Oklahoma Administrative Code
Title 435 - State Board of Medical Licensure and Supervision
Chapter 55 - Licensed Orthotists and Prosthetists and Registered Technicians and Assistants
Subchapter 7 - Regulation of Practice
Section 435:55-7-3 - Standards of ethics and professional conduct
Universal Citation: OK Admin Code 435:55-7-3
Current through Vol. 41, No. 13, March 15, 2024
(a) Purpose. The rules in this section on the profession of Orthotics and Prosthetics shall be to establish the standards of professional conduct and code of ethics required of a licensee.
(b) In the conduct of their professional activities the Orthotist and/or Prosthetist shall be bound by the following ethical and professional principles in conjunction with the canons of ethical conduct as published by the American Board for Certification and the Board for Orthotist Prosthetist Certification.
(1)
Responsibilities to the patient.
(A)
Services. The Orthotist
and/or Prosthetist shall provide orthotic and/or prosthetic devices in an
effective, dignified and efficient manner in accordance with the direction of
patient's physician.
(B)
Recognition of possible pathologies requiring orthotic and/or prosthetic
intervention. The Orthotist and/or Prosthetist shall assist lay people
to recognize problems and the need for appropriate medical care only out of a
desire to protect one who would not otherwise seek or obtain proper medical
attention. Such assistance should recommend that the patient have a physician
diagnose any orthopedic/vascular pathology.
(C)
Confidential information.
(i) The Orthotist and/or Prosthetist shall
keep all information relating to a patient's background, condition, treatment,
management plan or other areas relating to the orthotist and/or
prosthetist-patient relationship confidential unless prior written consent of
the patient or the patient's legal guardian is received.
(ii) The Orthotist and/or Prosthetist shall
keep patient information that may be derived as a result of any Orthotist
and/or Prosthetist's peer review process confidential by all participants
unless written permission to release the information is obtain from the patient
or the patient's legal guardian.
(iii) The Orthotist and/or Prosthetist shall
keep all patient information that is derived in a workplace from a working
relationship among orthotists and/or prosthetists relating to any patient
confidential.
(iv) The Orthotist
and/or Prosthetist shall strictly adhere to the confidentiality requirements
set forth in the subsection unless the release is ordered by a court of law or
release is necessary to protect the welfare of the patient and/or the community
in accordance with applicable legal requirements.
(D)
Competency.
(i) The Orthotist and/or Prosthetist shall
provide services that reflect the best practices in the profession and use best
efforts to meet the patient's orthotic and/or prosthetic
requirements.
(ii) Upon accepting
an individual for orthotic and/or prosthetic services, the orthotist and/or
prosthetist shall assume the responsibility for evaluating that individual;
planning, implementing and supervising the patient's care; reevaluating and
changing the orthotic and/or prosthetic program; and maintaining adequate
records of the case, including progress reports.
(iii) The orthotist and/or prosthetist shall
not fill a prescription that is beyond his/her degree of expertise.
(E)
Research. The
Orthotist and/or Prosthetist shall ensure that all research projects or studies
are done in accordance with standards accepted by the Board.
(F)
Trust and honesty. The
orthotist and/or prosthetist shall always be truthful and honest in orthotic
and/or prosthetic matters to the patient, physician, Board and the public in
general.
(G)
Fees and
compensation.
(i) The orthotist and/or
prosthetist shall not provide services solely for personal financial
gain.
(ii) The orthotist and/or
prosthetist shall not engage in false, misleading or deceptive representations
in relation to the cost of the services undertaken or furnished.
(iii) The orthotist and/or prosthetist shall
not recommend or provide continued orthotic and/or prosthetic services to a
patient when the orthotist and/or prosthetist is aware that the services are
being recommended or provided more frequently than necessary, or that orthotic
and/or prosthetic service has already progressed beyond the point at which
further benefit to the patient is possible.
(iv) The orthotist and/or prosthetist shall
not submit false or misleading information in requesting reimbursement from
third-party payers, including Medicare and private insurers.
(H)
Practice
arrangements.
(i) Except for fees
earned for services performed for the patient, the orthotist and/or prosthetist
shall not give or receive valuable consideration solely because of
referrals.
