Chapter 100-7 IMMORAL AND UNPROFESSIONAL CONDUCT DEFINED

Rule 100-7-.01 Immoral and Unprofessional Conduct

(1)	Failure to comply with any portion of Chapter 100-7 shall be deemed unprofessional conduct and may subject the licensee to revocation, suspension, probation, or other disciplinary action.

(2)	It shall be considered immoral and unprofessional conduct to knowingly performing an act which in any way aids, assists, procures, advises, or encourages any unlicensed person to practice chiropractic;

(3)	It shall be considered immoral and unprofessional conduct to fail to release patient records in compliance with O.C.G.A. § 31-33-2, to the patient, to another healthcare professional or any other authorized person within ten (10) business days upon proper written authorization by the patient.

Rule 100-7-.02 Inappropriate Representation

(1)

For the purposes of this Section, inappropriate representation shall include, but not be limited to, the following:

(a)	knowingly making misleading, deceptive, untrue or fraudulent representations in the practice of chiropractic, the filing of any insurance claim, or in any document connected herewith.

Rule 100-7-.03 Direct Contact with Prospective Patients

(1)	A chiropractor shall not compensate or give anything of value to a person or organization to recommend or secure the services of the chiropractor by a specific patient.

(2)

A chiropractor shall not send, or knowingly permit to be sent, on their behalf, any oral, written or graphic communication to a prospective patient for the purpose of solicitation to render patient care services if:

(a)	It has been made known to the chiropractor that said person does not desire to receive communications from the chiropractor;

(b)	The communication involves coercion, duress, fraud, overreaching, harassment, intimidation or undue influence;

(c)	The written communication concerns an action of personal injury or relates to an accident or disaster involving the person to whom the communication is addressed or a relative of that person, unless the accident occurred more than 30 days prior to the mailing of the communication; or

(d)	The chiropractor knows or reasonably should know the physical, emotional or mental state of the person is such that the person cannot exercise reasonable judgment in seeking chiropractic care services.

Rule 100-7-.04 Standards of Practice

(1)

For the purposes of this Section, standards of practice shall include, but not be limited to, the following:

(a)

Knowingly performing an act which in any way aids, assists, procures, advises, or encourages any unlicensed person to practice chiropractic;

1.	Nothing in this Section shall prohibit the activities authorized in O.C.G.A. 43-9-7.2(3)(A) and (B).

(b)

failing to conform or comply with the minimum standards of acceptable and prevailing chiropractic care;

1.

Chiropractic care shall include offering or rendering a professional chiropractic opinion, which has the capacity or intent of affecting the frequency, duration, necessity, or outcome of chiropractic treatment or patient care. Any person rendering such a chiropractic opinion in Georgia must identify themselves by name, degree designation, location of practice, and Georgia chiropractic license number.

(c)	Failing to release patient information to another healthcare professional or any other authorized person upon proper written authorization by the patient.

(d)

It shall be considered unprofessional conduct to deny care for a covered condition or service by a review agent when there is a reasonable expectation for improvement or the patient is demonstrating a reasonable rate of improvement. A reasonable rate of improvement would be influenced by condition chronicity, patient age, co-morbid factors, frequency of care and exposure to activities that would impede progress.

(e)

It shall be considered unprofessional conduct to deny care for a covered condition or service by a review agent for care to prevent the deterioration of a condition once the patient has achieved maximum clinical improvement, if sufficient evidence exists demonstrating that reduction or withdrawal of care has and will continue to have a deleterious effect on the patient.

Rule 100-7-.05 Sexual Misconduct

(1)

For the purposes of this Section, sexual misconduct shall include, but not be limited to, the following:

(a)	engaging in sexual misconduct with a patient.

(2)

"Patient" as used in this Section is any person, other than a spouse, who was being examined or who was under the care or treatment of the chiropractor when the incident or incidents of sexual misconduct allegedly occurred, regardless of whether the person was billed by or was paying for chiropractic services; regardless if the alleged sexual misconduct occurred outside of professional treatment sessions; or the alleged sexual misconduct was off the premises regularly used by the licensee for the professional treatment of patients and regardless of whether the person consented. A person shall be considered a patient until six (6) months has elapsed since the last date on which the chiropractor examined or treated the person.

(3)

"Sexual Misconduct" as used in this Section means sexual impropriety which may include but is not limited to:

(a)	Any behavior, gestures, or expressions which may reasonably be interpreted as inappropriately seductive or sexually demeaning;

(b)	Inappropriate sexual comments about and to a patient including sexual comments about an individual's body;

(c)	Requesting unnecessary details of sexual history or sexual likes and dislikes;

(d)	Making a request to date;

(e)	Initiating conversation regarding the sexual problems, preferences, or fantasies of the licensee;

(f)	Participation in acts of a sexual nature recorded on film, in print or in an electronic medium;

(g)	Acceptance of compensation for acts of a sexual nature and as described as "sexual intimacy."

