theannual business meeting. The delegate andalternate must be a Fellow or Administrative Fellow.

The chiropractic colleges, state, provincial, ornational associations, and interested individuals arewelcome to participate in FCLB projects on a non-voting basis.

Attendance at the annual business meeting is opento all who have registered for the annual conference.

What deadlines do I need to be aware of?

# Bylaws - proposals for bylaws changes needto be postmarked to the executive offices nolater than 90 days before the annual meeting.

# Registration of Delegates - must bepostmarked no later than 30 days before anyofficial meeting (generally district and annualmeetings).

# Resolutions - must be received in properformat by the Resolutions Committee no laterthan 8:00 AM the day before the annualmeeting.

What happens at the regional District meetings inthe fall?

Although these are generally informal networkingoccasions, official business may includerecommendation of resolutions to come before theFederation as a whole.

The districts are not separate organizations, so theydo not pass policies that apply only to themselves. However, they may assist one another with regionalconcerns, and may function as small groups tobrainstorm ideas and raise concerns for themembership to deal with at the annual meeting.

How does the FCLB work with other chiropracticorganizations?

Where the Federation is ultimately charged withassisting the licensing boards to protect the health,safety and welfare of the public, other chiropracticorganizations have purposes which mesh nicely withour goals.

For example, in the US, the national professionalassociations advocate for chiropractic, the NationalBoard of Chiropractic Examiners is responsible forUS examination and testing, and the Council onChiropractic Education handles US educationalaccreditation issues. Increasingly, FCLB is interestedand active in international issues as well.

Where does FCLB get money to operate?

Member boards pay dues which equal about 10% ofthe annual budget. Commercial subscriptions andaccess fees to CIN-BAD’s databases add roughlyanother 15%.

Additional support comes from the nationalprofessional associations, NBCE, and various special projects grants such as longstanding supportof CIN-BAD by NCMIC Insurance Co. Finally, theannual conference sometimes generates a smalloperating surplus thanks to our generous supporters,as does sale of FCLB publications.

How do I submit a resolution?

Robert's Rules of Order describes the proper formatfor resolutions, or you may contact any member ofthe FCLB board or staff for samples. It is importantto present the context of a resolution, so the"whereas" parts are vital.

Resolutions can come from groups or individuals,and should be sponsored by one or more memberboards. They can be submitted any time during theyear, but no later than 8:00 a.m. the day before theannual meeting. This is to allow the Resolutions &Bylaws Committee adequate time to review theresolution, to suggest clarification if required, and topresent its opinion on the resolution to themembership.

The Board of Directors may also need to reviewresolutions which have potential financial impact inorder to advise the Resolutions & Bylaws Committeewhether sufficient resources are available to take onsuggested projects.

How do I get to be on a committee?

Committee Chair appointments are made by thePresident annually in January. Memberrecommendations are made by Chairs, pendingPresidential approval. Appointments to standingcommittees require the approval of the Board. The President often seeks courtesy approval for allappointments. Additional requirements in thebylaws, such as Fellow or Administrative Fellowstatus, may also govern appointments.

To submit your name for consideration, use one ofthe committee interest forms, or discuss yourinterests with the President personally. Please bearin mind that there are usually more people interestedin committees than there are openings. ThePresident must also consider factors such asgeographical balance, minority representation, etc.

(A committee appointment protocol procedure hasbeen adopted by the FCLB Board to guide fair andequitable committee appointments.)

How do I help my board become more involvedwith national and international issues?

Discuss some of the interesting questions whichcome up at the FCLB meetings. Encourage newmembers of your board to attend.

Many people pay their own way to conference whentheir government reimbursement dollars arerestricted or denied. Significant changes in thechiropractic profession happen most often throughthe regulatory boards. Ours is a relatively small“family” where each good idea can make a realdifference.

Contact us...

Federation of Chiropractic Licensing Boards

5401 W. 10th Street, Suite 101Greeley, CO 80634

970-356-3500 • FAX 970-356-3599

www.fclb.org

[email protected]

FBI Field Offices

Field Office Field SSA Phone/Fax Field Office Field SSA Phone/FaxAlbany (AL) Brian P. Jacob (518) 431 7439 Miami (MM) Randall Culp (305) 957 7412

16100 (Acting) (518) 431 7314 16133 (305) 787 6436Albuquerque (AQ) Javier Almodovar (505) 889 1530 Joseph Jeziorski Jr (305) 787 6478

16101 (505) 889 1765 (305) 787 6337Anchorage (AN) Wayne Schaltenbrand (907) 265 8104 Milwaukee (MW) George R. Strong (414) 291 4230

16102 (907) 265 8400 16134 (414) 291 4888Atlanta (AT) James 'Mark' Harless (404) 679 1440 Minneapolis (MP) Richard A. Waller (612) 376 3355

16103 (404) 679 1430 16135 (612) 376 3433Baltimore (BA) Adam Drucker (410) 277 6305 Mobile (MO) Lawson B. Allen (251) 219 3502

16104 (410) 277 6654 16136 (251) 219 3517Birmingham (BH) Patricia Thompson‐James (205) 279 1442 Newark (NK) Sean Keyes (973) 792 7250

16105 (205) 279 1230 16137 (973) 792 3145Boston (BS) Christine O'Neill (617) 223 6371 New Haven (NH) Katherine Sullivan (203) 503 5232

16106 (617) 223 6025 16138 (203) 503 5136Buffalo (BF) Steven Halter (716) 843 5220 New Orleans (NO) David H. Steed (504) 816 3004

16107 (716) 843 4329 16139 (Acting) (504) 816 3154Charlotte (CE) Scott B. Cheney (704) 672 6540 New York (NY) Michael N. Rosanova (212) 384 2880

16109 (704) 672 6797 16140 (212) 384 8403Chicago (CG) Suzanne Beckerman (630) 577 1604 John J. Casale (212) 384 3600

(Acting) (630) 577 3410 (212) 384 8413Cincinnati (CI) Robert W. Warfel (513) 562 5703 Norfolk (NF) Michael Dashiell (757) 455 2555

16111 (513) 562 5613 16143 (757) 455 2514Cleveland (CV) Justin Shammot (216) 622 6804 Oklahoma City (OC) Julie Reid (405) 290 3670

16112 (216) 622 6831 16144 (405) 713 4046Columbia (CO) Christopher Garrett (803) 214 5630 Omaha (OM) Robert Georgi (402) 530 1268

16113 (Acting) (803) 214 5640 16145 (402) 530 1581Dallas(DL) Kevin M. Sheridan (972) 559 5153 Philadelphia (PH) Stephen J. Heaney (215) 418 4310

16114 (972) 559 5609 16146 (215) 418 4518Denver(DN) Douglas S. Oliver (303) 630 6540 Phoenix (PX) David A. Condo (623) 466 1014

16115 (303) 630 6539 16147 (623) 466 1488Detroit (DE) Maureen Reddy (313) 237 4230 Pittsburgh (PG) Steven Busching (412) 432 4005

16116 (313) 237 4362 16148 (412) 432 4013El Paso (EP) Sergio Barrio (915) 832 5066 Portland (PD) Matthew B. Floyd (503) 460 8271

16118 (915) 832 5259 16150 (503) 460 8286Honolulu (HN) George Glorioso (808) 566 4415 Richmond (RH) Sherri Onks (804) 627 4404

16120 "Tom" (808) 566 4470 16152 (Acting) (804) 627 4496Houston (HO) Elvis McBride (713) 936 8700 Sacramento (SC) Daniel Bryant (916) 977 2211

16121 (713) 936 8953 16153 (916) 977 2533Indianapolis (IP) Bradley Bookwalter (317) 845 4800 St. Louis (SL) Mark R. Aldrich (314) 589 2531

16122 (317) 845 7105 16154 (314) 589 2636Jackson (JN) Jim Shorter (601) 713 7604 Salt Lake City (SU) Michael Pickett (801) 579 4675

16123 (Acting) (601) 713 7550 16155 (801) 579 4697Jacksonville(JK) Byron Thompson (904) 248 7056 San Antonio (SA) Luis Carrillo (210) 650 6290

16124 (Acting) (904) 248 7424 16156 (210) 650 6292Kansas City (KC) Kelly Sallee (816) 512 8311 San Diego (SD) David Borunda (858) 653 4240

16125 (Acting) (816) 512 8562 16157 (858) 653 4212Knoxville (KX) Thomas J. Bailey (865) 602 7006 San Francisco (SF) Francine Gross (415) 553 7562

16126 (865) 602 7036 16158 (415) 575 5005Las Vegas (LV) Scott W. Hunter (702) 584 5601 San Juan (SJ) Sherie Rebollo (787) 754 6000

16127 (702) 584 5644 16159 (787) 277 2104Little Rock (LR) Kimberly F. Brunell (501) 228 8477 Seattle (SE) Aimee Richardson (206) 262 2244

16128 (501) 228 8531 16161 (206) 262 2149Los Angeles (LA) Robin McIlroy (310) 996 3863 Springfield (SI) Sue Ellen Clark (217) 353 4147

16129 (310) 996 3998 16162 (217) 353 4174Matthew McLaughlin (310) 996 3420 Tampa (TP) Andrew Sekela (813) 253 1001

(310) 996 3998 16163 (813) 253 1468Louisville (LS) Timothy Beam (502) 263 6037 WFO Darlene Hoyns (703) 686 6190

16130 (502) 263 6245 (703) 686 6191Memphis (ME) Michael R. Johnson (901) 747 9536 Eddie A. Winkley (202) 278 2054

16131 (901) 747 9525 (202) 278 2598

9:22 AM Updated on 8/15/2012

Federation of Chiropractic Licensing Boards

BYLAWS

Amended May 2012

ARTICLE I. NAME

The name of this organization is the Federation of ChiropracticLicensing Boards (also referred to as the “Federation” or“FCLB”).

ARTICLE II. PURPOSE

The Federation is organized for charitable and educationalpurposes to provide programs and services that assist memberchiropractic licensing boards to fulfill their statutory obligations toregulate the profession in the interest of public protection and forthe purpose of lessening the burdens of government.

These programs and services shall include, but not be limited to,those that promote uniform standards among licensing boards,examination and testing services, and chiropractic educationalprograms leading to the Doctor of Chiropractic degree,postgraduate chiropractic education, diplomate and certificationprograms, and continuing education for relicensure purposes.

ARTICLE III. DEFINITIONS

Section 1. Federation or FCLB.

"Federation" or “FCLB” means the Federation of ChiropracticLicensing Boards.

Section 2. Chiropractic Licensing Board

“Chiropractic Licensing Board” means the governmental agencyempowered to credential and regulate the practice ofchiropractic within established jurisdictions, territories, or insularpossessions of a sovereign country.

Section 3. Member Board.

"Member Board" means any Chiropractic Licensing Board thathas met the requirements of membership and has been dulyaccepted into the Federation pursuant to these Bylaws.

Section 4. Fellow.

“Fellow” means any individual currently serving on a MemberBoard.

Section 5. Administrative Fellow.

“Administrative Fellow” means the individual who administers theMember Board, its chiropractic regulatory act and/or otheractivities of the Member Board, and is designated as such inwriting by the Member Board in accordance with policies set bythe Board of Directors.

Section 6. Honorary Fellow.

“Honorary Fellow” means an individual who has been a Fellowfor three (3) or more years, is no longer serving on a MemberBoard, and who has submitted an application to the Federationrequesting recognition as an Honorary Fellow.

Section 7. Delegate.

"Delegate" means an individual designated by a Member Boardto serve as its representative to the Federation. This individualshall be a Fellow of the Member Board, or an Honorary Fellowwho has served on that board in the preceding five (5) years, orthe Member Board’s Administrative Fellow. Delegates must beproperly registered in writing in accordance with policies set bythe Board of Directors.

Section 8. Alternate Delegate.

"Alternate Delegate" means an individual designated by aMember Board to serve as its representative to the Federation inthe absence of the Delegate. This individual shall be a Fellow ofthe Member Board, or an Honorary Fellow who has served onthat board in the preceding five (5) years, or the MemberBoard’s Administrative Fellow. Alternate Delegates must beproperly registered in writing in accordance with policies set bythe Board of Directors.

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Section 9. Delegate Assembly.

"Delegate Assembly" means the governing body that iscomprised of the Member Boards.

Section 10. Professional Member.

"Professional Member” means a Fellow or Honorary Fellow whois a currently licensed doctor of chiropractic authorized by aMember Board to practice chiropractic in that jurisdiction.

Section 11. Public Member.

"Public Member" means a Fellow or Honorary Fellow whoserves as the public member of a Member Board as definedunder applicable state law.

Section 12. Quorum.

“Quorum” means the minimum number of members who mustbe present for the FCLB to legally transact business.

A. Annual or Special Meeting

For purposes of the Annual or Special Meeting of theDelegate Assembly, quorum means Delegatesrepresenting a majority of the Member Boards.

B. District Caucus

For purposes of the District Caucuses quorum means thenumber of Delegates in attendance at such District Caucus,irrespective of the number.

C. Board of Directors Meeting

For purposes of the Board of Directors Meetings, quorummeans a majority of the Board of Directors.

Section 13. Board of Directors.

The “Board of Directors” means those members duly electedunder Article V of these Bylaws.

Section 14. Officers.

“Officers” means those Officers duly elected under Article V ofthese Bylaws.

Section 15. District Directors.

“District Directors” mean those Board of Directors members dulyelected under Article V of these Bylaws.

Section 16. Alternate District Directors.

“Alternate District Directors” mean those individuals duly electedunder Article V of these Bylaws to serve in the absence of theDistrict Director.

Section 17. Administrative Fellow Director.

“Administrative Fellow Director” means the Board of Directorsmember duly elected under Article V of these Bylaws.

Section 18. Board Chair.

“Board Chair” means the District Director duly elected by theBoard of Directors under Article VII of these Bylaws.

Section 19. Executive Committee.

“Executive Committee” means the Immediate Past President,President, Vice President, Treasurer, and Board Chair.

Section 20. Notices.

All written notices and documents required by these Bylawsmean by postmarked mail or received by electronic means at theprinciple office of the Federation by the specified deadline.

ARTICLE IV. MEMBERSHIP

Section 1. Admittance to Membership.

A Chiropractic Licensing Board that meets the criteria formembership in these Bylaws may be admitted into theFederation as a Member Board and assigned to a District bymajority vote of the Board of Directors.

Section 2. Rights and Privileges.

A Member Board that is current on its payment of membershipdues shall be entitled to be represented by one voting Delegateand one Alternate Delegate, who shall be registered inaccordance with policies established by the Board of Directors.

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Section 3. Federation Districts.

A. Member Boards shall be divided into five (5) Federation Districts based on the following list:

District I District II District III District IV District VCanada Canada Canada Australia United States

Alberta Manitoba New Brunswick Mexico Alabama British Columbia Ontario Newfoundland/ New Zealand Arkansas Saskatchewan United States Labrador United States Florida

United States Illinois Nova Scotia Arizona Georgia Alaska Indiana Prince Edw. Isl. California Louisiana Idaho Iowa Quebec Colorado Mississippi Montana Kentucky United Kingdom Hawaii North Carolina Nebraska Michigan United States Kansas South Carolina North Dakota Minnesota Connecticut Nevada Tennessee Oregon Missouri Delaware New Mexico Virginia South Dakota Ohio District of Columbia Oklahoma West Virginia Washington Wisconsin Maine Texas U.S. Territories Wyoming Maryland Utah Puerto Rico

Massachusetts U.S. Territories U.S. Virgin Islands New Hampshire Guam New Jersey New York Pennsylvania Rhode Island Vermont

B. Chiropractic Licensing Boards duly admitted into Federation membership under Article IV shall be placed into a respective Districtand such admittance and placement into a District shall not constitute an amendment to these bylaws subject to Article XVI.

Section 4. Sanction or Termination of Membership of aMember Board

A. Grounds

The membership status of a Member Board may besanctioned or terminated if it is determined to be in thebest interest of the Federation.

B. Process

The Member Board shall be sanctioned or terminated by arecommendation from the Board of Directors followed by atwo-thirds vote at an Annual or Special Meeting of theDelegate Assembly. Written notice of the sanction ortermination to be considered and the cause for this actionshall be sent to the Member Boards not less than sixty (60)days prior to the meeting. The Member Board in questionshall have the opportunity to be heard at the meetingbefore a vote is taken on the sanction or termination.

C. Rights

After a vote for termination, all rights of the Member Boardas provided in these Bylaws shall cease immediately.

Section 5. Reinstatement of Membership.

Upon reapplication and compliance with the conditions set forthin the sanction or termination of membership, reinstatement maybe granted by a majority vote of the Board of Directors and bytwo-thirds vote of the Delegates at an Annual or Special Meetingof the Delegate Assembly. Written notice that reinstatement is tobe considered shall be sent to the Member Boards not less thansixty (60) days prior to the Annual or Special Meeting.

Section 6. Sanction or Termination of a Fellow, HonoraryFellow, or Administrative Fellow.

A. Grounds

Failure to demonstrate proper conduct may serve asgrounds for sanction or termination of an individual’sstatus as a Fellow, Honorary Fellow, or AdministrativeFellow. Grounds for sanction or termination may include,but not be limited to, any of the following:

1. Conviction, or similar judicial finding or plea,resulting from a criminal offense;

2. Disciplinary action taken against any professionallicense held by the individual;

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3. Failure to exercise proper regard for the health,safety, or legal rights of another person; or

4. Fraud, deception, breach of confidentiality, orinfraction of moral turpitude.

B. Process

Sanction or termination shall be by a recommendation bythe Board of Directors followed by a two-thirds vote at anAnnual or Special Meeting of the Delegate Assembly.Written notice of the sanction or termination to beconsidered and the cause for this action shall be sent tothe Member Boards not less than sixty (60) days prior tothe meeting. The individual in question shall have theopportunity to be heard at the meeting before a vote istaken on the sanction or termination.

C. Rights

Upon termination, all rights of the Fellow, Honorary Fellowor Administrative Fellow as provided in these Bylaws shallcease immediately.

Section 7. Reinstatement of a Fellow, Honorary Fellow, or Administrative Fellow.

Upon reapplication and compliance with the conditions set forthin the sanction or termination of membership, reinstatement maybe granted by a majority vote of the Board of Directors and bytwo-thirds vote of the Delegates at an Annual or Special Meetingof the Delegate Assembly. Written notice that reinstatement is tobe considered shall be sent to the Member Boards not less thansixty (60) days prior to the Annual or Special Meeting.

ARTICLE V. FEDERATION MEETINGS AND ELECTIONS

Section 1. Annual Meeting of the Delegate Assembly.

The Annual Meeting of the Delegate Assembly shall be held atsuch place and time as designated by the Board of Directors,provided that written notice is sent to Member Boards not lessthan sixty (60) days prior to such meeting.

Section 2. Special Meeting.

A Special Meeting of the Delegate Assembly can be called bythe President at any time with the approval of a majority of theBoard of Directors, provided that written notice and a proposedagenda is sent to Member Boards as soon as practical.

A Special Meeting of the Delegate Assembly can also be calledby a majority of the Member Boards at any time, provided thatwritten notice and a proposed agenda is sent to Member Boardsand the President via the Federation’s principle office as soon aspractical.

Section 3. District Caucus.

A District Caucus shall take place in conjunction with theFederation’s Annual Meeting of the Delegate Assembly for thepurpose of enabling each District to elect its District Director andAlternate District Director to the Board of Directors.

Section 4. Minutes.

The Federation shall keep minutes of all Annual and SpecialMeetings of the Delegate Assembly and shall make theseminutes available to the Member Boards.

Section 5. Other Meetings.

The Board of Directors may convene such other meetings as itdeems necessary to carry out its purpose provided that thesemeetings are not used to conduct the legal business of theFCLB.

Section 6. Elections.

A. General Provisions

Available positions on the Board of Directors for Officers,the Administrative Fellow Director, and NominatingCommittee shall be filled by election by majority vote ofthe Delegates at the Annual Meeting of the DelegateAssembly from candidates slated by the NominatingCommittee or candidates nominated from the floor. Thesewho are elected shall assume their positions at the closeof the Annual Meeting of the Delegate Assembly.

In the event that no candidate for an elected positionreceives a majority of the votes cast on the first ballot, arun-off election shall be held between the two (2)candidates receiving the most votes cast on the firstballot.

B. Candidates for Officer, Administrative Fellow Director,Nominating Committee

The Nominating Committee shall consider only thosecandidates for Officers, the Administrative Fellow Director,or the Nominating Committee who shall submit to theFederation’s principle office their intent to run for suchposition and curriculum vitae not less than sixty (60) daysprior to the date of elections.

The office of Immediate Past President does not requireelection.

C. Candidates for District Director

Not less than thirty (30) days prior to the elections, theFederation shall distribute the intent to run and curriculumvitae of only those Candidates for District Director and

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Alternate District Director who submit to theFederation’s principle office such documents notless than sixty (60) days prior to the date of DistrictCaucus where the elections are to occur.

ARTICLE VI. DELEGATE PRIVILEGES AND RESPONSIBILITIES

Section 1. Duties and Responsibilities.

At the Annual Meeting of the Delegate Assembly, the Delegatesshall provide direction to the Federation by consideration of suchbylaw amendments and properly submitted resolutions that areexpedient or desirable to fulfill and implement the statedpurposes of the Federation.

Section 2. Privilege of the Floor.

Fellows, Honorary Fellows, Administrative Fellows, committeemembers, Board of Director members, and Delegates have theprivilege of the floor during any meeting of the DelegateAssembly. At the discretion of the presiding officer, otherattendees may be granted the privilege of the floor.

Section 3. Voting

Absentee voting and voting by proxy are not allowed.

ARTICLE VII. BOARD OF DIRECTORS

Section 1. Responsibilities of the Board of Directors.

The Board of Directors shall manage the affairs of the Federationincluding the establishment of an annual budget and thetransaction of all business for and on behalf of the Federation.The Board of Directors shall carry out the legal resolutions,actions, or policies as authorized by the Delegates. The Board ofDirectors shall act for the Federation between Annual Meetingsof the Delegate Assembly, and is authorized to developappropriate policies to carry out the Bylaws and purposes of theFederation, and can authorize the Executive Committee of theBoard of Directors to act on its behalf.

Following each Annual Meeting of the Delegate Assembly, theBoard of Directors shall elect a Board Chair to serve a one-yearterm which includes presiding at the meetings of the Board ofDirectors and serving on the Executive Committee. The BoardChair must be one of the District Directors.

Section 2. Composition of the Board of Directors.

There shall be ten (10) members of the Board of Directors whichinclude the Immediate Past President, President, Vice President,Treasurer (collectively referred to as Officers), one director fromeach of the five (5) Districts of the Federation, and theAdministrative Fellow Director.

No member of the Board of Directors may simultaneously holdmore than one position on the Board of Directors.

Section 3. Qualifications for Nomination and Electionor Appointment.

A. Officers

1. President

At the time of nomination and election orappointment, the President shall be either a Fellow,an Honorary Fellow who has served as a memberof a Member Board within the last five (5) years, oris currently serving on the Federation Board ofDirectors.

2. Vice President

At the time of nomination and election orappointment, the Vice President shall be either aFellow, an Honorary Fellow who has served as amember of a Member Board within the last five (5)years, or is currently serving on the FederationBoard of Directors.

3. Treasurer

At the time of nomination and election orappointment, the Treasurer shall be either a Fellow,or an Honorary Fellow who has served as amember of a Member Board within the last five (5)years.

B. District Directors

At the time of initial nomination and election or at the timeof appointment, a District Director and Alternate DistrictDirector shall be either a Fellow, or an Honorary Fellowwho has served as a member of a Member Board withinthe last five (5) years.

C. Administrative Fellow Director

At the time of nomination and election or appointment,and throughout the term, the Administrative FellowDirector shall be an Administrative Fellow, it being theintention that upon loss of Administrative Fellowdesignation, a vacancy in the Federation Board ofDirectors shall immediately occur.

Section 4. Duties of Officers.

A. President

The President shall be the chief executive officer of theFederation. The President shall preside at all Annual and

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Special Meetings of the Delegate Assembly. ThePresident shall appoint committees andrepresentatives to other organizations subject to therequirements of these Bylaws and policies adoptedby the Board of Directors. The President shall serveas an ex-officio, non-voting member of allcommittees except for the Nominating Committee.

B. Vice President

The Vice President shall fulfill the duties of the President inthe absence of the President.

C. Treasurer

The Treasurer shall be custodian of all Federation fundsand keep an accurate record of said funds and property.The Treasurer shall oversee the payment of all billsapproved according to policies adopted by the Board ofDirectors. The Treasurer shall submit a written report of allFederation accounts during the Annual Meeting of theDelegate Assembly or when requested by the Board ofDirectors, and shall serve as chair of the FinanceCommittee.

D. Immediate Past President

The Immediate Past President shall provide informationand continuity regarding Federation matters. TheImmediate Past President shall Chair the NominatingCommittee.

Section 5. Terms and Limitations.

The terms of the Board of Directors shall be as follows:

A. Officers

Officers shall serve one (1) two-year terms to be elected inodd numbered years. The Immediate Past President shallnot be an elected position, but will automatically followservice as the President. No Officer may serve more thanone (1) term in the same office.

B. District Directors

The term of the District Directors and Alternate DistrictDirectors shall be three (3) years. District Directors andAlternate District Directors shall be ineligible to serve morethan two (2) consecutive terms.

C. Administrative Fellow Director

The term of the Administrative Fellow Directors shall bethree (3) years. Administrative Fellow Directors shall beineligible to serve more than two (2) consecutive terms.

D. Partial Terms

Serving a partial term in any position on the Board ofDirectors shall not be considered in calculating a term ofservice.

E. Conclusion of Service

All Members of the Board of Directors shall serve asspecified in these Bylaws or until a successor is dulyelected or appointed.

Section 6. Compensation.

Directors shall not receive compensation for their service, butshall be reimbursed for reasonable expenses incurred whilecarrying out their Federation responsibilities. Directors may beentitled to an honorarium in accordance with policies adopted bythe Board of Directors.

Section 7. Vacancies.

A. Officers

In the event of a vacancy in the office of President, theVice President shall immediately assume the position.

In the event of a vacancy in the office of Vice President,the President with the input and approval of the Board ofDirectors shall appoint one of the eligible Directors to fulfillthe duties, but not the office, of the Vice President until thenext Annual Meeting of the Delegate Assembly, where asuccessor shall be elected to fill the office until the nextregularly scheduled election.

In the event of a vacancy in the office of Immediate PastPresident, the President with the input and approval of theBoard of Directors shall appoint a preceding pastpresident to serve, with the most recent past presidentgiven first preference.

In the event of a vacancy in the office of Treasurer, thePresident with the input and approval of the Board ofDirectors shall appoint a qualified individual to serve untilthe next Annual Meeting of the Delegate Assembly, wherea successor shall be elected to fill the office until the nextregularly scheduled election

B. District Directors and Alternate District Directors

District Director vacancies shall be filled by the dulyelected Alternate Director from that district, who shallserve until the next Annual Meeting of the DelegateAssembly, at which time a District Director shall benominated and elected to complete the unexpired term.

6

A vacancy in the position of Alternate District Director shallnot be filled until election by the District Delegates inconjunction with the next Annual Meeting of the DelegateAssembly, at which time an Alternate District Director shallbe nominated and elected to complete the unexpired term.

If both the District Director and Alternate District Directorpositions are vacant, the President with the input andapproval of the Board of Directors shall appoint a qualifiedindividual from the District in which the vacancy occurs toserve as District Director until the next Annual Meeting ofthe Delegate Assembly at which time a District Directorand Alternate District Director shall be nominated andelected to complete the unexpired term.

D. Administrative Fellow Director

A vacancy shall occur immediately if the AdministrativeFellow Director fails to maintain employment with aMember Board during the term of service. The Presidentwith the input and approval of the Board of Directors shallappoint a qualified Administrative Fellow to serve until thenext Annual Meeting of the Delegate Assembly at whichtime an Administrative Fellow Director shall be nominatedand elected to fill the unexpired term.

Section 8. Removal.

A member of the Board of Directors may be removed prior to theend of his/her term when, in the judgment of the Board ofDirectors, the best interest of the Federation would be served,and in accordance with policies adopted by the Board ofDirectors. Removal shall require a two-thirds vote of theremaining members of the Board of Directors.

ARTICLE VIII. BOARD OF DIRECTORS MEETINGS

Section 1. Regular Meetings of the Board of Directors.

The Board of Directors shall hold meetings from time to time asdeemed necessary to carry out its responsibilities to the MemberBoards, and in such format (in person or electronic) as may bedetermined by the Board of Directors.

Section 2. Special Meetings of the Board of Directors.

Special Meetings of the Board of Directors may be convened atthe discretion of the President. A Special Meeting of the Board ofDirectors shall be convened by the President within thirty (30)days after having received a written request for such meetingfrom two-thirds of the members of the Board of Directors. Section 3. Notice and Agenda.

Notice and proposed agenda for any regular meeting of theBoard of Directors shall be given to the directors at least fifteen(15) days prior to the meeting. Notice and proposed agenda for

special meetings shall be given as soon as practical before thespecial meeting.

Section 4. Executive Session.

The Board of Directors may meet in executive session inaccordance with policies adopted by the Board of Directors.

Section 5. Minutes.

The Board of Directors shall keep minutes of its meetings, andshall make these minutes available to any Member Board.

ARTICLE IX. COMMITTEES

Section 1. Nominating Committee.

A. Composition and Appointment

There shall be six members of the Nominating Committeewhich shall include one representative from each of thefive Federation Districts and also the Immediate PastPresident who shall serve as Chair. The five Districtmembers shall be elected by majority vote by theDelegates at the Annual Meeting of the DelegateAssembly. The term of the Nominating Committeemembers shall be for one (1) year.

B. Eligibility

At the time of nomination and election or appointment,Nominating Committee members shall be a Fellow orAdministrative Fellow and shall have attended at least two(2) Annual Meetings. To be considered by the NominatingCommittee, interested candidates must submit a letter ofintent and curriculum vitae sixty (60) days prior to theAnnual Meeting of the Delegate Assembly to be eligible tobe slated. Candidates may also be nominated from thefloor during the Annual Meeting. No one may serve morethan three (3) consecutive terms on the NominatingCommittee.

C. Duties

The Nominating Committee shall submit to the MemberBoards at least thirty (30) days before the Annual Meetingof the Delegate Assembly, a slate of those candidates itconsiders to be best suited for leadership in the openpositions of the Officers and Administrative Fellow Directoron the Board of Directors, as well as the NominatingCommittee, in accordance with procedures approved bythe Board of Directors.

D. Limitations and Vacancies

Individuals serving on the Nominating Committee or thosewho resign from this committee shall be ineligible to be

7

slated or elected, but not appointed, to an Officer orAdministrative Fellow Director position within theirelected term. In the event of a vacancy on theNominating Committee, the President with the inputand approval of the Board of Directors shall appointa qualified individual to serve until the next AnnualMeeting of the Delegate Assembly.

Section 2. Finance Committee.


There shall be three (3) members on the FinanceCommittee, one of whom shall be the Treasurer who shallserve as Chair. Finance Committee members shall beappointed by the President with the input and approval ofthe Board of Directors. The term of the Finance Committeemembers shall be one (1) year.

B. Duties

The Finance Committee shall advise the Board ofDirectors on issues related to the use of the Federation'sassets to assure prudence and integrity of fiscalmanagement and responsiveness to the needs of theMember Boards. The Finance Committee shallrecommend financial policies which provide guidelines forfiscal management, and review the annual audit.

C. Vacancies

In the event of a vacancy on the Finance Committee, thePresident with the input and approval of the Board ofDirectors shall appoint a qualified individual to serve.

Section 3. Bylaws and Resolutions Committee.


There shall be at least five members on the Bylaws andResolutions Committee, appointed by the President withthe input and approval of the Board of Directors. The termof the Bylaws and Resolutions Committee members shallbe one (1) year.

B. Duties

The Bylaws and Resolutions Committee may submitproposed amendments to the Bylaws and shall considerproposed amendments to the Bylaws submitted inaccordance with these Bylaws, and shall consider allresolutions submitted in accordance with Federationpolicy. The Bylaws and Resolutions Committee shall makerecommendations to the Annual Meeting of the DelegateAssembly regarding their adoption.

C. Vacancies

In the event of a vacancy on the Bylaws and ResolutionsCommittee, the President with the input and approval ofthe Board of Directors shall appoint a qualified individualto serve.

Section 4. Ad-Hoc Committees.

Ad-hoc committees may be established and appointed by thePresident as needed. The composition and tenure of committeemembers shall be determined by the President in accordancewith policies adopted by the Board of Directors.

Section 5. Removal of Committee Members

With the exception of the Nominating Committee, appointedcommittee members may be removed prior to the end of his/herterm when, in the judgment of the Board of Directors, the bestinterest of the Federation would be served. Removal shallrequire a majority vote of the Board of Directors.

ARTICLE X. REPRESENTATIVES AND APPOINTEES

Section 1. Representatives or Appointees to Other Organizations.

All representatives or appointees of the Federation to otherorganizations shall be appointed by the President with the inputand approval of the Board of Directors.

Section 2. Appointees to the National Board of Chiropractic Examiners.

Appointees to the National Board of Chiropractic Examiners(NBCE) Board of Directors shall be appointed by the Presidentwith the input and approval of the Board of Directors and shallserve for a one (1) year term unless otherwise prohibited by theNBCE Bylaws. Such appointees shall be the Federationpresident and vice president unless either or both are unable toserve.

Section 3. Removal of Representatives or Appointees to other Organizations.

Any Federation representative or appointee to otherorganizations may be removed prior to the end of his/her termwhen in the judgment of the Board of Directors the best interestof the Federation would be served. Removal shall require amajority vote of the Board of Directors.

8

ARTICLE XI. FINANCES

Section 1. Fiscal Year.

The fiscal year of the Federation shall be the calendar year.

Section 2. Financial Records.

The Federation shall keep financial records available forinspection by Member Boards at the principle office of theFederation. A report shall be given on the financial condition ofthe Federation at the Annual Meeting of the Delegate Assembly,and the annual budget shall be presented to the Delegates.

Section 3. Audit.

The Board of Directors shall ensure that an annual audit shall beundertaken by a qualified individual or firm approved by theBoard of Directors. The annual financial statement of theFederation for the previous fiscal year shall be presented to theDelegates at the Annual Meeting of the Delegate Assembly.

Section 4. Contracts.

The Board of Directors may authorize any Officer or Officers, orthe Executive Director, to enter into any contract or execute anddeliver any instrument in the name of or on behalf of theFederation.

Section 5. Checks, Drafts, or Orders.

All checks, drafts, or orders for the payment of money, notes, orother evidences of indebtedness in the name of the Federationshall be signed by such officer or officers, agent or agents of theFederation and in such manner as authorized by the Board ofDirectors.

Section 6. Deposits.

All funds of the Federation shall be deposited to the credit of theFederation in such bank, trust company, or other depository asthe Board of Directors may direct, in accordance with policiesadopted by the Board of Directors.

Section 7. Limitations of Expenditures.

The Federation is limited to expending its funds for only thosepurposes described in the Certificate of Incorporation and theseBylaws.

Section 8. Insurance.

At the discretion of the Board of Directors and in accordance withpolicies adopted by the Board of Directors, the Federation shallsecure appropriate insurance.

Section 9. Dues.

A. Annual Dues

Each Member Board will be assessed annual dues formembership in the Federation.

B. Modification of Dues

All proposals for modification of annual dues formembership shall be submitted to the Annual Meeting ofthe Delegate Assembly for approval by a majority vote.

ARTICLE XII. ETHICAL CONDUCT AND CONFLICT OF INTEREST

Members of the Board of Directors, FCLB committee members,appointees, and employees shall abide by the Bylaws, rules,guidelines, policies and procedures duly adopted by theFederation and avoid engaging in activities which constitute ormay be perceived as a conflict of interest with regard toFederation matters.

ARTICLE XIII. EXECUTIVE DIRECTOR AND PRINCIPLE OFFICE

Section 1. Executive Director.

The Board of Directors shall hire an Executive Director to serveas the administrative officer of the Federation, who shall beaccountable to the Board of Directors.

Section 2. Principle Office.

The Board of Directors shall establish the location of its principleoffice.

ARTICLE XIV. INDEMNIFICATION AND QUALIFICATION

Section 1. Indemnification.

Subject to the limitations of this Article, the Federation shallindemnify any person who was or is a party of or is threatened tobe made a party to any threatened, pending or contemplatedaction, suit or proceeding, whether civil, criminal, administrativeor investigative (other than an action by or in the right of theFederation) by reason of the fact that such person is or was acommittee member, and including the Board of Directors, or staffof the Federation, against expenses, including attorneys' fees,judgments, fines, and amounts paid in settlement actually andreasonably incurred in connection with such action, suit orproceeding only if such person acted in good faith and in amanner reasonably believed to be in or not opposed to the bestinterest of the Federation and, with respect to any criminal actionor proceeding, had no reasonable cause to believe such conductwas unlawful. The termination of any action, suit or proceedingby judgment or settlement, condition or upon a plea of Nolo

9

Contendere or its equivalent shall not, in and of itself, create apresumption that such person did not act in good faith and in amanner reasonably believed to be in or not opposed to the bestinterests of the Federation and, with respect to any criminalaction or proceeding, had reasonable cause to believe that suchconduct was unlawful.

Section 2. Qualification.

Any indemnification under this Article shall be made by theFederation only as authorized in the specific case upon adetermination that indemnification is proper in the circumstancesbecause such person has met the applicable standard of conductset forth in this Article. Such determination shall be made by theBoard of Directors consisting of members who are not parties tosuch action, suit or proceeding or, if such quorum is notattainable, a quorum of disinterested members.

ARTICLE XV. PARLIAMENTARY AUTHORITY

The rules contained in the current edition of Robert’s Rules ofOrder, Newly Revised shall govern the Federation in all cases towhich they are applicable and in which they are not inconsistentwith these Bylaws and any special rules of order the Federationmay adopt.

ARTICLE XVI. AMENDMENTS

Section 1. Amendment Proposals.

These Bylaws may be amended at any Annual Meeting of theDelegate Assembly. Any Member Board either directly or throughits Delegate, or the Bylaws and Resolutions Committee, or theBoard of Directors may propose Bylaws amendments. Proposedamendments to the Bylaws shall be in writing and received at theFederation office not less than ninety (90) days prior to theAnnual Meeting of the Delegate Assembly. Such amendmentsshall be immediately forwarded to the Bylaws and ResolutionsCommittee for their recommendation, and then to the Delegates,Alternate Delegates, and all Member Boards not less than sixty(60) days prior to the Annual Meeting of the Delegate Assembly.

Section 2. Adoption.

Proposed amendments received in accordance with theseBylaws shall be presented at the Annual Meeting of the DelegateAssembly and must receive a two-thirds vote for adoption.

Section 3. Effective Date.

These Bylaws, and any other subsequent amendments thereto,shall become effective upon their adoption.

#

The foregoing are the Bylaws of the Federation, as adopted inHollywood, CA, May 8, 2009.

Amended - May 1, 2010 - Baltimore, MarylandAmended - May 7, 2011 - Marco Island, FloridaAmended - May 5, 2012 - San Antonio, Texas

10

FCLB Committee Appointments: 2013 - 2014

APPOINTMENTS TO OTHER ORGANIZATIONSTO WHICH FCLB HAS VOTING REPRESENTATION

NATIONAL BOARD OF CHIROPRACTIC EXAMINERS Board of Directors

LeRoy Otto, D.C. (MN) - Expires 5/15Farrel Grossman, D.C. (SC) - Expires 5/15

FEDERATION OF ASSOCIATIONS OFREGULATORY BOARDS (FARB)Board of Directors

Donna M. Liewer - No expiration date

COUNCIL ON CHIROPRACTIC GUIDELINESAND PRACTICE PARAMETERS

Albert Stabile, Jr., D.C. (NJ)

NATIONAL PRACTITIONER DATABANKEXECUTIVE COMMITTEE

Donna M. Liewer - Ongoing

FCLB STANDING COMMITTEES

Next cycle of appointments begins January 2014

FINANCE AND AUDIT COMMITTEE Expires 1/14

Farrel Grossman, D.C. (SC) - ChairHarvey Garcia, D.C. (NC)Carol Winkler, D.C. (ND)

Chaired by the Treasurer.

Prepares and submits a budget to themember chiropractic boards at the annualmeeting. Reviews the financial statementand audit of the corporation and advisesthe Board of Directors on changes infiscal status.

Appointed by the President, approved bythe FCLB Board of Directors

NOMINATING COMMITTEE Expires 5/14

Lawrence O’Connor, D.C. (NJ) - ChairDwight Schmidt, D.C. (ND)Greg Palkowski, D.C. (OH)Michael Fedorczyk, D.C. (MD)James Badge, D.C. (AZ)Harvey Garcia, D.C. (SC)

Five members, represent each of fivedistricts. Must be Fellows who have alsoattended at least one FCLB annualmeeting. Chaired by FCLB immediatepast president.

Committee reviews letters of interest andcvs which are submitted at least 60 daysprior, conducts interviews and sets forth aslate of those candidates it feels are bestsuited for leadership in the offices electedby the membership as a whole, includingthe Nominating Committee itself. No limitto number of candidates they may slate.

Nominating committee submits slate tomember boards not less than 30 daysprior to annual meeting.

Elected by the membership

RESOLUTIONS & BYLAWSCOMMITTEE - Expires 1/14

Ron Tripp, D.C., (OK) - Chair Daniel Cote, D.C. (OR)Lawrence R. Davis, D.C. (NV)Stephanie Chaney, D.C. (MD)Gary Pennebaker, D.C. (MN)

Maintains a continuing assessment of thebylaws, and receives all proposals foramendments thereof. Makesrecommendations to the Federationregarding all amendments.