(ii) Participation in
the business, partnership, corporation or other entity does not exempt the
orthotist and/or prosthetist, whether employer, partner or stockholder, either
individually or collectively, from the obligation of complying with this Code
of Ethics and the rules of the Board.
(iii) The orthotist and/or prosthetist shall
advise the Board and/or the advisory council of any employer or employee
practice that is in contradiction with this Code of Ethics.
(I)
Delay in
services. The orthotist and/or prosthetist shall not accept any
prescription when the orthotist and/or prosthetist knows or believes the
orthotic and/or prosthetic device cannot be furnished with in a reasonable
period of time unless the orthotist and/or prosthetist has advised the patient
in advance the approximate length of time it will take to fill the
prescription. In such instances, the orthotist and/or prosthetist must discuss
the situation with the patient and prescribing health care
practitioner.
(J)
Compliance
with laws and regulations. The orthotist and/or prosthetist shall
provide consultation, evaluation, treatment, business practices, and preventive
care, in accordance with the laws and regulations of the State of
Oklahoma.
(K)
Consumer
protection. The orthotist and/or prosthetist shall report to the Board
any conduct that appears to be unethical, incompetent or illegal. Failure to
report any such behavior that is known to the orthotist and/or prosthetist
shall be unethical.
(L)
Maintenance of patient records. The orthotist and/or prosthetist
shall initiate and maintain appropriate records about his/her service with each
patient. The orthotist and/or prosthetist has the duty to maintain patient
files in a safe manner and ensure the confidentiality of the patient's
records.
(M)
Delegation of
responsibility. The orthotist and/or prosthetist shall exercise adequate
supervision over persons to whom the orthotist and/or prosthetist has delegated
certain responsibilities requiring unique skills, knowledge or judgment. The
orthotist and/or prosthetist is responsible for orthotic and/or prosthetic care
performed by support personnel under his/her supervision. The orthotist and/or
prosthetist is responsible for assuring that adequate supervision of support
personnel (assistants, fitters, technicians) occurs to ensure the patient
receives the necessary and appropriate care. Additionally, the orthotist and/or
prosthetist is responsible in ensuring that said personnel receive annual
continuing education in order to perform their responsibilities at the highest
level of public protection.
(N)
Quality Assurance. The Orthotist and/or Prosthetist will conduct
and maintain a quality assurance program involving all treated
patients.
(O)
Illegal
discrimination. The orthotist and/or prosthetist shall not decline to
accept a patient on the basis of race, gender, color, religion or national
origin or on any basis that would constitute illegal discrimination.
(P)
Discontinuing service. The
orthotist and/or prosthetist has a duty to inform the physician if the patient
fails to follow the physician's plan for orthotic and/or prosthetic treatment
or discontinues the physician's plan for orthotic and/or prosthetic treatment
prematurely.
(2)
Practitioner responsibilities to the physician.
(A)
Diagnosis and prescription.
The orthotist and/or prosthetist must receive a prescription from a physician
before providing any orthotic and/or prosthetic device to a patient.
(B)
Orthotic and/or prosthetic
evaluation and recommendation.
(i) The
orthotist and/or prosthetist shall recognize that each individual patient is
different and deserves specific and responsible guidance from the orthotist
and/or prosthetist.
(ii) The
orthotist and/or prosthetist, after evaluating a patient, may recommend to the
physician specific orthotic and/or prosthetic device designs along with the
reasoning for such recommendation.
(iii) The orthotist and/or prosthetist has
the responsibility for the final design for the orthotic and/or prosthetic
device.
(iv) The orthotist and/or
prosthetist should only dispense orthotic and/or prosthetic devices that are in
accordance with the prescription and that meet the needs of the
patient.
(v) The orthotist and/or
prosthetist shall be guided at all times by concern for the physical,
emotional, social and economic welfare of the patient.
(C)
Changes in patient's
condition.
(i) When requested by the
patient and/or the patient's physician, the orthotist and/or prosthetist shall
monitor and observe the patient's physical condition in connection with the
orthotic and/or prosthetic care and the prescribed device.