(h)	Kissing or fondling of a sexual nature; or

(i)	Any other deliberate or repeated comments, gestures, or physical acts not constituting sexual intimacies but of a sexual nature.

(4)

"Sexual intimacy" as used in this Section means acts which may include engaging in any conduct that is sexual or may be reasonably interpreted as sexual, such as:

(a)	Sexual intercourse;

(b)	Genital contact;

(c)	Oral to genital contact;

(d)	Genital to anal contact;

(e)	Oral to anal contact;

(f)	Oral to oral contact;

(g)	Touching breasts or genitals;

(h)	Encouraging the patient or another to masturbate in the presence of the licensee;

(i)	Masturbation by the licensee when another is present; or

(j)	Any bodily exposure of normally covered body parts.

Rule 100-7-.06 Incompetence, Board Sanctions and Felony Convictions

(1)

For the purposes of this rule, incompetence, board sanctions and felony convictions shall include, but not be limited to, the following:

(a)	practicing the profession of chiropractic while suffering from some mental or physical incapacity that renders the licensee unable to practice chiropractic with reasonable skill and safety to patients;

(b)	being subject to revocation, suspension, or annulment of the license to practice chiropractic by any lawful licensing authority, or by having other disciplinary action taken against the licensee by any lawful licensing authority, or being denied a license by any such authority;

(c)

being convicted of a felony in the courts of this State or any state, territory, or country;

1.	"Conviction of a felony" as used in this Section shall include a conviction of an offense which, if committed in this state, would be deemed a felony without regard to its designation elsewhere;

2.	for the purposes of this Section, a "conviction" shall be deemed to include a finding or verdict of guilty, or plea of nolo contendere, regardless of whether an appeal of the conviction has been sought.

(d)

violating any statute, law, rule, or regulation of this State, any other state, the Board, the United States, or any other lawful authority without regard to whether the violation is criminally punishable, which statute law, rule, or regulation relates to or regulates the practice of the chiropractic.

Rule 100-7-.07 Patient Referrals and Patient Records

(1)	Licensed chiropractors are required to refer patients to an appropriate health care provider when it is clear that he/she knows or should have known that the patient condition is outside their scope of professional experience, training, or practice.

(2)

Patient records must contain and be retained in compliance with O.C.G.A 31-33-1 as well as the following:

(a)

must contain appropriate patient information to include but not be limited to:

1.	evidence of patient's evaluation, treatment and response to treatment;

2.	treatment notes following an acceptable format (i.e. SOAP);

3.	evaluations, diagnoses, prognoses;

4.	if applicable, x-rays;

5.	any other technical information used in assessing a patient's condition.

(b)	must be retained for ten (10) years from the date of the last patient visit.

(c)	must be released in compliance with O.C.G.A. 31-33-1 regardless of any outstanding bill or financial matter.

(d)

if an office closes, the chiropractor must post a legal notice of closing in the local legal organ (newspaper) as to the date the practice is closing and where the patient records should be obtained.

1.	the chiropractor must allow not less than thirty (30) calendar days to allow for retrieval of patient records.

(e)	must be retained, maintained and released in compliance with all federal and state laws, rules and regulations.

Rule 100-7-.08 Contractual Pre-Payments for Services

(1)

It is considered unprofessional conduct for any chiropractor to enter into a financial contract which obligates a patient for care or payment for care using coercion, duress, fraud, overreaching diagnosis, harassment, intimidation or undue influence.

(a)	Any services provided prior to the signing of the contract must not be included in the contract.

(b)	The patient must be given a permanent copy of the signed contact; and the contract must provide a clearly defined refund policy typed in not less than 12 point font. An initial line must be next to the refund policy and must be initialed by the patient.

(c)	The contract must contain the statement "There is insufficient evidence to suggest that not receiving chiropractic care will lead to death, paralysis, disability or permanent harm." Said statement must be typed in not less than 12 point font.

(2)

Any chiropractor who enters into a pre-payment financial contract with a patient must allow the patient 48 hours to sign and return the contract. During this 48-hour evaluation period from the time when a copy of the written contract is provided to the patient; no content of the contract can be changed.

(3)	Any chiropractor who enters into a pre-paid financial contract with a patient shall determine and record the patient's clinical objective which the pre-paid care is designed to achieve and provide the patient with a copy of this objective.

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