Receives all proposals for resolutions tobe considered by the Federation andmakes recommendations for approval ordenial.

Appointed by the President, approved bythe FCLB Board of Directors

FCLB Committee Appointments: 2013 - 2014

FCLB SPECIAL COMMITTEES

Task Forces and Special Committees expire annually in January or as determined by their responsibilities

CHIROPRACTIC BOARDADMINISTRATORS COMMITTEE

Beth Carter (OK) - ChairMarcia Walter (SD)Larry Spicer, D.C. (MN) - Board Liaison

Provides support and information forchiropractic board administrators. Participation is open to all boardadministrators.

FRAUD PREVENTION &IDENTIFICATION - Task Force

Michael Coon, D.C. (SC) - ChairDeb Hoffman, D.C. (FL)Ben Lurie, D.C. (NV)

Recommends to the FCLB Board projects and serves as speakers bureauto help identify and prevent fraud. Identifies trends in fraudulent practice andpossible educational programs forconferences.

INFORMED CONSENT - Task Force

Hugh Lubkin, D.C. (CA) - ChairShannon Gaertner-Ewing, D.C. (ID)John C. Greenhaugh, J.D.Steve Foreman, D.C. (CA)Sal LaRusso, D.C. (FL)Al Stabile, D.C. (NJ)Gary Pennebaker, D.C. (MN)

A targeted and short-term ad hoc taskforce to investigate utilization of informedconsent and draft a model document.

GOVERNMENT ISSUES - Task Force

Farrel Grossman, D.C. (SC) - ChairMaggie Colucci, D.C. (NV)Michael Fedorczyk, D.C. (MD)

A task force formed to target grants andfunding for the Federation of Chiroprac ticLicensing Boards.

MODEL PRACTICE ACT - Task Force

Kirk Shilts, D.C. (MA) - ChairRay Conley, D.C. (KS)Hank Hulteen, D.C. (SC)Gary Pennebaker, D.C. (MN)William Rademacher, D.C. (IL)Keita Vanterpool, D.C. (DC)Annette Zaro, D.C. (NV)

PACE COMMITTEEStaggered three year terms

Maggie Colucci, D.C. (NV) - Chair FCLB board member position

William Rademacher, D.C. (IL)Current regulatory board position

Patrice Pritzl (AZ) Board executive administrator position

Karen Mathiak, D.C. (GA) Regulatory board member within the pastfive years position

Vance Kinlaw, J.D. (NC)Public member position

John Downes, D.C. Life UniversityCurrent CE Provider position

Sherry McAllister, D.C. Palmer West ConsultantChair - Pace Review Team

SPORTS MOBILITY - Task Force

Maggie Colucci, D.C. (NV)Mark Bledsoe, D.C. (SD)Kevin Fogarty, D.C. (FL)

A task force formed to assess ways offacilitating mobility for chiropractorstraveling with sports teams.

FCLB NEWS ALERT: Joseph Wagner, D.C. August 5, 2011

From time to time, the FCLB receives subject matter that we believe may be of interest to our member boards. As part of our mission “to protect the public by promoting excellence in chiropractic regulation through service to our member boards” we are forwarding this information to your board for your consideration.

The Federation of Chiropractic Licensing Boards recognizes that persons identified in the attached documents may or may not have pending adjudication processes. No guilt or innocence should be presumed solely on the basis of this information.

Following, please find information involving:

Name Known Licenses (May or may not include all professional licenses)

Joseph Wagner FL

Please contact the FCLB should your board have any additional information that should be added to our CIN-BAD database.

WFTV.com

FBI Raids Chiropractic Clinic In Daytona Beach

Federal Agents Raid Daytona Beach Chiropractor's Office

Posted: 1:19 pm EDT August 5, 2011

DAYTONA BEACH, Fla. -- Federal agents raided a Daytona Beach chiropractor's office on Thursday.

AT THE SCENE: Images Of FBI Raid

FBI agents, along with the Volusia County Bureau of Investigation, raided the Wagner Chiropractic and Acupuncture Clinic on North Ridgewood Avenue (see map) Thursday morning at around 8:00 a.m.

For most of the day in Daytona Beach, agents with the Federal Bureau of Investigation were in and out of Dr. Joseph Wagner's chiropractic clinic. As they worked, investigators with masks from Volusia County assisted them.

The FBI would only say that the search conducted by the agents is related to an ongoing investigation.

On the sign outside of the building, Wagner is only listed as a physician's assistant; but WFTV found out that he is the father of Volusia County council member Josh Wagner, who WFTV tried to speak with after county council meeting on Thursday.

"I've been in this meeting the whole day so you guys probably know more about what's going on. I have no idea," said Josh Wagner.

Wagner is a local attorney who has many roots besides his father in Daytona Beach. His brother is also a chiropractor. He owns stake in a local magazine and was once involved with a deal to put a restaurant in the Main street pier, but it fell apart.

"I have to go to this school board meeting…so thank you," he said.

At this point, the FBI will not say if the councilman has been questioned. Sources told WFTV that Thursday's raid was the result of months of investigation, but the FBI would not say what they were looking for exactly.

Copyright 2011 by wftv.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Page 1 of 1FBI Raids Chiropractic Clinic In Daytona Beach - Print This Story News Story - WFTV ...

8/24/2011http://www.wftv.com/print/28778888/detail.html

Board What does your board do with malpractice claim settlement information you receive on licensees?

Alabama Alabama request documentation from the DC on the claim and has a panel review for any code violations. It is

posted publicly if there is a Board Order/ Agreement following investigation, etc. In Alabama if the panel finds

violations it is processed as a complaint. If no violations file is closed.

Arizona The Arizona Board opens a complaint for investigation. The fact that a complaint is currently pending and the

general nature of the complaint is public record.

Arkansas Typically no action is taken on the information received. I review the information and contact a board member,

usually the President. The paperwork is filed in the licensee file.

Florida All go before the board along with their application for licensure. The board determines if anything should be

done to those applicants, like additional CE, denial or approval with no conditions. All is included in their

profile which anyone can look at.

Idaho We just add malpractice settlement information to the licensee’s file; it is not posted publicly and the Board

does not take any action on it.

Louisiana It is filed in the licensee’s file.

No public post.

No action taken.

Maryland We open a case file to determine cause...validity...extent of allegations.

Mississippi No action taken. File in folder

Missouri Missouri does not post malpractice settlements.

A case is opened based upon the malpractice allegation(s).

Nebraska The Nebraska Board of Chiropractic would not publicly post malpractice claim settlement information. Such

information would likely trigger an investigation, and if it is determined that the Chiropractor violated

regulations related to practice in our state, action would be initiated against the license. Any action against a

Nevada In Nevada, malpractice settlements of $5000 or less are considered nuisance claims and no action is taken. if

there is only one malpractice claim settlement over $5000, the information is kept on file but take no action.

By statute, multiple malpractice (two or more) constitutes unprofessional conduct and a complaint is filed for

possible disciplinary action.

North

Carolina

We do not take any action but do file in the doctor's record. It is considered public information when

requested.

Ohio Malpractice reports are confidentially maintained. The Board is required to conduct an investigation for

repeated malpractice, which is defined as three or more claims within 5 years that result in judgment or

settlement of $10,000 or more. To date, no licensee has committed repeated malpractice.

Oklahoma We do not post this publicly. We simply file them away and we do not take action.

South

Carolina

SC investigates and if it is discovered that the licensee is in error they may be required to appear before the

board. If it is just a settlement and no guilt established then no action is required.

South

Dakota

The information is shared with the board but we do not post it or take any action against licensee.

FCLB PowerPoll

OK 5/21/2013

Malpractice Information

Board What does your board do with malpractice claim settlement information you receive on licensees?

Texas It depends on the information. In most cases we open a complaint. If it isn't worthy of a disciplinary action, the

complaint is closed with a letter of warning or closed as insufficient evidence/no evidence.

Utah No action is generally taken in Utah, but we do note the information for our files.

Virginia The Virginia Board does not post malpractice judgment/settlement information (ie, “medical malpractice

payment” or “MMP”) or provide such information to the public. However, our licensees are required to post all

MMPs greater than $10,000 for the most recent 10 year period on the Practitioner’s Profile. The Profile is

available to the public on our agency website. The information posted is simply the year the MMP was paid and

whether it was an “average” or “above average” MMP. The actual amount of the payment is not posted on the

Profile.

In addition to being required to post the MMP on his/her profile, licensees are required to report any MMP to

the Board. Medical malpractice insurers also are mandated by law to report MMPs paid on behalf of our

licensees to the Board. When we receive such mandated MMP reports, we investigate for possible standard of

care violations and if it appears a violation has occurred, we take action.

West

Virginia

the claim information is placed in the licensee’s file. It is not posted publicly and no action is taken.

PROGRAM OVERVIEW PACE, Providers of Approved Continuing Education, is a streamlined CE provider endorsement process. Continuing education providers who complete a rigorous application and review process demonstrate their capability and willingness to comply with a high standard of CE. Regulatory boards may choose to accept PACE endorsement as an indicator that a CE provider meets board standards, thus eliminating both the need for the CE provider to complete expensive and onerous application procedures multiple times and the need for boards to duplicate each others’ work in reviewing these CE providers.

PACE cannot and should not replace regulatory boards’ responsibility or authority over CE provider approval in their jurisdiction. However, it can and will ease the paperwork burden currently created by CE provider application and review.

Additionally, PACE is designed to simplify boards’ CE course attendance validation procedures by providing electronic records of D.C.’s attendance and course credits.

A PACE workgroup has proposed clarity revisions to the PACE Criteria. These revisions were sent to FCLB stakeholders on April 2, 2013 and will be voted on by the FCLB board of directors during the 2014 annual conference. For your review, these revisions follow this report. Please feel free to submit written comments for the board’s consideration.

PACE BY THE NUMBERS 25 jurisdictions accept PACE

18 Recognized Providers representing 21 campuses

3 layers of oversight and authority for each application review

13 years of development and input from interested parties

$1 minimum per DC fee

$10 maximum per DC fee

$0 fees for FCLB Member Boards

BOARDS ACCEPTING PACE

Alaska Kansas Nebraska North Dakota South DakotaArizona Maine Nevada Ohio Utah Idaho Massachusetts New Jersey Oklahoma Vermont Indiana Minnesota New Mexico Oregon Puerto Rico Iowa Montana North Carolina South Carolina Nova Scotia

PACE RECOGNIZED PROVIDERS

Academy of Chiropractic American Chiropractic Foundation (ACA) Canadian Memorial Chiropractic College Canham College, Inc / Professional Online Education ChiroCredit.com, A Division of OnlineContinuingEd, LLC

Colorado Chiropractic Association Logan College of Chiropractic University Programs Maryland Chiropractic Association / CE4You Milestone Continuing Education Minnesota Chiropractic Association National University of Health Sciences (2 campuses)

NRCME Training Systems, LLC / Oakstone Continuing Education

Palmer College of Chiropractic (3 campuses)

Continuing Education Department

Associate of Science in Chiropractic Technology Program

PESI HealthCare Pettibon Institute Standard Process, Inc TeamCME University of Western States

PACE ‐ Chiropractic Report ‐ Fall 2013

What PACE will do for your board CREATE ECONOMIES OF SCALE: Right now, for a program offered nationwide, every board has to look at and review the course. That means everybody is duplicating each others’ work. PACE does the job once to standards that board members helped develop. (Saves money via employee workload)

o Boards receive approx. 9,600 pages of application materials per year o Materials require 800 staff hours to review o Board’s average annual income from CE approval is less than $500

ELIMINATE FAVORITISM: There are some boards with a member or two who hands out approval based on the buddy system. That’s not really in the best interest of public protection.

OFFER INFORMED, PROFESSIONAL EVALUATIONS: Boards don’t have the time or manpower to be experts in everything related to post‐grad chiropractic education. PACE has volunteer Reviewers who are experts.

PROVIDE A CENTRAL LOCATION FOR COURSE SEARCHES: Course searching is available through the FCLB website, streamlining the process for licensees

INCLUDE AUTOMATIC CREDIT REPORTING: Your licensees who receive credits through PACE will have those credits automatically reported to you in whatever data format you prefer.

What PACE won’t do for your board:

PACE WON’T USURP BOARD AUTHORITY: Boards can’t legally give away their authority. With PACE they’re just delegating a job. They’re still the boss; PACE is the worker bee. It’s similar to accepting the National Board exams as sufficient to meet a board’s examination requirements.

PACE WON’T FORCE YOUR BOARD TO ACCEPT CREDITS IN PROHIBITED SUBJECTS: PACE has a pretty comprehensive list of subject matter. When credits are reported to boards, PACE notes which of those credits may be prohibited by a board, allowing the board to only accept those credits that are permitted for relicensure. Additionally, PACE does not allow courses in practice building.

PACE WON’T HURT YOUR BOTTOM LINE: Most boards report that their current fees do not sufficiently cover the cost of reviewing CE programs. Take a look at the PACE Recognized provider list. How much is your board currently earning from courses offered by those providers?

To determine whether PACE will meet your board’s standards, visit www.fclb.org. The PACE Criteria for Quality Continuing Education as well as the application for PACE Recognition are available for your review. Additionally, the PACE Course Review and Audit form for targeted and random course audits follows this report.

PACE Course Audit Form Course: Provider: Date and location:

Section 1: Staff Review Concerns noted by staff during in‐house review: _________________________________________________ _________________________________________________________________________________________ Section 2: Content Review Based on the submitted outline/syllabus, please mark the following items as agree or disagree. If you mark disagree, please explain.

Course appears appropriate for the allotted time Agree Disagree

Course appears appropriate for the subject matter breakdown provided Agree Disagree

Course includes topics pertinent to contemporary chiropractic practice Agree Disagree

Course is evidence‐based, authority‐based, or tradition‐based Agree Disagree

Course appears credible and academically rigorous Agree Disagree

Comments/Explanation

Section 3: Medium/format Review Based on the submitted outline/syllabus and, if available, the course evaluations, please mark the following items as agree or disagree. If you mark disagree, please explain.

The medium/format of the course is appropriate for the material covered Agree Disagree

The medium/format of the course encourages active participation Agree Disagree

The medium/format of the course is suitable for the number of participants Agree Disagree

Comments/Explanation

Section 4: Red Flags Based on course evaluations and/or onsite observations, please check if any of the following red flags appeared. If you mark any boxes please elaborate.

Were there any concerns expressed about the following issues?

Instructor or educational staff engaged in or allowed inappropriate behavior

The instructor did not appear qualified to teach the course material

There were an inadequate number of personnel

Instructor or educational staff engaged in sales during educational time

Commercial relationships were not made clear

The attendance was not monitored accurately or effectively

Facility issues interfered with the students’ ability to learn

Equipment issues (including A/V and chiropractic equipment) interfered with the students’ ability to learn

Students were not give the choice to opt‐out of hands‐on demonstrations

The content was not relevant to contemporary practice

The educational materials were not organized or appropriate

The course did not cover learning objectives as presented in the marketing materials

Comments/Elaboration

Section 5: Distance Learning Based on course evaluations and/or observations during online review of the course, please check if any of the following concerns appeared. If you mark any boxes, please elaborate.

Were there any concerns expressed about the following issues?

Deadlines, including time‐outs and expected course completion dates were not clearly identified

Instructor contact information was not easy to find or was not available

Instructor’s plan for response time and feedback was not reasonable or was not clearly stated

Course did not offer self‐assessment of mastery

Technical assistance was not available (if applicable)

The program was not easy to navigate or some features were not functional (only applicable for computer‐based courses)

The student was not instructed to create and retain appropriate records (only applicable for clinical courses)

Comments/Elaboration

TO: FCLB Stakeholders:

Member Regulatory Boards – Offices and Chairs PACE Recognized Providers Council on Chiropractic Education Association of Chiropractic Colleges – Member Programs Contact list – those who have expressed interest in learning more about the PACE program

FROM: Donna M. Liewer, FCLB Executive Director DATE: April 2, 2013 RE: Proposed Amendments to PACE Criteria In accordance with the program’s requirements to amend PACE governing documents under non-emergency conditions, the FCLB Board of Directors is hereby publishing a proposed amendment to the PACE Policies & Procedures at least 30 days prior to the FCLB’s 2013 San Francisco meeting. The board invites your written comments. A forum will be held at this meeting for discussion about these proposed amendments. The board will review comments throughout the remainder of 2013. The amendments will be approved or denied by the Board of Directors in conjunction with the 2014 annual meeting in Myrtle Beach. PACE Amendments

Issue Revisions to the PACE Criteria

Proposed by PACE Work Group (including members of the PACE Committee and Review Team).

Background Now that the PACE program has been in place long enough to have established administrative and oversight procedures, the volunteers who most frequently supervise PACE compliance have suggested some revisions to the PACE Criteria based on their experience. The purpose of these revisions is to clarify the role of PACE on an executable level.

Text of Amendments See below

Excerpts from current PACE Criteria with proposed amendment:

Criterion 4. Cooperative Courses When two or more PACE Recognized Providers cooperate to develop, distribute or present a continuing education course, each provider shall be equally and fully responsible for ensuring compliance with PACE quality criteria. The respective functions of each provider shall be identified and documented. When a PACE Recognized Provider cooperates with a provider not recognized by PACE to develop, distribute or present a course, the PACE Recognized Provider shall be fully responsible for ensuring compliance with PACE quality criteria. A PACE Recognized Provider shall fully disclose to course participants all commercial relationships between it and any other entity with which it has cooperated in the development, distribution or presentation of its course.

NOTE: Conflicts of Interest are addressed in Criterion 19, making this paragraph redundant.

Criterion 5. Publicity The provider shall ensure that all advertising and promotional materials associated with its continuing education program are complete, accurate and not false or misleading and in full compliance with the advertising laws of each jurisdiction where the course is offered. Information supplied to prospective participants shall include:

Name of the provider and any other entity giving financial support to the course; Course title; Description of course content; Educational objectives; Description of teaching methods used; All costs, including costs not covered by course fees; How and where to register; Instructors and their qualifications; Refund and cancellation policies; Location, date and time (or period of availability for online courses); PACE recognition status of each provider; Number of credit hours and requirements for obtaining credit; Commercial relationships between the provider or

instructors and any external entity giving financial support to the course;

Prior level of skill, knowledge or experience needed for effective participation.

Minimum system and equipment requirements

Criterion 6. Record Keeping The provider shall maintain records of its continuing education program sufficient to serve the needs of participants and regulatory bodies and shall retain these records for at least five years and in accordance with reasonable security standards. Documentation verifying attendance or participation shall include:

Name, license or registration number, regulatory jurisdiction, address and telephone number of each registrant;

Date, location and duration of the course; Title of course and subjects taught; For courses involving multiple sessions, the title and number of credits awarded for

each course segment; Educational methods used (e.g., lecture, videotape, clinical participation,

electronically mediated, etc.); Number of credit hours earned by each participant. Instructor

Criterion 14. Objectives The provider shall establish written educational goals and learning objectives to serve as a basis for evaluating the effectiveness of its continuing education courses. These goals and objectives shall be established at the inception of the course so that they may guide the development of content, instructional materials, learning assessment and course evaluation.

Educational goals and learning objectives shall be appropriate for the credit hours allocated to the course. The instructor shall present material clearly and in an organized fashion.

Criterion 16. Subject Matter

The provider shall ensure that its continuing education program addresses topics pertinent to contemporary chiropractic art, science, philosophy or practice.

Subject matter shall be evidence-based, authority-based or tradition-based and shall be credible, academically rigorous and presented in a balanced manner. Subject matter shall be appropriate for the level of education attained. Practice building courses are not eligible to be offered under the PACE program.

Criterion 20. Protection of Live Models

The provider shall be responsible for protecting the health, safety and welfare of any person whose body is used to demonstrate clinical techniques or procedures as part of a continuing education course. The provider shall:

Give students the choice to opt out and observe rather than actively participate in

demonstrations of procedures or techniques; Explain to the model the technique or procedure, including the potential risks, and

obtain the model’s informed written consent prior to the demonstration; Ensure that instructors and demonstration participants possess the skill, knowledge,

expertise, licensure status and professional liability coverage necessary to safely perform the technique or procedure being demonstrated;

Ensure that course attendees participating in demonstrations are properly supervised; Verify that the technique or procedure can lawfully be performed in the jurisdiction

where the demonstration takes place; Supply in good working order any equipment or instruments needed for the

demonstration; Supply adequate supervision during the demonstration; Arrange Plan for post-demonstration care, including access to emergency care.

Criterion 21. Educational Methods

The provider shall be responsible for choosing the educational methods used in its continuing education program. In selecting educational methods, the provider shall consider:

Course content and goals; Size and composition of the intended audience; Skill level of participants; Suitability of the Mmedium of presentation; Nature and extent Appropriateness of facilities; Number of instructors, evaluators and support personnel.

If the course requires participants to perform complex tasks under supervision or evaluation, the provider shall limit the number of participants to ensure effective learning. The provider shall caution participants concerning the risks of integrating new techniques or procedures into their practices after receiving only limited instruction. If the course requires electronic or technical capabilities, the provider shall consult with appropriate experts during course development.

Criterion 23. Distance Learning Continuing education courses offered as distance learning may include journal articles, manuals, CDs, DVDs, audio and video tapes, research projects, computer or Internet courses, and other emerging formats. Distance learning programs must comply with all other PACE requirements where applicable. In addition, rRegardless of format, the provider shall ensure that its distance learning course contains the following features:

A field-tested method of determining credit hours; Requisite course deadlines are clearly identified; Provision for participant feedback and interaction with instructors; Prompt response to participant questions; Instructor’s plan for response time and

feedback is reasonable and clearly stated; A mechanism by which the participant can assess mastery of subject matter. Longer

courses offer frequent progress assessments; References for further study; Technical assistance is available as applicable.

If a provider of a distance learning course anticipates that a participant will perform procedures or techniques upon a patient, the instructor shall direct the participant to create and retain appropriate clinical records; such as informed consent, history, X-rays or other diagnostic imaging, examination findings, treatments rendered, materials, methods and outcomes. If the distance learning course is computer-based, the course shall offer ease of navigation, and all features shall be functional. There shall be reliable security measures.

Criterion 25. Course Evaluation

The provider shall supply to each participant in its continuing education program a post-instructional evaluation form that, in addition to other questions that the provider might ask, requests the participant’s assessment of:

Physical location and facilities; Media and materials; Instructor presentations; Attainment of stated course objectives.

The evaluation form distributed to participants shall contain all satisfaction survey questions developed and approved by PACE for either the seminar or distance learning format, as applicable, but may include additional questions developed by the provider.

The provider shall report compiled results of the participant evaluation to PACE.

The provider shall conduct a periodic review of course components to ensure ongoing compliance with PACE quality criteria.

You may address your written comments to the FCLB by e-mail, fax, or postal delivery service: ATTN: Kelly Webb, PACE Coordinator Federation of Chiropractic Licensing Boards [email protected] FAX: 970-356-3599 5401 W. 10th Street, Suite 101 Greeley, CO 80634 The deadline for submitting written comments is December 31, 2013. The board will review any submissions at its January 2014 midyear meeting. Please feel free to contact any member of the Federation’s leadership or our executive offices if you have any questions. Kelly Webb PR & PACE Coordinator Federation of Chiropractic Licensing Boards 5401 W. 10th Street, Suite 101 Greeley, CO 80634 (970) 356‐3500 [email protected] www.fclb.org

LIBRARY

- DOCUMENTS PRODUCED BY OR FOR THE FCLB -

Caro, D.C., Wendy, Sexual Boundaries Survey Presentation. 1995

FCLB Brochures: FCLB Overview, CIN-BAD, PACE, CCCA

Federation of Chiropractic Licensing Boards, PACE Policies & Procedures and Criteria for QualityContinuing Education. 2009

--, Uniform Continuing Education Application Form. April 1996

--, FCLB Regulatory Resources for Doctors of Chiropractic with Ethics Issues - Booklet. October 2008

--, FCLB Ethics Handout. 2007

--, Model Code for Chiropractic Regulation - Draft 6. May 2007

--, Documentation and Recordkeeping Model Outline: Statute and Regulations.

FCLB Task Force to Develop a Model Disciplinary Code, Guidelines for the Development of aChiropractic Disciplinary Code. April 1999

FCLB Task Force to Develop a Regulatory Code of Ethics, Model Code of Ethics for Members ofRegulatory Boards for the Licensed Professions. April 1999

Giangrosso, D.C., Esq, Salvador, Board Regulation and Sexual Misconduct. 1995

Keating, Joseph C. Jr. And D. Liewer, Protection, Regulation & Legitimacy: FCLB & the Story ofLicensing in Chiropractic. Volumes I & II, 2012

Spicer, D.C., Larry, Professional Boundaries.April 1996

Triano, D.C., P.h.D., FCCS, John J., High-velocity, Low Amplitude Spinal Adjusting/ManipulationPerformance: Minimum criteria for safety and adequate competence.

- DOCUMENTS FROM FCLB COMMITTEES -(may not yet be adopted by full membership)

FCLB Uniform Review Process Task Force, Model Framework: Uniform Evaluative Process forTreatments & Devices. Spring 2008

Otto, D.C., LeRoy F., Interjurisdictional Mobility Task Force Member, Mobility Document: 1998 Memowith Survey. August 1998

Smith, D.C., Bud, Interjurisdictional Chairman, Mobility Document: 2000 Interjurisdictional CommitteeUpdate. November 2000

- RESOURCES FROM MEMBER BOARDS -

Kansas State Board of Healing Arts, Guidelines for the Imposition of Disciplinary Sanctions. April 2008

New Mexico House Bill, Formularies for Chiropractic. First Session, 2009

Stafford, Mark, Kansas State Board of Healing Arts, Experimental Treatments. presented at Fall 2007FCLB regional meetings)

State of Minnesota v. Express Health, P.A. and Cory D. Couillard, D.C. Summons and Complaint. August2009

State of Wisconsin, Wisconsin Act 28 relating to state finances and appropriations, constituting theexecutive budget act of the 2009 legislature. June 2009

Vallone, J.D., J.J., Chiropractic Practice Guide. May 2009

Washington State Department of Health, Cultural Competency in Health Services and Care: A Guide forHealth Care Providers, June 2010

--, Washington State Disciplinary Guidelines Manual. February 2007

FCLB LIBRARY (con’t)

- PUBLICATIONS FROM OUTSIDE SOURCES -

American Chiropractic Association, Clinical Documentation Manual. 2005

Chiropractic Research Review - Newsletter. June 1998 - Summer 2004

DHHS Office of Inspector General, Chiropractic Services in the Medicare Program: PaymentVulnerability Analysis. June 2005

--, Inappropriate Medicare Payments for Chiropractic Services. May 2009

Federation of Associations of Regulatory Boards, General Model Practice Act - Working Document. September 2001

--, Model Application for Licensure and Renewal. 2001

Foreman, D.C., Stephen, and Michael J. Stahl, D.C., Chiropractors Disciplined by a State ChiropracticBoard and a Comparison with Disciplined Medical Physicians. May 2003

--, Ethical Perspectives: Sexual Boundary Issues and the Chiropractic Paradigm. 2005

Haldeman, D.C., M.D., Ph.D., Scott, David Chapman-Smith, and Donald M. Petersen, Jr., Guidelines forChiropractic Quality Assurance and Practice Parameters. 1993

Hosenfeld, D.C., Cole J., and Tiffany R. Stevens, CTA, Chiropractic Therapy Assistant: A ClinicalResource Guide. 2009

Ladenheim, J.D., C. Jacob, Robert P. Sherman, D.C., Louis Sportelli, D.C., Professional ChiropracticPractice: Ethics, Business, Jurisprudence, and Risk Management - Developing MalpracticePrevention Strategies. 2001

Moore, J. Stuart, Chiropractic in America: The History of a Medical Alternative.1993

National Board of Chiropractic Examiners, Practice Analysis of Chiropractic. 2010

National Conference of State Legislatures, FY 2010 Actions & Proposals to Balance the Budget:Employee Actions, Furloughs and Layoffs.

Redleaf, Dr. Angelica, Behind Closed Doors: Gender, Sexuality, and Touch in the Doctor/PatientRelationship. 1998

--, Boundaries in Healthcare. 2008

Sportelli, D.C., Louis , Introduction to Chiropractic: A Natural Method of Health Care, 12th Edition.2009

World Health Organization, Guidelines on Basic Training and Safety in Acupuncture. January 1999

--, Guidelines on Basic Training and Safety in Chiropractic. 2005

Financial ReportRESERVE FUNDS - AUGUST 2013

Cash & Cash Equivalents

The FCLB began fiscal year 2013 with $827,644available cash for daily operations. Funds areinvested in certificates of deposit and interestbearing money market accounts.

12 Months Operating Reserve

With a total of $255,266, the fund is at 33.3% ofthe Board’s goal of a 12 month operatingreserve.

Using rigorous fiscal management the FCLB wasable to abide by its 2012 goal and $21,216 wasadded at year end. FCLB did not budget adding tothis fund in 2013.

PACE Reserve

In anticipation of the implementation costs for the PACE program, the board approved the fundestablishment in 2004 totaling $70,000. The board depleted the fund in September 2005 and thenreplenished it with $36,000 in January 2006. The board withdrew $30,000 in January 2007 for PACEexpenses. In January 2009 the board approved adding $25,000 to this fund. $15,000 was added in 2011in to help cover the anticipated 2012 cost of a PACE rubric team meeting. The fund now stands at$46,000.

Technology Reserve

Early in 2004, the board created a $30,000 technology fund to support programming and internet costs. In January 2007, $15,000 was applied toward technology costs. In December 2007, $80,000 was addedto the fund in anticipation of revamping the entire FCLB information technology infrastructure. Anadditional $20,000 was added in January 2009, and $40,000 was added in December 2009. The currentbalance is $155,000. The 2013 budget anticipates tapping this fund by $20,550 to aid in the cost ofprogramming to integrate PACE with the centralized database and import fresh licensing lists from everyboard.

Equipment Upgrade Fund

This fund was established in December 2004 to replace and upgrade hardware on a three to eight yearrotation schedule. It was used in the past to support CIN-BAD upgrade expenses and subsequentlyreplenished. An additional $10,000 was added in January 2009. The current balance is $19,000.

Current Reserve Funds Balances (August 31, 2013)

General Operating Fund $255,266 PACE Development Fund $ 46,000Technology Development Fund $155,000Equipment Replacement Fund $ 19,000

TOTAL $475,266

FCLB Financial Report Sep - Oct 2013 Report to the Membership

Financial ReportAdopted Budget 2013

PROJECTED REVENUES

NBCE General Operations $519,500 Meetings Income (Conf. & District) 68,000

Dues 62,000CIN-BAD Subscriptions & Queries 40,000NBCE Shared Conference Expenses 15,000PACE 15,000Supporter Income 8,500Auction Receipts 7,000CCCA 5,000Interest 4,000Rebate Income 1,000

2013 Total Projected Grants &Earned Revenue $745,000

Funded -Tech Dev Reserve 20,550Total Budgeted Revenues $765,550

2012 Total Grants & Earned Revenue $741,316

Updated information from NBCE indicates the 2013 General Operations contribution will be $499,904 per theNBCE/FCLB Funding Agreement. The FCLB Board of Directors has been made aware of this information andappropriate budgetary adjustments are planned for 2013.

PROJECTED EXPENSES

Salaries $281,000Meetings Expense* 225,000Information Technology 45,000Group Health & Dental 46,750Legal Services 40,000Payroll Taxes 26,000Retirement 13,700Postage & Shipping 11,000Equipment Maintenance & Copies 7,500Public Relations 7,200Office Supplies & Publications 7,000Telephone 6,800Audit Services 6,550Internet Services 6,500Gifts & Awards 6,000Insurance 5,500Equip - Large ($1,000+) 5,000Contract Labor 5,000

Bank & Credit Card Servicing Fees 4,800Dues (FARB, CCGPP, AHC, CLEAR) 3,500Equipment - Small (less than $1,000) 1,500Printing 1,500Storage 1,200Auction 1,000Staff Development & Misc. 500Resident Agent & Filing Fees 50

2013 Total Projected Expenses $765,550

Total Budgeted Expenses $765,550

2012 Total Expenes $700,847

*Includes travel expenses for participation at Annual Conference,Districts, Mid-Year BOD, PACE, FARB, CCGPP, Summit, ACC/RAC,WFC/ICRF, COCSA, CCE, CFCREAB, etc.

NOTE: FCLB appreciates the NBCE’s additionalannual in-kind contribution of office space andutilities valued at approximately $34,703.


Financial ReportStatement of Revenues, Expenses, and Changes in Fund Balance - Accrual Basis

Year Ended December 31, 2012

REVENUES

NBCE General Operations $511,482Meetings (Conf & Districts) 72,110Member Dues 59,845CIN-BAD Subscriptions & Queries 45,101NBCE Conference Shared Expenses 15,000PACE 11,635Supporter Income (Conference) 10,500Raffle Receipts 5,850Interest 4,135Rebate income 2,211Wolfson Scholarship 1,500History Book Sales 1,147Miscellaneous 500Directory Sales 300NBCE In Kind Contributions 34,703

SUBTOTAL REVENUES $776,019NBCE In Kind Contributions (34,703)

TOTAL 2012 REVENUES $741,316

TOTAL 2011 REVENUES $728,425

Note: FCLB appreciates the NBCE’s additionalannual in-kind contribution of office space andutilities valued by NBCE at $34,703.

OPERATING EXPENSES

Salaries $269,848Meetings Expense* 217,293Legal Services 40,798Group Health & Dental 35,229Information Technology 33,567Payroll Taxes 21,254Retirement 13,349Postage & Shipping 9,944Telephone 6,876Equipment Maintenance & Copies 6,517Audit Services 6,250Business Insurance 5,918Internet Services 5,801Office Supplies & Publications 5,529Equipment - Small (less than $1,000) 5,121Bank & Credit Card Servicing Fees 4,817Gifts & Awards 3,706Dues (FARB, CCGPP, CLEAR, AHC) 3,180Printing 2,034Public Relations 1,090Storage 1,076

Contract Labor 960Miscellaneous 653Resident Agent 37Staff Development & Misc. 0Rent & Utilities - NBCE In Kind 34,703Depreciation & Amortization 19,813

TOTAL EXPENSES $755,363 Rent & Utilities - NBCE In Kind (34,703) Depreciation & Amortization (19,813)

TOTAL 2012 EXPENSES $700,847

NET GAIN $40,469

TOTAL 2011 EXPENSES $716,167

*Includes travel expenses for participation at Annual Conference,Districts, Mid-Year BOD, PACE, FARB, CCGPP, Summit, ACC/RAC,WFC/ICRF, COCSA, CCE, CFCREAB, etc.


Financial Analysis

Net Assets: 12/31/12 $783,109Net Assets: 12/31/11 $762,453Net Assets: 12/31/10 $786,867

FCLB Revenues

12/31/12 $741,31612/31/11 $728,42512/31/10 $719,439

REVENUES

NBCE continues to be the Federation’s mainsource of funding. Testing is the primary avenueof support for all other federations of regulatoryboards. FCLB’s beautiful office space, provided byNBCE, was valued in 2012 at $34,703 and isshown as an in kind contribution in the 2012 Audit.

FCLB extends its warmest appreciation to NBCEfor its continued support.

Meetings income supports one of the larger andmost valuable of the member services, enablingFCLB to provide top quality educational programsfor both conference and district meetings.

Membership dues provided 8% of the 2012budget. The FCLB was pleased to add the UnitedKingdom as the organization’s newest member.

CIN-BAD database revenues increased as FCLBpicked up a new subscriber, and 2012 was are-credentialing year for several subscribers.

NBCE conference shared expenses is income tohelp offset dual conference costs.

PACE gained three new for-profit providers in 2012and received income in the form of records fees,annual renewal fees, and application fees from itsapproved providers.

Supporter contributions provided by chiropracticcolleges and independent sources assists FCLB inpresenting important and effective programs inchiropractic regulation.

Raffle income benefitted the CCCA program andwas used toward the purchase of equipmentnecessary for operation of the program.

Interest income is earned on available fundsthrough certificates of deposit and other interestbearing accounts.


Financial Analysis

EXPENSES

Salaries & Benefits - The Federation continuesto offer its five staff a retirement benefit and agroup health insurance plan.

Meetings - FCLB constantly strives to providethe highest quality program at a cost that fits thebudget of member boards and allows thegreatest attendance by regulators. This categoryincludes all costs involved in presenting and/orattending meetings including travel, hotelsleeping rooms, banquet fees, audiovisual, etc.,all of which continue to rise while FCLB meetingregistration fees have not increased.

In addition to the programs provided by FCLB,the board and executive director attend andparticipate in meetings of other stakeholders asnecessary.

Members of the board of directors are eligible toreceive a $300/day honorarium and a $75/dayper diem for meals and tips when traveling onbehalf of the FCLB.

Legal - Legal funds are expended for occasionalattorney participation in board meetings, andgeneral legal advice as needed.

Information Technology (IT) & Programming -FCLB went live in 2011 with its highlycustomized central database. In 2012 we beganto integrate PACE and CCCA into theprogramming to maintain continuity of ouroperations.

Postage & Shipping - includes shipping to educational conferences as well as daily postalcosts. Much communication is done by e-mailand via the FCLB website.

Audit Services - Approved by the Board ofDirectors, performed by the independent CPAfirm of Anton Collins Mitchell, LLP.

Business Insurance - Business owner’s liability,travel and accident liability, board of directors’liability, surety bonds, and worker’s compensationcoverage.

Internet Services - Hosting for the FCLBwebsite and central integrated database.

Bank and Credit Card Service Fees -Transaction costs charged to FCLB when services are paid for via credit card (a functionincreasingly preferred by stakeholders).

Gifts & Awards - Presented at conference inrecognition of those who serve in chiropracticregulation as well as small gifts given throughoutthe year for special occasions.

Dues - FCLB membership dues for participationin FARB, CCGPP, CLEAR, and AHC.

Public Relations - Small promotional itemsidentifying FCLB, such as pens and CIN-BADcalendars.


Financial AnalysisSIGNIFICANT NOTES

The 2012 figures are based on an audit by AntonCollins Mitchell, LLC, Certified Public Accounts. Theirofficial statement is available for review by anymember.

This report is not prepared by them but is presentedto help members better understand FCLB finances.

FCLB identifies but does not fund depreciation.

The Federation began the 2012 fiscal year projectinga need to transfer $37,405 from reserved funds byyear end to balance the budget.

The anticipated transfer was due in large part to thecontinuing costs of the information technologyrebuilding effort and had been held in reserves for thispurpose. However, strict fiscal management resultedin no need tor transfer funds from the reserveaccounts.

The savings are in large part due to the following:

# The Board continued to hold tight reigns onthe budget.

# Additional programming for the centraldatabase was absorbed by the generalincome.

# An increase in conference attendance andcontaining conference costs by combining theWednesday welcome reception and Fridaynight event into a single event.

Using rigorous fiscal management the FCLB wasable to abide by its goal of assigning $21,216 tothe board designated 12 months operationsreserve account.


Emily Willingham, Contributor

PHARMA & HEALTHCARE

8/08/2013 @ 2:00PM |2,160 views

Chiropractors In Australia Barred From Making Antivax Claims

Chiropractors, practitioners who tend to get the side-eye from science-based medicine types, have frequently been associated with practices at the fringes of medicine–or, indeed, nowhere near the territory of medicine at all. Among these associations is a link between chiropracty and a stance against vaccines. Evidently, the nation of Australia and its chiropracty oversight board has had enough of the latter. According to Amy Corderoy, health editor of the Sydney Morning Herald, who just introduced me to the word “shonky“:

On Thursday the chairman of the Chiropractic Board of Australia said it had removed some courses from its approved training schedule and would be randomly auditing practitioners

to ensure they were not making unsubstantiated claims about the benefits of chiropractic.

It also announced all registered chiropractors would be required to remove anti-vaccination claims from their websites.

Chiropracty subluxated itself into medicine in 1895 when a “magnetic healer and grocer” in Iowa claimed that he’d restored a deaf man’s hearing using the approach. The practice is based on the idea that the things that are wrong with you arise from misalignments of your spinal column (subluxations), but the level of adherence to this odd philosophy among chiropractors can vary. Practitioners claim that these “corrections of subluxations” can benefit a huge variety of health problems, from low back pain to asthma to ADHD and … infertility (!). At this point, I refer you to some of the red flags of real versus fake science, specifically red flag #7.

According to research, the connection between being a chiropractor and eschewing vaccines goes back to this emphasis on “subluxations” as a cause for disease rather than, you know, infectious agents like viruses and bacteria. Although some chiropractors have evidently moved away from this line of reasoning, the inverse connection between chiropracty and vaccine uptake persists. Even as late as 2005, more than a quarter of chiropractors surveyed in Alberta, Canada, were encouraging or advising their patients to avoid vaccination.

And it continues. A visit to the International Chiropractors Association’s Website turns up two vaccine-related books for sale: Vaccination: 100 Years of Orthodox Research Shows that Vaccines Represent a Medical Assault on the Immune System, by a “micropaleontologist,” and Vaccines: Are They Really Safe and Effective? The latter is described as follows on Amazon:

When New Atlantean Press first published “Vaccines: Are They Really Safe and Effective?” some people opposed our efforts to educate parents and health practitioners. Of course, many others were deeply grateful. … chiropractic colleges stock it in their bookstores and midwives recommend it to their clients. Many pediatricians and other doctors purchase this book as well. Often, they are surprised by the number of valid studies documenting vaccine hazards. This information was not taught in medical school.

I think we can tell how the book will answer the question it asks in its title, and again, I refer you to my list of 10 things to watch for in distinguishing real from fake science (see specifically #6). The reality is, of course, that the answer is ‘yes’. No medical intervention is without risk, but vaccines are among the safest and most effective public health interventions of all time.