(ii) The orthotist and/or prosthetist must
notify the referring physician and the patient as soon as possible of any
change in the patient's condition related to the orthotic and/or prosthetic
management plan.
(D)
Altering orthotic and/or prosthetic devices. The orthotist and/or
prosthetist may repair or adjust an orthotic and/or prosthetic device without
notifying the prescribing physician. However, such repairs or adjustments must
conform to the original prescription. Any repairs, adjustments, modifications
and/or replacements that alter the original prescription must be authorized by
the physician.
(3)
Responsibilities to colleagues and the profession.
(A)
Dignity and stature.
(i) The orthotist and/or prosthetist has the
personal responsibility to conduct himself or herself in a manner that will
assure the dignity and stature of the profession of orthotics and/or
prosthetics.
(ii) The orthotist
and/or prosthetist should discharge his/her responsibilities with honor and
integrity, making the greatest possible effort to satisfy the patient's
orthotic and/or prosthetic requirements.
(iii) Examples of unacceptable behavior
include, but are not limited to, the misuse of the license and
misrepresentation of capacity as a provider of services.
(B)
Commercialization. The
orthotist and/or prosthetist's primary professional function is to develop the
orthotic and/or prosthetic device as part of a medical treatment team. However,
the orthotist and/or prosthetist is not prohibited from providing non-custom,
prefabricated orthosis' and prosthesis' as long as each patient and the public
in general are made aware of the differences between the "off the shelf" and
custom fitted and fabricated orthosis and prosthesis.
(C)
Solicitation.
(i) It is unethical for an orthotist and/or
prosthetist to either directly or indirectly solicit the patronage of
individual patients by way of intimidation, threats, harassing conduct, undue
influence, coercion, duress, or solicitation of a patient who is apparently in
a mental condition that impairs his/her personal judgment to make decisions
concerning the products or services being offered.
(ii) The orthotist and/or prosthetist shall
abide by current Medicare or comparable government regulations regarding
patient solicitations.
(D)
Board review. The Advisory
Committee on Orthotics and Prosthetics will determine whether the orthotist
and/or prosthetist is practicing in accordance with the laws and rules of the
Board. In the event that the Committee determines that there are violations of
these laws or rules, the Committee will refer the matter to the Board who shall
handle the matter as a complaint and proceed in accordance with the Oklahoma
Administrative Procedures Act.
(E)
Education.
(i) The orthotist
and/or prosthetist is encouraged to support quality educational
programs.
(ii) It is unethical for
the orthotist and/or prosthetist to participate in any programs, educational or
otherwise, that falsely or deceptively represent the rights and privileges of
the profession.
(iii) It is
unethical for the orthotist and/or prosthetist to falsify his/her continuing
education units and may lead to permanent license revocation.
(iv) An orthotist and/or prosthetist shall
teach only in areas of service within his/her credential and scope of
practice.
(F)
Standards of practice. The orthotist and/or prosthetist should
adhere to a standard of practice as outlined in the Act and rules and as
recommended by the American Board for Certification and/or the Board for
Orthotic Prosthetic Certification. The orthotist and/or prosthetist can engage
in practice beyond the standards of practice if the orthotist and/or
prosthetist's scope of practice includes such (i.e.: pedorthics, etc.) or if
the Orthotist and/or Prosthetist holds credentials in that
profession.
(4)
Patient care by other professionals.
(A) The orthotist and/or prosthetist should
conduct himself/herself in a professional manner.
(B) Concerns regarding patient care provided
by physicians or other medical professionals should be addressed directly to
the professional rather than to the patient. In the event that such concerns
rise to the level of criminal violation, incompetency, malpractice or a
violation of the Oklahoma law or the rules of the Board, then the orthotist
and/or prosthetist must immediately notify the Board or other appropriate
regulatory agency.
(5)
Licensure. The orthotist and/or prosthetist shall use the fact
that they are licensed only as evidence of meeting the requisite standard of
knowledge and competency in the profession as defined by the Board. It is
unethical for a non-licensed orthotist and/or prosthetist to represent,
directly or indirectly, that he or she is licensed or equally
qualified.
Added at 19 Ok Reg 549, eff 12-28-01 (emergency); Added at 19 Ok Reg 2323, eff 6-28-02
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