Nevada Administrative Code
Chapter 634 - Chiropractic
STANDARDS OF PRACTICE
Section 634.430 - Unprofessional conduct: Interpretation of statutory definition
Universal Citation: NV Admin Code 634.430
Current through February 27, 2024
1. As used in subsection 10 of NRS 634.018, the Board will interpret the phrase "conduct unbecoming a person licensed to practice chiropractic or detrimental to the best interests of the public" to include, without limitation:
(a) Engaging in
or soliciting sexual misconduct.
(b) Performing manipulation on a patient
under anesthesia without complying with the requirements set forth in NAC
634.3665.
(c) Entering into a
financial agreement or making a financial arrangement with a potential or
existing patient as an inducement to enter into or continue care. This
paragraph does not prohibit a licensee from providing complimentary
chiropractic services to an existing patient.
(d) Participating in any verbal or written
arrangement that involves capping or fee splitting.
(e) Engaging in practices regarding the
billing of patients or the making of claims under a contract of insurance that
are abusive or fraudulent, or both, including, without limitation:
(1) Billing patients or making claims under a
contract of insurance for chiropractic services that have not been
performed.
(2) Billing patients or
making claims under a contract of insurance in a manner which misrepresents the
nature of the chiropractic services that have been performed.
(3) Submitting to patients or carriers of
insurance bills or claims which fail to disclose pertinent information or which
contain false information, including, without limitation:
(I) Failing to disclose to a patient that a
bill has already been paid, in full or in part, by a carrier of
insurance.
(II) Failing to disclose
to a carrier of insurance that a claim has already been paid, in full or in
part, by a different carrier of insurance.
(III) Stating falsely that the injury of a
patient is the result of an accident or work-related incident.
(f) Engaging in a
practice of waiving, abrogating or rebating the deductible or copayment
required to be paid by a policy of insurance or a third party if the practice
is used as a device for advertising or marketing, or both.
(g) Failing to make any report or record
available to the Board upon lawful request, failing to cooperate with any
investigation by the Board or knowingly giving false information to the Board,
including, without limitation, falsifying documentation concerning continuing
education.
(h) Failing to make any
report or record available to another licensee, practitioner, patient or
institution upon a lawful request to do so in compliance with the provisions of
chapter 629 of NRS.
(i) Being
delinquent in the payment of a judgment for the payment of child support
pursuant to chapter 425 of NRS or being subject to a court order for the
support of one or more children and not complying with the order or a plan
approved by the district attorney or other public agency enforcing the order
for the repayment of the amount owed pursuant to the order.
(j) Being in default on the payment of a
student loan.
(k) Violating the
rules or regulations of a federal program that relates to the practice of
chiropractic.
(l) Engaging in
fraud, misrepresentation or deception in any business affairs that relate to
the practice of chiropractic.
(m)
Allowing a person to:
(1) Perform chiropractic
services; or
(2) Engage in any
aspect of the provision of chiropractic care to patients, if that person is not
authorized to perform such services or provide such care pursuant to this
chapter and chapter 634 of NRS. The prohibition set forth in this paragraph
does not apply to a person who is licensed or certified as a provider of health
care pursuant to one or more of the chapters of title 54 of NRS.
(n) Engaging with a patient in a
romantic or dating relationship unless the patient is the spouse of the
licensee.
(o) Examining or treating
the anus, breast or genitalia of a patient without first:
(1) Obtaining from the patient an informed
consent that refers to the specific procedures that will be performed on those
parts of the body of the patient; and
(2) Making a note of such consent in the
record of the patient.
(p) Violating a provision of a chapter of
title 54 of NRS other than chapter 634 of NRS pursuant to which the licensee
holds a license or certificate as a provider of health care.
(q) Knowingly giving a false or factually
unsupported opinion in a peer review, records review, independent medical
examination or chiropractic examination for the purpose of reducing a payment
or reimbursement to a licensee for the care or treatment of a
patient.
(r) Failing to either post
a written disclosure or give a written disclosure to a patient and maintain the
written disclosure concerning a lack of maintaining professional liability
insurance in accordance with the requirements of NRS 634.1295 and NAC
634.445.
(s) Practicing
chiropractic while impaired by alcohol, the use of illicit drugs, the
unauthorized or improper use of a prescription drug or controlled substance, or
any known or diagnosed mental illness or cognitive deficit.
(t) Paying or receiving any remuneration in
such a manner and amount as would constitute a violation of 42 U.S.C. §
1320a-7b(b), regardless of whether the patient for whom the remuneration is
paid or received is a patient under a federal health care program.
2. A patient's consent to, initiation of or participation in sexual behavior or involvement in a romantic or dating relationship with a licensee does not excuse the conduct of the licensee.
3. As used in this section:
(a) "Capping" means the use by a
licensee of the services of:
(1) A person who
is remunerated for referring to the licensee a new patient who has been
involved in a motor vehicle accident or who has been injured as a result of the
actions of another person.
(2) A
person who, with or without remuneration, refers a prospective new patient to
the licensee:
(I) At the scene of a traffic
crash;
(II) At a county or city
jail or detention facility; or
(III) Within 72 hours after the prospective
new patient has been involved in a motor vehicle accident or been injured as a
result of the actions of another person, if the person who refers the
prospective new patient is not a person who is licensed or certified as a
provider of health care pursuant to one or more of the chapters of title 54 of
NRS or the laws of another state or the District of Columbia.
(b) "Fee splitting"
means the acceptance of remuneration by a licensee for referring a patient to
another provider of health care or a health care facility or the provision of
remuneration by a licensee for a referral to the business of the
licensee.
(c) "Sexual misconduct"
means:
(1) Sexual relations between a licensee
and a patient of that licensee, regardless of whether the patient initiated or
consented to those sexual relations.
(2) Conduct by a licensee, in regard to a
patient, that is sexual in nature, sexually suggestive or sexually demeaning to
the patient.
(3) The commission by
a licensee of one or more of the offenses defined in NRS 200.368, 200.730,
201.210 and 201.220.
(4) The use by
a licensee of deception, misrepresentation or force for the purpose of engaging
in sexual conduct with a patient in:
(I) A
clinical setting; or
(II) A setting
that is used ordinarily for the provision of chiropractic services.
The term does not include sexual conduct or sexual relations that take place between a licensee and his or her spouse or between a licensee and a person who was a patient after the chiropractic physician-patient relationship has been terminated for a reasonable time.
(d) "Sexual relations"
means:
(1) Sexual intercourse.
(2) Any touching of sexual or other intimate
parts of a person or causing such person to touch the sexual or other intimate
parts of the licensee for the purpose of arousing or gratifying the sexual
desire of either the licensee or the patient.
Added to NAC by Bd. of Chiropractic Exam'rs, eff. 7-29-88; A 1-31-94; A by Chiropractic Physicians' Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R034-05, 10-31-2005; R140-05, 11-17-2005; A by R150-13, eff. 3/28/2014; A by R007-19A, eff. 10/22/2019; A by R115-23A, eff. 2/9/2024
NRS 634.030, 634.130
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