In spite of this track record, though, just this year, opposition to getting the flu shot was reported as an “industry-wide stance” among US chiropractors, and Corderoy reported back in April in the Sydney Morning Herald that some chiropractors were maintaining their government-mandated continuing education by taking classes with “anti-vaccination physicians.”

Evidently, the resulting controversy and accompanying comments from the Australian Medical Association drew the attention of the chiropracty governing board in Australia, leading to this new prohibition against having anti-vaccination language on chiropractic websites. I’m curious to see how they’ll handle phrasing on chiro websites like this one, which begins with “the benefits of vaccination are well known” but then expends hundreds of words on why people don’t need vaccines, how diseases like measles are “good for us,” and how Andrew Wakefield showed that autism and vaccines are linked. This new prohibition obviously will require sufficient teeth to take a bite out of such slippery evasions.

This article is available online at: http://www.forbes.com/sites/emilywillingham/2013/08/08/chiropractors-in-australia-barred-from-making-antivax-claims/

h�p://www.theage.com.au/victoria/chiro-ruled-guilty-of-misconduct-20130604-2noaa.html

Chiro ruled guilty of misconductPublished: June 5, 2013 - 3:00AM

A chiropractor has been found guilty of professional misconduct after misrepresenting the likely effectiveness of hyperbaric oxygen treatment for a patient's cerebral palsy.

The Victorian Civil and Administrative Tribunal found Malcolm Hooper guilty of three counts of professional misconduct and five counts of unprofessional conduct, in a finding delivered on Tuesday.

Fairfax has previously reported that Dr Hooper provided Essendon players with more than $50,000 worth of hyperbaric oxygen treatment at his South Yarra clinic.

The finding related to Dr Hooper's treatment of a patient who received 269 hours of hyperbaric oxygen between August 2007 and May 2008, along with 79 hours of treatment on a treadmill-like device that is claimed to help the body relearn how to walk.

The patient, who was on a disability pension, incurred debts of more than $44,000 for the treatments.

In 2011 Dr Hooper admitted professional misconduct in a statement of facts agreed with the Chiropractic Board of Australia but subsequently withdrew his admissions, claiming they were made under ''extreme duress''.

He challenged the allegations made against him by the board in a VCAT hearing before three VCAT members between January and May this year.

The tribunal found Dr Hooper had engaged in professional misconduct and unprofessional conduct. It is yet to rule on penalties but said it believed Dr Hooper would be unable to observe the high standards expected of him as a chiropractor.

Essendon's chiropractor charged disabled patient $45,000 for unproven treatments http://www.heraldsun.com.au/sport/afl/essendons-chiropractor-charged-disabled-patient-45000-for-unproven-treatments/story-fni5ezdm-1226657449801

ESSENDON players were given hyperbaric chamber treatments by a chiropractor who has been found guilty of misconduct.

Dr Malcolm Hooper was yesterday found to have charged a disabled patient almost $45,000 for unproven treatments.

The Victorian Civil and Administrative Tribunal found he engaged in professional misconduct by charging a patient with cerebral palsy for 150 hours of unproven oxygen therapies and by making unfounded claims about his ability to treat more than 30 conditions, including cerebral palsy, cancer, multiple sclerosis, infertility and autism.

The penalties could include cancellation of his registration.

The South Melbourne chiropractor previously has said he was assisting the Australian Sports Anti-Doping Authority with its Essendon inquiries, after the club used his Hypermed clinic in April-July last year.

On his website, Dr Hooper claims his hyperbaric oxygenation therapy can "upregulate" peptides and ensure "that target tissues are fully exposed to the benefits of peptide therapies".

Under "Oxysports" treatments, he promotes use of AOD-9604 - the anti-obesity drug at the centre of the Essendon inquiry - in "settings where bone and soft tissues are compromised".

There is no suggestion any treatment of Essendon players breached the World Anti-Doping Agency code.

Essendon refused to comment on Dr Hooper. His involvement with Essendon formed no part of the Chiropractic Board of Australia's case and no allegations were made about treatments administered to players.

Dr Hooper told the Herald Sun it would not be appropriate to comment. He said treatments for Essendon players were "in the style" of therapies detailed on his website, but that hyperbaric use was not restricted by WADA or ASADA.

"There's many patients that are referred in with all sorts of different conditions, undertaking all sorts of different therapies, and the catalyst effect of hyperbaric certainly has been well documented to assist patients with a wide range of conditions," he said.

Doctor betrayed trust of patients, says Chiropractic Board of Australia http://www.heraldsun.com.au/news/victoria/doctor-betrayed-trust-of-patients-says-chiropractic-board-of-australia/story-fni0fit3-1226681624564

by:James Dowling Herald Sun July 18, 20138:48PM

A CHIROPRACTOR who treated Essendon players last year is facing a three-year ban after he charged a disabled patient $50,000 for an unproven treatment.

Dr Malcolm Hooper was found guilty of professional misconduct after the Chiropractic Board of Australia said he betrayed the trust and gave false hope to the cerebral palsy patient.

Dr Hooper had zealous beliefs that hyperbaric chamber treatment was a panacea for patients with cerebral palsy, autism and multiple sclerosis, the board claimed.

In a ruling last year The Victorian Civil and Administrative Tribunal found he was guilty of professional misconduct, unprofessional conduct and bringing the profession into "undeserved ill-repute".

Dr Hooper also made unsubstantiated claims on his Hypermed website that oxygen therapy could treat 30 conditions ranging from cancer, autism, hepatitis and paraplegia.

Dr Hooper did not provide the cerebral palsy patient with all the information on oxygen therapy before performing the expensive treatment, the board alleged.

In his submission to VCAT Dr Ian Freckelton for the Chiropractic Board of Australia said Dr Hooper relied heavily on one textbook he deemed the "holy grail" that supported his view that oxygen treatment was a panacea to all types of conditions. He said he provided false hope to seriously ill patients, betrayed their trust and took their money.

Neill Murdoch, representing, Dr Hooper said his client wanted to express his sorrow that his conduct caused the patient, known as QS, embarrassment.

Mr Murdoch said Dr Hooper was an undischarged bankrupt who had dependent children and would like to keep working.

His involvement with Essendon formed no part of the Chiropractic Board of Australia's case.

He said the VCAT panel ruled Dr Hooper was off good character and truly believed the hyperbaric chambers could treat patients with cerebral palsy.

Mr Murdoch said his client had practised in Melbourne since 1983 and was not a "fly-by-night operator".

His involvement with Essendon formed no part of the Chiropractic Board of Australia's case and no allegations were made about treatments administered to players. ###

Agassiz chiropractor reprimanded by college

By Agassiz‐Harrison Observer

Published: May 23, 2013 12:00 PM / Updated: May 23, 2013 12:3812 PM

An Agassiz chiropractor has admi ed to engaging in sexual conduct with a pa ent, according to a public no ce by the

College of Chiropractors of Bri sh Columbia (CCBC).

Dr. Kevin Henke has been reprimanded by the college for his ac ons, which occurred between Dec. 2007 and Feb. 2008.

The resul ng discipline order was made on May 3, and has been published online as public informa on. Dr. Henke

declined to speak to the Observer about the ma er.

One of the condi ons handed to Henke by the CCBC is a six‐month suspension from prac cing. Henke's lawyer, Patrick F.

Lewis, stated in an email that the suspension will begin on July 3 this year – a meframe that could be stayed by three

months if all other terms of the order are met. Those include paying costs of $10,000 and comple ng approved

coursework on boundary issues, at Dr. Henke's own expense.

Diana MacKay, deputy registrar at the CCBC, said the issue is "not a criminal act."

"But we did have a complaint, and we do have a code of conduct," she said. "We can only say that we take seriously the

complaints that come into us."

The suspension is not immediate because the college has to put pa ents' health as top priority, she said.

"If we just issued an order and said today you have to stop prac cing, we then have an issue with them (pa ents) not

receiving care," MacKay said.

Licence suspended The TimesMay 28, 2013

An Agassiz chiropractor has been suspended from practising for six months and fined $10,000 for "engaging in sexual conduct" with a patient.

According to the College of Chiropractors of British Columbia, Kevin Henke admitted that the sexual conduct took place between December 2007 and February 2008.

That conduct contravened the rules of the college, which handed down its punishment earlier this month.

According to the college, "Dr. Henke consented to an order from the Inquiry Committee (1) reprimanding him for professional misconduct, (2) suspending his registration for six months commencing no later than 60 days from the Order issued on May 3, 2013 (with three months to be stayed if all other terms of the order are met), and requiring him to (3) complete approved coursework on boundary issues at his own expense; and (5) pay costs of $10,000."

Henke operates Mount Cheam Family Chiropractic.

According to his website, Henke has been a practising chiropractor in Agassiz for eight years.

Read more: http://www.chilliwacktimes.com/health/Licence+suspended/8443274/story.html#ixzz2WWMxqESv

Bri sh Columbia regulatory board

Fort Myers chiropractor arrested for fraud

http://www.nbc-2.com/story/22262666/fort-myers-chiropractor-arrested-for-fraud

Posted: May 15, 2013 2:59 PM MDT

By Matt Wright, Reporter

A Fort Myers chiropractor is in trouble with the law. Investigators say Dr. David Greydinger paid patients to fake injuries from car crashes to rip off insurance companies.

Investigators say the fraud scheme operated out of an unassuming Fort Myers storefront at MYO Health Clinic. That is where they say Greydinger paid a confidential informant to fake injuries from a non-existent car crash. Then, they say he collected $6,000 in insurance payments.

"Greed is the primary force behind everything with insurance fraud. It all comes down to money," said Detective William Quick, with the Florida Division of Insurance Fraud.

Wearing a wire, investigators were able to monitor their informant's appointments over five months.

After some of them, she was led to Greydinger's nearby office where investigators say he handed over cash kickbacks totaling $800. Authorities moved in and arrested Greydinger last week. According to the arrest report, when investigators asked if he'd ever paid the informant, Greydinger said, "We don't pay here, and by law we're not allowed to pay. I don't pay her."

Greydinger's Fort Myers clinic is still open for business; but the receptionist says he is working out of an Orlando office this week. When we reached Greydinger by phone, he simply hung up.

Insurance agent Tim Shaw says fraud now makes up an entire third of the cost of your auto insurance premium. And while fraudsters profit from their schemes, insurers pass on the cost.

"I'm disgusted by it. Insurance fraud is a huge problem for all of us," he said. "It seems innocuous and seems like it's OK, but it's fraud. We all pay the price."

h p://dailyridge.com/headlines‐now/2013/08/04/re red‐chiropractor‐charged‐with‐55‐counts‐of‐child‐pornography/

Retired Chiropractor Charged With 55 Counts of Child Pornography Posted on Sunday, August 4, 2013

Winter Haven, Florida – “We are commi ed to protec ng our children, and we are dedicated to

ensuring those who prey on children are held accountable. If you download or distribute child

pornography – you are contribu ng to the vic miza on of children, and you will go to jail.” Sheriff

Grady Judd

On Friday, August, 2, 2013, Polk County Sheriff’s Office detec ves, working with Indian River

Internet Crimes Against Children detec ves, arrested 67‐year‐old, re red Polk County

Chiropractor, Samuel Oklesh, DOB 02/16/1946, 1166 6th Avenue Apt. 16D, Vero Beach, and

charged him with 55 Counts of Possession of Child Pornography.

On December 21, 2012, PCSO undercover detec ves executed a search warrant at 216 Lake

Region Boulevard, Winter Haven, in reference to a subject downloading child pornography. An on‐scene preview was

conducted, however it was inconclusive at the me and required a full forensic examina on.

A full forensics was later competed and approximately 500 images/videos of child pornography were located. The images

were of children exposing their genitals in a lewd manner, children engaging in sexual acts with other children, and adults

engaging in sexual acts with children. The images included infants and children up to 10 years of age.

An arrest warrant was obtained for Oklesh however, it was discovered the suspect and his live‐in ex‐wife, Kim Wilson,

moved in the middle of the night, several days later. Detec ves then learned of a possible residence in Indian River

County.

Working with Indian River ICAC detec ves Oklesh was located and arrested. Oklesh is currently being held in the Indian

River County Jail.

See FL Board website – the

board secured an immediate

voluntary relinquishment

h�p://dailyridge.com/headlines-now/2013/08/04/re�red-chiropractor-charged-with-55-counts-of-child-pornography/

Retired Chiropractor Charged With 55 Counts of Child PornographyPosted on Sunday, August 4, 2013

Winter Haven, Florida – “We are commi�ed to protec�ng our children, and we are dedicated to ensuring those who prey on children are held accountable. If you download or distribute child pornography – you are contribu�ng to the vic�miza�on of children, and you will go to jail.” Sheriff Grady Judd

On Friday, August, 2, 2013, Polk County Sheriff’s Office detec�ves, working with Indian River Internet Crimes Against Children detec�ves, arrested 67-year-old, re�red Polk County Chiropractor, Samuel Oklesh, DOB 02/16/1946, 1166 6th Avenue Apt. 16D, Vero Beach, and charged him with 55 Counts of Possession of Child Pornography.

On December 21, 2012, PCSO undercover detec�ves executed a search warrant at 216 Lake Region Boulevard, Winter Haven, in reference to a subject downloading child pornography. An on-scene preview was conducted, however it was inconclusive at the �me and required a full forensic examina�on.

A full forensics was later competed and approximately 500 images/videos of child pornography were located. The images were of children exposing their genitals in a lewd manner, children engaging in sexual acts with other children, and adults engaging in sexual acts with children. The images included infants and children up to 10 years of age.

An arrest warrant was obtained for Oklesh however, it was discovered the suspect and his live-in ex-wife, Kim Wilson, moved in the middle of the night, several days later. Detec�ves then learned of a possible residence in Indian River County.

Working with Indian River ICAC detec�ves Oklesh was located and arrested. Oklesh is currently being held in the Indian River County Jail.

See FL Board website – the board secured an immediate voluntary relinquishment

The Cost of Fraud By Stephen M. Perle, DC Last year, I attended the American College of Chiropractic Consultants/College of Forensic Sciences annual meeting, which I have done many times. This is always a great conference to attend. The speakers are typically scientists and clinicians providing information on standards of care and best practices in the peer evaluation. This time there was a very unusual presenter. It was a doctor who had recently pleaded guilty in federal court to a very large amount of insurance fraud. He had already paid restitution in the amount of $2.94 million. He was speaking to us as part of his effort to prevent getting any jail time for his crimes. The court had given him six months to demonstrate his remorse. During that time he had given a talk similar to the one we heard to both professionals and students in various health career schools and other similar groups. A doctor at a recent ethics seminar I gave told me that she heard this doctor speak when she was a chiropractic student. His story was compelling and, it seems, would very likely motivate clinicians to stay on the straight and narrow. I thought he “came clean.” Everyone in attendance that I heard from likewise thought he had revealed all. He willingly answered questions from what was, to say the least, probably his most skeptical and potentially hostile audience. He told how he started committing the fraud by continuing to bill for services ordinarily rendered, but not during some office visits because patients periodically asked to only get adjusted and forgo other procedures and modalities due to time constraints. He said that his poor control of billing practices extended to his five other clinics. He did not tell us that prior to the FBI approaching him in 2010, insurance companies had told him three times that his billing practices were improper. One time, this resulted in his returning to an insurer half a million dollars. A few years later, he returned $70,000 to another insurer who later required that all of his bills be subject to pre-payment review. None of these events seemed to deter him from continued fraud—i.e., billing for services not rendered. During his plea hearing, he admitted doing this not out of need. He didn’t have creditors beating at the door because he was broke. He just “pushed the envelope” when he saw that insurance companies continued to pay. This was simple greed. The trial judge went against sentencing guidelines when he sentenced the doctor. The judge noted in part the cost of incarceration and decided that during the six months before his sentence was handed down the doctor, who had performed 391 hours of community service (the lectures about fraud to health sciences students and professional groups), provided 18 days of free chiropractic care at homeless shelters, painted an elementary school gym and paid restitution, had paid his debt to society and let him off without prison time. This was the doctor’s goal, as he told us his only desire in life was to be a parent and being away from his children was the worst thing he could ever imagine. The federal government, however, believed no jail time was too lenient and appealed the sentence. On March 13, 2013, the federal Circuit Court of Appeals agreed with the government and wrote: “The district court’s sentence does not reflect the seriousness and extent of the crime, nor does it promote respect for the law, provide just punishment, or adequately deter other similarly inclined health care providers. We therefore find the sentence to be substantively unreasonable, and an abuse of the district court’s discretion.”1 The district court has not revised its sentence yet. Nevertheless, it appears that the doctor, despite his best efforts, will end up in federal prison. The cost of fraud is high. References www.ca11.uscourts.gov/opinions/ops/201115959.pdf Published in the June/July 2013 ACA News

Following a period of suspension, this doctor is now on proba on in Georgia un l 2017.

h p://www.law360.com/ar cles/422628/print?sec on=appellate

Portfolio Media. Inc. | 860 Broadway, 6th Floor | New York, NY 10003 | www.law360.com

Phone: +1 646 783 7100 | Fax: +1 646 783 7161 | [email protected]

11th Circ. Demands Jail Time For Doc In $3M Fraud Case By Rachel Slajda

Law360, New York (March 11, 2013, 5:23 PM ET) -- A Georgia chiropractor should get jail time for a $3 million insurance fraud scheme, the Eleventh Circuit ruled Friday, finding that a lower court's sentence of time served was too lenient and would not deter others from committing health care fraud. The chiropractor, Rick Kuhlman, pled guilty in March 2011 to billing health insurance companies for services he never performed. He stole about $2.9 million from Aetna Inc., Blue Cross Blue Shield and United HealthCare Services Inc., according to prosecutors. Although prosecutors asked for a three-year jail sentence, U.S. District Judge Marvin H. Shoob was impressed that Kuhlman had paid full restitution to the insurance companies, and gave the doctor six months to perform community service before coming back for his sentencing. Kuhlman spent 391 hours speaking about health care fraud at medical and chiropractic schools and providing chiropractic services at homeless shelters. At his sentencing in November 2011, Judge Shoob applauded Kuhlman's service and sentenced him to time served. In explaining the sentence, Judge Shoob invoked the high cost of incarceration as well as the case of a "budding rock star" who was convicted on a weapons charge. The Atlanta Journal-Constitution identified the case as that of rapper Bruce Falson, to whom Judge Shoob also granted a six-month reprieve. Falson gave a series of radio interviews meant to discourage young people from taking up a criminal lifestyle, and Judge Shoob later sentenced him to probation. Prosecutors appealed, incensed that Kuhlman would not spend any time in prison. On Friday, an Eleventh Circuit panel agreed, vacating the sentence and remanding it back to the district court. "Such a sentence fails to achieve an important goal of sentencing in a white collar crime prosecution: the need for general deterrence," the panel wrote. "We are hard-pressed to see how a noncustodial sentence serves the goal of general deterrence." The U.S. attorney's office had argued that deterrence is especially important in health care

fraud cases, "because health care fraud is so rampant that the government lacks the resources to reach it all," according to the court. Therefore, it is important to send a message by making an example of convicted fraudsters. "Kuhlman's sentence sends the opposite message — it encourages rather than discourages health care providers from engaging in the commission of health care fraud because they might conclude that the only penalties they will face if they are caught are disgorgement and community service. We do not mean to imply that probation can never be an option available to a court in fashioning a reasonable sentence in a white collar crime case," the court said. "But not here." Kuhlman's attorney, Jay Strongwater of Strongwater & Associates LLC, told Law360 that the defense believed that speaking with medical students about fraud was a better deterrence than jail time. "We disagree with the court that general deterrence can only be satisfied by incarceration," Strongwater said. The U.S. attorney's office in Atlanta declined to comment. Under federal sentencing guidelines, Kuhlman could have received between about five and six years. Prosecutors had recommended a sentence of three years. Kuhlman is represented by Jay Strongwater of Strongwater & Associates LLC and Darryl B. Cohen of Cohen Cooper Estep & Allen LLC. The case is USA v. Rick Kuhlman, case number 11-15959, in the U.S. Court of Appeals for the Eleventh Circuit. --Editing by Katherine Rautenberg.

h p://drstevehoffman.com/blog/?p=212

Dr. Steve's Practice Tip Blog Practice Tips from Dr. Steve Hoffman

The Danger and Demise of hCG for Chiropractic By Kyle D. Morgan, D.O. and AJ Deeds Posted on February 23, 2011 by Dr. Steve

Many Chiropractors are considering or using human chorionic gonadotropin (hCG), the female

pregnancy hormone drug, as a weight loss program[i] due to its tremendous popularity and healthy

financial margins.

Developed by British doctor A.T.W. Simeons in the 1950’s, the protocol provided for injections of the

hCG drug plus a strict 500-calorie per day diet. Proponents claimed weight loss of 1-2 lbs per day over

a 27-40 day program.[ii]

A lack of validation via double blind, placebo-based studies[iii],[iv],[v],[vi],[vii],[viii],[ix],[x],[xi],[xii],

coupled with regulations by the FDA[xiii],[xiv],[xv],[xvi] and FTC[xvii],[xviii] greatly curtailed the

previous burst of public interest in hCG in the mid-1970’s. Spurred by development of homeopathic

hCG drops in the 1990’s[xix] and Kevin Trudeau’s controversial bestseller “Weight Loss Cure They

Don’t Want You to Know About” in 2007[xx], hCG regained its popularity, eventually spawning

thousands of websites, companies and sources for the drug. “hCG Diet” became the most searched

health and wellness term on Google in 2010[xxi].

Yet by being defined as a prescription drug, hCG requires a prescription and a pharmacy license to

legally dispense. [xxii] The so-called “non-prescription” homeopathic hCG is not a legal homeopathic

drug[xxiii] at all because the hCG active ingredient is a Rx (prescription) drug [xxiv] and hCG is not

listed in the Homeopathic Pharmacopeia of the United States (HPUS) [xxv]. To be legal, all

homeopathic substances must have an approved monograph in the HPUS[xxvi], signifying the

substance meets the principles of homeopathy and has been tested and approved via homeopathic

formulation and production requirements. hCG does not have a monograph in the HPUS and is not

legal to sell in the US.[xxvii]

On January 23, 2011, the FDA publicly declared homeopathic hCG an illegal substance.[xxviii]

Enforcement has been of a lower priority due to less serious health side effects on users, yet the FDA

indicated it would enforce regulations at any time. For example, a March, 2010 enforcement raided

the offices of a Naturopathic Doctor (ND) in Washington state who had both imported hCG from

China/ India and had purchased homeopathic hCG from a compounding pharmacy in Florida.

Although the ND had the right to prescribe the drug for fertility treatments, the FDA took patient

files, computers and hCG inventory following the 10-month investigation of the ND importing an

unapproved drug and for misbranding.[xxix]

Chiropractors will want to seek experienced legal counsel to review the predictable risks and dangers

that can result from selling hCG, which include:

- penalties for selling a prescription drug (Rx) without a license[xxx]

- State Chiropractic board discipline including potential loss of license for selling a Rx drug or selling

a supplement containing Rx ingredients as well as for questionable standards of care

- legal action from dissatisfied patients

- recent announcements by the FDA of increased enforcement targeting sellers of adulterated and

misbranded weight loss products that contain Rx ingredients.[xxxi]

The dangers of hCG to the Chiropractic profession are now public and the FDA’s formal position gives

limited defense against not knowing the regulations surrounding this drug. While hCG will

undoubtedly continue to be made available by those willing to bet that the lucrative sales of an illegal

substance can last a bit longer with limited risk of FDA enforcement, the demise of hCG use by the

Chiropractic profession will occur much sooner. We would also suggest that there is an equally

effective if not superior weight loss product for Chiropractors without the risks associated with

hCG.[xxxii]

Authors

Kyle D. Morgan, D.O. is an Alternative Medicine Doctor of Osteopathy licensed in the state of

Michigan. Dr. Morgan is the inventor the Weight Balancing System™, Brain Detox™ and other

unique tools and methods that help people to reach a healthy balance in life.

AJ Deeds is President of Loving Works, LLC, a direct marketing firm that offers the Weight Balancing

System™ —a reduced portion plan food program combined with the Wt Balancer®, an all-natural,

liquid dietary supplement, that helps users release 10-25 lbs. per month without hormones, hCG,

strong stimulants, blockers or suppressors.

For more information: www.mylovingworks.com/drsteve

For reprints of this article and ALL the references cited in it, please email Dr. Steve by CLICKING

HERE

Print Page By AMY HANSEN OST news editor • [email protected]

Board denies reinstating chiropractor’s licenseAn Osceola chiropractor isn’t going to have his license reinstated — for now.

In documents released Monday from the Iowa Board of Chiropractic, the board denied reinstating the license of Dr. Stuart Hoven, with Clarke County Chiropractic and Winterset Family Chiropractic.

According to the Iowa Board of Chiropractic, Hoven engaged in unethical conduct or practiced harmful or detrimental to the public. It was determined Hoven had improper sexual conduct with, or made suggestive, lewd, lascivious or improper remarks or advances to a patient numerous times in 2005, 2009 and 2012.

Hoven isn’t allowed to file for reinstatement again until he has met all of the board’s conditions concerning the future safety and welfare of patients.

First complaint

Hoven was issued a license to practice as a chiropractor in the state of Iowa in 2001.

According to court documents, in April 2005, the board found Hoven had engaged in unethical conduct when he improperly touched the breasts of two female patients and made suggestive remarks to them.

According to the board, before Hoven’s current suspension, he was still allowed to practice but must have had a female, nonfamily member chaperon at all times when providing treatment to female patients.

Hoven was not allowed to perform any soft-tissue chiropractic treatment to female clients on or around the breast.

His license was then returned to full privileges in July 2010.

Most recent complaints

The most recent allegations arose from a complaint by a female patient who said Hoven had touched her breasts during a chiropractic visit Feb. 14, 2012.

According to the board, on May 11, 2012, another female patient reported she went to Hoven for chiropractic treatment in 2009 and claimed he “cupped her breast during one session and rubbed against her during a second.”

The woman didn’t make a complaint in 2009 because she was “embarrassed.”

However, in May 2012, the woman’s husband saw a television newscast about Hoven and a complaint was filed against him.

The board decided to suspend Hoven’s license.

Court documents further state, Hoven’s current suspension meant he could not apply for reinstatement until he completed a comprehensive assessment regarding professional sexual misconduct.

It was further ordered that not until Hoven has completed the provisions of his suspension will the board consider any application for reinstatement.

The assessment took place at the Behavioral Medicine Institute (BMI) of Atlanta, Ga.

Hearing

A licensure reinstatement hearing was held July 10 in Des Moines.

BMI found Hoven was unsafe to practice, and he followed up by attending treatment at Acumen, one of the providers recommended by BMI.

Hoven filed an application for reinstatement March 1, which was only four days into his treatment at Acumen, even though he had completed less than a week of his three-week session with Acumen.

During testimony, Hoven admitted he filed the application early so he could get on the board’s March agenda.

In an analysis from the board, it states, “the troubling aspect of (Hoven’s) application is how closely it tracks his application for reinstatement after the board suspended his license in 2005. ... The board suspended respondent’s license on April 27, 2005. From that point, respondent started a race to reinstatement.”

Acumen recommended Hoven return to practice so that it could monitor and assess compliance in future sessions. However, Acumen recognized the board ultimately decides whether to reinstate a license.

Final follow-up

Page 1 of 2Print Version:Board denies reinstating chiropractor’s license

9/11/2013http://www.osceolaiowa.com/2013/09/09/board-denies-reinstating-chiropractors-license/a602isb/?...

The final follow-up for Hoven at Acumen is scheduled March 12-14, 2014. If Acumen issues a report stating Hoven is safe to return to practice after the session, he could return to BMI for a comprehensive in-person evaluation.

If BMI finds Hoven is safe to return to practice, he may file an application for reinstatement with the board. Hoven may not file until all of the conditions are met.

From the July 10 hearing, Hoven is ordered to pay $75 for fees associated with conducting the disciplinary hearing and $68.75 for the court reporter. He is ordered to remit $143.75 for these expenses within 30 days of receipt of the bill.

Mondays board documents states, “The board is not willing to risk returning (Hoven) to practice before he can prove to the board that he is not a danger to the public welfare. He has yet to do that.”

Copyright © 2013 Osceola Sentinel-Tribune. All rights reserved.



Board: Iowa chiropractor gave patient drugs, booze Monday June 17, 2013 1:15 PM

CLIVE, Iowa (AP) — A chiropractor in central Iowa has been accused of giving a young patient

illegal drugs and alcohol.

The Iowa Board of Chiropractic says Cameron Hart, of Clive, sent the patient numerous text

messages that were of a sexual and graphic nature. Hart began treating the patient when the

patient was a high school senior.

Hart is accused of giving the patient marijuana and alcohol, and waiving co-payments without

telling his third-party provider.

Hart faces five counts, including committing unethical conduct by having improper sexual

contact with, or making suggestive, lewd, lascivious or improper remarks or advances to a

patient.

Hart faces a disciplinary hearing with the board on Oct. 9. A message left at Hart's office was

not immediately returned Monday.

When are board charges public?

Animal Chiropractor Daniel Kamen Prompts State Crackdown

Published Wednesday, Jun. 19, 2013

BUFFALO GROVE, Ill., June 19, 2013 ‐‐ /PRNewswire/ ‐‐ In 1995 chiropractor Daniel Kamen conducted his first of four

hundred animal chiroprac c technique seminars that was not just for licensed chiropractors and veterinarians, but also

for regular horse and dog owners. Each seminar quickly sold out. Kamen, an animal chiroprac c pioneer and author of

three bestselling books on animal chiroprac c technique, The Well Adjusted Dog, The Well Adjusted Horse, and The Well

Adjusted Cat, was swi ly served with cease and desist le ers from several states claiming he violated their veterinary

laws by teaching non‐professionals to manipulate Spot, Seabiscuit, and Fluffy.

"Soon a er I conducted my first few seminars I heard from a lot of states warning me to stay out. Minnesota, Oklahoma,

Arkansas, Georgia, Washington, Ohio, Louisiana, and Nevada all sent me cease and desist le ers. Nevada! They allow

gambling and pros tu on but they'll lock you up for cracking a horse's tuchus."

Nevada even threatened Kamen with legal ac on if he didn't remove seminar announcements from his website,

www.animalchiroprac c.com .

"It's all about money," Kamen said. "Dog owners won't spend five grand for hip dysplasia surgery when a simple, almost

free chiroprac c technique can help prevent its onset."

Aside from the hip dysplasia technique, dog owners paid close a en on when Kamen demonstrated the bladder control

move. "It just takes four minutes a day," Kamen said. "And no more soiled carpets."

By far, the most popular chiroprac c technique among Thoroughbred trainers and barrel racers is the "Pre‐Race

Adjus ng Sequence," which, according to Kamen, "increases efficiency and can shave frac ons off the me."

Prac oners from as far away as Hong Kong, Australia, South Africa, and England flew in to learn these techniques. "My

seminars a racted people from all over the world," said Kamen, 57, who is mostly re red and now conducts only one

seminar a year. "A Saudi prince once flew his personal chiropractor to my Philadelphia seminar so he could adjust his

prized Arabians."

State laws regula ng the prac ce of animal chiroprac c haven't changed much in 18 years. Even though there is a

na onal veterinary chiroprac c associa on cer fying licensed prac oners, there are s ll less than two hundred full

me professional animal chiropractors na onwide. Addi onally, most veterinary boards have shut out licensed human

chiropractors who are also cer fied in animal chiroprac c. It's no wonder horse and dog owners who want their animals

adjusted have to fend for themselves.

"That's why my seminars thrived," Kamen said. "Horse and dog owners were just as fed up with the system as I was and

were forced to learn how to adjust their own animals who suffered from neck, back, and leg pain. Their frustra on in

searching for a trained professional fueled my business. The states who made it illegal for licensed chiropractors to adjust

animals were really doing me a favor. They created a lay market for me for which I am eternally grateful. My only

problem now is finding the appropriate thank you card at Walgreens."

Kentucky tax cheats could lose drivers and professional licenses starting July 1 Published: June 7, 2013

Read more here: http://www.kentucky.com/2013/06/07/2670112/kentucky-tax-cheats-could-lose.html#storylink=cpy

By Valarie Honeycutt Spears — [email protected]

Beginning July 1, Kentuckians who don't pay their state taxes can lose their drivers and professional licenses and their ability to register and license a vehicle.

State revenue officials say they expect to use the measure rarely and as "a last resort," but some lawmakers who voted in March for a bill containing the tougher tax penalties now say they were unaware of the provision and think it may go too far.

Professionals ranging from attorneys to hair dressers could be denied renewal of their state licenses under the law, which was approved on the final day of the 2013 General Assembly as part of a compromise bill to reform the state's ailing pension system.

Earlier this week, at a meeting of the Interim Joint Committee on Transportation, leaders of the Senate and House transportation committees said the change was a surprise.

"This is something that we want to iron out," House Transportation Chairman Hubert Collins, D-Wittensville, said Thursday in an interview.

How can people pay taxes if their professional licenses have been suspended and "they aren't working," Collins asked.

Sen. Bob Leeper, an independent from Paducah, was on a small committee that hashed out details of the bill behind closed doors.

"Probably because we did it so quickly I am not sure it was as well thought out as we would have liked it to have been," Leeper said Friday. "I feel pretty confident it will be revisited."

The new regulation was recommended last year by the Governor's Blue Ribbon Commission on Tax Reform at the request of the state Department of Revenue, according to the commission's 2012 report.

Pamela Trautner, a spokeswoman for the Finance & Administration Cabinet, said officials expect the measure to net $10 million for Kentucky over the next two years. Trautner said the law allows revenue officials to block the renewal of professional licenses administered by state government, driver's licenses and vehicle registration.

The measure is aimed at taxpayers who have exhausted appeals and still refuse to pay any state tax other than real property taxes, which are collected at the local level, she said.

The law specifically says attorneys who are delinquent taxpayers can lose their license to practice law. Trautner said revenue officials will advise the state Supreme Court, who oversees attorneys, about delinquent taxpayers.

Amy Carman, a spokeswoman for the Kentucky Bar Association, said any notification that group receives will be sent to the Supreme Court "for appropriate action." Carman said the association didn't have any further comment about the measure.

Charles Lykins, the executive director of the Kentucky State Board of Hairdressers and Cosmetologists, said his board and others that oversee professional licenses have been required to send names of the people they license to revenue officials. He said he didn't have any major concerns about the measure.

"My guess is that it will affect very few" of the cosmetologists in the state, Lykins said.

Revenue officials are still determining how many people will be affected, Trautner said. But she said "95 percent of Kentuckians pay their taxes."

The measure is aimed at those "who have just ignored every effort that revenue has made," she said.

Trautner said citizens affected by the change will be notified with a letter sometime after July 1. Those who agree to a payment plan will be considered in compliance and not at risk of the sanctions, she said.

Transportation Cabinet spokesman Chuck Wolfe said the Department of Motor Vehicle Regulation already withholds drivers licenses for a variety of reasons, including when it gets notices from the Administrative Office of the Courts of certain traffic convictions.

"It's a mandate we will carry out," Wolfe said. "It will be very similar to what we already do with notices from AOC."

The Governor's tax reform commission reported that Massachusetts and Delaware have similar programs that deny and revoke vehicle registration, drivers licenses and professional licenses.

Only professional licenses are denied or revoked in Hawaii, Illinois, Indiana, Iowa, Kansas, Maine, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Oklahoma, Oregon, Pennsylvania, Vermont, and Wisconsin, the report said.

Senate Transportation Chairman Ernie Harris, R-Crestwood, said Thursday that he wants to hear more about the measure from revenue officials but thinks "it's not as onerous as what we thought earlier because we didn't have full information."

"I'm going to make the assumption," Harris said, that revenue officials "will do everything it can to resolve the issue before they suspend the license."

#

Marin chiropractor arrested with alleged crystal meth, pipe and pills in San Rafael By Gary Klien Marin Independent Journal Posted: 07/17/2013 05:42:59 PM PDT http://www.marinij.com/sananselmo/ci_23681551/marin-chiropractor-arrested-alleged-crystal-meth-pipe-and

A Marin County chiropractor was arrested in San Rafael on allegations he was carrying crystal methamphetamine, a meth pipe and unauthorized prescription medications.

Joseph Michael Kwait, 41, of Larkspur was booked into Marin County Jail on suspicion of possession of controlled substances, possession of unlawful drug paraphernalia, possession of narcotics and possession of a dangerous drugs without a prescription. His bail was set at $5,000.

Kwait was released on bail pending further review by the district attorney's office.

Kwait was arrested at about 1 p.m. Tuesday after San Rafael police received a report of a suspicious man in the C and Treanor streets in San Rafael. The man was wearing a blue hooded sweatshirt, carrying a duffel bag and looking under cars, said police spokeswoman Margo Rohrbacher.

When police arrived, they saw the suspect peering into cars in the area. Police identified the man as Kwait, who said he was looking for a friend and then said he was looking for his car, Rohrbacher said.

Police asked Kwait what he was carrying in his duffel bag. He said there was nothing in it but his dry cleaning, but a subsequent search of the duffel bag and Kwait's pockets turned up a plastic bag of suspected crystal meth, a suspected drug pipe, the painkiller Oxycontin, the anxiety drug Xanax and a plastic bag containing 23 pills of the painkiller hydrocodone.

Kwait could not be reached for comment Wednesday. His website lists his office address as 6 Bridge St. in San Anselmo, but he has also practiced previously at other offices in Marin.

Kwait has an active license with the California Board of Chiropractic Examiners. The board lists no record of disciplinary action against him.

Kwait has no prior criminal cases in Marin Superior Court. A medical malpractice suit was filed against him on Wednesday.

Contact Gary Klien via email at [email protected] or https://twitter.com/GaryKlien

—-

Media checks license status

h p://ar cles.la mes.com/2013/apr/26/local/la‐me‐0427‐rx‐medical‐board‐20130427

California's medical board backs some prescription-drug-abuse reforms

But the panel balks at a proposal to shift its authority to investigate physician misconduct to the state attorney general's office.

April 26, 2013|By Lisa Girion and Scott Glover, Los Angeles Times

The Medical Board of California on Friday embraced a host of reforms aimed at combating prescription drug abuse and reducing overdose deaths but balked at a proposal to strip it of its authority to investigate physician misconduct.

The board, meeting in Los Angeles, voted to support proposed legislation that would upgrade the state's prescription drug monitoring system, require coroners to report prescription drug overdose deaths to the board, and give the panel new power to halt a doctor's prescribing in some cases.

The pending legislation was inspired by an investigative series published in The Times last year that revealed that nearly half of the prescription drug deaths in four Southern California counties from 2006 through 2011 included at least one drug that had been prescribed by a doctor. The medical board was unaware of the vast majority of the deaths. In some cases, patients died while investigations into their doctors dragged on for months or years.

Although the board was supportive of those reforms, a proposal by two state legislators to transfer its investigators to the state attorney general's office was met with more resistance. Sen. Curren Price (D-Los Angeles) and Assemblyman Richard Gordon (D-Menlo Park) said they think shifting investigative responsibilities to the state attorney general would foster cooperation between investigators and prosecutors and streamline the process.

Board members labeled the proposal "drastic" and "radical," though ultimately decided they did not have sufficient information to take a vote on the matter. Some members struck a defensive tone, blaming lawmakers and the media for failing to grasp the complexity of investigating and disciplining the state's 100,000-plus doctors.

"It's easy to assault us," said board member Reginald Low, adding, "there's no way the attorney general could take our investigators or hire their own and do what we do."

When it came to the board's performance, Low said, "I see the cup as half full, not half empty."

Fellow board member Gerrie Schipske seemed to agree.

"There's nobody who would say we can't improve," Schipske said. "But there's a witch hunt going on right now."

Others seemed to take a more introspective view.

Inves gators in the AG’s office, not board

Michael Bishop said he thought Price and Gordon were motivated by a sense of frustration with the status quo — the pair wrote a letter to the board earlier this month threatening to dissolve the panel if it did not become more proactive and show significant progress in its oversight role.

"What they are telling us is: This is your last chance. We've given you a lot of rope and you've hung yourself," Bishop told his colleagues.

"So far, the board just hasn't gotten it," Bishop added. "We need to get it."

The idea of placing investigators in the attorney general's office is not a new one.

A similar plan was proposed in 2004 by Julianne D'Angelo Fellmeth, a public interest lawyer who was appointed by the Legislature to examine the medical board's oversight of physicians. The plan was supported by then-Atty. Gen. Bill Lockyer, the medical board, the California Medical Assn. and other key players. Ultimately, however, there was political opposition to the idea and it was dropped from proposed legislation.

On Friday, Fellmeth told the board she still considers the transfer "the last best hope" for more timely investigations.

Board members agreed to further study the issues before taking an official position. They also discussed the need to better communicate with the public — and lawmakers — about what they do and how they do it.

To that end, they asked a top staff member to set up a meeting between Price and Gordon and board president Sharon Levine so they could discuss issues, including the proposed transfer of investigators, face to face.

Board member David Serrano Sewell told Levine he thought she needed to personally tell lawmakers of the board's plan for the future and to assure them of the board's commitment to seeing it through.

"It think that's what it's going to take," Sewell said.

In other business Friday, the board voted unanimously to create a task force to develop guidelines for the treatment of pain and the prescription of narcotic painkillers.

Notably absent from the board's discussion was the question of whether it would support the use of CURES, the state's prescription drug monitoring system, to look for problem doctors as well as drug-abusing patients.

The Centers for Disease Control and Prevention has called on state medical boards to use prescription data to do so, but the idea has been controversial among physician groups that fear it could have a chilling effect on legitimate prescribing.

Board member Barbara Yaroslavsky appeared to touch on the topic, talking about "the technology out there that allows us to know who is prescribing what to whom."

But the matter was dropped without further discussion.

