NAC634.430. Unprofessional conduct: Interpretation of statutory definition.

     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 as defined in subsection 2.

     (b) Performing any chiropractic service on a patient who is under the age of 18 years without first obtaining the consent of the parent or legal guardian of that patient if the consent is required pursuant to NRS 129.030.

     (c) Performing manipulation on a patient under anesthesia without complying with the requirements set forth in NAC 634.3665.

     (d) 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.

     (e) Participating in any verbal or written arrangement that involves capping or fee splitting.

     (f) 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.

     (g) 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.

     (h) 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.

     (i) 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.

     (j) 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.

     (k) Being in default on the payment of a student loan.

     (l) Violating the rules or regulations of a federal program that relates to the practice of chiropractic.

     (m) Engaging in fraud, misrepresentation or deception in any business affairs that relate to the practice of chiropractic.

     (n) Allowing a person to:

          (1) Perform chiropractic services; or

          (2) Engage in any aspect of the provision of chiropractic care to patients,

Ê 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.

     (o) Engaging with a patient in a romantic or dating relationship unless the patient is the spouse of the licensee.

     (p) 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.

     (q) 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.

     (r) 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.

     (s) 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.

     2. As used in this section:

     (a) “Capping” means the use by a licensee of the services of 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.

     (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.

Ê 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 chiropractor-patient relationship has been terminated for a reasonable time.

     (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)