[email protected]

[email protected]

Copyright 2013 Los Angeles Times

h p://www.thedenverchannel.com/news/call7‐inves gators/denver‐chiropractors‐ordered‐to‐cease‐and‐desist‐

prac cing‐unlicensed‐medicine

Denver chiropractors ordered to cease and desist practicing unlicensed medicine

Order follows years of CALL7 investigations

Posted: 06/22/2013 Last Updated: 3 days ago

DENVER - A husband and wife pair of Denver chiropractors is being ordered to cease and desist the unlicensed practice of medicine after the Colorado Medical Board finds they misled patients.

For nearly two years the CALL7 Investigators have covered the case against Heather and Brandon Credeur. They've interviewed hundreds of patients who said they'd paid the Credeur's practice in advance for help with thyroid and diabetes problems from someone they believed was an endocrinologist.

The Colorado Medical Board order says the Credeurs are the incorporators of Stone-Credeur Family Chiropractic, a business that operated under the name "Functional Endocrinology Center of Colorado."

Although they are licensed chiropractors, neither Heather nor Brandon Credeur are licensed to practice medicine.

The Medical Board, however, found the Credeurs told patients they could assume responsibility for prescribing medications for the treatment of endocrine misfunction.

Additionally, the cease and desist order says the Credeurs operated email addresses and websites calling themselves doctors or physicians without any clarification that their licensed services were exclusively chiropractic - facts that were among the many patient concerns brought forward in an extensive series of investigative reports by CALL7 Investigator Theresa Marchetta.

Brandon Credeur kept his chiropractic license despite settling a 25 count complaint with the Department of Regulatory Agencies and the Chiropractic Board in September of 2012. Marchetta found that the Attorney General's office spent more than 3,000 hours on the case but failed to call a qualified chiropractor to testify in proceedings, according to experts and records reviewed by CALL7 Investigators.

The hearing in that case lasted less than two weeks. Credeur admitted to nothing, kept his license and agreed to keep better records.

Read the June 19, 2013 cease and desist order here: http://ch7ne.ws/12SXGOS

Chiropractors Heather and Brandon Credeur charged with practicing medicine without a license Posted: 09/05/2013 http://www.thedenverchannel.com/news/call7-investigators/controversial-chiropractors/chiropractors-heather-and-brandon-credeur-charged-with-practicing-medicine-without-a-license

Theresa Marchetta | Email Me Phil Tenser | Email Me

DENVER - Chiropractors accused of practicing medicine without a license are fighting back against a cease and desist order from the Colorado Medical Board.

Although they are licensed chiropractors, neither Heather nor Brandon Credeur are licensed to practice medicine.

The Medical Board, however, found the Credeurs told patients they could assume responsibility for prescribing medications for the treatment of endocrine misfunction.

Brandon Credeur is the shareholder and president of Respondent Family Chiropractic P.C. According to the notice of charges filed by the Medical Board, the Credeurs' practice also did business as "Functional Endocrinology Center of Colorado."

The notice of charges says they advertise with this statement on their website:

"You see, where most physicians test for blood sugar levels and A1C levels and not much else, I've designed an integrative testing approach that goes into much more depth. I then use my detailed finding to individually tailor and customize a treatment plan for each patient based on his or her own underlying causative factors."

Additionally, the notice of charges says the Credeurs operated email addresses and websites implying they were doctors or physicians without any clarification that their licensed services were exclusively chiropractic -- facts that were among the many patient concerns brought forward in an extensive series of investigative reports by CALL7 Investigator Theresa Marchetta.

Because the Credeurs challenged a cease and desist order, the Medical Board filed the 12-page notice of charges to bring them to administrative court. The document is organized to support three counts:

- Holding oneself out to the public as being authorized to practice medicine

- Holding oneself out to the public as being able to provide medical services

- Maintenance of company website and physical office to provide medical services

Later this month, a representative of the Medical Board will appear in court to schedule the time and date of a hearing on those charges. The Credeurs are not required to appear or send a representative to that scheduling meeting.

-- Credeurs also filed for bankruptcy --

Unfortunately for many former patients trying to get their money back from the Credeurs, the chiropractors declared bankruptcy on the same day the notice of charges was filed.

Marchetta is dissecting the documents from that filing for a future report. So far, she has found it contains a 35-page list of creditors and details about the Credeurs' lavish lifestyle.

7NEWS is among the creditors listed in the filing. Our records show he owes $5,700 for advertising that aired prior to Marchetta's series of investigative reports.

-- Years of investigations --

CALL7 Investigator Theresa Marchetta began to investigate the Credeur's nearly three years ago. During that time they settled a class action lawsuit with former patients and were investigated by the State Chiropractic Board.

In a web video posted on YouTube.com a year ago, the couple said they were cleared by the chiropractic board of charges similar to the ones now being made by the Medical Board.

"We have been exonerated and vindicated of all this nastiness," Dr. Brandon Credeur stated on the video.

But in that case, it was not the medical board that made the decision, according to Department of Regulatory Agencies spokeswoman Cory Everett-Lozano.

Everett-Lozano explained in a June email, "The Medical and Chiropractic Boards are separate boards with separate functions. The Chiropractic Board is charged with the licensure and governing the practice of chiropractors. The Medical Board is charged with licensure of physicians, physician assistants, and anesthesiology assistants and their practices and the unlicensed practice of medicine by individuals."

After the Medical Board filed their cease and desist order, Marchetta revisited former patients who said they were pleased but surprised by the action.

"We've been scammed, lied to and we’ve been deceived," said Cheri Carey. "I'll never get back the time, money; that will never come back."

"I think he'll get around it," Carey said about the cease and desist order. "It is not going to stop anything. He's been doing this since day one. He will find a way around it."

- To read the notice of charges: http://ch7ne.ws/18Et7tY

Attorney Charged with Participating in Extensive Insurance Fraud Conspiracy

U.S. Attorney’s Office July 31, 2013 District of Connecticut(203) 821-3700

Deirdre M. Daly, Acting United States Attorney for the District of Connecticut, and Kimberly K. Mertz, Special Agent in Charge of the New Haven Division of the Federal Bureau of Investigation, announced that a federal grand jury in New Haven has returned a nine-count indictment charging attorney JOSEPH P. HADDAD, 65, of Orange, with federal offenses related to his participation in an extensive insurance fraud scheme.

The indictment was returned on July 25, 2013 and was unsealed today. HADDAD appeared this afternoon before United States Magistrate Judge Holly B. Fitzsimmons in Bridgeport, entered a plea of not guilty and was released on a $150,000 bond.

This matter stems from Operation Running Man, a 14-month undercover fraud investigation headed by the Federal Bureau of Investigation. The investigation included the use of recordings of an undercover special agent meeting with HADDAD, various doctors, and chiropractors in relation to auto-accident personal injury litigation.

As alleged in the indictment, HADDAD, a Bridgeport-based personal injury attorney, conspired with chiropractors and others to defraud several insurance companies by exaggerating the auto accident injuries of HADDAD’s clients, and the cost of their medical care, to justify larger monetary settlements with the insurance companies. As part of the scheme, the co-conspirators fabricated medical records, prescribed unnecessary pain medication, performed unnecessary chiropractic treatment, ordered and billed for diagnostic tests of questionable medical value, and overstated injuries or permanent partial disabilities that were allegedly caused by the accidents.

“This kind of blatant fraud drives up the cost of insurance for all people,” stated Acting U.S. Attorney Daly. “With the help of the FBI, the U.S. Attorney’s Office is committed to uncovering these schemes and prosecuting those who are the most responsible, especially corrupt attorneys and doctors who drive these schemes and profit the most in direct violation of their professional oaths.”

“The level of detail and orchestration alleged in this conspiracy to defraud automobile insurance companies is wrought with unadulterated greed and avarice,” stated FBI Special Agent in Charge Mertz. “As an attorney, Mr. Haddad is an officer of the court and, therefore, privileged and entrusted with upholding its laws and ethical canons. Instead, because of his selfish actions, Mr. Haddad is now a defendant in federal court and

Is your board communica ng

with the FBI?

“Opera on Running Man”

faced with some very serious charges.”

The indictment alleges that, between December 2006 and February 2010, HADDAD conspired in the scheme with Francisco R. Carbone, who had been licensed to practice medicine until his license was revoked by the State of Connecticut in March 2005, and with Dr. Mark Kirshner, who owned and operated two chiropractor offices in Bridgeport and one in Stamford.

As part of the scheme, it is alleged that HADDAD would pay “runners” to locate and deliver to him clients for his personal injury practice. Because state law barred attorneys from hiring runners in personal injury cases, HADDAD attempted to hide this practice by paying the runners in cash. Dr. Kirshner regularly met with HADDAD to provide him with thousands of dollars in cash and, in return, HADDAD reimbursed Kirshner with checks written from his business account. HADDAD often included on the checks false memo lines suggesting that the checks were for medical expenses incurred by his clients. During the course of the conspiracy, it is alleged that Kirshner gave HADDAD more than $100,000 in cash. HADDAD also paid runners with checks directly from his client trust account, often disguising these payments as “independent investigative services.”

The indictment further alleges that HADDAD regularly instructed clients to see Carbone for purported medical treatment, even though HADDAD was aware that Carbone had lost his medical license. Carbone provided HADDAD’s clients with prescription pain medication, even if the medication was not needed and, in reports, fabricated the clients’ injuries, medical conditions and permanent partial disability ratings. In multiple instances, Carbone did no medical examination at all. Carbone billed the victim insurance carriers in his name or in the name of another physician for services he allegedly rendered, and provided prescriptions, bills, medical reports and final reports to HADDAD, who submitted the documents to the victim carriers to support requests for settlement.

It is further alleged that HADDAD referred clients to Dr. Kirshner’s Bridgeport chiropractor offices, which operated under the name Health First Medical, P.C., and that Kirshner often permitted HADDAD to influence the course of patients’ medical treatments by acquiescing to HADDAD’s instructions that a patient receive more treatment and diagnostic tests despite the questionable need for both. Kirshner and other chiropractors at Health First, including Jennifer Netter, established a protocol to treat patients in HADDAD’s cases for six months, regardless of medical need, and would not resolve treatment of patients unless instructed to do so by HADDAD. Netter and others at Health First often falsified medical records by indicating that they had examined the patients when they had not, and by misrepresenting that patients’ pain complaints and other symptoms continued. After the six-month period, each patient would receive a permanent partial disability rating, regardless of the permanence of the medical condition. If a patient had received a permanency rating for a prior accident, the protocol was to give a higher or different disability rating for the present accident.

Kirshner also owned a diagnostic testing company, Midas Medical LLC, and instructed his employees to conduct Nerve Conduction Velocity (NCV) tests whenever a patient’s symptoms could potentially implicate testing, even though he knew the test results would not change the course of treatment. It is alleged that HADDAD and Kirshner arranged for Carbone to order the tests, believing that, if ordered by a doctor, the tests would be given greater weight by the victim insurance companies and increase the likelihood of higher settlement payments. It is further alleged that HADDAD summoned at least one chiropractor to his office so that Kirshner could explain that the chiropractor would receive a kickback of several hundred dollars for each referral of HADDAD’s clients for NCV testing. Kirshner’s office would provide to HADDAD a bill of approximately $2,000 for each NCV test, and HADDAD would submit the bills to the victim carriers as part of settlement discussions.

As disclosed during today’s court proceeding, more than 10 insurance carriers lost a total of approximately $2.5 million as a result of this fraud scheme.

The indictment charges HADDAD with one count of conspiracy to commit mail fraud and eight counts of mail fraud. If convicted, HADDAD faces a maximum term of imprisonment of 20 years on each count.

Carbone, Kirshner, Netter, two other chiropractors and a licensed doctor of osteopathic medicine have pleaded guilty to charges stemming from this scheme. Each awaits sentencing.

As to HADDAD, Acting U.S. Attorney Daly stressed that an indictment is not evidence of guilt. Charges are only allegations, and each defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt.

This matter is being investigated by the Federal Bureau of Investigation, with the assistance of the National Insurance Crime Bureau, the Metropolitan Property and Casualty Insurance’s Special Investigation Unit and the Travelers Insurance Company.

The case is being prosecuted by Assistant United States Attorneys Christopher W. Schmeisser and Robert M. Spector.

Published on The Lund Report (http://www.thelundreport.org) Home > Cultural Competency in Healthcare Heads to Governor

Cultural Competency in Healthcare Heads to Governor Sen. Jackie Winters championed the measure to give state medical boards the right to make cultural competency education a prerequisite for a continued license. By: Christopher David Gray

May 22, 2013 — Sen. Jackie Winters said 40 or 50 years ago, when some black Americans had diabetes, they had a colloquial term for it — “the sugars” — which their doctors may not understand.

May 22, 2013 — Sen. Jackie Winters said 40 or 50 years ago, when some black Americans had diabetes, they had a colloquial term for it — “the sugars” — which their doctors may not understand.

Winters, a black Republican senator from Salem, told The Lund Report that ethnic and racial minorities often face increased health disparities, often for purely cultural reasons, since physicians and nurse practitioners are more likely to come from an ethnic group different than their own.

That’s what’s led her to find a legislative route that would compel health professionals to become educated in cultural competency. On Tuesday, she saw the fruition of a multi-year effort with the Senate’s passage of House Bill 2611 [3] — which allows the state health professional boards to require cultural competency training as a right of licensure.

The boards license everyone from doctors and nurses to chiropractors, massage therapists and direct-entry midwives. The bill also affects home care workers, who assist elderly Oregonians.

HB 2611 allows the state universities and community colleges to require that anyone providing healthcare to students be trained in cultural competency.

“We can’t deliver patient-delivered care if it does not respond to the individual culture of the patient,” Winters told her Senate colleagues, who approved HB 2611 on a 26-2 vote.

Winters has been invited to discuss cultural competency and her legislative victory with a presentation next month in San Francisco at the National Black Caucus of State Legislature’s Promoting Healthy Lifestyles Symposium.

Ron Williams, the executive director of Oregon Action, praised Winters: “She really stepped up, and we’re really pleased with the strong vote she got in the Senate.”

Oregon Action has been one of several community groups spearheading the effort to push Oregon’s health community to become more culturally competent.

Originally, the bill would have required that all health professionals in Oregon inform their licensing boards by 2017 that they had received cultural competency training. The revised bill leaves the requirements to the discretion of the individual boards.

Sen. Elizabeth Steiner Hayward, a Portland Democrat and physician at Oregon Health & Science University, said she would have opposed the bill if it had forced all health professionals to take cultural competency courses, but she was pleased with the amended bill, which allows the state health professional licensing boards to include it in licensees’ continuing education.

Steiner Hayward added she had been involved with cultural competency courses at the state medical school and understands their importance.

But Sen. Chip Shields, D-Portland, told The Lund Report that the Legislature may need to do more if it finds that licensing boards are ignoring the desire to integrate cultural competency training into their continuing education curriculum.

“I think it will stay on people’s radar,” he said. “If we find the boards are not adopting cultural competency, we’ll come back and make it mandatory.”

Williams said a critical aspect of the legislation is that it will allow state agencies to track how many professionals are actually taking cultural competency courses.

Two years ago, the mandated requirement passed the Senate only to die on the House floor [4] in a chamber with an even party split. The new approach found broad bipartisan support this session and passed the House on a 46-12 vote in early April.

The state has a ways to go to meet HB 2611’s objective. Sen. Laurie Monnes Anderson, D-Gresham, said that a culturally competent healthcare workforce does not yet exist in Oregon.

“Many Oregonians face a lot of barriers to good healthcare,” she said.

Tricia Tillman, the director of the Oregon Health Authority Office of Equity & Inclusion, said her office would engage the health community to help lay out just what kinds of courses need to be offered.

Tillman said there is a wide range of interest in cultural competency across 21 different boards, but that the Oregon Medical Association and Oregon Nursing Association had shown a lot of enthusiasm in offering programs to their members.

The Senate also passed House Bill 2134 [5] on a unanimous vote, which would require the Oregon Health Authority and the Department of Human Services to engage community groups to gather demographic data that is more precise.

Monnes Anderson carried this bill on the Senate floor Tuesday, telling her colleagues that collecting more specific data about ethnic groups in Oregon would give the state agencies better tools to improve health outcomes and public health. The information acquired is voluntarily reported from the public.

Currently, such public health surveys may not break racial groups down beyond white, black, Asian, Hispanic, American Indian and other large racial constructs. Within each of these racial groups are a wide range of ethnicities who may have very different health experiences and needs.

HB 2134 was amended slightly from the House version to encompass all public health surveys, not just those administered through the Oregon Health Plan.

PO Box 82841, Portland OR, 97282 | [email protected]

Source URL: http://www.thelundreport.org/resource/cultural_competency_in_healthcare_heads_to_governor

Questions and Answers on HCG Products for Weight Loss http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm281834.htm

1. What actions are the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) taking against human chorionic gonadotropin (HCG) drug products marketed for weight loss?

FDA and FTC are issuing seven joint warning letters to firms marketing over-the-counter (OTC) HCG drug products that are labeled as homeopathic for weight loss. The firms are receiving these letters because they are violating the Federal Food, Drug, and Cosmetic Act and the Federal Trade Commission Act by selling unapproved new drugs and misbranded drugs that make unsubstantiated claims about weight loss.

These unapproved “homeopathic” HCG drug products are marketed OTC on websites and in retail stores, and can be in the form of oral drops, pellets, and sprays. FDA has not evaluated these products for safety or effectiveness.

FDA and FTC will monitor the firms’ responses to the warning letters and take further action as needed. Firms that do not correct the violations may face enforcement action, possible legal penalties, or criminal prosecution.

2. What is HCG?

Human chorionic gonadotropin (HCG) is a hormone produced by the human placenta and found in the urine of pregnant women. HCG is FDA-approved for the treatment of select cases of female infertility and hormone treatment in men. FDA-approved HCG products are only available in injection-form and require a prescription from a licensed medical professional.

There are no FDA-approved HCG products for weight loss.

3. Why is FDA concerned about the use of homeopathic HCG drug products marketed for weight loss?

Currently, there are no FDA-approved HCG drug products for weight loss. HCG has not been demonstrated to be effective therapy in the treatment of obesity. There is no substantial evidence that HCG increases weight loss.

Additionally, the labeling for the “homeopathic” HCG products states that each product should be taken in conjunction with a very low calorie diet (VLCD). Consumers on a VLCD are at increased risk for side effects including gallstone formation, electrolyte imbalance, and heart arrhythmias. A VLCD should only be used under proper medical supervision.

4. Which homeopathic HCG products and manufacturers/distributors are affected?

The following table provides the products and manufacturers/distributors that are the subjects of this action. This is not an all inclusive list of illegal “homeopathic” HCG products currently on the market. At this time, all drug products claiming to include “homeopathic” HCG are illegally marketed.

Manufacturer/Distributor Name Product Name

HCG Diet Direct, LLC HCG Diet Homeopathic Drops

HCG 1234 LLC (The hCG Drops LLC)

Homeopathic HCG

HCG Platinum LLC; RightWay Nutrition

HCG Platinum HCG Platinum X-30 HCG Platinum X-14

Nutri Fusion Systems LLC HCG Fusion 30 HCG Fusion 43

www.resetthebody.com1; www.theoriginalhcgdrops.com2

Homeopathic Original HCG Homeoapthic HCG

Hcg-miracleweightloss.com HCG Extra Weight Loss Homeoapthic Drops

Natural3 Medical Supply Alcohol Free hCG Weight Loss Formula

5. Are prescription HCG products safe and effective for weight loss?

No. FDA-approved uses for prescription HCG products include female fertility and select hormonal treatment in males, and FDA has not approved prescription HCG for any other uses, including weight loss. Current scientific evidence does not support the claim that HCG is safe and effective for weight loss or for the treatment of obesity. In fact, FDA labeling for the approved HCG drug products requires the following statement about the use of HCG for weight loss:

“HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or ‘normal’ distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.”

FDA is aware that healthcare professionals sometimes prescribe prescription injectable HCG for unapproved uses such as weight loss. FDA understands that sometimes approved products are used to treat conditions that the products were not approved for (i.e., “off-label” uses). The “off-label” use of products usually presents greater uncertainty about both the risks and benefits because less information is available on safety and effectiveness. Unexpected adverse events may occur in this context. FDA has received reports of serious adverse events associated with the use of HCG injections for weight loss including cases of pulmonary embolism, depression, cerebrovascular issues, cardiac arrest, and death.

6. What should consumers do?

FDA advises consumers who are using “homeopathic” HCG for weight loss to stop using the product, to stop following any labeled dieting instructions, and to discard the product. Consumers who suspect they have experienced adverse effects as a result of the use of HCG drug products for weight loss should contact a licensed health care professional immediately.

FDA urges both health care professionals and consumers to report harmful effects experienced from using HCG for weight loss to the FDA’s MedWatch Adverse Event Reporting program by doing one of the following:

Complete and submit the report online: www.fda.gov/MedWatch/report.htm4

Download form5 or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

h p://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm282334.htm

FDA NEWS RELEASE

For Immediate Release: December 6, 2011 Media Inquiries: Shelly Burgess 301-796-4651, [email protected] or Tamara Ward 301-796-7567, [email protected] Consumer Inquiries: 888-INFO-FDA

FDA, FTC act to remove “homeopathic” HCG weight loss products from the market Joint action is first step in halting sale of the products

The U.S. Food and Drug Administration and the Federal Trade Commission (FTC) today issued seven Warning Letters to companies marketing over-the counter (OTC) HCG products that are labeled as “homeopathic” for weight loss.

Human chorionic gonadotropin (HCG) is a hormone produced by the human placenta and found in the urine of pregnant women. HCG is FDA-approved as an injectable prescription drug for the treatment of some cases of female infertility and other medical conditions.

The letters warn the companies that they are violating federal law by selling drugs that have not been approved, and by making unsupported claims for the substances. There are no FDA-approved HCG drug products for weight loss.

The joint action is the first step in keeping the unproven and potentially unsafe products from being marketed online and in retail outlets as oral drops, pellets, and sprays.

The labeling for the “homeopathic” HCG products states that each product should be taken in conjunction with a very low calorie diet. There is no substantial evidence HCG increases weight loss beyond that resulting from the recommended caloric restriction. Consumers on a very low calorie diet are at increased risk for side effects including gallstone formation, electrolyte imbalance, and heart arrhythmias.

“These HCG products marketed over-the-counter are unproven to help with weight loss and are potentially dangerous even if taken as directed,” said Ilisa Bernstein, acting director of the Office of Compliance in FDA’s Center for Drug Evaluation and Research. “And a very low calorie diet should only be used under proper medical supervision.”

“Deceptive advertising about weight loss products is one of the most prevalent types of fraud,” said David Vladeck, director of the FTC’s Bureau of Consumer Protection. “Any advertiser who makes health claims about a product is required by federal law to back them up with competent and reliable scientific evidence, so consumers have the accurate information they need to make good decisions.”

According to the Warning Letters, the companies have 15 days to notify the FDA of the steps they have taken to correct the violations cited. Failure to do so may result in legal action, including seizure and injunction, or criminal prosecution. Consumers and health care professionals are encouraged to report adverse events (side effects) that may be related to the use of these products to MedWatch, the FDA's voluntary reporting program, by calling 800-FDA-1088, or electronically at www.fda.gov/medwatch/report.htm1.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological

products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

#

Case highlights staged car accidents, PIP insurance fraud in Florida June 1, 2013|By Amy Pavuk, Orlando Sentinel

http://articles.orlandosentinel.com/2013-06-01/news/os-staged-accidents-fraud-arrests-20130601_1_staged-accidents-insurance-fraud-car-accidents

Although Junel Basile's job title was "driver," what he really did for Metro Chiropractic & Wellness Center, federal authorities say, was recruit people to participate in staged car accidents and meticulously plan the crashes.

At the same time, the manager at Metro Chiropractic, Sergei Kusyakov, paid Florida Hospital employees to steal patient data so the center could solicit legitimate car-accident victims for business, according to federal-court records.

Experts say the cases, both being prosecuted in Orlando federal court, are examples of the kind of insurance fraud that costs Americans billions of dollars each year.

"If you were going to do a TV series on [personal-injury-protection] fraud, this would be a great plot," said Frank G. Scafidi, spokesman for the National Insurance Crime Bureau.

Fraud is the second-most-costly white-collar crime in the United States, behind tax evasion, the National Insurance Crime Bureau reports. And in Florida, authorities have noted a significant increase in the number of staged accidents in recent years.

Under Florida's personal-injury-protection (PIP) requirement for auto insurance, insurance companies are required to pay up to $10,000 per person for medical treatment, regardless of who was at fault.

Authorities say medical clinics that run staged-accident schemes make patients receive unnecessary treatments or bill for services never rendered, and exhaust the $10,000 PIP limits as quickly as possible.

Florida lawmakers made sweeping changes to the PIP system last year, but a judge found the new law unconstitutional in March. The state is appealing that ruling.

In a 17-page criminal complaint filed against Basile earlier this year, an FBI agent said clinics usually try to hide the role of "runners" — those who solicit people to participate in staged accidents — by employing them as "drivers."

Basile, they say, would brief his recruits how the crash would occur, which driver would be at fault, the number of passengers he wanted in each car and what to tell the police.

The recruits, some of whom were promised up to $1,500 apiece for their involvement, had to then seek treatment at Metro Chiropractic & Wellness Center, which paid Basile more than $140,000 in 2011 in his role as "driver."

Court records show the center took in more than $1.5 million in payments from insurance companies from January 2010 through October 2011. It's not clear, however, whether any of those payments were for legitimate claims.

Haitians recruited



The FBI learned about Basile's scheme through the cooperation of an informant who aided authorities because, according to the criminal complaint, the person objected to the fact that local Haitians were being recruited to participate in the staged accidents.

"The [informant] felt the Haitian community was being taken advantage of by clinic owners and Haitian people operating as runners," the complaint said.

Investigators recorded several conversations between the informant and Basile in 2011, in which Basile tried to plan an "accident" involving the informant.

It was clear 36-year-old Basile, who is Haitian, had an intimate knowledge of insurance policies, agents said.

On April 13, 2011, Basile met the informant in front of the clinic's office building on Vineland Road in southwest Orlando.

Records show Basile said he planned a crash for the next day and had already paid a man $1,000 to participate. He said he wanted three people in the informant's vehicle at the time of the accident and promised to pay them each $1,500.

Basile ended up delaying the crash because the driver of the other car recruited to participate had not paid his insurance premium.

Throughout their investigation, agents questioned several other people about their involvement with Basile and staged accidents. Basile told one person, whom he was recruiting to be another driver, that he would provide the two cars and the passengers for the accident.

Kusyakov, the manager at Metro Chiropractic who was arrested in September for paying two Florida Hospital employees to illegally access thousands of patient records, was sentenced in April to four years in federal prison.

Basile, who was indicted by a grand jury May 1 on a count of conspiracy to commit wire and health-care fraud, remains at the Orange County Jail. His defense attorney, H. Kyle Fletcher, would not comment.

And David Greydinger, the chiropractor associated with Metro Chiropractic and other clinics in Fort Myers and Lake Mary, was arrested May 9 on patient-brokering and insurance-fraud charges in Lee County. It's not clear whether those charges are related to the staged-accident scheme in Orlando; authorities in Fort Myers did not return calls seeking comment Friday.

'Unfortunate reality' Scafidi, whose Des Plaines, Ill.-based organization partners with law enforcement and insurance companies to identify fraud cases, said Basile's alleged crimes aren't unusual.

It isn't surprising that the FBI's informant said Central Florida's Haitian community was being targeted either, Scafidi said. He said it isn't unlike the mafia and other organized-crime groups running scams through their close-knit communities.

"A lot of seedier elements within those communities always tend to victimize their own people. It's an unfortunate reality," Scafidi said.

Compounding the problem with insurance fraud is a common attitude that people don't think they are hurting anyone when they make false or exaggerated claims, Scafidi said.

Some people, he said, think that because they've been paying their insurance premiums, fraudulent claims are a form of payback.

"Ultimately, everybody who buys insurance is picking up the tab for that illegal activity," Scafidi said.

[email protected] or 407-420-5735

mailto:[email protected]

Cape chiropractor sentenced on insurance fraud charges Published: Aug 14, 2013 5:09 PM EDT

http://www.winknews.com/Local-Florida/2013-08-14/Cape-chiropractor-sentenced-on-insurance-fraud-charges

FORT MYERS, Fla.- Dr. Stephen M. Lovell, 55, of Windermere, was sentenced today to five years in federal prison for conspiracy to commit health care fraud. As part of his sentence, the court also entered a money judgment in the amount of $1.7 million, the proceeds of the offense.

A jury found Lovell guilty on February 28, 2013, following a two-week trial. According to testimony presented at trial, Xtreme Care Rehabilitation Center Inc. (“Xtreme Care”) was operating in Cape Coral, as an unlicensed health care clinic since 2009.

The State of Florida licensing requirements were circumvented by the conspirators as a result of the purported exclusive ownership of these clinics by licensed health care practitioners, including licensed chiropractor Dr. Stephen M. Lovell.

As a result of the purported ownership of the clinics by a licensed health care practitioner, these clinics avoided greater regulatory scrutiny. In actuality, other conspirators including Francisco Huici Fernandez and Ernesto Diaz were the true owners of the clinics.

In furtherance of the health care fraud, the conspirators caused individuals to be recruited to be involved in staged accidents and received injuries. These individuals would then go to Xtreme Care in exchange for payment. Xtreme Care then billed insurance companies by submitting false claims through the mail for alleged medically necessary treatments that these patients received.

Treatment was either never provided to these patients or was not medically necessary. Upon payment by the insurance company, the proceeds of the fraudulent activity were then transferred to corporations created by the conspirators to launder the proceeds of the criminal activity. Ultimately, Lovell and his co-conspirators received the benefits of the fraudulent activity through payments or expenditures for themselves from the corporate bank accounts.

Francisco Huici Fernandez and Ernesto Diaz previously pleaded guilty for their roles in the case. On March 13, 2013, Fernandez was sentenced to five years and ten months in federal prison. On July 15, 2013, Diaz was sentenced to eight years in federal prison.



http://www.winknews.com/

Hillsborough loses bid to crack down on accident fraud http://tbo.com/news/politics/hillsborough-loses-bid-to-crack-down-on-accident-fraud-20130812/

TAMPA — A Hillsborough County law designed to reduce staged-accident fraud is in trouble.

On Friday, the state’s Second District Court of Appeals upheld an injunction issued in January that blocked enforcement of the ordinance. The appeals court issued no written opinion in affirming the injunction.

“Where they do that, there is no further avenue to go, to the state Supreme Court or anyplace else,” said Rob Brazel, county managing attorney of the litigation division.

Brazel said the county now will look at amending the ordinance, which sought to rid the county of pain clinics thought to be tied to staged-accident fraud. Amending the ordinance will require county commission approval.

Meanwhile, Luke Lirot, attorney for the plaintiffs, declared victory Monday.

“I would certainly opine that the nature of the circuit court’s opinion means the writing is on the wall,” Lirot said. “There is no legislative way the county commission can repair this misguided effort.”

Commissioners passed the ordinance in September 2011 in an effort to stop accidents staged to collect money under Florida’s personal injury protection insurance law, commonly known as PIP. Law enforcement and the insurance industry said criminal gangs defrauding PIP were aided by phony clinics that billed insurance companies for bogus medical care.

But Lirot’s plaintiffs — about 25 clinics, several doctors and a chiropractor — argued that the county ordinance unlawfully sought to pre-empt state law under which they are licensed.

“It treats the clinic owners in Hillsborough County different than any other clinic owners in the state,” Lirot said. “And just the way the county reviewed the applications and made some accommodations for some applicants and not others, we felt it wasn’t being fairly applied.”

The plaintiffs also felt the law was treating some of them unfairly, refusing their county registration to work under the new law because of earlier transgressions such as drug abuse or sexual harassment for which the doctors had atoned.

“They could deny licenses based on issues that occurred decades ago that had nothing to do with fraud and had been remedied to the state’s satisfaction,” Lirot said.

County Commissioner Kevin Beckner, who pushed to pass the ordinance at the request of the Sheriff’s Office and the National Insurance Crime Bureau, would not comment about the appeals court decision other than to say the county was “reviewing all our legal options.”

[email protected] / (813) 259-8303

County law cannot supersede state licensing

http://tbo.com/news/politics/hillsborough-loses-bid-to-crack-down-on-accident-fraud-20130812/

mailto:[email protected]

Fort Myers chiropractor arrested for fraud

http://www.nbc-2.com/story/22262666/fort-myers-chiropractor-arrested-for-fraud

Posted: May 15, 2013 2:59 PM MDT

By Matt Wright, Reporter

A Fort Myers chiropractor is in trouble with the law. Investigators say Dr. David Greydinger paid patients to fake injuries from car crashes to rip off insurance companies.

Investigators say the fraud scheme operated out of an unassuming Fort Myers storefront at MYO Health Clinic. That is where they say Greydinger paid a confidential informant to fake injuries from a non-existent car crash. Then, they say he collected $6,000 in insurance payments.

"Greed is the primary force behind everything with insurance fraud. It all comes down to money," said Detective William Quick, with the Florida Division of Insurance Fraud.

Wearing a wire, investigators were able to monitor their informant's appointments over five months.

After some of them, she was led to Greydinger's nearby office where investigators say he handed over cash kickbacks totaling $800. Authorities moved in and arrested Greydinger last week. According to the arrest report, when investigators asked if he'd ever paid the informant, Greydinger said, "We don't pay here, and by law we're not allowed to pay. I don't pay her."

Greydinger's Fort Myers clinic is still open for business; but the receptionist says he is working out of an Orlando office this week. When we reached Greydinger by phone, he simply hung up.

Insurance agent Tim Shaw says fraud now makes up an entire third of the cost of your auto insurance premium. And while fraudsters profit from their schemes, insurers pass on the cost.

"I'm disgusted by it. Insurance fraud is a huge problem for all of us," he said. "It seems innocuous and seems like it's OK, but it's fraud. We all pay the price."

h p://dailyridge.com/headlines‐now/2013/08/04/re red‐chiropractor‐charged‐with‐55‐counts‐of‐child‐pornography/

Retired Chiropractor Charged With 55 Counts of Child Pornography Posted on Sunday, August 4, 2013

Winter Haven, Florida – “We are commi ed to protec ng our children, and we are dedicated to

ensuring those who prey on children are held accountable. If you download or distribute child

pornography – you are contribu ng to the vic miza on of children, and you will go to jail.” Sheriff

Grady Judd

On Friday, August, 2, 2013, Polk County Sheriff’s Office detec ves, working with Indian River

Internet Crimes Against Children detec ves, arrested 67‐year‐old, re red Polk County

Chiropractor, Samuel Oklesh, DOB 02/16/1946, 1166 6th Avenue Apt. 16D, Vero Beach, and

charged him with 55 Counts of Possession of Child Pornography.

On December 21, 2012, PCSO undercover detec ves executed a search warrant at 216 Lake

Region Boulevard, Winter Haven, in reference to a subject downloading child pornography. An on‐scene preview was

conducted, however it was inconclusive at the me and required a full forensic examina on.

A full forensics was later competed and approximately 500 images/videos of child pornography were located. The images

were of children exposing their genitals in a lewd manner, children engaging in sexual acts with other children, and adults

engaging in sexual acts with children. The images included infants and children up to 10 years of age.

An arrest warrant was obtained for Oklesh however, it was discovered the suspect and his live‐in ex‐wife, Kim Wilson,

moved in the middle of the night, several days later. Detec ves then learned of a possible residence in Indian River

County.

Working with Indian River ICAC detec ves Oklesh was located and arrested. Oklesh is currently being held in the Indian

River County Jail.

See FL Board website – the

board secured an immediate

voluntary relinquishment

h�p://dailyridge.com/headlines-now/2013/08/04/re�red-chiropractor-charged-with-55-counts-of-child-pornography/

Retired Chiropractor Charged With 55 Counts of Child PornographyPosted on Sunday, August 4, 2013

Winter Haven, Florida – “We are commi�ed to protec�ng our children, and we are dedicated to ensuring those who prey on children are held accountable. If you download or distribute child pornography – you are contribu�ng to the vic�miza�on of children, and you will go to jail.” Sheriff Grady Judd

On Friday, August, 2, 2013, Polk County Sheriff’s Office detec�ves, working with Indian River Internet Crimes Against Children detec�ves, arrested 67-year-old, re�red Polk County Chiropractor, Samuel Oklesh, DOB 02/16/1946, 1166 6th Avenue Apt. 16D, Vero Beach, and charged him with 55 Counts of Possession of Child Pornography.

On December 21, 2012, PCSO undercover detec�ves executed a search warrant at 216 Lake Region Boulevard, Winter Haven, in reference to a subject downloading child pornography. An on-scene preview was conducted, however it was inconclusive at the �me and required a full forensic examina�on.

A full forensics was later competed and approximately 500 images/videos of child pornography were located. The images were of children exposing their genitals in a lewd manner, children engaging in sexual acts with other children, and adults engaging in sexual acts with children. The images included infants and children up to 10 years of age.

An arrest warrant was obtained for Oklesh however, it was discovered the suspect and his live-in ex-wife, Kim Wilson, moved in the middle of the night, several days later. Detec�ves then learned of a possible residence in Indian River County.

Working with Indian River ICAC detec�ves Oklesh was located and arrested. Oklesh is currently being held in the Indian River County Jail.

See FL Board website – the board secured an immediate voluntary relinquishment

The Cost of Fraud By Stephen M. Perle, DC Last year, I attended the American College of Chiropractic Consultants/College of Forensic Sciences annual meeting, which I have done many times. This is always a great conference to attend. The speakers are typically scientists and clinicians providing information on standards of care and best practices in the peer evaluation. This time there was a very unusual presenter. It was a doctor who had recently pleaded guilty in federal court to a very large amount of insurance fraud. He had already paid restitution in the amount of $2.94 million. He was speaking to us as part of his effort to prevent getting any jail time for his crimes. The court had given him six months to demonstrate his remorse. During that time he had given a talk similar to the one we heard to both professionals and students in various health career schools and other similar groups. A doctor at a recent ethics seminar I gave told me that she heard this doctor speak when she was a chiropractic student. His story was compelling and, it seems, would very likely motivate clinicians to stay on the straight and narrow. I thought he “came clean.” Everyone in attendance that I heard from likewise thought he had revealed all. He willingly answered questions from what was, to say the least, probably his most skeptical and potentially hostile audience. He told how he started committing the fraud by continuing to bill for services ordinarily rendered, but not during some office visits because patients periodically asked to only get adjusted and forgo other procedures and modalities due to time constraints. He said that his poor control of billing practices extended to his five other clinics. He did not tell us that prior to the FBI approaching him in 2010, insurance companies had told him three times that his billing practices were improper. One time, this resulted in his returning to an insurer half a million dollars. A few years later, he returned $70,000 to another insurer who later required that all of his bills be subject to pre-payment review. None of these events seemed to deter him from continued fraud—i.e., billing for services not rendered. During his plea hearing, he admitted doing this not out of need. He didn’t have creditors beating at the door because he was broke. He just “pushed the envelope” when he saw that insurance companies continued to pay. This was simple greed. The trial judge went against sentencing guidelines when he sentenced the doctor. The judge noted in part the cost of incarceration and decided that during the six months before his sentence was handed down the doctor, who had performed 391 hours of community service (the lectures about fraud to health sciences students and professional groups), provided 18 days of free chiropractic care at homeless shelters, painted an elementary school gym and paid restitution, had paid his debt to society and let him off without prison time. This was the doctor’s goal, as he told us his only desire in life was to be a parent and being away from his children was the worst thing he could ever imagine. The federal government, however, believed no jail time was too lenient and appealed the sentence. On March 13, 2013, the federal Circuit Court of Appeals agreed with the government and wrote: “The district court’s sentence does not reflect the seriousness and extent of the crime, nor does it promote respect for the law, provide just punishment, or adequately deter other similarly inclined health care providers. We therefore find the sentence to be substantively unreasonable, and an abuse of the district court’s discretion.”1 The district court has not revised its sentence yet. Nevertheless, it appears that the doctor, despite his best efforts, will end up in federal prison. The cost of fraud is high. References www.ca11.uscourts.gov/opinions/ops/201115959.pdf Published in the June/July 2013 ACA News

Following a period of suspension, this doctor is now on proba on in Georgia un l 2017.

h p://www.law360.com/ar cles/422628/print?sec on=appellate



11th Circ. Demands Jail Time For Doc In $3M Fraud Case By Rachel Slajda

Law360, New York (March 11, 2013, 5:23 PM ET) -- A Georgia chiropractor should get jail time for a $3 million insurance fraud scheme, the Eleventh Circuit ruled Friday, finding that a lower court's sentence of time served was too lenient and would not deter others from committing health care fraud. The chiropractor, Rick Kuhlman, pled guilty in March 2011 to billing health insurance companies for services he never performed. He stole about $2.9 million from Aetna Inc., Blue Cross Blue Shield and United HealthCare Services Inc., according to prosecutors. Although prosecutors asked for a three-year jail sentence, U.S. District Judge Marvin H. Shoob was impressed that Kuhlman had paid full restitution to the insurance companies, and gave the doctor six months to perform community service before coming back for his sentencing. Kuhlman spent 391 hours speaking about health care fraud at medical and chiropractic schools and providing chiropractic services at homeless shelters. At his sentencing in November 2011, Judge Shoob applauded Kuhlman's service and sentenced him to time served. In explaining the sentence, Judge Shoob invoked the high cost of incarceration as well as the case of a "budding rock star" who was convicted on a weapons charge. The Atlanta Journal-Constitution identified the case as that of rapper Bruce Falson, to whom Judge Shoob also granted a six-month reprieve. Falson gave a series of radio interviews meant to discourage young people from taking up a criminal lifestyle, and Judge Shoob later sentenced him to probation. Prosecutors appealed, incensed that Kuhlman would not spend any time in prison. On Friday, an Eleventh Circuit panel agreed, vacating the sentence and remanding it back to the district court. "Such a sentence fails to achieve an important goal of sentencing in a white collar crime prosecution: the need for general deterrence," the panel wrote. "We are hard-pressed to see how a noncustodial sentence serves the goal of general deterrence." The U.S. attorney's office had argued that deterrence is especially important in health care

fraud cases, "because health care fraud is so rampant that the government lacks the resources to reach it all," according to the court. Therefore, it is important to send a message by making an example of convicted fraudsters. "Kuhlman's sentence sends the opposite message — it encourages rather than discourages health care providers from engaging in the commission of health care fraud because they might conclude that the only penalties they will face if they are caught are disgorgement and community service. We do not mean to imply that probation can never be an option available to a court in fashioning a reasonable sentence in a white collar crime case," the court said. "But not here." Kuhlman's attorney, Jay Strongwater of Strongwater & Associates LLC, told Law360 that the defense believed that speaking with medical students about fraud was a better deterrence than jail time. "We disagree with the court that general deterrence can only be satisfied by incarceration," Strongwater said. The U.S. attorney's office in Atlanta declined to comment. Under federal sentencing guidelines, Kuhlman could have received between about five and six years. Prosecutors had recommended a sentence of three years. Kuhlman is represented by Jay Strongwater of Strongwater & Associates LLC and Darryl B. Cohen of Cohen Cooper Estep & Allen LLC. The case is USA v. Rick Kuhlman, case number 11-15959, in the U.S. Court of Appeals for the Eleventh Circuit. --Editing by Katherine Rautenberg.

h p://drstevehoffman.com/blog/?p=212

Dr. Steve's Practice Tip Blog Practice Tips from Dr. Steve Hoffman

The Danger and Demise of hCG for Chiropractic By Kyle D. Morgan, D.O. and AJ Deeds Posted on February 23, 2011 by Dr. Steve

Many Chiropractors are considering or using human chorionic gonadotropin (hCG), the female

pregnancy hormone drug, as a weight loss program[i] due to its tremendous popularity and healthy

financial margins.

Developed by British doctor A.T.W. Simeons in the 1950’s, the protocol provided for injections of the

hCG drug plus a strict 500-calorie per day diet. Proponents claimed weight loss of 1-2 lbs per day over

a 27-40 day program.[ii]

A lack of validation via double blind, placebo-based studies[iii],[iv],[v],[vi],[vii],[viii],[ix],[x],[xi],[xii],

coupled with regulations by the FDA[xiii],[xiv],[xv],[xvi] and FTC[xvii],[xviii] greatly curtailed the

previous burst of public interest in hCG in the mid-1970’s. Spurred by development of homeopathic

hCG drops in the 1990’s[xix] and Kevin Trudeau’s controversial bestseller “Weight Loss Cure They

Don’t Want You to Know About” in 2007[xx], hCG regained its popularity, eventually spawning

thousands of websites, companies and sources for the drug. “hCG Diet” became the most searched

health and wellness term on Google in 2010[xxi].

Yet by being defined as a prescription drug, hCG requires a prescription and a pharmacy license to

legally dispense. [xxii] The so-called “non-prescription” homeopathic hCG is not a legal homeopathic

drug[xxiii] at all because the hCG active ingredient is a Rx (prescription) drug [xxiv] and hCG is not

listed in the Homeopathic Pharmacopeia of the United States (HPUS) [xxv]. To be legal, all

homeopathic substances must have an approved monograph in the HPUS[xxvi], signifying the

substance meets the principles of homeopathy and has been tested and approved via homeopathic

formulation and production requirements. hCG does not have a monograph in the HPUS and is not

legal to sell in the US.[xxvii]

On January 23, 2011, the FDA publicly declared homeopathic hCG an illegal substance.[xxviii]

Enforcement has been of a lower priority due to less serious health side effects on users, yet the FDA

indicated it would enforce regulations at any time. For example, a March, 2010 enforcement raided

the offices of a Naturopathic Doctor (ND) in Washington state who had both imported hCG from

China/ India and had purchased homeopathic hCG from a compounding pharmacy in Florida.

Although the ND had the right to prescribe the drug for fertility treatments, the FDA took patient

files, computers and hCG inventory following the 10-month investigation of the ND importing an

unapproved drug and for misbranding.[xxix]

Chiropractors will want to seek experienced legal counsel to review the predictable risks and dangers

that can result from selling hCG, which include:

- penalties for selling a prescription drug (Rx) without a license[xxx]

- State Chiropractic board discipline including potential loss of license for selling a Rx drug or selling

a supplement containing Rx ingredients as well as for questionable standards of care

- legal action from dissatisfied patients

- recent announcements by the FDA of increased enforcement targeting sellers of adulterated and

misbranded weight loss products that contain Rx ingredients.[xxxi]

The dangers of hCG to the Chiropractic profession are now public and the FDA’s formal position gives

limited defense against not knowing the regulations surrounding this drug. While hCG will

undoubtedly continue to be made available by those willing to bet that the lucrative sales of an illegal

substance can last a bit longer with limited risk of FDA enforcement, the demise of hCG use by the

Chiropractic profession will occur much sooner. We would also suggest that there is an equally

effective if not superior weight loss product for Chiropractors without the risks associated with

hCG.[xxxii]

Authors

Kyle D. Morgan, D.O. is an Alternative Medicine Doctor of Osteopathy licensed in the state of

Michigan. Dr. Morgan is the inventor the Weight Balancing System™, Brain Detox™ and other

unique tools and methods that help people to reach a healthy balance in life.

AJ Deeds is President of Loving Works, LLC, a direct marketing firm that offers the Weight Balancing

System™ —a reduced portion plan food program combined with the Wt Balancer®, an all-natural,

liquid dietary supplement, that helps users release 10-25 lbs. per month without hormones, hCG,

strong stimulants, blockers or suppressors.

For more information: www.mylovingworks.com/drsteve

For reprints of this article and ALL the references cited in it, please email Dr. Steve by CLICKING

HERE

Print Page By AMY HANSEN OST news editor • [email protected]

Board denies reinstating chiropractor’s licenseAn Osceola chiropractor isn’t going to have his license reinstated — for now.

In documents released Monday from the Iowa Board of Chiropractic, the board denied reinstating the license of Dr. Stuart Hoven, with Clarke County Chiropractic and Winterset Family Chiropractic.

According to the Iowa Board of Chiropractic, Hoven engaged in unethical conduct or practiced harmful or detrimental to the public. It was determined Hoven had improper sexual conduct with, or made suggestive, lewd, lascivious or improper remarks or advances to a patient numerous times in 2005, 2009 and 2012.

Hoven isn’t allowed to file for reinstatement again until he has met all of the board’s conditions concerning the future safety and welfare of patients.

First complaint

Hoven was issued a license to practice as a chiropractor in the state of Iowa in 2001.

According to court documents, in April 2005, the board found Hoven had engaged in unethical conduct when he improperly touched the breasts of two female patients and made suggestive remarks to them.

According to the board, before Hoven’s current suspension, he was still allowed to practice but must have had a female, nonfamily member chaperon at all times when providing treatment to female patients.

Hoven was not allowed to perform any soft-tissue chiropractic treatment to female clients on or around the breast.

His license was then returned to full privileges in July 2010.

Most recent complaints

The most recent allegations arose from a complaint by a female patient who said Hoven had touched her breasts during a chiropractic visit Feb. 14, 2012.

According to the board, on May 11, 2012, another female patient reported she went to Hoven for chiropractic treatment in 2009 and claimed he “cupped her breast during one session and rubbed against her during a second.”

The woman didn’t make a complaint in 2009 because she was “embarrassed.”

However, in May 2012, the woman’s husband saw a television newscast about Hoven and a complaint was filed against him.

The board decided to suspend Hoven’s license.

Court documents further state, Hoven’s current suspension meant he could not apply for reinstatement until he completed a comprehensive assessment regarding professional sexual misconduct.

It was further ordered that not until Hoven has completed the provisions of his suspension will the board consider any application for reinstatement.

The assessment took place at the Behavioral Medicine Institute (BMI) of Atlanta, Ga.

Hearing

A licensure reinstatement hearing was held July 10 in Des Moines.

BMI found Hoven was unsafe to practice, and he followed up by attending treatment at Acumen, one of the providers recommended by BMI.

Hoven filed an application for reinstatement March 1, which was only four days into his treatment at Acumen, even though he had completed less than a week of his three-week session with Acumen.

During testimony, Hoven admitted he filed the application early so he could get on the board’s March agenda.

In an analysis from the board, it states, “the troubling aspect of (Hoven’s) application is how closely it tracks his application for reinstatement after the board suspended his license in 2005. ... The board suspended respondent’s license on April 27, 2005. From that point, respondent started a race to reinstatement.”

Acumen recommended Hoven return to practice so that it could monitor and assess compliance in future sessions. However, Acumen recognized the board ultimately decides whether to reinstate a license.

Final follow-up



The final follow-up for Hoven at Acumen is scheduled March 12-14, 2014. If Acumen issues a report stating Hoven is safe to return to practice after the session, he could return to BMI for a comprehensive in-person evaluation.

If BMI finds Hoven is safe to return to practice, he may file an application for reinstatement with the board. Hoven may not file until all of the conditions are met.

From the July 10 hearing, Hoven is ordered to pay $75 for fees associated with conducting the disciplinary hearing and $68.75 for the court reporter. He is ordered to remit $143.75 for these expenses within 30 days of receipt of the bill.

Mondays board documents states, “The board is not willing to risk returning (Hoven) to practice before he can prove to the board that he is not a danger to the public welfare. He has yet to do that.”

Copyright © 2013 Osceola Sentinel-Tribune. All rights reserved.



Board: Iowa chiropractor gave patient drugs, booze Monday June 17, 2013 1:15 PM

CLIVE, Iowa (AP) — A chiropractor in central Iowa has been accused of giving a young patient

illegal drugs and alcohol.

The Iowa Board of Chiropractic says Cameron Hart, of Clive, sent the patient numerous text

messages that were of a sexual and graphic nature. Hart began treating the patient when the

patient was a high school senior.

Hart is accused of giving the patient marijuana and alcohol, and waiving co-payments without

telling his third-party provider.

Hart faces five counts, including committing unethical conduct by having improper sexual

contact with, or making suggestive, lewd, lascivious or improper remarks or advances to a

patient.

Hart faces a disciplinary hearing with the board on Oct. 9. A message left at Hart's office was

not immediately returned Monday.

When are board charges public?

Animal Chiropractor Daniel Kamen Prompts State Crackdown

Published Wednesday, Jun. 19, 2013

BUFFALO GROVE, Ill., June 19, 2013 ‐‐ /PRNewswire/ ‐‐ In 1995 chiropractor Daniel Kamen conducted his first of four

hundred animal chiroprac c technique seminars that was not just for licensed chiropractors and veterinarians, but also

for regular horse and dog owners. Each seminar quickly sold out. Kamen, an animal chiroprac c pioneer and author of

three bestselling books on animal chiroprac c technique, The Well Adjusted Dog, The Well Adjusted Horse, and The Well

Adjusted Cat, was swi ly served with cease and desist le ers from several states claiming he violated their veterinary

laws by teaching non‐professionals to manipulate Spot, Seabiscuit, and Fluffy.

"Soon a er I conducted my first few seminars I heard from a lot of states warning me to stay out. Minnesota, Oklahoma,

Arkansas, Georgia, Washington, Ohio, Louisiana, and Nevada all sent me cease and desist le ers. Nevada! They allow

gambling and pros tu on but they'll lock you up for cracking a horse's tuchus."

Nevada even threatened Kamen with legal ac on if he didn't remove seminar announcements from his website,

www.animalchiroprac c.com .

"It's all about money," Kamen said. "Dog owners won't spend five grand for hip dysplasia surgery when a simple, almost

free chiroprac c technique can help prevent its onset."

Aside from the hip dysplasia technique, dog owners paid close a en on when Kamen demonstrated the bladder control

move. "It just takes four minutes a day," Kamen said. "And no more soiled carpets."

By far, the most popular chiroprac c technique among Thoroughbred trainers and barrel racers is the "Pre‐Race

Adjus ng Sequence," which, according to Kamen, "increases efficiency and can shave frac ons off the me."

Prac oners from as far away as Hong Kong, Australia, South Africa, and England flew in to learn these techniques. "My

seminars a racted people from all over the world," said Kamen, 57, who is mostly re red and now conducts only one

seminar a year. "A Saudi prince once flew his personal chiropractor to my Philadelphia seminar so he could adjust his

prized Arabians."

State laws regula ng the prac ce of animal chiroprac c haven't changed much in 18 years. Even though there is a

na onal veterinary chiroprac c associa on cer fying licensed prac oners, there are s ll less than two hundred full

me professional animal chiropractors na onwide. Addi onally, most veterinary boards have shut out licensed human

chiropractors who are also cer fied in animal chiroprac c. It's no wonder horse and dog owners who want their animals

adjusted have to fend for themselves.

"That's why my seminars thrived," Kamen said. "Horse and dog owners were just as fed up with the system as I was and

were forced to learn how to adjust their own animals who suffered from neck, back, and leg pain. Their frustra on in

searching for a trained professional fueled my business. The states who made it illegal for licensed chiropractors to adjust

animals were really doing me a favor. They created a lay market for me for which I am eternally grateful. My only

problem now is finding the appropriate thank you card at Walgreens."

Kentucky tax cheats could lose drivers and professional licenses starting July 1 Published: June 7, 2013

Read more here: http://www.kentucky.com/2013/06/07/2670112/kentucky-tax-cheats-could-lose.html#storylink=cpy

By Valarie Honeycutt Spears — [email protected]

Beginning July 1, Kentuckians who don't pay their state taxes can lose their drivers and professional licenses and their ability to register and license a vehicle.

State revenue officials say they expect to use the measure rarely and as "a last resort," but some lawmakers who voted in March for a bill containing the tougher tax penalties now say they were unaware of the provision and think it may go too far.

Professionals ranging from attorneys to hair dressers could be denied renewal of their state licenses under the law, which was approved on the final day of the 2013 General Assembly as part of a compromise bill to reform the state's ailing pension system.

Earlier this week, at a meeting of the Interim Joint Committee on Transportation, leaders of the Senate and House transportation committees said the change was a surprise.

"This is something that we want to iron out," House Transportation Chairman Hubert Collins, D-Wittensville, said Thursday in an interview.

How can people pay taxes if their professional licenses have been suspended and "they aren't working," Collins asked.

Sen. Bob Leeper, an independent from Paducah, was on a small committee that hashed out details of the bill behind closed doors.

"Probably because we did it so quickly I am not sure it was as well thought out as we would have liked it to have been," Leeper said Friday. "I feel pretty confident it will be revisited."

The new regulation was recommended last year by the Governor's Blue Ribbon Commission on Tax Reform at the request of the state Department of Revenue, according to the commission's 2012 report.

Pamela Trautner, a spokeswoman for the Finance & Administration Cabinet, said officials expect the measure to net $10 million for Kentucky over the next two years. Trautner said the law allows revenue officials to block the renewal of professional licenses administered by state government, driver's licenses and vehicle registration.

The measure is aimed at taxpayers who have exhausted appeals and still refuse to pay any state tax other than real property taxes, which are collected at the local level, she said.

The law specifically says attorneys who are delinquent taxpayers can lose their license to practice law. Trautner said revenue officials will advise the state Supreme Court, who oversees attorneys, about delinquent taxpayers.

Amy Carman, a spokeswoman for the Kentucky Bar Association, said any notification that group receives will be sent to the Supreme Court "for appropriate action." Carman said the association didn't have any further comment about the measure.

Charles Lykins, the executive director of the Kentucky State Board of Hairdressers and Cosmetologists, said his board and others that oversee professional licenses have been required to send names of the people they license to revenue officials. He said he didn't have any major concerns about the measure.

"My guess is that it will affect very few" of the cosmetologists in the state, Lykins said.

Revenue officials are still determining how many people will be affected, Trautner said. But she said "95 percent of Kentuckians pay their taxes."

The measure is aimed at those "who have just ignored every effort that revenue has made," she said.

Trautner said citizens affected by the change will be notified with a letter sometime after July 1. Those who agree to a payment plan will be considered in compliance and not at risk of the sanctions, she said.

Transportation Cabinet spokesman Chuck Wolfe said the Department of Motor Vehicle Regulation already withholds drivers licenses for a variety of reasons, including when it gets notices from the Administrative Office of the Courts of certain traffic convictions.

"It's a mandate we will carry out," Wolfe said. "It will be very similar to what we already do with notices from AOC."

The Governor's tax reform commission reported that Massachusetts and Delaware have similar programs that deny and revoke vehicle registration, drivers licenses and professional licenses.

Only professional licenses are denied or revoked in Hawaii, Illinois, Indiana, Iowa, Kansas, Maine, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Oklahoma, Oregon, Pennsylvania, Vermont, and Wisconsin, the report said.

Senate Transportation Chairman Ernie Harris, R-Crestwood, said Thursday that he wants to hear more about the measure from revenue officials but thinks "it's not as onerous as what we thought earlier because we didn't have full information."

"I'm going to make the assumption," Harris said, that revenue officials "will do everything it can to resolve the issue before they suspend the license."

#

http://www.winnipegfreepress.com/local/city-chiropractor-guilty-of-beating-sexually-assaulting-ex-girlfriend-208619571.html

Winnipeg Free Press - PRINT EDITION

City chiropractor guilty of beating, sexually assaulting ex-girlfriend By: Aldo Santin Posted: 05/23/2013 1:00 AM |

A local chiropractor was found guilty Wednesday of beating and raping a former girlfriend.

Justice Colleen Suche found Marlin Vandermeulen guilty of six of the nine charges he was facing, including sexual assault causing bodily harm and assault causing bodily harm.

Court was told Vandermeulen and the victim had been in a relationship for several years. The assaults occurred in the final months of the relationship, when Vandermeulin forced the victim to have sex with him.

There is a ban on publication of evidence that would identify the victim.

Vandermeulin operates Marlin Chiropractic on south Osborne Street.

A spokesman for the Manitoba Chiropractors' Association, which governs and regulates the industry in Manitoba, said the convictions will have to be reviewed.

Taras Luchak, executive director of the association, said a practitioner convicted of an indictable offence, as Vandermeulen was, could be considered guilty of professional misconduct.

Luchak said he could not comment on Vandermeulen's situation but added in general any similar situation would result in a formal investigation, as set out by the association's regulations.

Vandermeulen was originally arrested Jan. 29, 2010, after the victim had been attacked in a room at a downtown hotel. He was re-arrested Feb. 27, 2010, for breaching bail conditions and then charged with three other attacks on the victim in July and August 2009.

Suche said much of the evidence in the case was based on testimony from the victim and Vandermeulen, who denied the allegations and said the sex was at all times consensual. The victim said she didn't want to have sex with him but was afraid to refuse him.

Suche said the testimony of the victim was "straight forward and matter of fact," but Vandermeulen was "evasive and sometimes vague."

The victim said she only went to the police when she feared Vandermeulen was going to kill her.

"To an objective observer, tolerating the degrading and controlling attitude and physical violence by (Vandermeulen) makes no sense," Suche stated in a written ruling. "However, a complex emotional and psychological framework in intimate relationships involving violence is not uncommon."

A date for a sentencing hearing has not been set. The trial was held in late February.

[email protected]

Manitoba board

h p://blog.syracuse.com/news/print.html?entry=/2013/06/dewi _chiropractor_pleads_gui.html

DeWi chiropractor pleads guilty to 6 counts of

forcible touching Ken Sturtz | [email protected] By Ken Sturtz | [email protected]

on June 04, 2013 at 6:35 PM, updated June 05, 2013 at 1:03 AM

DeWi , NY ‐‐ The DeWi man accused of inappropriately touching women at his Chiroprac c and massage business has

pleaded guilty to six counts of forcible touching.

Eli Guterman, 30, appeared Tuesday in DeWi Town Court with his a orney Emil Rossi in front of Judge David Gideon to

accept a plea agreement.

As part of the agreement with the Onondaga District A orney's Office, Gu erman pleaded guilty to six counts of forcible

touching, a misdemeanor.

He also agreed to immediately give up his licenses to prac ce chiroprac cs and massage therapy in New York, and the

right to ever reapply for licensing, Assistant District A orney Tony Germano said. He will likely be sentenced to six years

proba on, Germano said.

"I think the agreement that was reached today was a good and fair outcome for everybody," he said.

There was some discussion among the lawyers and Gideon about whether Guterman could reside in Michigan and s ll

be on proba on in New York, but that issue was not resolved.

Guterman ‐‐ who was a chiropractor and massage therapist at the Back N Touch Center on East Genesee Street ‐‐ was

arrested on Dec. 17, 2012 for inappropriately touching a woman at his office, the Onondaga County Sheriff's Office said.

He was charged with three counts of forcible touching and one count of third‐degree sexual abuse.

Sheriff's detec ves eventually took more than 20 calls and iden fied nine more people who reported similar offenses.

Allega ons by five people had fallen outside the statute of limita ons, which meant Guterman was only charged in

connec on with the remaining four people, the sheriff's office said.

Then in January, Guterman was charged again: two counts of first‐degree sexual abuse and two counts of forcible

touching. The new charges stemmed from allega ons of inappropriate contact that took place between September 2010

and May 2011 at Guterman's office.

All the previous charged were wrapped up in Tuesday's plea agreement, Germano said.

Rossi declined to comment a er his client's court appearance.

Gu erman is scheduled to reappear in DeWi Town Court on Sept. 3 for sentencing.

© syracuse.com. All rights reserved.

h p://www.hollandsen nel.com/newsnow/x1806116227/Pharmacist‐has‐license‐suspended‐a er‐

marijuana‐convic on#thecomments

Pharmacist has license suspended a er marijuana convic on

By JIM HAYDEN

The Holland Sen nel

Posted Jul 03, 2013 @ 10:41 AM

An Allegan County man has had his license to prac ce as a pharmacist suspended a er he was found

guilty of possessing marijuana, according to the Michigan Department of Licensing and Regulatory

Affairs.

Donald James Buckley, R.Ph., of Glenn, was found guilty in Allegan County District Court on Oct. 11 of

possession of marijuana, a misdemeanor. Buckley was ordered to pay fines and costs, and was placed on

proba on for six months with terms, according to a LARA press release issued today.

LARA issued an order on June 27 summarily suspending Buckley’s license pursuant to the Public Health

Code which provides for the mandatory summary suspension of a health professional’s license upon the

convic on of a felony, a misdemeanor punishable by imprisonment for a maximum term of two years, or

a controlled substance‐related convic on.

For more informa on on disciplinary ac ons taken by the health professional licensing boards within

LARA, visit michigan.gov/healthlicense, and click on “Licensing for Health Professionals.”

Mandatory suspension or revoca on

h p://www.prweb.com/releases/2013/6/prweb10796753.htm

Monday, June 17, 2013

Proposed law Would Prohibit A orney Solicita on of

Auto Accident Vic ms

HB 4770‐71 would stop ambulance chasing lawyers from contac ng people 30 days a er a car

accident and punish the a orneys who do solicit with up to $30,000 in fines and a possible

felony, says a orney Steven Gursten of Michigan Auto Law.

These laws would strictly prohibit lawyers from contac ng accident vic ms within the first 30 days of a

crash, and the punishments are severe.

There is a new package of bills aiming to stop a prac ce called "a orney solicita on" in Michigan, where

injury lawyers download police accident reports and use them to call vic ms of motor vehicle accidents

and mail them solicita on packages, says a orney Steven Gursten, head of Michigan Auto Law in

Farmington Hills.

"The real "ambulance chasers" engage in this prac ce to drum up business by preying on people when

they're at their most vulnerable – immediately a er a crash when the injuries, the stress and the loss are

just se ng in; and when people have lots of ques ons about what will happen next," Gursten said. "But

these lawyers might not be able to harass car crash vic ms for much longer."

There are two new proposed laws that address a orney solicita on in Michigan, and they carry some

harsh consequences, Gursten said.

HB 4770, sponsored by Rep. Ellen Cogen Lipton (D‐27th District): This law only allows certain people and

agencies to access an accident vic m's police report within 30 days of the crash, therefore prohibi ng

injury lawyers from accessing the informa on and contac ng the accident vic ms.

Under HB 4770, only the following people are allowed to access accident reports within the first 30 days:

Individuals, vehicle owners and property owners involved in the motor vehicle accident.

A family member of an individual involved in the motor vehicle accident.

The representa ve of an individual, vehicle owner or property owner involved in the motor

vehicle accident (as contacted by the accident vic m).

The a orney general or other prosecutor.

The insurance producer, insurer, or employee or agent of an individual, vehicle owner or

property owner involved in the motor vehicle accident.

An employee of a radio or television sta on licensed by the Federal Communica ons

Commission.

A local, state or federal government agency that's authorized to have access to a report in

furtherance of the agency's du es.

An en ty that is authorized by a law enforcement agency to manage the law enforcement

agency's reports.

An employee of a newspaper.

The people or organiza ons that are authorized to access the motor vehicle accident reports are

required to submit certain documenta on in order to access the accident reports.

The punishment: A person or a orney who violates the proposed law would be guilty of a felony

punishable by imprisonment for up to two years or a fine of up to $15,000, or both.

HB 4771, sponsored by Rep. Joseph Graves (R‐51st District): A person is not allowed to inten onally

contact an accident vic m or family member of that vic m with a direct solicita on to provide a service

un l 30 days a er the accident.

This doesn't apply if the accident vic m has requested contact from that person.

Under HB 4771, "Direct solicita on" means "a verbal or wri en solicita on or offer, including by

electronic means, made to the injured individual or a family member seeking employment to provide a

service that is based upon the knowledge or belief that the individual has sustained a personal injury and

that is directed toward that individual or a family member."

The punishment: A misdemeanor punishable by a fine of up to $15,000 for the first viola on and up to

$30,000 for a second or subsequent viola on(s).

The current law on a orney solicita on in Michigan

There is a Michigan Rule of Professional Conduct (Rule 7.3 regarding Direct Contact with Prospec ve

Clients) that prohibits a orneys in Michigan from solici ng and contac ng accident vic ms by phone or

mail.

But the rule has a very large loophole. It allows lawyers "sending truthful and non decep ve le ers to

poten al clients known to face par cular legal problems," Gursten noted.

"It didn’t take long for many injury lawyers to figure out how to get around the direct contact of car

accident vic ms ban. Many a orneys are now using proxies such as chiropractors and front organiza ons

they create themselves to get around the rule," Gursten said. "These lawyers also send mail packages

with a copy of the crash vic m's police report and glossy promo onal materials, because sending the

police report creates the loophole that enables them to send the glossy marke ng materials too."

Gursten said that HB 4770‐71 are an important start to protec ng auto accident vic ms. He hopes these

bills will stop unethical a orney solicita on.

"These laws would strictly prohibit lawyers from contac ng accident vic ms within the first 30 days of a

crash, and the punishments are severe. Beyond that, they prohibit everyone else from contac ng

accident vic ms, like healthcare providers or other front organiza ons that are commonly used to get

around the rules," Gursten said. "When a orney solicita on is banned, it will give accident vic ms me

to grieve, and if they choose, find the lawyer who has the best creden als to protect them."

Minnesota board allows chiropractor convicted of fraud to practice

http://www.startribune.com/local/216305411.html

Article by: Alejandra Matos July 22, 2013 - 10:41 AM

A Twin Cities chiropractor with a history of fraud-related felonies is on track to have his license fully reinstated, despite owing more than $1.5 million to 20 victims, some of whom were former patients or colleagues.

Some victims, the Washington County attorney’s office and Attorney General Lori Swanson have -complained that the state licensing board is letting Dr. Randy Miland get back in the business without paying for his crimes. Ben Wogsland, a spokesman for Swanson, said the board’s decision to reinstate Miland’s license despite owing more than $1 million to his victims “doesn’t seem sensible.”

Larry Spicer, executive director of the Minnesota Board of Chiropractic Examiners, said requiring Miland to repay his victims as a condition of getting his license back is “completely impermissible. ... The board’s focus is strictly on the license of the individual.”

Spicer said the board’s job is to protect the public and based on documents and rehabilitation provisions, the board believed “it was unlikely that he would engage” in future fraudulent conduct.

In an interview last week, Miland said he takes full responsibility for his past actions and that it is his “full intention” to repay his victims. “I would like to pay everything off tomorrow if I could,” he said. “I don’t have the wherewithal to pay all those judgments, but I don’t have a problem at all with working on payments.”

Miland’s license was suspended by the Board of Chiropractic Examiners in 1999. That year, he pleaded guilty in Washington County District Court to five counts of theft by swindle involving a bogus scheme to invest in Blockbuster video stores. The board determined that Miland had “exercised influence on several patients in such a manner as to exploit them for financial gain,” according to the 1999 stipulation.

He was released from state custody in 2001 but five years later was convicted in federal court of wire fraud and sentenced to 41 months in prison for a phony high-return real estate scheme.

In 2011, the chiropractic board rescinded Miland’s suspension and allowed him to practice under a probationary license as long as he abstained from drugs and alcohol, passed ethics screenings and

paid a $1,000 civil penalty. Now practicing in Vadnais Heights, Miland could have his license fully restored in November.

Modest payments were made

As part of his state sentence, Miland was ordered to make payments to victims of the scheme. Several of his victims said they had received less than $50 a month, even though Miland owed each of them amounts as high as $277,000.

Fred Fink, criminal division chief for the Washington County attorney’s office, said Miland satisfied his obligations under criminal law, which including making modest payments. The court was powerless to enforce the judgments once Miland completed the terms of his sentence in 2004, Fink said. He said the responsibility to collect then fell to the victims.

“We took the level of the theft into account when we dealt with him. That included demanding restitution and obviously he didn’t pay,” Fink said. “As a result, he was able to avoid that responsibility and someone should hold him responsible.”

Swanson sent a letter to the chiropractic board in January emphasizing that point. In a letter to Swanson in May, Spicer wrote “it was Miland’s pledge and the Board’s stated expectation that regaining his licensure would increase his income and facilitate increased restitution payments.”

Robert Harvey, one of Miland’s victims, says he hasn’t seen a payment in many years. Harvey invested over $62,000. Harvey still has boxes and three-inch-thick binders brimming with hundreds of documents, letters to the governor and regulatory agencies, along with personal notes and transcripts. He led the group of victims, many of whom were elderly and invested their life savings with Miland, he said.

Harvey is pessimistic that Miland will meet his obligations. “Fifteen years later, we’ve survived this scam, but the same can’t be said for all his victims,” he said. Miland “will get his license back, the victims will not be repaid, and the board will not monitor. It will be forgotten about and he will have a lavish lifestyle and many of his victims will continue to suffer.”

Alejandra Matos • 612-673-4028

© 2013 Star Tribune

Chiropractor with history of fraud placed on probation for assault and 'false' records

Article by: ALEJANDRA MATOS

August 11, 2013 - 8:21 AM

http://www.startribune.com/printarticle/?id=219128371

Just two months after Dr. Patrick Corrick’s chiropractic license was fully reinstated, Corrick assaulted employees at the African Assistance Program, attempting to choke one of them, according to a new disciplinary action issued by the Minnesota Chiropractic Examiners Board.

The board suspended Corrick’s license for two years earlier this month, but stayed that decision as long as he participates in psychotherapy and substance monitoring. He was given a five-year probationary license as part of the agreement.

This isn’t Corrick’s first time facing disciplinary action. In 2001, the board revoked his license for paying “runners” to bring new patients involved in auto accidents into his office. According to the 2001 order, Corrick, who was practicing in Brooklyn Park, attempted to defraud no-fault insurance policies by submitting false and deceptive billing statements.

Five years after the license was revoked, the board gave Corrick a five-year probationary license. After complying with the terms of his probation, including anger management training, Corrick received an unconditional license in August 2011.

In November of that year, Corrick went into the office of the African Assistance Program in Brooklyn Park and accused its employees of encouraging patients to leave his care and go somewhere else. Dr. Larry Spicer, president of the Minnesota Chiropractic Examiners Board, said the state allowed Corrick to continue practicing because the new allegations were “a different set of circumstances.”

“Dr. Corrick was the subject of a court order in the past, but he presented evidence that he had been rehabilitated,” Spicer said.

In its most recent investigation, the board noted the assault on the employees at the African Assistance Program, but also found problems with Corrick’s billing practices. The order says Corrick failed to keep written chiropractic records justifying course of treatment and some records were “false, illegible and/or nonsensical, at times using incorrect personal pronouns,” an indicator of “copy and paste” record keeping.

Corrick’s record keeping was an issue back in 2001 when the board found Corrick “generated identical letters about dozens of different patients, with identical findings about range of motion of the patient and symptoms.”

Spicer said in their most recent investigation that there was not enough evidence to prove that Corrick may be engaging in insurance fraud.

Corrick’s attorney Michael Padden said he would not comment on the specific issues of the investigation but said Corrick will comply “100 percent with the decision of the board.” Corrick’s office is now operating in Crystal, under the name Corrick Chiropractic.

“Throughout his entire career, he’s been an exemplary chiropractor,” Padden said. “There were some disputes about the allegations, and he has accepted the decision and has paid the fine and will comply with the stipulation.”

Corrick pleaded guilty to disorderly conduct in Hennepin County District Court last March in the assault.

Spicer said the board has to take into consideration the state’s criminal rehabilitation act when deciding if doctors who have committed repeated offenses should be allowed to practice.

The state’s policy is “to encourage and contribute to the rehabilitation of criminal offenders and to assist them in the resumption of the responsibilities of citizenship.”

“A license, once issued, is a property right and there has to be substantial due process. It can’t just be taken away capriciously,” Spicer said. “A doctor or nurse has a property right to that license.”

Alejandra Matos • 612-673-4028

© 2013 Star Tribune

UNETHICAL PRACTICES LAWSUIT (RE: 1‐800‐411‐PAIN et al)

Licensee guidance posted on the Minnesota Board website

http://www.mn-chiroboard.state.mn.us/Whats%20new.htm#UNETHICAL_PRACTICES_LAWSUIT_(RE:_1-800-411-PAIN_et_al)

UNETHICAL PRACTICES, Re: 1‐800‐411‐PAIN, Truman Injury, and Sergio Triana vs. The Board members of the Minnesota

Board of Chiroprac c Examiners

Recently, the Legislature amended a law [M.S. 65B.54, Subd. 6(d)(1)‐(3), (5), and (6)] related to personal injury insurance.

This law has become the subject of a cons tu onal challenge and request for injunc on filed in Federal Court to prevent

or modify this law’s implementa on. Driving the suit, was 1) the fact that the licensing authori es (i.e. the Boards) were

empowered to take disciplinary ac on against a licensee who violated the law, and 2) the law was to go into effect on

January 1, 2013. In summary, the amendments to the law dictated that solicita ons for adver sement must:

1. Be undertaken only by or at the direc on of a health care provider;

2. Prominently display or reference the legal name of the health care provider;

3. Display or reference the license type of the health care provider, or in the case of a health care provider that is a

business en ty, the license type of all of the owners of the health care providers (without needing to list all the

names of the providers);

4. Not include any reference to the dollar amounts of the poten al benefits under this chapter, and;

5. Not imply endorsement by any law enforcement personnel or agency.

In a decision issued on December 28, 2012, Judge Susan Nelson denied plain ff’s mo on for an injunc on. This means

that this law currently remains in effect, and the above condi ons must be met. Doctors of chiroprac c are advised to be

aware of the condi ons of this statute, and comply accordingly with all adver sing requirements, including these.

(For a full version of the law, please see h ps://www.revisor.mn.gov/statutes/?id=65B.54 (The por on relevant to this

lawsuit, is Subdivision 6) SEE BELOW

2012 Minnesota Statutes 65B.54 CLAIMS PRACTICES.

Subd. 6.Unethical practices.

(a) A licensed health care provider shall not initiate direct contact, in person, over the telephone, 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 licensee. This subdivision prohibits such direct contact whether initiated by the licensee individually or on behalf of the licensee by any employee, independent contractor, agent, or third party, including a capper, runner, or steerer, as defined in section 609.612, subdivision 1, paragraph (c). This subdivision does not apply when an injured person voluntarily initiates contact with a licensee.

(b) This subdivision does not prohibit licensees, or persons acting on their behalf, from mailing advertising literature directly to such persons, so long as:

(1) the word "ADVERTISEMENT" appears clearly and conspicuously at the beginning of the written materials;

(2) the name of the individual licensee appears clearly and conspicuously within the written materials;

(3) the licensee is clearly identified as a licensed health care provider within the written materials; and

(4) the licensee does not initiate, individually or through any employee, independent contractor, agent, or third party, direct contact with the person after the written materials are sent.

(c) This subdivision does not apply to:

(1) advertising that does not involve direct contact with specific prospective patients, in public media such as telephone directories, professional directories, ads in newspapers and other periodicals, radio or television ads, Web sites, billboards, mailed or electronically transmitted communication, or similar media if such advertisements comply with paragraph (d);

(2) general marketing practices, other than those described in clause (1), such as giving lectures; participating in special events, trade shows, or meetings of organizations; or making presentations relative to the benefits of a specific medical treatment;

(3) contact with friends or relatives, or statements made in a social setting;

(4) direct contact initiated by an ambulance service licensed under chapter 144E, a medical response unit registered under section 144E.275, or by the emergency department of a hospital licensed under chapter 144, for the purpose of rendering emergency care; or

(5) a situation in which the injured person:

(i) had a prior professional relationship with the licensee;

(ii) has selected that licensee as the licensee from whom the injured person receives health care; or

(iii) has received treatment related to the accident from the licensee.

(d) For purposes of this paragraph, "legal name," for an individual means the name under which an individual is licensed or registered as a health care professional in Minnesota or an adjacent state, and for a business entity, a name under which the entity is registered with the secretary of state in Minnesota or an adjacent state, so long as the name does not include any misleading description of the nature of its health care practice; and "health care provider" means an individual or business entity that provides medical treatment of an injury eligible as a medical expense claim under this chapter. In addition to any laws governing, or rules adopted by, a health care provider licensing board, any solicitation or advertisement for medical treatment, or for referral for medical treatment, of an injury eligible for treatment under this chapter must: (1) be undertaken only by or at the direction of a health care provider; (2) prominently display or reference the legal name of the health care provider; (3) display or reference the license type of the health care provider, or in the case of a health care provider that is a business entity, the license type of all of the owners of the health care provider but need not include the names of the owners; (4) not contain any false, deceptive, or misleading information, or misrepresent the services to be provided; (5) not include any reference to the dollar amounts of the potential benefits under this chapter; and (6) not imply endorsement by any law enforcement personnel or agency.

(e) A violation of this subdivision is grounds for the licensing authority to take disciplinary action against the licensee, including revocation in appropriate cases.

PROFESSION

Ruling jeopardizes authority of state medical boards■ The AMA and others in organized medicine are concerned that a decision against a dental board will mean unfair antitrust scrutiny for regulatory agencies.By ALICIA GALLEGOS (HTTP://WWW.AMEDNEWS.COM/APPS/PBCS.DLL/PERSONALIA?ID=AGALLEGOS) amednews staff— Posted June 17, 2013

Physician leaders say a ruling by the 4th U.S. Circuit Court of Appeals could prove a significant impediment to the ability of state licensing boards to regulate the practice of medicine.

On May 31, the court ruled that a North Carolina dental board exceeded its authority when it attempted to stop nondentists from providing teeth-whitening services. In siding with the Federal Trade Commission, judges said the board is not shielded from antitrust scrutiny because it is not actively supervised by the state and its members are private market participants.

Legal experts say the decision could discourage physicians from serving on state boards and inhibit board members from making difficult regulatory decisions for fear of federal scrutiny. The opinion also could lead to legislative rules that impose more state oversight over licensing boards, doctors and attorneys say.

American Medical Association President Jeremy A. Lazarus, MD, called the ruling “deeply flawed” and expressed concern that the decision will impair states’ authority to safeguard public health and patient safety. The Litigation Center of the American Medical Association and the State Medical Societies had issued a friend-of-the-court brief in support of the dentalboard. The brief also was joined by medical societies in North Carolina, South Carolina, Virginia and West Virginia.

“It is crucial that all state regulatory boards — not just dental boards — carry out the responsibilities assigned to them by state legislatures without being intimidated by federal antitrust charges,” Dr. Lazarus said in a statement. “The American Medical Association strongly objects to subjecting state medical boards to second-guessing from the legal system and unfair antitrust scrutiny.”

The FTC hailed the decision as a victory for healthy competition among health care professionals.

“We are pleased that the 4th Circuit agreed that a state regulatory board dominated by self-interested private actors cannot shield its anti-competitive conduct from antitrust review using the state action doctrine,” FTC Chair Edith Ramirez said. “This decision … recognizes that exemptions to the antitrust laws are to be applied narrowly and that consumers are best off when there is vigorous competition.”

Page 1 of 4Ruling jeopardizes authority of state medical boards - amednews.com

7/8/2013http://amednews.com/article/20130617/profession/130619946/2/

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The case started when the North Carolina State Board of Dental Examiners received a complaint that unlicensed teeth whiteners were providing services at shopping malls amid unsanitary conditions. From 2006 to 2009, the board issued cease-and-desist letters to the nondentists, warning them about a state ban against stain removal by unlicensed practitioners.

The nondentists complained to the FTC, and an agency administrative law judge found that the board’s conduct constituted an unreasonable restraint of trade. The board argued that its conduct was protected from antitrust oversight by the state action doctrine, a legal rule that applies to some state board conduct. The doctrine exempts from antitrust scrutiny state agencies that are actively supervised by the state.

The FTC argued that the board falls outside the doctrine because it is made up of market participants and is not actively supervised by a sovereign part of the state government. The dental board requested that the 4th Circuit review the FTC’s 2011 order.

Appellate judges rejected the board’s position. Because the board’s members are elected by other dentists, the board is a private entity and must prove state supervision, the court said.

“Here, the cease-and-desist letters were sent without state oversight and without the required judicial authorization,” the court said. “The board has pointed to certain reporting provisions and ‘good government’ provisions in North Carolina law, but those fall far short. … At the end of the day, this case is about a state board run by private actors in the marketplace taking action outside of the procedures mandated by state law to expel a competitor from the market.”

The dental board is considering its legal options, said board attorney Noel Allen. Possibilities include requesting a rehearing by the 4th Circuit or petitioning the U.S. Supreme Court to hear the case.

Decision may discourage physician participationWhile the court’s ruling focuses on the actions of a dental board, the same issues easily could play out with state medical licensing boards, said Ray E. Stowers, DO, president of the American Osteopathic Assn. The AOA joined the AMA’s brief in support of the dental board.

“The decision jeopardizes state boards’ authority to determine when nonphysician clinicians are providing a level of treatment that exceeds the education and training that they must complete to competently carry out the services and procedures they wish to perform,” Dr. Stowers wrote in an email. “At a time when rising health care expenditures are a national concern, it is tempting to depict decisions made by state dental and medical licensing boards as restraining trade to prevent competition. What the court’s decision fails to take into account, however, is that the quality of health care rests on the skill and ability of professionals who have been trained to deal with the complexities of diagnosing and treating patients, and who understand when it is appropriate to delegate care to another aptly qualified member of the health care team.”

Concern about increased federal scrutiny could discourage physician leaders from serving on state boards, said Stephen Keene, general counsel for the North Carolina Medical Society.

“Perhaps this case and decision will make board members think about the implications of federal regulatory scrutiny over their personal conduct as board members,” he said. “I don’t think board members today are thinking about that when they consider whether to serve on the board. It could have a chilling effect.”

The ruling also could lead to additional and unnecessary state regulations for boards, said Allen, the dental board attorney.



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“A legislature could superimpose an additional layer of bureaucracy to provide additional ‘supervision,’ even though the legislature has already adopted strict ethics and conflicts of interest requirements,” he said.

The ruling could affect state resources negatively as well. Decisions on applications, rule-making and enforcement require expertise, which board members provide essentially for free, he said.

“If the states cannot have that expertise from licensee board members, they will have to pay for it through new staff or expert witnesses,” Allen said. In addition, “the FTC claimed that the state board could not send ‘cease and desist’ letters, but would apparently have to go to court for each enforcement. Going to court in every case of unauthorized practice could be an expensive, unrealistic alternative.”

Differences in member selectionThe 4th Circuit decision will not affect the majority of state licensing boards because most board actions do not jeopardize competition, said Imad Abyad, an FTC attorney. The ruling applies only to boards that affect competition negatively and request an antitrust exemption, he said.

Abyad said the FTC’s objection in the North Carolina case stemmed from the board taking the law into its own hands as opposed to obtaining a cease-and-desist order from a court.

The case is a reminder to state boards that they should review their structures to ensure that they are protected from antitrust scrutiny, said Lisa Robin, chief advocacy officer for the Federation of State Medical Boards. The federation submitted a friend-of-the-court brief in support of the dental board.

She said the dental board’s members are elected by dentists. Other state boards, including a majority of medical boards, are elected or appointed by state officials. That approach provides a layer of protection if antitrust suspicion arises, she said.

“Boards need to look at their structure within the state to be sure they would meet the criteria of a [protected] state agency,” Robin said. The ruling “would certainly give states a reason to look at all their health professional boards and how they are appointed to make sure those protections are in place and that they are acting within a system of accountability.”

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ADDITIONAL INFORMATION

Case at a glanceDid a dental board violate antitrust laws when it attempted to stop nondentists from whitening teeth?

The 4th U.S. Circuit Court of Appeals said yes. Judges rejected the North Carolina State Boardof Dental Examiners’s argument that it is exempt from antitrust scrutiny. The court said a board is protected by the state action doctrine only when it is supervised by the state. The dental board could not prove it was adequately supervised by a sovereign part of the state government, judges said. Because board members are made up of market participants, the board violated antitrust rules when it attempted to stop the nondentists from practicing.



Impact: Some experts say the decision could discourage physicians from serving on state boards and inhibit board members from making difficult regulatory decisions for fear of federal scrutiny.North Carolina State Board of Dental Examiners v. Federal Trade Commission, 4th U.S. Circuit Court of Appeals, May 31 (link)

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EXTERNAL LINKS

North Carolina State Board of Dental Examiners v. Federal Trade Commission, 4th U.S. Circuit Court of Appeals, May 31 (link: http://www.ca4.uscourts.gov/Opinions/Published/121172.P.pdf )

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Copyright © 2013 American Medical Association. All rights reserved.



Beach Legislation Criminalizing The Unlicensed Practice of Psychology, Chiropractice, Social Work and Psychoanalysis Clears Committee

By Trish Graber | June 6th, 2013 - 4:51pm

Bill Would Crack Down On Therapeutic Treatments By Unlicensed Individuals

TRENTON – Legislation sponsored by Senator Jim Beach that would make it a third degree crime to practice psychology, chiropractic, social work, or psychoanalysis without the appropriate license or certification was unanimously approved today by the Senate Judiciary Committee.

“Patients place an enormous amount of trust in healthcare professionals, and they deserve the guarantee of knowing that their practitioners are properly licensed or certified to administer medical care,” said Senator Beach, D-Camden. “By cracking down on unlicensed individuals who perform mental health and therapeutic treatments, this bill will go a long way to protect the safety and well-being of all New Jersey residents.”

The bill, S-2543, would make it a third degree crime if a person knowingly does not possess a license to practice psychology, chiropractic, or social work, or knowingly has had such a license suspended, revoked, or otherwise limited, and he or she: engages in the practice or any activity for which the license is a necessary requisite; exceeds the scope of the practice permitted by an order enacted by the State Board of Psychological Examiners; or falsely represents oneself to the public as a person being eligible to engage in the practice.

Provisions of the bill would also apply to a person who fraudulently holds himself or herself as being a state certified psychoanalyst, practices psychoanalysis under a false or assumed name, or falsely impersonates another person who is a state certified psychoanalyst.

Currently, it is a crime of the third degree to practice medicine or podiatric medicine, dentistry, or acupuncture without a license. The bill would add the unlicensed practice of psychology, chiropractic, and social work, and the uncertified practice of psychotherapy to that list. A crime of the third degree is punishable by a term of imprisonment of three to five years or a fine of up to $15,000 or both.

The bill now heads to the full Senate for consideration.

Contact Info: Danielle Kim / NJ Senate Majority Office / 609-847-3700 Read more at http://www.politickernj.com/66215/beach-legislation-criminalizing-unlicensed-practice-psychology-chiropractice-social-work-and-p#ixzz2WWi26QTM

Paterson chiropractor charged with employing 'runners' to find car crash patients

Seth Augenstein/The Star-Ledger By Seth Augenstein/The Star-Ledger Follow on Twitter on July 18, 2013 at 7:20 AM, updated July 18, 2013 at 8:30 AM

http://www.nj.com/passaic-county/index.ssf/2013/07/paterson_chiropractor_charged_with_employing_runners_to_find_car_cras

h_patients.html

Joseph Salomone, 45

PATERSON — A chiropractor has been arrested and charged with an illegal scheme to pay “runners” to illegally refer patients in car crashes to him, authorities said.

Joseph Salomone, a 45-year-old from Clifton, ran his practice out of the Pain and Injury Center of North Jersey, on Broadway in Paterson, said Camelia Valdes, the Passaic County Prosecutor.

Salomone allegedly used “runners” who would get ahold of police accident reports, and then contact those injured in car crashes, Valdes said.

The victims would be directed to Salomone, who would then allegedly help them file personal injury protection claims against their automobile insurance policies, Valdes said.

Salomone would allegedly pay the “runners” $800 to $1,000 for each referral, Valdes added.

Illegal running of the kind Salomone is accused of is a third-degree offense punishable by three to five years in state prison, and carries a mandatory jail term upon a conviction, authorities said.

The arrest came after a three-month investigation by the prosecutor’s Insurance Fraud Unit, Valdes said. The investigation is continuing, she added.

Last year, the state Attorney General charged Salomone with bilking insurance companies of about $89,000 through false injury claims related to car accidents.

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IN THE COURT OF APPEALS OF THE STATE OF NEW MEXICO

Opinion Number: __________

Filing Date: July 31, 2013

Docket No. 31,690 (consolidated with No. 31,668)

INTERNATIONAL CHIROPRACTORSASSOCIATION,

Plaintiff-Appellant,

v.

NEW MEXICO BOARD OFCHIROPRACTIC EXAMINERS,

Defendant-Appellee,

and

NEW MEXICO BOARD OF PHARMACYand NEW MEXICO MEDICAL BOARD,

Plaintiffs-Appellants,

v.

NEW MEXICO BOARD OF CHIROPRACTIC EXAMINERS,

Defendant-Appellee.

Direct Appeal from Rulemaking by the New Mexico Board of Chiropractic Examiners

Cuddy & McCarthy LLPCharles V. GarciaAlbuquerque, NMPatrick OrtizSanta Fe, NM

Swankin & TurnerJames S. Turner, Esq.

2

Washington, D.C.

for Appellant International Chiropractors Association

Gary K. King, Attorney GeneralZachary A. Shandler, Assistant Attorney GeneralSanta Fe, NM

for Appellee New Mexico Board of Chiropractic Examiners

Odin, Feldman & Pittleman, P.C.Thomas R. DalyReston, VA

Sutin, Thayer & BrowneSusan M. HapkaAlbuquerque, NM

for Amicus Curiae, American Chiropractic Association

Gary K. King, Attorney GeneralDaniel R. Rubin, Special Assistant Attorney GeneralSanta Fe, NMMary H. Smith, Assistant Attorney GeneralAlbuquerque, NM

for Appellants New Mexico Board of Pharmacy and New Mexico Medical Board

Gary K. King, Attorney GeneralZachary A. Shandler, Assistant Attorney GeneralSanta Fe, NM

for Appellee New Mexico Board of Chiropractic Examiners

OPINION

WECHSLER, Judge.

{1} This appeal is taken under the Uniform Licensing Act, NMSA 1978, §§ 61-1-1 to -34(1957, as amended through 2013), to challenge rules adopted by Appellee, the New MexicoBoard of Chiropractic Examiners (the Chiropractic Board). The rules in question approvean amended advanced practice chiropractic formulary that includes minerals and additionaldrugs to be administered by injection (2010 formulary) and a new rule establishingadditional educational requirements for advanced practice chiropractic physicians (training

3

rule). Appellants, the New Mexico Board of Pharmacy (the Pharmacy Board), the NewMexico Medical Board (the Medical Board), and the International Chiropractors Association(the ICA), challenge the 2010 formulary, asserting that it violates the requirement of NMSA1978, Section 61-4-9.2(B) (2009) of the Chiropractic Physician Practice Act, NMSA 1978,§§ 61-4-1 to -17 (1968, as amended through 2009), that prior approval of the PharmacyBoard and the Medical Board be obtained. The ICA also challenges the training rule,arguing that it lacked the necessary prior approval of the Medical Board. We hold that the2010 formulary that includes minerals and additional drugs to be administered by injectionviolates Section 61-4-9.2(B)’s requirement that the formula receive approval from thePharmacy Board and the Medical Board. We find no fault with the training rule.Accordingly, we set aside the 2010 formulary.

BACKGROUND

{2} A certified “advanced practice chiropractic” physician has “prescriptive authority fortherapeutic and diagnostic purposes.” Section 61-4-9.1; 16.4.15.7(B) NMAC (7/23/2010).The Chiropractic Board has the statutory obligation to approve formularies for substancesto be administered by certified advanced practice chiropractic physicians. Section 61-4-9.2(B). A formulary is a listing of the approved substances and includes the manner inwhich they may be administered. 16.4.15.11 NMAC (11/13/2011). Formularies areembodied under a rule of the Chiropractic Board. Id. A formulary that includes “[d]angerousdrugs or controlled substances, drugs for administration by injection and substances notlisted in Subsection A of” Section 61-4-9.2 requires prior submission to the Pharmacy Boardand the Medical Board for approval. Section 61-4-9.2(B).

{3} Effective September 11, 2009, the Chiropractic Board adopted an administrative ruleestablishing an advanced practice chiropractic formulary. This 2009 formulary was thesubject of prior litigation between the parties. After the voluntary dismissal of its appeal tothis Court, the Pharmacy Board gave its approval for certain substances, and the manner fortheir administration, to be included in the formulary. The Chiropractic Board decided toreplace the formulary proposed in 2009 with the 2010 formulary that was effective July 23,2010. On July 29, 2011, the Chiropractic Board issued notice that it would hold a hearingand regular meeting to consider various items, including the 2010 formulary. The 2010formulary included an amendment to the formulary of 16.4.15.11 NMAC to include mineralsand additional drugs to be administered by injection and a new rule, 16.4.15.12 NMAC(11/13/2011), establishing additional educational requirements for certified advancedpractice chiropractic physicians that was not approved by the Medical Board.

{4} The Chiropractic Board did not submit its proposed 2010 formulary to the PharmacyBoard or the Medical Board prior to the August 30, 2011 hearing. In connection with thehearing, both boards advised the Chiropractic Board that they did not approve the 2010formulary. The ICA also objected to the 2010 formulary as well as the training rule. TheChiropractic Board approved the 2010 formulary that amended 16.4.15.11 NMAC and thenew language of 16.4.15.12 NMAC. The Pharmacy Board and the Medical Board filed a

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single appeal from the Chiropractic Board’s action, and the ICA filed a separate appeal. ThisCourt consolidated the appeals and granted a stay of the two administrative rules pendingthe resolution of this appeal.

ARGUMENTS OF THE PARTIES

{5} In this appeal, the Pharmacy and Medical Boards and the ICA contend that the 2010formulary, 16.4.15.11 NMAC, is contrary to law because the Chiropractic Board adopted itwithout approval of the Pharmacy and Medical Boards, as required by Section 61-4-9.2(B).The ICA additionally argues that the Chiropractic Board’s own regulations required it toobtain the approval of the Pharmacy and Medical Boards before approving the 2010formulary. It further contends that the training rule, 16.4.15.12 NMAC, violates Section 61-4-9.1(D) and 16.4.15.10(C) NMAC (3/31/2009) because the Medical Board did not approvethe new training requirements.

{6} The Chiropractic Board counters that its 2010 formulary does not require approvalof the Pharmacy and Medical Boards based on its interpretation of Section 61-4-9.2(B) thatconstrues the plain meaning of the statutory language, avoids surplusage, and complies withproper re-punctuation. It argues that its interpretation of Section 61-4-9.2 does not result inany conflict with its regulations. It further contends that the Medical Board was not requiredto approve the training rule.

STANDARD OF REVIEW

{7} In an appeal of the adoption of a regulation under the Uniform Licensing Act, thisCourt may set aside the regulation only if it finds the regulation to be: “(1) arbitrary,capricious or an abuse of discretion; (2) contrary to law; or (3) against the clear weight ofsubstantial evidence of the record.” Section 61-1-31(C). The arguments in this appeal raisethe question of whether the 2010 formulary and the training rule are contrary to law. Ourinterpretation of the relevant statutes and administrative rules and regulations is also aquestion of law. See PC Carter Co. v. Miller, 2011-NMCA-052, ¶ 11, 149 N.M. 660, 253P.3d 950. We review the Chiropractic Board’s application of the law de novo. See id.

THE 2010 FORMULARY

{8} “An administrative agency has no power to create a rule or regulation that is not inharmony with its statutory authority.” Rivas v. Bd. of Cosmetologists, 1984-NMSC-076, ¶3, 101 N.M. 592, 686 P.2d 934. The statutory authority at issue is contained in Section 61-4-9.2, which states that:

A. A certified advanced practice chiropractic physician mayprescribe, administer and dispense herbal medicines, homeopathic medicines,over-the-counter drugs, vitamins, minerals, enzymes, glandular products,protomorphogens, live cell products, gerovital, amino acids, dietary

5

supplements, foods for special dietary use, bioidentical hormones, sterilewater, sterile saline, sarapin or its generic, caffeine, procaine, oxygen,epinephrine and vapocoolants.

B. A formulary that includes all substances listed in SubsectionA of this section, including compounded preparations for topical and oraladministration, shall be developed and approved by the board. A formularyfor injection that includes the substances in Subsection A of this section thatare within the scope of practice of the certified advanced practicechiropractic physician shall be developed and approved by the board.Dangerous drugs or controlled substances, drugs for administration byinjection and substances not listed in Subsection A of this section shall besubmitted to the [Pharmacy Board] and the [Medical Board] for approval.

{9} The central issue before us concerns the meaning of the third sentence of Section 61-4-9.2(B) as to the circumstances under which approval of the Pharmacy and Medical Boardsis required. We thus seek to interpret Section 61-4-9.2 to establish the Legislature’s intentin enacting the statute. See Bd. of Educ. for Carlsbad Mun. Sch. v. N.M. State Dep’t of Pub.Educ., 1999-NMCA-156, ¶ 16, 128 N.M. 398, 993 P.2d 112 (“The primary purpose ofstatutory interpretation is to ascertain and give effect to legislative intent.” (internalquotation marks and citation omitted)). As the Chiropractic Board points out, this Courtrefers to the canons of statutory construction to interpret statutory meaning. Janet v.Marshall, 2013-NMCA-037, ¶ 9, 296 P.3d 1253. The Chiropractic Board specificallyrequests that we interpret Section 61-4-9.2 based on three such canons: that a statute shouldbe interpreted in accordance with its plain meaning, see Janet, 2013-NMCA-037, ¶ 9; thata statute should be interpreted to give effect to its entire language such that no language issurplusage, see Benny v. Moberg Welding, 2007-NMCA-124, ¶ 8, 142 N.M. 501, 167 P.3d949; and that a court may re-punctuate a sentence to fulfill the legislative intent. See Cityof Roswell v. Hall, 1941-NMSC-011, ¶ 4, 45 N.M. 116, 112 P.2d 505.

{10} We address each of the Chiropractic Board’s arguments. However, we believe thatthe Legislature’s intent is best resolved by looking to the language of Section 61-4-9.2 in thecontext of “its history and background” and the manner in which it “fits within the broaderstatutory scheme.” Chatterjee v. King, 2012-NMSC-019, ¶ 12, 280 P.3d 283. In this regard,we examine Section 61-4-9.2 in conjunction with statutes that address the same subjectmatter in order to ensure “a harmonious, common-sense reading.” Chatterjee, 2012-NMSC-019, ¶ 12.

History and Background of Section 61-4-9.2

{11} In 2008, the Legislature amended the Chiropractic Physician Practice Act. Amongthe amendments, the Legislature for the first time authorized the Chiropractic Board toestablish by rule an advanced chiropractic practice physician certification registry. Section61-4-9.1. The Legislature distinguished an advanced chiropractic practice physician from

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other chiropractors. It permitted an advanced chiropractic practice physician to “haveprescriptive authority for therapeutic and diagnostic purposes as authorized by statute” andincluded within this authority the ability to administer “a drug by injection.” Id.; Section 61-4-2(C). With this distinctive authority, the Legislature required that an advancedchiropractic practice physician be licensed and certified by a nationally-recognizedcredentialing agency, have completed three years of post-graduate clinical practice orequivalent clinical experience and annual continuing education, and have “completed aminimum of ninety clinical and didactic contact course hours in pharmacology,pharmacognosy, medication administration and toxicology certified by an examination froman institution of higher education approved by the [Chiropractic Board] and the [MedicalBoard].” Section 61-4-9.1(D).

{12} With the creation of the advanced chiropractic practice physician status in 2008, theLegislature also required the Chiropractic Board to develop a formulary to address advancedpractice chiropractic physicians’ prescribing, administering, and dispensing and furtherrequired that the formulary be approved by the Pharmacy and Medical Boards. Section 61-4-9.2 (2008). The Legislature additionally required coordination between regulatory boardsby mandating joint approval of the Chiropractic and Medical Boards of higher educationrequirements. Section 61-4-9.1(D).

{13} The Legislature’s authority to enact the Chiropractic Physician Practice Act stemsfrom its exercise of the state’s power to regulate for the protection of the health, safety, andwelfare of its citizens. See State ex rel. Dep’t of Pub. Safety, State Police Div. v. One 1986Peterbilt Tractor, Black in Color, with an Altered VIN, 1997-NMCA-050, ¶ 15, 123 N.M.387, 940 P.2d 1182 (“The [L]egislature is the proper branch of government to determinewhat should be proscribed under the police power, and a determination of what is reasonablynecessary for the preservation of the health, safety and welfare of the general public is alegislative function.” (alteration, internal quotation marks, and citation omitted)). Althoughthe Legislature did not include a specific purpose provision in the Chiropractic PhysicianPractice Act, it did mandate that the Chiropractic Board establish educational requirements“for the purpose of protecting the health and well-being of the citizens of this state.” Section61-4-3(G). The statutes forming the Pharmacy and Medical Boards specifically state thepurpose of the statutes as within the state’s police power. See NMSA 1978, § 61-11-1.1(B)(1997) (“The purpose of the Pharmacy Act is to promote, preserve and protect the publichealth, safety and welfare[.]”); NMSA 1978, § 61-6-1(B) (2003) (stating the purpose of theMedical Practice Act to be “[i]n the interest of the public health, safety and welfare”).

Plain Meaning of Section 61-4-9.2

{14} The Chiropractic Board makes two arguments concerning the plain meaning ofSection 61-4-9.2. In its answer brief, it raises an argument that draws upon the originallanguage of Section 61-4-9.2 as enacted by the Legislature in 2008. That language read:

A certified advanced practice chiropractic physician may prescribe,

7

administer and dispense herbal medicines, homeopathic medicines, vitamins,minerals, enzymes, glandular products, naturally derived substances,protomorphogens, live cell products, gerovital, amino acids, dietarysupplements, foods for special dietary use, bioidentical hormones, sterilewater, sterile saline, sarapin or its generic, caffeine, procaine, oxygen,epinephrine and vapocoolants. A formulary shall be developed by the boardand approved by the [Medical Board] and the [Pharmacy Board].

Section 61-4-9.2 (2008).

{15} The Chiropractic Board’s plain meaning interpretation of Section 61-4-9.2 raised inits brief focuses on the first two sentences of Subsection B. According to the ChiropracticBoard, the first sentence plainly authorizes it to adopt a formulary allowing an advancedpractice chiropractic physician to prescribe and administer a substance listed in SubsectionA. With its amendment to Section 61-4-9.2 in 2009, the Legislature removed fromSubsection A the language requiring Pharmacy and Medical Board approval. Thus, to theChiropractic Board, under the plain meaning of the first sentence of Subsection B, thePharmacy and Medical Boards do not need to approve the formulary. See N.M. CattleGrowers’ Ass’n v. N.M. Water Quality Control Comm’n, 2013-NMCA-046, ¶ 8, 299 P.3d436 (“The law of statutory construction presumes that when the Legislature amends a statute,it intends to change the existing law.”), cert. granted, 2013-NMCERT-003, 300 P.3d 1181.

{16} The Chiropractic Board similarly analyzes the plain meaning of the second sentenceof Subsection B. It reads this sentence to permit it to adopt a formulary allowing anadvanced practice chiropractic physician to administer by injection a substance listed inSubsection A if it ensures that such formulary is consistent with the scope of practice of anadvanced practice chiropractic physician. Again, because the second sentence of SubsectionB does not contain language requiring that the Pharmacy and Medical Boards approve suchformulary, the Chiropractic Board does not consider such approval to be within the plainmeaning of Subsection B.

{17} By its own account, the Chiropractic Board’s plain meaning interpretation of Section61-4-9.2 raised in its brief does not address the third sentence of Subsection B. And it is themeaning of the third sentence that is the crux of the issue before us. Indeed, the languageof this sentence indicates a legislative intent to require Pharmacy and Medical Boardapproval for the use of certain drugs and substances by an advanced practice chiropracticphysician. The question is which drugs or substances are subject to the required approvals.

{18} The Chiropractic Board raised an alternative argument at oral argument to this Court.It argued that the plain meaning of the third sentence of Section 61-4-9.2(B) is reflected inthe Legislature’s reference to “substances in Subsection A” in the first and second sentences.According to the Chiropractic Board, the Legislature’s use of the language “substances listedin Subsection A” in connection with its requirement that the Chiropractic Board developformularies in the first two sentences indicates that when the Legislature required Pharmacy

8

and Medical Board approval in the third sentence of Subsection B for “substances not listedin Subsection A,” it plainly meant to exclude substances listed in Subsection A from therequired approval.

{19} In addressing these arguments, we note the interchangeable use of “drug” and“substance” in the Chiropractic Physician Practice Act. Section 61-4-9.2(B) refers to the“substances” listed in Subsection A. But Subsection A includes “over-the-counter drugs.”The third sentence of Subsection B uses the terms “[d]angerous drugs,” “controlledsubstances,” “drugs for administration by injection,” and “substances not listed in SubsectionA.” Section 61-4-9.2(B). The definitions section of the Chiropractic Physician Practice Actdefines “chiropractic” in part by including “the administering of a drug by injection by acertified advanced practice chiropractic physician[.]” Section 61-4-2(C). It does not,however, define “drug” or “substance” for the purposes of the Chiropractic PhysicianPractice Act. At oral argument, the Chiropractic Board and the Pharmacy Board bothindicated that the Chiropractic Physician Practice Act uses the terms “drug” and “substance”interchangeably. By virtue of this interchangeable use, we do not make any distinctionbetween “drug” and “substance” in the language of the Chiropractic Physician Practice Act.Cf. Hanson v. Turney, 2004-NMCA-069, ¶ 12, 136 N.M. 1, 94 P.3d 1 (stating that, when theLegislature was aware of a distinction used in other statutes and did not adopt it, it intendedotherwise).

{20} When we then turn to the language of the third sentence of Section 61-4-9.2(B), andfocus only on “drugs for administration by injection,” we observe no lack of clarity in therequirement that a formulary that includes “drugs for administration by injection” or“substances not found in Subsection A” be approved by the Pharmacy and Medical Boards.The Chiropractic Board, however, contends in its brief that, in context, the second and thirdsentences are confusing and do not permit such an isolating focus. In particular, it arguesthat a reading of Section 61-4-9.2(B) that addresses the first two sentences as establishingthe Chiropractic Board’s authority to develop and approve formularies and the third sentenceas limiting that authority does not make sense and renders statutory language duplicative orsurplusage.

{21} In order to address these arguments, we must consider the other types of drugs theLegislature listed in the third sentence. Because the Chiropractic Physician Practice Actdoes not define these terms, we look elsewhere for guidance. See Janet, 2013-NMCA-037,¶ 11 (“The statute itself does not define [the term], so we look to case law and other statutesfor guidance.”). “Dangerous drugs” and “controlled substances” are defined in the contextof laws that similarly address regulated drugs. “Controlled substances” are defined in theschedules of the Controlled Substances Act, NMSA 1978, §§ 30-31-1 to -41 (1972, asamended through 2011), and are subject to regulation by the Pharmacy Board. Controlledsubstances are also defined in the New Mexico Drug, Device and Cosmetic Act by referenceto the Controlled Substances Act. NMSA 1978, § 26-1-2(D) (2011). As defined in the NewMexico Drug, Device and Cosmetic Act, a “drug” is an article “recognized in an officialcompendium” that is “intended for use in the diagnosis, cure, mitigation, treatment or

9

prevention of disease.” Section 26-1-2(E)(1), (2). Also as defined in the New Mexico Drug,Device and Cosmetic Act, a “dangerous drug” is

a drug, other than a controlled substance enumerated in Schedule I of theControlled Substances Act, that because of a potentiality for harmful effector the method of its use or the collateral measures necessary to its use is notsafe except under the supervision of a practitioner licensed by law to directthe use of such drug.

Section 26-1-2(F).

{22} These definitions were in place when the Legislature amended Section 61-4-9.2 in2009. Although the Legislature did not specifically refer to the New Mexico Drug, Deviceand Cosmetic Act or the Controlled Substances Act for definitions, as it could have, it hadalready linked the New Mexico Drug, Device and Cosmetic Act to the ChiropracticPhysician Practice Act by mandating coordination between the Chiropractic Board and thePharmacy Board, which oversees the operation of the New Mexico Drug, Device andCosmetic Act. See NMSA 1978, § 61-11-6(1), (9) (2005). Moreover, we believe that theLegislature intended the use of the New Mexico Drug, Device and Cosmetic Act andControlled Substances Act definitions to apply because it used the terms “dangerous drugs”and “controlled substances” that are clearly defined in those acts. “Controlled substance”does not have meaning without reference to the Controlled Substances Act that defines it.See Gutierrez v. J & B Mobile Homes, 1999-NMCA-007, ¶ 8, 126 N.M. 494, 971 P.2d 1284(applying “a common sense interpretation to the plain language of the statute”). In addition,when interpreting a statute, we seek to harmonize statutes involving the same or similarsubject matter. See Sinclaire v. Elderhostel, Inc., 2012-NMCA-100, ¶ 14, 287 P.3d 978(stating that “[w]hen two statutes cover the same subject matter, we attempt to harmonizeand construe them together in a way that facilitates their operation and the achievement oftheir goals” (alteration in original) (internal quotation marks and citation omitted)). Underthe definition of “dangerous drugs” in the New Mexico Drug, Device and Cosmetic Act, weagree with the Pharmacy and Medical Boards that a drug that is administered by injectionfalls within the definition because it is not safe unless it is administered under thesupervision of an appropriately licensed practitioner.

{23} Returning to the Chiropractic Board’s arguments, it first contends that if theLegislature had intended the third sentence to be a limitation of the second sentence, “itwould have been clearer if the [L]egislature had expressly added the phrase ‘shall besubmitted to the [Pharmacy Board] and Board of Medicine’ to the end of the secondsentence.” The Legislature had used this approach in 2008 and removed this language in2009. While this approach may have more directly stated the legislative intent, we do notsecond guess the approach the Legislature utilized. See Marckstadt v. Lockheed MartinCorp., 2010-NMSC-001, ¶ 31, 147 N.M. 678, 228 P.3d 462 (stating that this Court “will notsecond-guess” the method chosen by the Legislature). Although the adopted approach may

10

be more indirect because of the need to reference the New Mexico Drug, Device andCosmetic Act, we do not consider it to be ambiguous. See Bd. of Educ. for Carlsbad Mun.Sch., 1999-NMCA-156, ¶ 18 (“A statute is ambiguous if reasonably informed persons canunderstand the statute as having two or more meanings.”). We also do not consider thisapproach to render the second sentence of Section 61-4-9.2(B) surplusage. As we haveexpressed, the second sentence granted the authority to the Chiropractic Board to adopt aformulary for drugs administered by injection, and the third sentence required theChiropractic Board to submit such a formulary to the Pharmacy and Medical Boards forapproval.

{24} The Chiropractic Board’s second argument asserts that, under a construction in whichthe third sentence of Section 61-4-9.2(B) limits the second sentence, the legislative use ofthe phrase “drugs for administration by injection” in the third sentence of Section 61-4-9.2(B) duplicates the use of the term “[d]angerous drugs” earlier in the same sentence. Weagree that there is overlap in the language because, as we have discussed, the term“dangerous drugs” includes drugs for administration by injection. Nevertheless, we do notconsider this overlap to confuse the legislative intent. See Bd. of Educ. for Carlsbad Mun.Sch., 1999-NMCA-156, ¶ 16 (“The primary purpose of statutory interpretation is to ascertainand give effect to legislative intent.” (internal quotation marks and citation omitted)). Drugsadministered by injection are a subset of “dangerous drugs.” While the Legislature couldhave excluded drugs administered by injection, or used other language such as “dangerousdrugs, including drugs for administration by injection,” we do not believe that separatelylisting such drugs alters the legislative intent. We could not construe the separate listing assurplusage unless we attached a different meaning either to “drugs for administration byinjection” or to “dangerous drugs.” However, we do not perceive a meaning that is differentfrom those we have discussed for either term, and the Chiropractic Board has not assertedthat there is a different meaning for the terms.

{25} The Chiropractic Board’s oral argument position does not affect our analysis becausewe read the third sentence of Subsection B as an overarching requirement with respect to theformularies required by the first two sentences. “[S]ubstances not listed in Subsection A”is but a single category requiring approval. The language used distinguishes the categoryfrom the substances listed in Subsection A. But, particularly in view of theinterchangeability of the terms “drugs” and substances” in the Chiropractic PhysicianPractice Act, we do not consider the use of the language to have greater meaning. To theextent that “substances in Subsection A” are also “dangerous drugs” or “drugs administeredby injection,” they fit within the specific categories identified in the third sentence ofSubsection B.

{26} When we thus read Section 61-4-9.2 both in connection with the history and otherprovisions of the Chiropractic Physician Practice Act and the definitions of the New MexicoDrug, Device and Cosmetic Act, which is a similar exercise of the Legislature’s policepower to protect the health and safety of its citizens, the meaning of the third sentence ofSection 61-4-9.2(B) is clear. In creating the advanced practice chiropractic physician, the

11

Legislature’s primary purpose was to protect the public health and safety. Seeminglybecause of the existing authority and purpose of the Pharmacy and Medical Boards to protectthe public health and safety concerning the prescribing and administering of drugs, theLegislature mandated a coordinated effort among the Chiropractic, Pharmacy, and MedicalBoards to fulfill its purpose. It linked the Chiropractic Board to the Medical Board indeveloping a special educational requirement for advanced practice chiropractic physicians.It further required, in Section 61-4-9.2(B), that the Pharmacy and Medical Boards approvethe use of dangerous drugs and drugs for administration by injection, among others. TheLegislature has adopted similar coordinated efforts for other health professionals.See NMSA 1978, Section 61-9-17.2(B) (2002) (requiring the State Board of PsychologistExaminers and the Board of Medical Examiners to jointly develop guidelines concerning apsychologist’s prescribing of psychotropic medication); NMSA 1978, Section 61-3-23.3(E)(2001) (requiring the Board of Nursing to develop a formulary for prescriptive authority ofcertified registered nurse anesthetists in collaboration with the Board of Medical Examiners).

{27} In 2008, the legislative language left no room to question the need for the Pharmacyand Medical Boards to approve the Chiropractic Board’s formularies. Although the 2009amendment modified the language of Section 61-4-9.2, we do not believe that it modifiedthe Legislature’s mandate that the Pharmacy and Medical Boards approve the ChiropracticBoard’s formularies that it considered necessary for the protection of the public health andsafety. In 2009, the Legislature relaxed its requirement that the Chiropractic Board submitall formularies to the Pharmacy and Medical Boards for approval. However, using termswith which it was familiar because of their use in the New Mexico Drug, Device andCosmetic Act and the Controlled Substances Act, the Legislature required approval for,among other drugs and substances, dangerous drugs. By using this term, the Legislatureintended to follow the established definition in the New Mexico Drug, Device and CosmeticAct. Otherwise, the Legislature would have created an ambiguity, or worse, a new,conflicting definition, a result that we do not believe that it intended. See Bd. of Educ. forCarlsbad Mun. Sch., 1999-NMCA-156, ¶ 18 (“A statute is ambiguous if reasonablyinformed persons can understand the statute as having two or more meanings.”).

{28} In summary, we read Section 61-4-9.2(B) to authorize the Chiropractic Board todevelop and approve formularies to permit an advanced practice chiropractic physician toprescribe and administer the substances listed in Subsection A. The formularies may includeboth topical and oral administration and administration by injection. However, theChiropractic Board must submit its formularies to the Pharmacy and Medical Boards forapproval to the extent that the formularies include dangerous drugs, as defined in the NewMexico Drug, Device and Cosmetic Act. As defined in the New Mexico Drug, Device andCosmetic Act, dangerous drugs include drugs for administration by injection.

Re-Punctuation

{29} The Chiropractic Board differs with this interpretation and would have us re-punctuate the third sentence of Section 61-4-9.2(B) to adopt what it argues is the legislative

12

purpose. According to the Chiropractic Board, Dr. Stephen Perlstein and Dr. Robert Jones,proponents of the 2009 amendment, testified at the rulemaking hearing that the intent of the2009 amendment was to distinguish natural substances from all others and that there was nodebate as to whether the Chiropractic Board had oversight over the natural substances.These natural substances are the ones listed in Subsection A. The proponents intended theamendment to enable the Chiropractic Board to oversee the dispensing of the Subsection Asubstances without approval of the Pharmacy Board and the Medical Board. They believedthat they had worked out the third sentence to read: “Dangerous drugs or controlledsubstances and drugs for administration by injection not listed in [Subsection] A shall besubmitted to the [Pharmacy Board] and the [Medical Board] for approval.” The ChiropracticBoard contends in this appeal that this interpretation is consistent with the second sentencethat allows it to develop a formulary for the substances of Subsection A to be administeredby injection without approval by the Pharmacy and Medical Boards. Dr. erlstein testifiedat the rulemaking hearing that a drafter at the Legislative Council Service modified thislanguage by placing a comma after “dangerous drugs or controlled substances” that set off“dangerous drugs or controlled substances” and changed the meaning of the intendedlanguage.

{30} The Chiropractic Board suggests two ways in which this Court could alter the thirdsentence of Section 61-4-9.2(B) to achieve the substance that it contends was intended.First, it suggests that the emphasis of the third sentence should be on the language “not listedin Subsection A” such that “not listed in Subsection A” modifies all three items covered inthe sentence, “[d]angerous drugs or controlled substances,” “drugs for administration byinjection,” and “substances.” To capture this emphasis, the Chiropractic Board suggests thatwe modify the third sentence to delete the comma after “controlled substances” and insert“and” in its place. The suggested sentence would read:

Dangerous drugs or controlled substances and drugs for administration byinjection and substances not listed in Subsection A of this section shall besubmitted to the [Pharmacy Board] and the [Medical Board] for approval.

Alternatively, the Chiropractic Board suggests that we re-punctuate the third sentence to adda comma before and after “not listed in Subsection A of this section” so that “not listed inSubsection A of this section” will modify all other items listed in the sentence. The sentencewould thus read:

Dangerous drugs or controlled substances, drugs for administration byinjection and substances, not listed in Subsection A of this section, shall besubmitted to the [Pharmacy Board] and the [Medical Board] for approval.

{31} We find the Chiropractic Board’s suggestions to be problematic for four reasons.First, it is not the realm of this Court to re-write a statute to comport with our opinion as tothe manner it should be interpreted. See Martinez v. Sedillo, 2005-NMCA-029, ¶ 7, 137N.M. 103, 107 P.3d 543 (“We will not rewrite a statute.”). The Chiropractic Board relies

13

on a single case, Roswell, 1942-NMSC-011, ¶ 4, 45 N.M. 116, 112 P.2d 505, to support itsposition. In that case, our Supreme Court observed from the face of a city ordinance that aword was incorrectly used. Id. ¶ 2. It considered the error to be clerical and substituted aword and a comma that was also used in a parallel clause in the ordinance. Id. As the Courtpointed out, “[w]hen the ordinance is read as a whole, there can be no question as to itsintended meaning.” Id. ¶ 3. In this case, there is no apparent clerical error in the Section 61-4-9.2(B) as written that frustrates the intended meaning.

{32} Second, the Chiropractic Board rests its argument on the testimony of Drs. Perlsteinand Jones concerning the Legislature’s intent in amending Section 61-4-9.2. New Mexicocourts look primarily to the legislation itself to ascertain legislative intent. Regents of theUniv. of N.M. v. N.M. Fed’n of Teachers, 1998-NMSC-020, ¶ 30, 125 N.M. 401, 962 P.2d1236. As a general rule, the Legislature “speaks solely through its concerted action asshown by its vote.” U.S. Brewers Ass’n, Inc. v. Dir. of the N.M. Dep’t of Alcohol BeverageControl, 1983-NMSC-059, ¶ 9, 100 N.M. 216, 668 P.2d 1093 (emphasis, internal quotationmarks, and citation omitted). Although contemporaneous documents presented to theLegislature or statements of legislators made while legislation is pending may be consideredto bear upon legislative intent, our courts do not generally consider statements of legislatorsor others after legislation has passed. State ex rel. Helman v. Gallegos, 1994-NMSC-023,¶ 35, 117 N.M. 346, 871 P.2d 1352; Claridge v. N.M. State Racing Comm’n, 1988-NMSC-056, ¶¶ 24, 28, 107 N.M. 632, 763 P.2d 66. Moreover, Drs. Perlstein and Jones testified atthe rulemaking hearing about their intent as proponents of the 2009 amendment, not aboutthe Legislature’s intent.

{33} Third, notwithstanding the testimony of Drs. Perlstein and Jones, the ChiropracticBoard asks that we re-write Section 61-4-9.2(B) to adopt a meaning that was not clearly theintent of the Legislature. As we have earlier discussed, the history and background of theChiropractic Physician Practice Act support the requirement that the Pharmacy and MedicalBoards approve formularies that contain dangerous drugs.

{34} Last, the Chiropractic Board’s suggested alterations to the third sentence do notpersuade us that the Legislature intended Pharmacy and Medical Board approval to applyonly to substances not listed in Subsection A. In its first suggestion, the words “not listedin Subsection A of this section” are not separated from the immediately previous word“substances” so as to indicate that they refer to any items other than “substances.” See Halev. Basin Motor Co., 1990-NMSC-068, ¶ 9, 110 N.M. 314, 795 P.2d 1006 (stating thedoctrine of the last antecedent as “[r]elative and qualifying words, phrases, and clauses areto be applied to the words or phrase immediately preceding, and are not to be construed asextending to or including others more remote” (internal quotation marks and citationomitted)). In the alternative suggestion, the word “substances” placed before a comma andthe words “not listed in Subsection A of this section” do not make sense without a furtherdescriptor or modifier. Each of the other references to drugs or substances in the sentenceis more specifically described.

14

THE ICA’S ARGUMENTS CONCERNING THE CHIROPRACTIC BOARD’SREGULATIONS

{35} The ICA raises additional arguments on appeal concerning the Chiropractic Board’sregulations. It contends that the Chiropractic Board’s adoption of the 2011 formularyviolated its own regulations, that the regulations require Medical Board approval for trainingprograms for advanced practice chiropractic physicians, and that the Chiropractic Board’sprescribed training does not meet statutory and regulatory requirements. We consider theICA’s arguments in turn.

{36} As to the adoption of the 2011 formulary, the ICA points to 16.4.15.7(E) NMAC,16.4.15.8(A) NMAC (7/23/2010), and 16.4.15.8(H) NMAC. Regulation 16.4.15.7(E) of theAdministrative Code defines “[c]hiropractic formulary” as “those substances that have beenapproved for use by the chiropractor registered in advanced practice by the [ChiropracticBoard] and as by statute with consensus between the [Medical Board] and [PharmacyBoard].” Regulation 16.4.15.8(A) of the Administrative Code provides in part that activelyregistered chiropractic physicians “are allowed prescription authority that is limited to thecurrent formulary as agreed on by the [Chiropractic Board] and as by statute, by the[Pharmacy Board] and the [Medical Board].” Regulation 16.4.15.8(H) of the AdministrativeCode addresses amendments to advanced practice formularies. It permits the ChiropracticBoard to review the formularies annually for necessary amendments and further providesthat all amendments “be made following consensus of the [Medical Board], [the PharmacyBoard] and the [Chiropractic Board].” 16.4.15.8(H) NMAC. The ICA argues that theseregulations read together “all provide that any expansion of the chiropractic formulary mustbe made by consensus of all three boards.”

{37} On their face, 16.4.15.7(E) NMAC and 16.4.15.8(A) NMAC do not go as far as theICA argues. Both require the involvement of the Pharmacy and Medical Boards “as bystatute.” By this express language, the regulations do not require any more than what isrequired by statute.

{38} Regulation 16.4.15.8(H) of the Administrative Code requires the consensus of theChiropractic Board and the Pharmacy and Medical Boards for an amendment to advancedpractice formularies. The adoption of the 2011 formulary amended the previous formulary.16.4.15.11 NMAC. Although it appears that the Chiropractic Board may be acting in amanner that is inconsistent with this regulation, we need not address this argument in viewof our holding that the Chiropractic Board is statutorily required to obtain the Pharmacy andMedical Board’s approval of the formulary to the extent it includes dangerous drugs.

{39} The ICA’s remaining arguments concern the Chiropractic Board’s adoption of16.4.15.12 NMAC, the training rule pertaining to the educational requirements of advancedpractice chiropractic physicians. The Medical Board objected to 16.4.15.12 NMAC, statingthat because the hours of training do not appear to be sufficient, it would “continue todisapprove all injectables until adequate training is proposed and agreed to by the” Medical

15

Board. Section 61-4-9.1(D) requires an advanced practice chiropractic physician to have“completed a minimum of ninety clinical and didactic contact course hours” in specifiedsubjects “from an institution of higher education approved by the [Chiropractic Board] andthe [Medical Board].” Regulation 16.4.15.7(D) of the Administrative Code similarlyrequires that “[a]ny educational institution allowed to provide clinical and didactic programscredited toward advanced practice certification must have concurrent approval from the[Medical Board] and the [Chiropractic Board].” Regulation 16.4.15.8(B)(2) of theAdministrative Code provides that a chiropractic physician applying for advancedchiropractic physician registry must submit documentation of the completion of the specifiedninety hours of education “provided by an institution approved by the [Medical Board] andthe [Chiropractic Board].” We find no fault with the training rule.

{40} These provisions require the Medical Board to approve the institutions of highereducation that provide the minimum of ninety specified educational hours to an advancedpractice chiropractic physician. They do not give the Medical Board authority to decline anyother type of approval. The ICA’s position that the Medical Board could object to theformulary because it did not believe that the educational rule provided sufficient training isnot supported by the statute and regulations it cites. As a result, the approval of highereducation requirements by the Medical Board will not translate into a justification to rejectseparate “drug or substance” formularies proposed by the Chiropractic Board. The issuesare distinct and we reject this argument by the ICA.

CONCLUSION

{41} We hold that the 2010 formulary that includes minerals and additional drugs to beadministered by injection violates Section 61-4-9.2(B)’s requirement that the formula receiveapproval from the Pharmacy Board and the Medical Board. We find no fault with thetraining rule. Accordingly, we set aside the 2010 formulary.

{42} IT IS SO ORDERED.

____________________________________JAMES J. WECHSLER, Judge

WE CONCUR:

____________________________________TIMOTHY L. GARCIA, Judge

____________________________________J. MILES HANISEE, Judge

h p://www.reviewjournal.com/columns‐blogs/jane‐ann‐morrison/will‐doctor‐isnt‐bill‐chiropractors‐assistants‐cause‐pain

Posted date May 23, 2013 - 12:40am Updated May 23, 2013 - 6:24am

LAS VEGAS REVIEW-JOURNAL

Will 'doctor isn't in' bill for chiropractors' assistants cause pain? By JANE ANN MORRISON, LAS VEGAS REVIEW-JOURNAL Two warring factions among Nevada chiropractors split over a bill that has passed both houses of the Legislature without any “no” votes, despite one faction’s concerns that this bill poses a danger to public safety.

One faction is headed by Dr. James Overland Sr., head of the Nevada Chiropractic Association. He wanted the law changed so licensed chiropractic assistants could perform therapy on patients even if the chiropractor wasn’t present.

The other faction, including Nevada Chiropractic Physicians Board members Dr. Benjamin Lurie and Dr. Annette Zaro and former board members Dr. Margaret Colucci and Dr. Stephanie Youngblood, contends that the bill creates dangers for patients.

After the bill was amended so that the licensing board could write regulations to define what assistants could and could not do, the board voted to take a neutral position on the bill, not a ringing endorsement.

To be a licensed chiropractic assistant you have to be 18, have a high school diploma or the equivalent, have six months on-the-job training and pass a written test. On the most recent test in March, 80 percent of students failed the first time they took the written test, and 57 percent failed the second time they took it.

Zaro, Lurie and Youngblood all told legislators that allowing unsupervised treatment by assistants wasn’t safe and pointed out potential dangers.

Overland and the association’s lobbyist Marlene Lockard said safety wasn’t an issue. “They’re not going to be doing a thing that they don’t already do,” she said.

The Federation of Chiropractic Licensing Board wrote that under its Model Practice Act a clinical assistant may not provide clinical services in the absence of a licensed chiropractor. Yet Tennessee has had a similar law since 2000 allowing assistants to treat patients unsupervised and hasn’t reported any problems.

When this reaches Gov. Brian Sandoval’s desk, he’ll have to ask himself: Would I want an assistant working on a member of my family without a chiropractor in the building? Put that way, he might feel the need to veto Senate Bill 198. Or he might have no concerns and be willing to trust the Legislature. Or he might want to ask around.

It’s rare that there are complications, but it does happen, and when it does, do you want your chiropractor out of town, but supposedly accessible by an electronic device, to deal with it long distance?

Sure, you can sue if things go wrong, but is that really the answer to every problem?

The bill was sponsored by state Sen. Joe Hardy, R-Boulder City, a medical doctor.

In Overland’s written testimony in favor of the bill during the March 6 hearing in the Senate Committee on Commerce, Labor and Energy, Overland wrote: “We have all had the unpleasant experience of patients waiting

too long or leaving the office because the chiropractors could not be present due to unforeseen circumstances. In this case, the patient receives no therapy as well as incurring an unfortunate expense for travel time.”

But here’s his kicker: “The chiropractor is also denied the income the patient would have generated.”

It’s seems to be about the money, honey.

Youngblood is forceful in her opposition to the bill. In her letter to Assemblywoman Maggie Carlton, D-Las Vegas, Youngblood wrote, “If you want to play golf, having long lingering lunches or make money while you are on a vacation, get a cover doctor.”

Youngblood said that in her 26 years as a chiropractor, she has experienced “gross mistakes” by chiropractic assistants even under direct supervision. “Thank goodness a doctor was on site to rectify any of the situations.”

The bill doesn’t go into effect until the licensing board develops regulations, so the board will have the last word on creating the regulations saying when and where the unsupervised treatment would be allowed. Carlton was emphatic that she didn’t want to see chiropractic mills where one doctor has offices all over the valley staffed by assistants.

The bill specifies that the assistants cannot do adjustments or interview new patients and make diagnoses.

It’s possible to burn patients from the inside using electric muscle stimulators. The bill assumes that each time a patient goes f or treatment, the previous therapy is repeated and the patient’s medical condition has not changed.

Overland, a provider for Culinary union Local 226, dismissed all the safety issues as coming from “a few naysayers” and said he didn’t know their agenda. He said the low pass rate by assistants on written tests is not a valid argument and compared chiropractic assistants to lawyers who have to take the Bar exam several times.

But Overland, a sole practitioner, undercut his own logic when he said even with the bill, about half of his patients wouldn’t come if they knew he wasn’t in the office. “More than half would wait until I got back.”

He said the bill would be used f or instances such as recently, when he was 20 minutes late from a lunch meeting and because the assistants couldn’t work without him in the building, five patients left.

Zaro informed Assembly Commerce and Labor Chairman David Bobzien, D-Reno, she opposed the bill. “In my opinion, and the opinion of many others, this (bill) poses a danger to the public.”

“This seems to be clearly a doctor-driven bill that is designed to allow the (chiropractor) to not be in the office but still collect money for treatment without regard to the safety of the patient,” she wrote the chairman.

She also testified about checking a regular patient after his therapy and discovering he was having a medical emergency. With this bill, he would have left without seeing her and might have had a long-term permanent disability because he didn’t see her.

Apparently, her concerns didn’t concern Bobzien.

Can’t help but wonder if they’ll concern Gov. Sandoval.

Jane Ann Morrison’s column appears Monday, Thursday and Saturday. Email her at [email protected] or call her at 702-383-0275.

Chiropractor with prior indecency conviction charged again

UPDATED 3:18 PM EDT Aug 07, 2013

http://www.wyff4.com/news/local-news/anderson-news/acso-upstate-chiropractor-exposed-himself-to-2-women-charged/-/9654706/21367746/-/item/0/-/gbp208/-/index.html

ANDERSON COUNTY, S.C. -

An Upstate chiropractor was arrested after two women said he exposed himself to them without their consent, according to Anderson County investigators.

Investigators said Gregg Battersby operates a chiropractor business out of his home on Highway 81 south in Starr.

According to an incident report, the incidents happened on May 23 and June 2.

Battersby is charged with two counts of indecent exposure and is out of jail on bond.

Battersby's attorney, Sara Drawdy, said, "These charges are ridiculous and we look forward to the truth coming out and having our day in court."

Drawdy says law enforcement didn't do anything to try and corroborate the allegations.

"Before charges like this are brought, law enforcement should do a thorough investigation," Drawdy said. "They did not talk to my client at all before bringing these charges, and at the end of the day, this is a he-said-she-said case at best." According to the Ohio State Chiropractic Board, Battersby was also charged with public indecency in 2006.

Records show a woman interviewing for a housecleaning job said Battersby exposed his "private parts" after announcing he was "a nudist."

After pleading no contest, Battersby was found guilty. As a result, his license in Ohio was suspended for 10 days.

Drawdy said, "I'm aware of what allegedly occurred in Ohio, and it's simply not relevant to the charges that have been brought (here)."

According to documents from Arizona, Battersby's license there was revoked in 2008.

Currently, the South Carolina Board of Chiropractic Examiners shows his license is active.

Deputies say anyone who feels they were victimized should call CrimeStoppers at 888-CRIME-SC.

Gregg Battesby: charged with indecent exposure

h p://blog.cleveland.com/open_impact/print.html?entry=/2013/06/ohio_senate_poised_to_give_chi.html

Ohio Senate poised to give chiropractors authority to clear young

athletes who suffer head injuries

Brandon Blackwell, The Plain Dealer By Brandon Blackwell, The Plain Dealer

on June 03, 2013 at 7:00 PM, updated June 03, 2013 at 7:02 PM

COLUMBUS, Ohio ‐ Some Ohio physicians are upset over a budget provision that would allow

chiropractors to make the calls on pu ng student athletes with head injuries back in the game.

Senate lawmakers on Thursday are likely to pass a version of the budget, House Bill 59, that gives

chiropractors the authority to clear the return of young athletes who are taken off the field for

symptoms of a concussion or head injury. The move has upset those who say chiropractors do not

have the proper training to handle the responsibility.

"I think that when we're talking about serious head injuries to children, a physician's training and scope

of exper se is broader and more comprehensive than a chiropractor," said Tim Maglione, senior

director of the Ohio State Medical Associa on. "Chiropractors have a role in the con nuum of care for

athletes. We just don't think it should go as far as assessing head injuries for young children."

Supporters of the provision, however, say chiropractors receive rigorous training in neurology and are

well qualified to make the assessments.

Current law gives doctors of medicine or osteopathic medicine the authority to clear a young athlete

for a return to sports. The amendment would extend that authority to chiropractors.

Maglione sent a le er last month to the Senate asking lawmakers to toss the provision.

"The simple fact is that physicians are granted ul mate oversight...because they are best equipped in

terms of educa on and training to act in that role," Maglione said in the le er. "Those without

adequate educa on and training should not be making return to play decisions independently.

"The training and educa on of a physician is vastly different and indeed more rigorous than that

required for a chiropractor."

The le er included signatures from officials with the Ohio Chapter of the American Academy of

Pediatrics, Ohio Children's Hospital Associa on, Ohio Athle c Trainers Associa on, Ohio Hospital

Associa on and the Ohio Osteopathic Associa on.

Republican Rep. John Adams added the amendment to HB 59 in April before the House sent the budget

to the Senate.

The amendment adjusts legisla on passed in December during the General Assembly's lame duck

session that requires coaches and referees to take a player out of a game or prac ce who is showing

symptoms of a concussion or head injury. Players are not allowed to return un l cleared directly or

under the guidance of a doctor of medicine or osteopathic medicine. Cleveland Clinic, University

Hospitals and other health care organiza ons stood by the move.

However, some say the legisla on wrongfully sidelined chiropractors from making return‐to‐play

decisions.

"Doctors of chiroprac c are sufficiently prepared to release concussed athletes back to normal

ac vi es," said Adams, of Sidney, in a statement. "Per the Ohio State Chiroprac c Board, chiropractors

in the state of Ohio have been able to diagnosis, manage and clear individuals with concussions since

1975, and should con nue to be part of the chiropractors scope of prac ce."

Kreg Huffer, chiropractor and spokesman for the Ohio State Chiroprac c Associa on, agreed and

tes fied in favor of the amendment.

"For years doctors of chiroprac c have served as high school team physicians, volunteering their me

on the hardwood, football field and other athle c venues tending to athlete's injuries," Huffer said.

"We as an associa on and as a profession believe this was an unintended consequence due to the

nature of the bill being passed during lame‐duck."

Huffer said chiropractors in the state are licensed only a er comple ng 149 hours in neurology training,

271 hours studying X‐rays and 168 hours of course work in orthopedics.

Nicholas Strata, director of legisla ve affairs for OSCA, said neurology training for chiropractors can be

more rigorous than for doctors of medicine.

"We're not saying MDs are not able to treat this issue. We are saying that we are able to treat this issue

too," Strata said.

A er this week's floor vote, HB 59 will move to a conference commi ee, where lawmakers from both

chambers will put their finishing touches on the budget. The governor must sign the proposal by June

30.

"We are happy we could get to go back to prac cing what we went to school for," Strata said. "The

game's not over. We're in the fourth quarter, but we're winning."

On Twi er: @BlackwellTweets

© 2013 cleveland.com. All rights reserved.

Capitol Report, Wayne Greene: Percent of licensing fees shuttled to state coffers BY WAYNE GREENE World Senior Writer

Sunday, July 07, 2013

7/07/13 at 5:22 AM

http://www.tulsaworld.com/site/printerfriendlystory.aspx?articleid=20130707_11_A19_Ifyour935135

If you're an architect, a chiropractor, a nurse, a veterinarian or a dentist, you're paying about 10 percent extra for

your annual licensing fees to help out the state budget.

So are cosmetologists, psychologists, social workers, pharmacists and several other state-licensed professionals,

according to a legislative report released last week.

"The state is making money off those fees, and maybe it shouldn't be," said Sen. Patrick Anderson, R-Enid. "I don't

think you can look at the 10 percent as anything short of a 10 percent tax."

Anderson was the chairman of the Senate committee that wrote the report.

Twenty-four of the so-called nonappropriated state agencies - those that are supported completely with fees and not

state tax revenue - are making contributions of at least 10 percent of their annual budget to the state general

revenue fund.

Most are small-budget licensing agencies, such as the Oklahoma Board of Optometry, which has a $251,000 annual

budget and the equivalent of three full-time employees and sent more than $33,000 to the general revenue fund in

fiscal year 2012.

The biggest money-maker for the state, the Oklahoma Department of Securities, is making contributions well above

that 10 percent level.

Its payback to the general revenue fund is 75 percent to 80 percent of its annual budget - more than $15 million in

fiscal year 2012, according to the report.

Irving Faught, administrator of the Securities Department, pointed out that most of those fees are paid by out-of-

state companies looking to sell securities and mutual funds within the state. The fees aren't large, and the

companies pay the funds so they don't have any problem doing business in the state, Faught said.

It's pretty much the same in every other state, he said.

In total, nonappropriated agencies contributed more than $17.1 million to the general revenue fund, the one that

pays for things like schools and state troopers, in fiscal year 2012.

Sen. Nathan Dahm, R-Broken Arrow, was a member of the committee. He said you can argue this either way:

The nonappropriated agencies are still a part of state government and, as such, they use state resources. The tax

commission, for example, collects and disperses many of the fees that support the nonappropriated agencies, he

said. Seen that way, the agencies should be contributing to the cost of maintaining the entire state government

structure, and their fee-paying licensees should shoulder that burden.

On the other hand, as a general rule, fees should represent the actual cost of providing a service and not be used to

underwrite general government services. Fees pay for services. General taxes support general costs.

Dahm says he thinks the area is "absolutely" an area in need of reform. He and Anderson say they're interested in

legislation to address the issue.

The report also suggests that some nonappropriated agencies should be essentially privatized because they "may

no longer need to be a state agency."

Such agencies aren't in the licensing business but essentially are voluntary trade promotion groups: The Oklahoma

Peanut Commission, the Sheep and Wool Commission, the Wheat Commission and the Oklahoma Energy

Resources Board.

The sheep and wool commission has a $6,000 budget and no employees. The peanut commission has a $158,933

budget and one full-time employee.

The wheat commission has a $2.9 million budget and 3.5 employees.

The energy resources board has a $14.8 million budget and technically no employees. All of its workers are

contractors.

The report also pointed to three nonappropriated agencies that could be absorbed by similar agencies: the Motor

Vehicle Commission and the Used Motor Vehicle and Parts Commission might be combined; the Oklahoma

Corporation Commission might take over the duties of the Liquefied Petroleum Gas Board; and the Supreme Court

or the attorney general might absorb the Council of Judicial Complaints, the report suggests.

Original Print Headline: Portion of license fees shuttled to state coffers

Wayne Greene 918-581-8308

[email protected]

Amarillo man accused of sexual battery at his Guymon chiropractic clinic Posted: August 9, 2013 - 3:40am h p://amarillo.com/news/local‐news/2013‐08‐09/amarillo‐man‐accused‐sexual‐ba ery‐guymon‐chiroprac c‐clinic

By Amanda Castro-Crist [email protected]

An Amarillo man has been charged with three counts of sexual battery after a trio of women said he inappropriately touched them during chiropractic sessions at a clinic in Guymon, Okla.

Dr. James V. McCollum was arrested after a 46-year-old woman filed a report with Guymon Police Department on July 19, Lt. Jason Bond said. The woman told police she had been assaulted by McCollum during a July 17 session at McCollum Clinic of Chiropractic in Guymon.

Bond said McCollum was called in for questioning after the report was filed, but his attorney did not allow him to be interviewed. Police had enough evidence, and McCollum was arrested and charged with one count of sexual battery, Bond said. McCollum was able to post bond, and police said he is not required to stay in

Guymon at this time. Bond said McCollum and his wife, with whom he shares the practice in Guymon, reside in Amarillo when they are not working.

A second woman, also 46 years old, filed a report July 26 stating she had been assaulted Feb. 11, and McCollum was charged with two additional charges of sexual battery, Bond said. A woman filed a report Aug. 1 claiming she was assaulted by McCollum during a session in 1983, Bond said, but no additional charges were filed because the statute of limitations had expired.

Bond said the third woman will serve as a witness for the other two cases.

No other charges have been filed, but Bond said the district attorney is still reviewing the case and there is a possibility others might come forward to file a report as they hear about the case.

McCollum has been practicing in Guymon for the past 30 years, Bond said.

Statute of limita ons

Clackamas chiropractor cleared of false charges

Heather Steeves, The Oregonian By Heather Steeves, The Oregonian

on July 30, 2013 at 3:43 PM, updated July 30, 2013 at 8:14 PM

An administra ve law judge decided a Clackamas chiropractor didn't commit fraud, pinch a

client's bu or commit other improper acts but was the target of lies by a disgruntled former

employee.

The Oregon Board of Chiroprac c Examiners recently released its final order, which clears Kim

Jameson's name. Jameson had filed a lawsuit to force the board to release the judge's order. The

board hasn't done that, but the final order heavily quotes the judge, who exonerated Jameson of

all the accusa ons except one record keeping viola on. For that, she was ordered to 12 hours

con nuing educa on.

In the new document, the Oregon Board of Chiroprac c Examiners admits its lead witness,

Caroline Rackley, commi ed perjury and that six of their other seven witnesses tes fied based on

Rackley's statements.

The judge said "Rackley likely provided this informa on in an effort to cover up her own wrongdoing and to shi

suspicion and blame onto Dr. Jameson. In short, without informa on provided, directly or indirectly, by Rackley, the

Board has li le or no substan ve evidence against Dr. Jameson."

The board's order alludes to accusa ons that Rackley borrowed money from the chiropractor's clients and took pe y

cash.

In her lawsuit, Jameson said she lost business because of the false accusa ons. Some insurance companies won't pay for

services by a doctor who is being inves gated, she wrote. Some clients heard about the accusa ons and stopped going

to her.

"I'm grateful that my name has finally been cleared," Jameson said in an email. "That's what I've wanted for the past two

years."

Jameson intends to sue the board and its inves gator for damages, her a orney said.

–Heather Steeves

h p://blog.oregonlive.com/clackamascounty_impact/print.html?entry=/2013/07/clackamas_chiropractor_cleared.html

h p://www.heraldandnews.com/members/news/inside/ar cle_ff8e6dc4‐cf36‐11e2‐9ca8‐001a4bcf887a.html

State board files injunction against Klamath Falls health practitioner Posted: Friday, June 7, 2013 12:00 am

By ANDREW CREASEY H&N Staff Reporter Herald and News / [email protected]; @HN_Creasey

The State Board of Chiropractic Examiners is seeking an injunction against a Klamath Falls health practitioner, alleging

that he is not licensed to practice his primary procedure and that the aggressive pulls on the neck it features could result

in spinal damage.

Christopher McCutcheon, owner of Balanced Wellness Health Center, was named in the injunction, which seeks to

permanently bar McCutcheon from practicing any form of spinal manipulation. The injunction was filed in Klamath County

Circuit Court May 21.

It is not McCutcheon’s first run-in with the chiropractic board. In June 2010, he was fined $10,000 for practicing

chiropractic medicine without a license.

In the latest filing, the chiropractic board is alleging that McCutcheon, who is not a licensed chiropractor, is still performing

the procedure that provoked the board to action in 2010 — the Alphabiotic Alignment/Chrane condyle lift.

“It looks to us that he’s out there doing what he was doing before — fooling with people’s necks without a license,” said

Dave McTeague, executive director of the State Board of Chiropractic Examiners. “You can’t yank on people’s neck

without a license. He could really hurt somebody.”

McCutcheon denied the charge, saying his latest practice, which opened in January, uses “different techniques.” He would

not elaborate, saying that he wanted to take more time to evaluate the details of the board’s claim. He also said he has

not been served with a notice of the injunction.

Both Alphabiotics and the Chrane condyle lift have had a contentious relationship with the chiropractic community.

A case heard in Washington in 2000 established the neck alignments implemented in the condyle lift as a chiropractic

variant. The defendant in the case, former chiropractor John Brown, was ultimately fined $30,000 for practicing the

procedure.

One patient in the case was diagnosed with a stroke caused by dissections of both vertebral arteries, which her

physicians believe Brown’s procedure caused.

In the 2010 case against McCutcheon, a board investigator who received treatment as part of the 2010 investigation

references McCutcheon discussing the benefits of Alphabiotics. Alphabiotics is not part of the literature on McCutcheon’s

current website. He refers to himself as a neurological balance technician on his business card.

The patients whose complaints were cited in the 2010 case complained about neck pains, dizziness and headaches.

According to the case, a health practitioner found indications of severe cervical strain/axial load injury from distraction and

rotation of the neck.

The health practitioner said that he had treated one patient for some time prior to McCutcheon’s treatments, and that, in

his medical opinion, her neck condition was “much worse” due to McCutcheon’s adjustments, according to court

documents.

McCutcheon, however, said that his practice and methods have changed. He said he was confident that the board’s

action will not affect his practice.

Currently, McCutcheon still owes $9,686 in penalties as a result of the 2010 ruling, according to court documents.

1

The healing touch: Chiropractor Kevin McCarthy works to make all patients — animal as well as human — feel better

Published: June 2, 2013 / By Chris Rosenblum

COLLEGE TOWNSHIP — Not many chiropractors start sessions by sitting on the floor and letting their patients smell their hands.

Kevin McCarthy thought nothing of it.

How else was he going to relax Ariel? A bundle of nerves masquerading as a fox terrier mix, she shook while starting her appointment at Metzger Animal Hospital. McCarthy persisted. Slowly, she drew closer for a sniff.

But it wasn’t until McCarthy cut away the cone shielding her from her surgically-repaired kneecap that the visit could begin in earnest.

“Now we’re buddies,” he said.

Putting animals at ease before making them feel better is McCarthy’s specialty. He’s an internationally board-certified animal chiropractor, among the few in the state. Throughout Pennsylvania, he said, only 24 others practice at his level, all in the Pittsburgh or Philadelphia areas.

McCarthy, 33, also treats two-legged patients in the chiropractic clinic, Hands on Health, that he and his wife, Kelli Datres, run a few doors down from the hospital.

That’s his main business, but for two years, he has straightened lopsided dogs and loosened stiff horses through his side venture, McCarthy Animal Chiropractic.

“I’ve always loved animals,” he said.

But despite that, while growing up in Canada, McCarthy never wanted to be a veterinarian.

“I think because even though you can save their life I don’t really like seeing them in life or death situations,” he said.

2

“Becoming a licensed animal chiropractor is a great way to bridge the gap and help animals get back to their old selves without seeing them in a lot of pain.”

Now, he works with veterinarians at the hospital, complementing traditional medical procedures and treatments.

“You’re still helping, but it’s less stressful,” he said.

He sets out to identify disruptions in the “closed feedback loop” between animals’ brains and their muscles, joints and organs — breaks that can lead to dysfunction and disease. Among the causes can be repetitive movements or trauma.

Once he figures out the cause of muscle tightness or imbalance, McCarthy works to fix the weak links in neural connections, using some of the same applied kinesiology techniques he employs with people: gentle pressure and manipulations that remove stressors on the nervous system and allow bodies to heal themselves.

Though licensed to treat any animals, he mainly works with dogs and horses. Ariel came to him with trouble walking after surgery on her back right leg.

Her owner, Beth Spiegelmyer, was new to animal chiropractic treatment, so McCarthy explained his initial plan for Ariel.

“I’m trying to get it so I can get rid of all the problems that would cause her to slowly heal,” he told Spiegelmyer.

“Later on, we’ll play with that knee, but right now, it’s too early.”

An eye for body language

He relies on his observations and sense of touch.

Unlike in his other practice, McCarthy can’t consult his animal patients. But they still communicate with him beyond occasional growls or snorts. By now, he has a keen eye for body language, for telltale movements in gaits that indicate an animal is compensating for tightness or pain, or protecting a sensitive spot.

Then he lets his fingers go to work.

He has yet to be bitten while probing for knots or massaging tight spots, though he’s “not going to take it personally when it eventually happens.” Over time, he has learned to trust his senses, to know when to proceed and when to back off and give an animal space.

With most animals, he said, it’s not an issue after a few minutes.

“They realize you’re trying to help them, and they relax with you,” McCarthy said.

He got his fondness for animals from visiting his grandparents’ farm every weekend, riding around on a tractor and playing with pigs and cows. His interest in physiology and neurology stems from when he needed medical care — urgently.

When he was 12, a garbage truck struck him near his house in the small town of Jarvis, Ontario, not far from Lake Erie. The impact pitched him 20 feet, landing him in intensive care for six weeks.

3

“I broke everything except my heart and brain,” he said.

Every day, his family drove an hour to visit him in the hospital. Against all odds, he recovered and gained not only his strength, but also an appreciation for the human body.

“They said I wasn’t supposed to make it,” McCarthy said. “Ever since I was 12, I was curious about how the body could restore itself.”

At Western University in London, Ontario, he set out to be a teacher. But a week before school started, he had an epiphany while thumbing through a dull education textbook in the school bookstore.

He put down the book, walked to the registrar’s office, tapped into his childhood interest and decided to major in kinesiology.

“Something switched on in my head,” he said.

Another injury, a pulled groin sustained playing college soccer, drew him to his profession. A chiropractor fixed him in one visit, impressing McCarthy enough to consider becoming one himself.

He enrolled in the New York Chiropractic School in the Finger Lakes region, where he studied for four years and met his wife, a Williamsport native who went to Penn State. Together, they worked for a chiropractor for three years before starting their own practice about 14 months ago.

McCarthy branched out further because of a lame dachshund.

Disc herniation prevented the dog from using its back legs. Its owners, friends of the family, called him and asked if there was anything he could do. An anti-inflammatory prescription just wasn’t working.

McCarthy paid the dog a visit.

“I adjusted the dog, then placed it back on the mat where it had been laying,” he said. “After 20 minutes, the dog scooted across the mat. I was completely shocked.”

Spurred by the experience, he attended the Veterinary Chiropractic Learning Centre in Brantford, Ontario — one of the few schools of its kind in North America and open to only chiropractors or veterinarians. Most of his class of 17 were vets.

“I wanted to know if (the dachshund’s recovery) was 100 percent fluke or if there was something to it,” he said.

“Valuable addition” to hospital

Five months of rigorous training later, he had his certification from the College of Animal Chiropractors.

That mattered to Fred Metzger.

When McCarthy approached him about doing chiropractic work and said it could make a difference at the hospital, Metzger was receptive to the idea. He has been moving toward an integrative, more holistic approach to treating animals, adding alternative medicine to traditional care, and chiropractic sounded like it would fit right in.

“I think the older I get, the more I have an open mind,” Metzger said.

4

But the fact that McCarthy was getting instruction from veterinarians, by one of Metzger’s former Purdue University classmates no less, sealed the deal.

“My big thing is you have to have people who are certified and have had advanced training,” Metzger said.

He also liked McCarthy’s focus on applied kinesiology techniques, rather than more typical chiropractic adjustments.

“An animal can’t say, ‘Ow, that really hurts,’ ” Metzger said. “If you’re going to adjust them, that flips me out.”

McCarthy, he said, has become a valuable addition to the hospital. Metzger appreciates the different perspective that McCarthy brings. He admires his professionalism, innovation and “natural bedside manner.”

But most importantly, Metzger is pleased with the results.

“I think we’ve seen some big successes, and I think we’re going to see more,” he said.

With Ariel, the fox terrier mutt, McCarthy saw quick results.

As the dog leaned against her owner’s stomach, McCarthy felt along her back legs, hips and spine.

“I don’t know if you can tell, but she’s tighter on this side than that side,” he told the dog’s owner.

He worked his way up the dog’s spine with small squeezes, then pressed his thumb down on a ligament near the base of her tail, releasing tense myofascial tissue along her tight side. Normally when that happens, dogs shudder as if shaking off water — a sign of relief.

Ariel was too nervous for that, but McCarthy could tell by how she stood and moved that the treatment had worked.

“That’ll keep her even while she’s healing up,” he said.

Generally, McCarthy sees four categories of patients: animals compensating after surgery, geriatric animals with arthritic issues, performance or show animals whose owners want to maximize their performance and animals injured in accidents.

Abby, a Yorkie, definitely suffered from old age.

She walked unevenly, legs bowing, back dipping. Consulting with a hospital orthopedic surgeon, Abby’s owner and a local veterinary acupuncturist who has worked on the dog, McCarthy gingerly pressed on Abby’s hips with one hand while cupping her belly. He lightly kneaded her shoulders.

In the end, Abby still had a lot of work ahead of her, but McCarthy noticed her topline looked straighter as she ambled around the hospital, checking out ankles.

“It looks like she’s sagging less,” he said.

His next patient, a Corgi/terrier mix named Lucy, was even older — 19. Since she fell down basement stairs last year, McCarthy has been regularly treating her.

5

“Hello, Lucy,” McCarthy said as the dog shuffled into the room.

On this day, owner Sue Seybert briefed McCarthy that Lucy kept turning to her left. With the information, McCarthy began examining the gray-muzzled dog. Seybert looked on, a true believer.

From the chiropractic treatments, she said, Lucy has gotten stronger, risen better and fallen down less.

“Had we not been able to do this work, she would not have been here,” Seybert said. “She was having real mobility issues. So it’s magical.”

“Friends for life”

McCarthy loves his two practices equally, but he finds animals “awesome to work with because their recovery rate is so much faster than an adult human.”

“I get excited waking up on Tuesdays and Thursdays because I know that I’ll be going into Metzger’s (hospital) to help some animals get back to their old selves again,” he said.

But he also makes house calls.

Recently, he drove to a College Township stable to work on Jesse, a genial thoroughbred and a rescued race horse.

Jesse suffered from a knotted muscle in his neck and other stiffness. McCarthy could see that when owner Danna Antoine trotted him in a circle clockwise, then at McCarthy’s request, the other way.

The first time Jesse moved smoothly; the second, less so.

McCarthy knew what to do.

Standing on a foam box, the small talk over and his face set in concentration, he worked out tension in Jesse’s neck, hips, shoulders, spine, forehead and knees. He used the same ligament release technique as with Ariel the dog.

At one point, he nudged the horse’s misaligned jaw back into place, prompting a noisy exhalation of pure pleasure.

Then came the real test. Jesse trotted in circles again, faster and more fluidly than before, both times. He seemed perkier.

“He’s already feeling better. See his neck? That’s awesome,” McCarthy said, another patient helped. “We’re friends for life.”

Read more here: http://www.centredaily.com/2013/06/02/3637955/the-healing-touch-chiropractor.html#storylink=cpy

Chiropractor charged with sex assault has history of misconduct

Posted on June 17, 2013 at 9:25 AM / Updated today at 5:26 PM

http://www.wfaa.com/news/local/Carrollton-chiropractor-accused-of-sexually-assault-patient--211813571.html

CARROLLTON –– A Carrollton chiropractor accused of sexually assaulting a female patient during an exam was arrested

Friday, according to a statement released Monday morning by the Carrollton Police Department.

Scott Tan Viet Lai, a chiropractor at SSC Chiropractic, PA, was charged with sexual assault and is being held on a $100,000 bond at the Carrollton Municipal Jail.

According to an arrest affidavit, the assault occurred on June 11 during the victim's third visit with Lai. The victim told police that her cousin located the Vietnamese clinic for her when she began suffering lower back and neck pains after a crash.

The affidavit stated the doctor began touching the victim inappropriately as he told her he was adjusting her tailbone and whispered, "Do you want me to help you relax?" The exam ended when she questioned the doctor's treatment.

"Dr. Lai quickly got up and stated that she should have known what the procedure would be since she was studying to be a nurse," the affidavit read.

She called police from the bathroom of the office and left after Lai had her sign some paperwork, the complaint says.

Lai has been accused of sexual misconduct before. The Board of Chiropractic Examiners suspended his license last year for indecency with a 16-year-old girl.

Carrollton police arrested him in 2009. Documents show, ".... He allegedly kissed the patient in the mouth and placed his hand in her shirt."

He was given seven years probation when he pled no contest.

His license was suspended for six months and the state monitored him for six and a half more years.

According to the SSC Chiropractic website, the family-owned clinic was started in 2002 and has a second location in Arlington.

News 8's Rebecca Lopez contributed to this report

Repeat offenders

Unprofessional conduct charge for DUI is constitutionalPosted on June 19, 2013 by plr

The state medical board was within its rights to discipline a doctor for unprofessional conduct after he was convicted of driving under the influence, the Court of Appeals of Tennessee in Nashville ruled January 9 (Ernest B. Kleier v. Tennessee Board of MedicalExaminers). The court found that the state’s statute for charging physicians with unprofessional conduct is not unconstitutionally vague.

Tennessee physician Ernest Kleier was arrested for driving

under the influence in the summer of 2008. Kleier, whose blood-alcohol level was 0.182%, more than twice the legal limit of 0.08%, at the time of his arrest, pled guilty to criminal charges that September and the Tennessee Board of Medical Examiners filed its own charges the following fall.

After Kleier’s case went to a hearing in January of 2010, the board imposed a two-year probation on his license, and ordered him to seek treatment. After six months, Kleier would be allowed to petition for the lifting of the probation.

Kleier was not happy with the decision and he appealed, arguing that the Tennessee statute under which he had been disciplined, prohibiting licensees from engaging in “unprofessional, dishonorable, or unethical conduct,” was unconstitutionally vague because it did not spell out what sort of actions could be considered unprofessional, dishonorable, or unethical.

An appellate court agreed with Kleier, ruling that the statute was unconstitutionally vague and noting that the doctor’s “unseemly conduct in another state was used as a platform for disciplining his professional license without describing how that conduct undercut the minimally acceptable level of professional competence expected of all physicians in Tennessee.”

Now it was the medical board’s turn to appeal, and the case went to the Court of Appeals of Tennessee in Nashville, which issued a decision by Judge Richard Dinkins.

In its appeal, the board made two primary claims: 1) the statute was not unconstitutionally vague; and 2) the lower appellate court had been wrong to make any ruling based on a failure to elaborate a standard of care, as Kleier had not been charged with incompetent treatment of a patient.

Page 1 of 2Unprofessional conduct charge for DUI is constitutional | Professional Licensing Report

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Dinkins agreed with the board on both points. “The board,” he wrote, “could properly consider driving under the influence an act which could jeopardize the interest of the public, and be an indication of ‘unfitness to practice medicine.’”

“In this manner,” he continued, “the term ‘unprofessional, dishonorable, or unethical conduct’ is adequate to advise Dr. Kleier that a conviction for driving under the influence could subject him to a proceeding before the Board to determine his fitness to practice and is not unconstitutionally vague.”

Dinkins also noted the difference between discipline charges which result from the direct treatment of a physician’s patients and those that do not. Because Kleier had not been charged with unprofessional conduct in the direct treatment of his patients, the lower appellate court had been wrong to cite a failure to elaborate the standard of care as a reason for overturning the board’s decision.

This entry was posted in Uncategorized by plr. Bookmark the permalink[http://www.professionallicensingreport.org/?p=877] .

Page 2 of 2Unprofessional conduct charge for DUI is constitutional | Professional Licensing Report

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8 Houston Attys Accused Of Chiropractor Kickback Scheme By Jess Davis

http://www.law360.com/articles/427175/print?section=competition

Law360, Dallas (March 25, 2013, 7:09 PM ET) -- Eight Houston-area attorneys, including a member of the Texas House of Representatives, were hit Monday with arrest warrants on barratry charges in an alleged $250,000 scheme involving kickbacks to the owner of several chiropractic clinics, according to Montgomery County District Attorney Brett Ligon. Rep. Ron Reynolds, D-Missouri City, and seven other personal injury attorneys face allegations that they paid kickbacks to Robert Valdez, part owner of the Greenspoint Health and Injury Center and Eastex Health and Injury Center chiropractic clinics, according to search warrant affidavits. Valdez allegedly targeted victims of recent car accidents and had them sign contracts for legal representation, matching the attorneys with “preferred” insurance companies in exchange for weekly cash payments and checks, the warrants say. “We’ve executed arrest warrants for barratry on those individuals for that offense,” Ligon told Law360, declining further comment. Authorities for Montgomery County, which includes The Woodlands and other Houston suburbs, on Monday morning raided the chiropractic clinics and the offices of Clyde Miller of Tax Masters, Darren A. Miller of D. Miller & Associates PLLC, Jerome G. “Jerry” Gottesman of Gottesman Law Firm, Jeffrey Michael Nathan of Jeffrey M. Nathan PC, Nhan H. Nguyen of the Law Office of Nhan H. Nguyen PC, Ty Alexander Gibson of Ty A. Gibson & Associates PC and Nader Rabie of West Loop Law. Reynolds’ legislative office did not immediately respond to requests for comment, and the other attorneys could not immediately be reached Monday. Valdez currently is being held in the county jail for an unrelated assault, according to the warrants. According to the warrants, the Montgomery County DA got a tip March 8 from an employee for Valdez, who said her daily duties included printing accident reports from the Houston Police Department, then contacting victims and posing as the “appointment setter” for 12 Houston law firms. The tipster said she would set up consultations for the victims to meet with the firms and promised that their emergency room bills would be paid and that they could “receive a personal injury check for $3,000 to $6,000.” Valdez allegedly had the victims sign legal representation forms before they met with the attorneys and within 30 days of their accidents, in violation of state law. Barratry under

these circumstances is considered a third-degree felony and a “serious crime” under state bar rules that could threaten the attorneys' law licenses. According to the warrants, Reynolds, an attorney at Brown Brown & Reynolds PC, gave Valdez a small, white envelope filled with about $1,000 in $100 bills at his office on March 1. Jeffrey M. Nathan PC allegedly wrote $158,000 of checks to Valdez between July and February, and reported about $63,000 paid to him in nonemployee compensation on a 2012 tax return, the warrant says. The Law Office of Nhan Nguyen reported $25,000 in payments to Valdez on its 2012 tax return, according to the warrant. Reynolds faced similar allegations from the Harris County district attorney last year, but denied pressuring patients to sign contracts before they met him, according to KHOU. Case and counsel information was not immediately available. --Editing by Richard McVay.

http://www.khou.com/news/local/State-Rep-Reynolds-7-other-attorneys-arrested-in-alleged-kickback-scheme-199889371.html

State Rep. Reynolds, 7 other a orneys charged in alleged kickback scheme by Jeremy Rogalski / KHOU 11 News I-Team

khou.com

Posted on March 25, 2013 at 12:25 PM

HOUSTON -- Dozens of law enforcement officers simultaneously raided multiple law offices and two chiropractic clinics Monday morning for their alleged involvement in a kickback scheme to sign up clients, according to an I-Team review of court records.

In all, arrest warrants were issued for eight Houston-area lawyers, including State Representative Ron Reynolds. They are charged with barratry, commonly known as “ambulance chasing,” a third degree felony punishable by up to ten years in prison a $10,000 fine.

Reynolds and the other attorneys are accused of paying kickbacks to Robert Valdez, the alleged ringleader of the operation. Prosecutors said Valdez routinely scour accident reports, then approach and aggressively persuade crash victims to sign contracts for legal representation.

“We have information from a confidential informant, that Ron Reynolds delivered cash in envelopes to Mr. Valdez, in exchange for referring clients to him on numerous occasions,” said Phil Grant, First Assistant Montgomery County District Attorney.

Reynolds faced the same charge in Harris County last summer, but the case was dropped after the lead investigator faced some personal legal troubles that potentially tainted the case.

“It appears that Representative Reynolds stepped away from this organization during the period of time he was charged in Harris County,” Grant said.

“After his case was dismissed, it appears that he got right back in,” he said.

Montgomery County prosecutors picked up the case because Valdez is a resident, and a confidential informant there provided extensive documentation of the alleged scheme. Grant said records indicate a simple fender would fetch $600 in kickbacks, while a commercial vehicle

accident commanded $6000 or more. Additionally, Valdez is accused of steering patients to two chiropractic clinics in Northeast Houston, which he partially owned.

“He was working both ends of the scheme,” Grant said. “He was getting kickbacks allegedly from the attorneys, but he was also making a lucrative amount of money from trumping up medical treatments for individuals who had been in car accidents.”

Grant called the operation “extremely well-organized and prolific” and estimated Valdez signed up hundreds of clients for hundreds of thousands of dollars in kickbacks every year. He allegedly even ran the scheme from the Montgomery County Jail, while incarcerated on an unrelated charge. As a habitual felony offender, Valdez faces up to life in prison upon conviction, according to prosecutors.

Grant said in many accident cases victims really don’t need a lawyer, and can receive a reasonable settlement on their own from the at-fault party’s insurance company. It’s why legislators passed a 30-day no contact law, which prohibits attorneys or their representatives from hounding accident victims. After 30 days, they can only do so in writing.

“You can’t contact them in person, you can’t call them up on the phone, and you can’t give them the hard sell like at a car dealership,” Grant said.

Authorities also served arrest warrants on the following Houston attorneys: Darren Miller, Clyde Miller, Jerry Gottesman, Jeffrey Nathan, Nahn Nguyen, Ty Gibson, and Nader Rabie. Investigators seized records from their offices as well as the Greenspoint Health and Injury Center and Eastex Health and Injury Center. The I-Team was unable to reach any of them for comment as of press time.

The Montgomery County District Attorney’s office was assisted by the Montgomery County Sheriff’s Department, Conroe Police Department, Texas Department of Public Safety, the Texas Rangers, Houston Police Department and the FBI.

Carrollton Leader > News Carrollton chiropractor charged with sexual assault

By Dan Eakin, [email protected]

http://www.carrolltonleader.com/articles/2013/08/14/carrollton_leader/news/705.txt

Published: Tuesday, June 18, 2013 7:14 AM CDT

A Carrollton chiropractor was arrested Friday on charges of having sexually assaulted a 31-year-old woman. Dr. Scott Tan Viet Lai, 40, was placed in the Carrollton Municipal Jail Friday and then transferred to the Lew Sterret Justice Center in Dallas where he was released after posting $100,000 bond. Nicole Rodriguez of the Carrollton Police Department said police arrested Lai, who has been a chiropractor at SSC Chiropractic at 1212 N. Josey Lane in Carrollton after an investigating officer filed a complaint. Lai allegedly assaulted the female during an office visit in Carrollton. He was arrested after the woman went to Baylor Medical Center of Carrollton where she was examined by a nurse who called Carrollton police. According to the police affidavit, the alleged victim went to the office in Carrollton about 11 a.m. Friday morning. The victim said the doctor, who only takes patients by appointment and not walk-ins, locked the front door after she entered the building. She said that made her feel uneasy. She said the doctor had her to lie down on a table. She said he placed his hands on inappropriate places on and inside her body and then leaned over and whispered in her ear. The alleged victim, who is a nurse, said she did not want the chiropractor to think she was about to call the police, so she attempted to remain as calm as possible. She said she signed papers he had requested and left the building before going to the emergency room at the hospital. SSC Chiropractic has been located in Carrollton since 2002, and also has a location in Arlington. Copyright © 2013 - Star Local News



Texas High Court Won't Take Up Chiropractor Rule Challenge By Jess Davis

Law360, Dallas (June 14, 2013, 4:46 PM ET) -- The Texas Supreme Court on Friday said it won’t review the Texas Medical Association’s request that the court overturn a Texas Board of Chiropractic Examiners rule the doctors’ group says unconstitutionally allows chiropractors to diagnose patients. The court’s decision lets stand an Austin Court of Appeals ruling from July that held a rule passed in 2006 by the TBCE allows chiropractors to diagnose limited conditions related to the spine and muscle system in their patients in line with state law, despite arguments from the TMA that it was wrongly blocked from making alternate arguments on appeal for why the rule is invalid. An attorney for the Texas Chiropractic Association said Friday the decision lets chiropractors in the state continue to evaluate their patients as needed. "The stakes in this appeal were high," said Matt Wood of Baker Botts LLP. "Diagnosis is a critical part of providing health care, and it's something Texas chiropractors have been doing for years. This ruling allows them to continue doing so." Wood said he thinks the Supreme Court saw that the reasoning of the appeals court was sound. The dispute dates back to 2006, when the TBCE adopted the rules and was shortly thereafter sued by the TMA, which contended the rules wrongly allowed chiropractic doctors to “practice medicine” without a medical license in violation of the state constitution. The TMA challenged the diagnosis rule as well as a rule that allowed chiropractors to perform needle electromyography and manipulation under anesthesia. A trial judge struck the needle electromyography rule and, in a separate decision, affirmed that chiropractors can diagnose patients but said the rule that allowed diagnosis was overly broad and invalid. Twin appeals were filed, with the TBCE asserting its rules were valid, and with the TMA pressing the court to prevent chiropractors from being authorized to diagnose patients at all. In April 2012, an appeals court reversed the trial court’s invalidation of the diagnosis rule and said it lacked jurisdiction to consider the TMA’s argument in favor of the invalidation, and reiterated that position in July when it denied a motion for rehearing. TMA’s general counsel, Rocky Wilcox, said Friday the organization is still considering its options for review of the decision, and said TMA will continue to challenge the constitutionality of the TBCE rules that allow diagnosis of the biomechanical condition of the musculoskeletal system. The group says the rule, as written, would allow chiropractors to diagnose hundreds of conditions related to the spine, including cancers, neurological diseases and muscular dystrophy. “We expect the case to be remanded to the trial court,” Wilcox said. “Still in play is the issue of whether the Texas Constitution allows for this result: The Texas Constitution provided for one standard or school of medical practice, not two.”

In November, an appeals court remanded another TMA challenge to a TBCE rule enacted in 2006 that allows for vestibular-ocular-nystagmus testing, which the medical group says looks at the brain and inner ear and would qualify as “practicing medicine,” while the chiropractors say the test is used to evaluate balance disorders. The Austin Court of Appeals said a trial court needs to hear further evidence and issue a ruling on what the test is actually for, without relying solely on the disparate arguments advanced by both sides, before it could determine the rule’s validity. The Texas Medical Association is represented by in-house counsel Donald P. “Rocky” Wilcox and Andrea Schwab, as well as David F. Bragg of David F. Bragg PC. The Texas Chiropractic Association is represented by Jason D. Ray and Jennifer S. Riggs of Riggs Aleshire & Ray PC, and Thomas R. Phillips and Matt C. Wood of Baker Botts LLP. The Texas Board of Chiropractic Examiners and Executive Director Glenn Parker are represented by Joe H. Thrash and Jeb E. Boyt of the Attorney General’s Office. The Texas Medical Board is represented by Angela Veronica Colmenero and Nancy K. Juren of the Attorney General’s Office. The case is Texas Medical Association v. Texas Board of Chiropractic Examiners et al., case number 12-0667, in the Supreme Court of the State of Texas. --Editing by Lindsay Naylor.

Texas Court Blocks Release of Chiropractor Docs h p://www.law360.com/ar cles/407830/texas‐court‐blocks‐release‐of‐chiropractor‐docs

By Helen Christophi

Law360, Los Angeles (January 16, 2013, 7:57 PM ET) ‐‐ A Texas appeals court on Wednesday reversed a lower court ruling

that the Texas Board of Chiroprac c Examiners must release documents on the inves ga on of complaints against its

members, finding that the trial court misinterpreted state law in its decision.

A three‐judge panel of the Texas Court of Appeals for the Third District reversed the lower court's summary judgment in

the Texas state a orney general's favor, finding that the chiroprac c board wasn't required to release medical records

from its inves ga on of a board‐licensed chiropractor because they are considered confiden al and exempt from

disclosure under the Texas Public Informa on Act, or PIA.

In ruling for the chiroprac c board, Chief Jus ce J. Woodfin Jones said the a orney general's open records division had

misinterpreted the state occupa ons code by combining two separate provisions to assert the board was required to

release the documents, saying that two sec ons of a law can only be combined if they are in pari materia, or similar

enough to interpret "one in light of the other."

"For two statutes to be in pari materia ... they must have been enacted with the same purpose in mind,” the judge

wrote. "The fact that the statutes could possibly cover the same person and the same property does not by itself warrant

an in pari materia construc on."

The chiroprac c board sued the a orney general for a declara on that some of its documents are exempt from the PIA's

disclosure requirements and subsequently appealed the lower court's decision against it, arguing that the two sec ons

of the occupa ons code the a orney general had used in its decision didn't create a "right of access," according to

Jus ce Jones' opinion.

Under the PIA, informa on a government agency collects in connec on with official business is public informa on and

must be released. But that informa on is exempt from disclosure if it is considered confiden al by law.

According to the ruling, Texas' occupa ons code prohibits the release of medical records to pa ents, but includes two

separate special provisions requiring providers to give pa ents their records under limited circumstances. The a orney

general erroneously combined the special provisions in an a empt to preempt the code's general provision prohibi ng

the release of confiden al medical informa on, the judge wrote.

"[The code's general and special provisions] were not wri en to achieve the same objec ve and therefore do not share a

common purpose," Jus ce Jones added. "Because these statutes are not in pari materia, do not share a common

purpose, and are not intended to be construed together, it follows that one provision could not be considered as

controlling over the other or as crea ng an excep on to it."

A spokesman for the a orney general's office declined to comment on the decision Wednesday.

Representa ves for the chiroprac c board weren't immediately available to comment.

The case is Texas State Board of Chiroprac c Examiners v. Greg Abbo , A orney General of the State of Texas, case

number 03‐11‐00735, in the Texas Court of Appeals for the Third District.

‐‐Edi ng by Katherine Rautenberg.

h p://haleyolson.com/texas‐trial‐law‐advocate/texas‐supreme‐court‐holds‐chiropractor‐had‐a‐duty‐to‐

disclose/

Texas Supreme Court Holds Chiropractor Had a Duty to Disclose

Posted on: 12‐26‐2012

In Felton v. Love , No. 11‐0252, 2012 WL 5971207 (Tex. 2012), a pa ent, who suffered vertebral arterial

dissec on and stroke as a result of a neck manipula on, brought an ac on against a chiropractor,

alleging that he failed to disclose risks associated with the neck manipula on procedure.

The jury found in favor of the pa ent and awarded damages against the chiropractor. The chiropractor

appealed.

A reasonable health care provider must disclose the risks that would influence a reasonable pa ent in

deciding whether to undergo treatment. A health care provider may be liable for failing to disclose to a

pa ent the risks inherent in proposed treatment.

The issue in this case was whether the possibility that a pa ent would suffer a nega ve reac on to a

procedure due to an undetectable physical condi on was a risk that was inherent in the procedure.

The court of appeals concluded that because the pa ent’s injury would not have occurred but for his

own physical condi on—an unhealthy vertebral artery—the risk could not have been inherent in the

chiropractor’s treatment. The Texas Supreme Court held that the court of appeals ruling “ignores the

evidence that the pa ent’s injury would not have occurred but for the chiropractor’s treatment, that

chiroprac c neck manipula on can result in vertebral artery dissec on, and that dissec on and stroke

are known risks of chiroprac c treatment that should be disclosed.” As such, the Texas Supreme Court

held that risk of vertebral artery dissec on and stroke was inherent in neck manipula ons, and, thus, the

chiropractor had a duty to disclose the risk.

Informed consent

Your health, your choices

Chiropractic

How chiropractic is performed Typically, your first chiropractic session will involve an assessment of your general health and medical history, and a physical examination.

The treatment that follows usually involves hands-on manipulation techniques, which focus on the spine.

You may also be given other treatments and advice on exercise, diet and lifestyle (see below for more).

Sessions typically last between 15 and 30 minutes.

You can learn more by reading the GCC leaflet 'What can I expect when I see a chiropractor?'

The length of a course of treatment will depend on the type and severity of symptoms. In the case of persistent lower back pain, NICE recommends that treatment should include up to nine sessions over the course of 12 weeks.

Initial assessment

As part of this assessment, a chiropractor should:

ask about your symptoms •ask about your general state of health and previous health conditions •carry out a physical examination that may involve an examination of your spine and posture, and where relevant an attempt to find the source of your discomfort or pain

•

They may also take X-rays of your spine.

If your chiropractor discovers or suspects that you have a serious health condition, they should advise you to see your GP. Do not use a visit to a chiropractor as a substitute for a visit to a GP.

Once this assessment has been carried out, you should be given a care plan. This describes the chiropractor’s diagnosis and outlines the suggested treatment.

Initial assessments typically last between 45 and 60 minutes.

Treatments

Your chiropractor will advise you on treatments intended to address your health condition, and help you to manage or avoid it in the future.

This may involve manipulation of your muscles, bones and joints, often in the spine. This kind of treatment is sometimes called “manual treatment”.

It may also involve massage or manipulation of soft tissue. Additionally, it may also involve advice on diet, exercise and lifestyle, and a rehabilitation programme for you to follow in your own time.

Spinal manipulation

The main technique used in chiropractic is spinal manipulation. The chiropractor uses their hands to apply force to the muscles, bones and joints in and around your spine.

During the session, you will be asked to sit or lie down. You will usually be asked to remove your upper body clothing so the chiropractor can access your spine. If you are asked to undress, you should be offered a gown.

Chiropractors use a wide range of manual techniques, including:

short, sharp thrusts applied to the spine (intended to remove joint restrictions and improve the range of movement)•gradually moving joints through a range of different positions (intended to reduce tension within a joint) •pulling or stretching muscles in a certain direction (intended to strengthen the muscle and improve its range of movement) •

Usually, chiropractic treatment is not painful. If the chiropractor is treating an injury that is painful or inflamed, there may be some minor pain or discomfort. If you experience any pain or significant discomfort while having chiropractic treatment, tell your chiropractor immediately.

During spinal manipulation, you may experience a popping sensation in your joints and hear a popping or cracking sound. It is thought this is caused by gas bubbles in the fluids that surround your joints. It is a normal part of spinal manipulation and other manual treatments.

Other elements of treatment

Some chiropractors can make other treatments available, as well as manual therapy.

These can include advice on exercise, diet and nutrition, which is intended to help improve, manage or avoid the recurrence of your health condition, and to improve your general health.

They can also include rehabilitation programmes in which you are taught exercises that are intended to help you recover from your health condition, and prevent it recurring.

Some chiropractors may also offer other complementary and alternative treatments, such as acupuncture.

Page 1 of 2Chiropractic - What happens - NHS Choices

7/15/2013http://www.nhs.uk/Conditions/chiropractic/Pages/Whathappens.aspx

1

Donna Liewer

From: Yount, Leann (DOH) [mailto:[email protected]] Sent: Monday, July 15, 2013 3:46 PM To: [email protected] Subject: Rule Filed - WAC 246-08-400 Allowable Fees Healthcare Providers May Charge for Healthcare Records FYI:

The purpose of this notification is to inform you that the Washington State Department of Health (department) has officially adopted the updated rule on allowable fees health care providers may charge for searching and duplicating health care records under WAC 246-08-400. The rule was adopted and filed by the department following a public hearing held on June 5, 2013, in Tumwater, Washington. The rule was filed with the Code Reviser’s Office on July 1, 2013 (WSR #13-14-092). The updated rule language is attached above. The updated fees are as follows:

No more than $1.09 per page for the first 30 pages No more than .82 per page for all additional pages A $24 clerical fee may be charged for searching and handling records

There were no comments received in regard to this rule change. Thank you.

Sherry Thomas, Policy Coordinator Washington State Department of Health Health Systems Quality Assurance PO Box 47850, Olympia, WA 98504-7850 Phone: (360) 236-4612 Public Health – Always Working for a Safer and Healthier Washington

Districts I & IV - Registrants

Districts I & IV Meeting 2013 Vancouver, Washington

Dr. James J Badge Chair State of Arizona Board of Chiropractic Examiners 15 E Cactus Wren Dr Phoenix, AZ 85020-4814 Ph: 602-738-4231 Email: [email protected] Dr. Mark A Bledsoe President South Dakota Board of Chiropractic Examiners 1312 N. Arch St Aberdeen, SD 57401 Ph: 605-229-1212 Email: [email protected] Dr. James Buchanan President Wyoming Board of Chiropractic Examiners 50 E Brundage St Sheridan, WY 82801 Ph: Email: [email protected] Ms. Beth Carter Executive Director Oklahoma Board of Chiropractic Examiners 201 NE 38th Terrace Ste 3 Oklahoma City, OK 73105 Ph: 405-524-6223 Email: [email protected]

Mr. Dennis Clark Executive Officer Montana Board of Chiropractors 301 S Park PO Bx 200513 Helena, MT 59620-051 Ph: 406-841-2390 Email: [email protected] Dr. Maggie R. Colucci Treasurer Federation of Chiropractic Licensing Boards 2085 Village Center Cir, Ste 110 Las Vegas, NV 89134 Ph: 702-880-5335 Email: [email protected] Dr. Raymond N Conley Board Member Kansas State Board of Healing Arts 11313 Grant Street Overland Park, KS 66210 Ph: 913-730-3430 Email: [email protected] Dr. Daniel Mario Côté District I Director National Board of Chiropractic Examiners 951 N. 2nd St Silverton, OR 97381 Ph: 503-873-8099 Email: [email protected]


Dr. Gary Counselman District IV Director, FCLB Board Member, Kansas State Board of Healing Arts 1408 S. Topeka Blvd Topeka, KS 66612 Ph: 785-234-0521 Email: [email protected] Dr. Lawrence Ronald Davis Board Member Chiropractic Physicians' Board of Nevada 4600 Kietzke Ln, Suite M245 Reno, NV 89502 Ph: 775-827-1200 Email: [email protected] Dr. Donn J Fahrendorf District I Director Federation of Chiropractic Licensing Boards 1901 East Edgewood Rd Sioux Falls, SD 57103 Ph: 605-339-2324 Email: [email protected] Dr. Cathleen H Fellows Vice President Montana Board of Chiropractors 753 S 24th St W Billings, MT 59102 Ph: 406-656-4500 Email: [email protected] Dr. Jerrid W Goebel Secretary-Treasurer South Dakota Board of Chiropractic Examiners 824 1st St #b Sturgis, SD 57785 Email: [email protected]

Dr. Ann Goldeen Vice President Oregon Board of Chiropractic Examiners 3218 Pringle Rd. SE, Ste 150 Salem, OR 97302 Ph: 503-325-3311 Email: [email protected] Dr. Scott Eugene Hansing President Montana Board of Chiropractors 62 S Last Chance Gulch, Ste A Helena, MT 59601 Ph: 406-449-0814 Email: [email protected] Dr. James Heston President Alaska State Board of Chiropractic Examiners 141 W Pioneer Ave Homer, AK 99603 Ph: 907-235-7146 Email: [email protected] Dr. Winfield Hobbs Board Member Washington Chiropractic Quality Assurance Commission Washington Board PO Box 47852 Olympia, WA 98504 Dr. Lee S. Hudson Professional Member Montana Board of Chiropractors 2812 7th Ave S Great Falls, MT 59405 Ph: 406-315-3037 Email: [email protected]


Dr. Shayne Javersak President Oklahoma Board of Chiropractic Examiners 1501 E. Wade Watts Ave McAlester, OK 74501 Ph: 918-423-1873 Email: [email protected] Dr. Lisa Anne Kouzes Board Member Oregon Board of Chiropractic Examiners 3218 Pringle Rd SE Ste 150 Salem, OR 97302 Ph: 503-942-5601 Email: [email protected] Dr. Jeffrey R Kramer Vice President South Dakota Board of Chiropractic Examiners 301 S Main St Tripp, SD 57376 Email: [email protected] Dr. Benjamin S. Lurie Vice President Chiropractic Physicians' Board of Nevada 3430 N. Buffalo Dr, #110 Las Vegas, NV 89129 Ph: 702-233-2626 Email: [email protected] Dr. Michael S McLean President International Chiropractors Association 210 25th St Virginia Beach, VA 23451 Ph: 757-425-1421 Email: [email protected]

Mr. Dave McTeague Executive Director Oregon Board of Chiropractic Examiners 3218 Pringle Rd SE Ste 150 Salem, OR 97302-631 Email: [email protected] Dr. Amanda Miller-Housh Board Member Oklahoma Board of Chiropractic Examiners 1809 Commons Circle Ste A Yukon, OK 73099 Ph: 405-577-6268 Mr. Bob Nicoloff Executive Director Washington Chiropractic Quality Assurance Commission PO Bx 47852 Olympia, WA 98504-7852 Email: [email protected] Dr. LeRoy Otto President, FCLB Professional Member, Minnesota Board of Chiropractic Examiners 127 S High St Lake City, MN 55041- Ph: 651-345-3361 Email: [email protected] Dr. Harold Hans Rasmussen Board Member Washington Chiropractic Quality Assurance Commission 4411 California Ave S W Seattle, WA 98116 Ph: 206-935-7222 Email: [email protected]


Dr. Cathy A Riekeman Professional Member New Mexico Board of Chiropractic Examiners 2001 A. San Mateo NE Albuquerque, NM 87110 Ph: 505-255-2466 Email: [email protected] Dr. John H Riggs III Board Member Texas Board of Chiropractic Examiners 333 Guadalupe Ste 3-825 Austin, TX 78701 Dr. Christine Carolyn Robinson Board Member Oregon Board of Chiropractic Examiners 3218 Pringle Rd SE Ste 150 Salem, OR 97302 Dr. Ronald G Rogers Board Member Washington Chiropractic Quality Assurance Commission North Beach Chiropractic Clinic PO Box 1514 Ocean Shore, WA 98569 Ph: 360-289-2834 Email: [email protected] Dr. Dwight Schmidt Vice President North Dakota Board of Chiropractic Examiners 102 2nd Ave SW Jamestown, ND 58401 Ph: 701-251-1550 Email: [email protected]

Dr. Gary Schultz Professor and Chair, Clinical Sci. Dept. University of Western States 2900 NE 132nd Ave Portland, OR 97230 Ph: 503-251-5742 Email: [email protected] Ms. Bridget Seader CIN-BAD / Program Administrator Federation of Chiropractic Licensing Boards 5401 W 10th Street, Ste 101 Greeley, CO 80634 Ph: 970-356-3500 Email: [email protected] Dr. Gabe Smith Chair, Washington Chiropractic Quality Assurance Commission 337 NE 5th Ave Camas, WA 98607 Ph: 360-834-7533 Email: [email protected] Mr. Glenn Taylor Public Member Oregon Board of Chiropractic Examiners 3218 Pringle Rd SE, Ste 150 Salem, OR 97302-6311 Dr. Ronald Byron Tripp District IV Director National Board of Chiropractic Examiners 2400 Tee Cir Norman, OK 73072-6378 Ph: 405-321-8530 Email: [email protected]


Dr. Doug VanderBroek Board Member Nebraska Board of Chiropractic 301 Centennial Mall South PO Box 94986 Lincoln, NE 68508 Ph: 402-483-4409 Email: [email protected] Dr. Christopher Waddell Vice President Oklahoma Board of Chiropractic Examiners 2621 N. Broadway Shawnee, OK 74804 Ph: 405-878-1340 Email: [email protected] Dr. Matthew Kevin Waldron Vice Chair Washington Chiropractic Quality Assurance Commission 23009 56th Ave W Ste B Mountlake Terrace, WA 98043 Email: [email protected] Dr. Terry L Webb Board Member Kansas State Board of Healing Arts 421 E 30th Ave Hutchinson, KS 67502 Ph: 620-484-1080 Email: [email protected] Dr. Joel C Weiss President North Dakota Board of Chiropractic Examiner 1360 10th St N Fargo, ND 58102 Ph: 701-237-5517 Email: [email protected]

Dr. Viki White Secretary-Treasurer Oklahoma Chiropractic Board of Examiners 102 W Randolph Enid, OK 73701 Ph: 580-233-4300 Email: [email protected] Dr. Mark Wurth Chair Nebraska Board of Chiropractic 301 Centennial Mall South Licoln, NE 68508 Ph: 402-551-1322 Email: [email protected] Ms. Yvette Yarbrough Executive Director Texas Board of Chiropractic Examiners 333 Guadalupe Tower III, Ste 825 Austin, TX 78701 Ph: 512-305-6716 Email: [email protected] Dr. Jason Jamaal Young Board Member Oregon Board of Chiropractic Examiners 3218 Pringle Salem, OR 97302 Dr. Stephanie J. Youngblood International Chiropractors Association 500 S Rancho Dr Ste E-9 Las Vegas, NV 89106 Ph: 702-870-8030 Email: [email protected]


Ms. Leann Yount Program Administrator Washington Chiropractic Quality Assurance Commission PO Bx 47852 Olympia, WA 98504-7852 Ph: 360-236-4856 Email: [email protected] Dr. Annette Yvonne Zaro Board Member Chiropractic Physicians' Board of Nevada 4600 Kietzke Lane, Suite M245 Reno, NV 89502 Ph: 702-376-6449 Email: [email protected]

Reports from

Other Organizations

& Committees

HANDOUTS

2013 District Meetings

The FCLB Board of Directors seeks your comments on the

scope section of the FCLB Draft Model Practice Act

As you know, with a few variations, regulatory laws are

generally constructed in two parts:

Statutes – adopted by the legislature

Regulations – approved by the board following

due process

The FCLB Draft Model Practice Act scope language is

presented in these two parts.

What is the FCLB MPA and its Task Force?

In 1994, the FCLB began working on a Model Practice Act,

determining that FCLB did not have sufficient resources

to build its own document. By 2005, the project took on

renewed urgency when the Office of the Inspector

General’s report on documentation and recordkeeping

errors by chiropractors threatened the continued

viability of the profession. That section was adopted by

the membership in 2007. Other sections have been

under development since then, including the scope

language which was initially discussed beginning in 2010.

Continued input from the FCLB member boards has been

valuable in bringing the MPA to where it is today.

The draft statutory definition section was modified and

accepted by the FCLB board of directors on July 22, 2011.

It was subsequently presented at FCLB‘s 2013 San

Francisco meeting, once the Board determined the

overall MPA document should be formatted to include

both statutes and regulations.

What is the process for the Draft Scope Section?

The FCLB Board of Directors and the MPA Task Force

have been reviewing the document before you up to last

week. The draft language is now presented at our fall

regional meetings, and will subsequently be available to

other stakeholders for comment following the meetings.

The Task Force will review the comments, make any

appropriate modifications, and will present their final

recommendations for the FCLB Board of Directors’

consideration at its January 17 – 18, 2014, midyear

meeting in Greeley, Colorado. The Board will adopt or

amend and adopt this section at that time.

What happens with the full Model Practice Act?

The final and complete Model Practice Act will be

presented to the membership with plenty of time for

boards to review the MPA as a whole prior to an

anticipated vote in Myrtle Beach, South Carolina, on May

3, 2014 at the Federation’s 88th Annual Congress.

How can member boards use the Model Practice Act?

Boards that want to adopt new language or modify their

current language may find this resource to be helpful.

They may wish to excerpt or adapt a given section,

particularly if they are addressing such current pressing

issues as international mobility, travel to treat for

athletes, teaching, or disaster care, or regulation of

chiropractic clinical assistants.

Jurisdictions seeking regulation of chiropractors may find

this and other similar resources from other countries to

be helpful in developing initial legislation.

Remember, the authority for each regulatory board is

derived from its own legislature.

Model documents are provided to take advantage of the

collective wisdom of the membership, and serve as a

resource to be used only as desired by each regulatory

agency.

Comments are due by October 31, 2013.

Send to [email protected]

DRAFT – FOR DISCUSSION PURPOSES – Please submit comments to FCLB by October 31, 2013

For discussion at the Fall 2013 FCLB District Regional Meetings

MPA, Scope of Practice Section & Pertinent Definitions

As reviewed by the FCLB Board of Directors September 10, 2013

STATUTES Article I. Title, Definitions and Declaration.

Section 103. Statutory Definitions For the purpose of this Act, the following terms shall have the following meanings:

“Chiropractic”, means a primary care health discipline that recognizes the inherent recuperative power of the body, whose practitioners promote and facilitate health through the evaluation, diagnosis, treatment and/or management of biomechanical or physiological conditions or disorders that compromise neural integrity and/or organ system function.

RULES and REGULATIONS 1.00 Regulatory Definitions

Section 1.01 Definitions For purposes of Rules and Regulations 1.00 through 10.00 the following terms shall have the following meanings.

Chiropractic Adjustment means the application of a specific corrective force, done either by hand or with the aid of a mechanical instrument, which is applied directly to the body for the purpose of reducing or correcting a Chiropractic Subluxation or somatic dysfunction to improve health.

Chiropractic Subluxation means a kinesiopathic; myopathic; histopathic or pathophysiologic disorder or combinations thereof of the spine, pelvis or extraspinal structures that result in neural compromise and physiological dysfunction.

Controlled Pharmaceutical means a drug or medicine that requires a license or certificate from the jurisdictional drug regulatory agency for dispensing or prescribing to the public. A Controlled Pharmaceutical does not include products, agents or substances available without restriction for offer or sale to the public.

Supportive Procedures and Therapies means those manual, electrical, mechanical, thermal, nutritional or other modes of care which may be administered, dispensed or prescribed in addition to the Chiropractic Adjustment for the purpose of assisting a patient to achieve a timely and favorable clinical outcome.

2 – DRAFT FCLB MPA – Scope of Practice Section & Pertinent Definitions

DRAFT – FOR DISCUSSION PURPOSES – Please submit comments to FCLB by October 31, 2013

6.00 Standards of Practice and Professional Conduct

Section 6.01 Scope of Practice

A Chiropractor is a direct access primary health care practitioner who serves patients of all ages employing a compilation of holistic health services and conservative modes of care.

(A) A Chiropractor who is duly licensed by the Board may perform any and all procedures, functions and services intended to promote and facilitate health within the definition of “Chiropractic” as set forth in the Chiropractic Practice Act, Article I, Section 103. Such procedures, functions and services include, but are not limited to:

(1) Evaluating and examining patients for the purpose of determining the presence or absence of physical or physiologic illnesses, injuries, conditions or disorders of the body;

(2) Performing an analysis for detecting Chiropractic Subluxations or somatic dysfunctions;

(3) Ordering, performing and/or interpreting laboratory, radiological, electrodiagnostic or any other diagnostic studies for which the Chiropractor has been properly trained;

(4) Rendering a diagnosis from which a care plan can be developed, or referral of the patient to an appropriate health care setting or professional;

(5) Treating such illnesses, injuries, conditions, disorders, subluxations or dysfunctions through:

(a) the administration of the Chiropractic Adjustment for the purpose of maintaining, restoring or improving biomechanical and/or physiological function;

(b) the administration, dispensing or prescribing of Supportive Procedures and Therapies, as defined in regulation Section 1.01;

(c) the dispensing or prescribing of dietary supplements, nutritional therapies or natural substances;

(d) the performance of any other therapeutic procedure or service for which the Chiropractor has been appropriately trained by an accredited chiropractic school or college or other authority;

(6) Managing, coordinating or delegating patient care functions including initiating referrals to specialists for additional and/or alternative services or care the Chiropractor believes is most suited for the patient’s condition; and

(7) Counseling and instructing patients regarding general health matters, including but not limited to the following: activities of daily living, diet and weight management, ergonomics, exercise, hygiene, nutrition, risk factor screening, wellness, and good health habits.

(B) A Chiropractor is prohibited from performing procedures, functions or services that require the possession of a specific license or authorization, other than a license to practice Chiropractic, pursuant to jurisdictional law. Such procedures, functions and services include, but are not limited to:

(1) Dispensing or prescribing Controlled Pharmaceuticals; and

(2) Performing incisive surgical services, other than procedures incidental to providing first aid or wound management.

(draft 7/24/13)

Why participate in the “Federation of All Federations”?

The FCLB helped establish the original health‐related gathering of all organizations similar to

chiropractic’s federation back in 1974. For much the same reason your board belongs to FCLB,

membership in FARB makes sense – the hard work of regulation is too complex and lonely to do

by ourselves.

FARB identifies the cutting‐edge legal issues and helps regulators better prepare for them. Legal

trends can be tracked by recent court decisions and new regulatory statutes and regulations.

FARB keeps us all smart. Smaller professions can benefit from the resources (and exposure)

faced by larger ones, and the “big guns” can learn something from the speed and flexibility of

the little organizations.

FARB has been around 38 years, but this is the first time that the chiropractic profession has

held the top elected spot on its governing board. I’m very proud to represent my adopted

profession as FARB president, and I’m also learning what it is to worry all the time about the

future of a treasured organization, the professional and personal health of a great staff, and

how to make limited resources do triple work. In short, I have a fresh new perspective on the

world of elected service chosen by many of you, our chiropractic regulatory family.

FARB has two terrific meetings that might interest our FCLB member boards:

1. The Attorney Certification Course is an in‐depth training program for both new

and experienced legal counsel. Your lawyers probably get CE credit toward their license renewal, but more importantly, they learn what’s new in administrative law. Please urge them to attend this annual seminar – it offers first class material, and will help them give you the best advice possible.

2. The FARB Forum tackles the hottest issues in regulation from a multi‐disciplinary

perspective. Everything from eligibility for initial licensure to renewals to monitoring licensee compliance with board decisions make it to the FARB agenda, and always in the context of the latest court decisions. Fascinating stuff, and reminds us that sometimes chiropractic is at the front of the pack, sometimes we need to catch up. But in all cases, we’re not alone in our mission to protect the public.

FCLB Fall 2013 District Meetings

A short report from Donna M. Liewer, FCLB Appointee to the FARB Board of Directors and current FARB President

Federation of Associations of Regulatory Boards

TO: FCLB District Meeting Attendees

FROM: Dr. Al Stabile, FCLB Appointee to the Council on Chiropractic Guidelines and Practice Parameters

DATE: August 21, 2013

RE: CCGPP REPORT

The following information was provided at the request of the FCLB for the CCGPP to provide their

Mission Statement and the latest Algorithms.

The Algorithms have been amended as requested by FCLB to remove numbers of visits and the 2 week

re‐evaluation point.

CCGPP Mission Statement: VISION – MISSION – VALUES

VISION:

A world in which doctors of chiropractic provide evidence‐based care and utilize best practices

to lead the way in improving health and wellness for its people.

MISSION:

To promote, protect, and support chiropractic's evolving relationship between the patient, the

provider and evidence‐based research.

VALUES:

Integrity, Passion, Accountability

The Algorithms for the Chiropractic Management of Acute and Chronic Spine‐Related Pain may be

downloaded from www.ccgpp.org Click on Scientific Studies.

FCLB UPDATE: Federal Databanks ‐ NPDB / HIPDB By Donna M. Liewer, FCLB representa ve on the NPDB Execu ve Commi ee September 2013

FCLB serves as repor ng agent for over half the US chiroprac c licensing boards – a free service from your Federa on. We help boards comply with ever‐changing regula ons and with periodic compliance audits conducted by the Databanks. Even if we are not your repor ng agent, we’re glad to help your board with federal repor ng issues.

The NPBD (Na onal Prac oner Data Bank) is merging with the HIPDB (Healthcare Integrity and Protec on Databank) from a func onal standpoint. Sec on 1921 of the Social Security Act (March 2010) now adds adverse state licensure ac ons to the NPDB. There are subtle differences in what must be reported to each of the two databanks.

Another federal databank compliance audit for 2010‐2011 is currently in process.

REPORTING

All US chiroprac c regulatory boards must report to the Databanks. En es (boards) must keep registra on current. En ty re‐registra on takes place every two years or when personnel change.

FINES

Repor ng fines can be complex. NPDB requirements are slightly different from HIPDB requirements. Please contact Bridget Seader at FCLB or the Databank helpline for detailed informa on about repor ng fines. It is possible that a certain fine scenario could be reportable to NPDB but not HIPDB.

TIPS FOR FEDERAL COMPLIANCE

1. Know how fines work

2. Keep your En ty and Administrator registra on current

3. Report reinstatement of license when proba on or revoca on ends – it’s easiest to have a regular, formal process of bringing these cases before the board for approval or ra fica on. It can be a simple procedure but it gets the decision on record.

4. If the board denies an applica on for licensure because of an adverse ac on, taken through a formal proceeding, it’s reportable to the Databanks, as is cases such as misrepresen ng informa on on the applica on. On the other hand, if the applicant fails to meet administra ve requirements or withdraws the applica on (re rement, personal reasons), it’s not reportable.

REMEMBER, ACCESS TO CIN‐BAD IS FREE TO OUR MEMBER BOARDS.

US Boards must report to the US federal Databanks, but are not required to query them. Federal queries cost $16 and include both databanks. (It is not possible to query just one of the two databanks.)

Recognition RequestApplication for Honorary Fellow Status

of the Federation of Chiropractic Licensing Boards

From the FCLB BylawsArticle III, Section 6: Honorary Fellow. “Honorary Fellow” means an individual who has been aFellow for three (3) or more years, is no longer serving on a Member Board, and who hassubmitted an application to the Federation requesting recognition as an Honorary Fellow.

Name

Date

Board

Dates of Licensing Board Service (must have served for a minimum of three years)

Mailing Address

City, State or Province, Postal Code

E-mail Address

Day Phone

Signature

2013 District Meeting and FCLB Services Evaluation . Name Board What will you do differently as a result of participating in this meeting? _________________

__________________________________________________________________________________________

Do you anticipate referencing your meeting materials in the future? _______________________

__________________________________________________________________________________________

Suggestions for 2014 (topics, speakers, social events) _____________________________________

__________________________________________________________________________________________

Comments on roundtable discussions ______________________________________________________

__________________________________________________________________________________________

Comments on speakers (if applicable) ____________________________________________________

__________________________________________________________________________________________

Comments on the hotel/location/social events ______________________________________________

__________________________________________________________________________________________

Title on Board: ___________________________________________________________________________

Cell Phone: ______________________________________________________________________________

E-mail: __________________________________________________________________________________

Date Appointment Effective: _____________________________________________________________

Term ends: _____________________________________________________________________________

Eligible for Reappointment? Y N Degree(s) held and Conferring School(s) _________________________________________________ __________________________________________________________________________________________ Please send me the following materials: #___ copies of the FCLB brochure #___ copies of the CIN-BAD brochure #___ copies of the PACE brochure #___ copies of the Ethics brochure #___ copies of the PACE governing documents (please limit 10 copies of each item)

District Meeting

Please Update Your Information

Materials Request

Which FCLB services does your board currently use? (mark all that apply) CIN-BAD (for checking licenses) Web site Links CIN-BAD (for HIP reporting) Model Documents PACE Official Directory NewsAlerts PowerPolls Ethics Brochure Other ________________________________________ What services would you like the FCLB to offer? ___________________________________________

__________________________________________________________________________________________

Questions for FCLB staff _________________________________________________________________

__________________________________________________________________________________________

What tasks do you believe the FCLB needs to accomplish? ________________________________

__________________________________________________________________________________________

Would you be willing to serve on a task force? ____________________________________________

__________________________________________________________________________________________

Is your board planning to send anyone to the 2014 conference in Myrtle Beach? Y N

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Thank you! We appreciate your input.

Please return evaluations to FCLB staff or fax to (970) 356-3599

FCLB Services

Other Comments

AGENDA - District Meeting - Federation of Chiropractic ...

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