Louisiana State Board of
CHIROPRACTIC PRACTICE ALERTS
CHIROPRACTIC PRACTICE ALERTS
These "alerts" are provided by the Board to alert licensees to items of recent interest that may impact their practice.
"Telehealth medicine", such as recommending exercise, general hygiene, at-home palliative care, DME recommendations, ordering and interpreting tests or nutrition advice may be appropriate. Active examination procedures that do not require direct one-on-one contact to perform such as range of motion may be appropriate. Passive examination procedures which require direct one-on-one contact by the physician to determine a response such as a straight leg raise would not be appropriate. Treatment procedures which require direct one-on-one physician contact are not allowed. All Telehealth activities should fall within the scope of chiropractic as defined by L.R.S. 36. 2801 (3)
The LA Department of Health issued Healthcare Facility Notice/Order Number 2020-COVID 19- All-007. In part, it states that all healthcare providers postpone all in-person healthcare services that can safely be postponed for 30 days. You are to use your best clinical judgment to make this determination. You shall consider the entire clinical picture when determining if the service can be safely postponed, including the consequences of postponement to the patient, and the consequences to the health-care system. Providers acting in good faith will be not found to be in violation of this directive.
Pursuant to LA R.S. 2816.A.8, all contagious infectious disease protocols should be followed. Guidelines can be found at CDC.gov/coronavirus/2019-NCOV/infec.HTML
In addition, in compliance with Governor Edwards statewide stay at home order, the LA Board office will be closed to the public, vendors and licensees. Phone lines are being maintained during office hours. Please reference the website, www.lachiropracticboard.com for the most current information about this and other pertinent issues pertaining to chiropractic licensing and regulation.
To clarify our 03/16/2020 communication below, the Board is not mandating closures.
In answer to the many questions about telepractice or telemedicine, the following apply:
· You may use electronic means to recommend, change, or address activities which do not require direct patient contact such as at home exercise, general hygiene, at home palliative care, nutrition, diet and general wellness recommendations and referrals.
· Physician activities which require direct patient contact, such as examinations, shall not be conducted via electronic means.
In response to the COVID-19 (Corona Virus) concerns, the LA Board is not directing any office closures at this time. Use your own discretion. You should follow all CDC (Centers for Disease Control), Federal, State, Regional and Local guidelines and advisories.
"Telepractice", such as recommending exercise, general hygiene, at-home palliative care or nutrition may be appropriate. Physician actions, such as examinations, that usually require direct patient contact, would not be allowed.
The Board office will be temporarily closed to all public, visitors and vendors. Any business inquiries can be conducted via telephone, email, fax, or US Mail. The Board office will be staffed (limited basis) daily. Thank you for your patience, consideration and understanding.
1) CE vouchers must be submitted with license renewal paperwork from the licensee and will not accepted at any other time during the year or from any other source.
2) The CE voucher should have the seminar approval number, which was assigned to it by the Board, on the voucher.
3) HIPAA regulations have now made healthcare fraud a federal crime.
1) Any chiropractic assistant who takes x-rays must be 18 years of age, a high school graduate or equivalent, and have completed a course in x-ray function and safety approved by the LA Board of Chiropractic Examiners. Violation of the related statute can result in as much as a $50.00 per day fine.
2) When reporting procedures to third-parties, the most accurate and current CPT code should be used. Be careful of accepting vendor-provided codes. There have been cases in the past where these codes were incorrect.
1) Impaired Physician Program:
Effective July 20, 2006, the LA Board of Chiropractic Examiners began a new program for the rehabilitation of a chiropractor who is impaired by substance abuse or other mental or physical conditions. Physicians wishing to enroll themselves in this program may call the Board office for information. In addition, chiropractors may be recommended to the program by any concerned third-party. The identities of participants in this program will remain confidential unless required by law. (See LAC 46:XXVII.701 et seq)
2) Free Advertising:
Advertisement, which offers free goods or services or discounts, must contain the usual charge for the service even if the chiropractor does not normally charge for the service. Please reference Page 27 and 20 in your blue book (LAC 46:XXVII. 307 - 308)
1) Baccalaureate degree requirement:
Beginning 07/01/2011, each applicant for licensure shall hold a baccalaureate degree from a college or university approved by an accrediting agency of the US Department of Education. (Act 44 of 2007 LA Legislature (HB 387)
2) Delinquent license renewal fees increase:
Effective 08/15/2007, the delinquent license renewal fee will increase to $250.00 for any license not renewed by December 31st and further, after 60 days of 12/31, the fee shall increase by $100.00 for each additional month or each part of the month that the renewal has not been paid. (Act 44 of 2007 LA Legislature (HB 387)
3) Reciprocity license requirements:
Effective 08/15/2007, reciprocity licensure requirements will change to:
has maintained a license and has been in active practice in good standing in another jurisdiction for five consecutive years immediately prior to his application
. (Act 44 of 2007 LA Legislature (HB 387)
Effective May 20, 2009, the LA Board of Chiropractic Examiners published rules in the Louisiana Register as required by law relative to patient solicitation. Particular attention should be paid to the following:
Continuing Education Requirements Change For Risk Management CE:
Continuing Education Requirements Change For Risk Management CE:
Effective from Board action of 10/22/2009, for the 2011 license renewal, you will be required to attend and present proof of attendance of at least 3 hours in record keeping or documentation for the 6 hours risk management CE requirements.
The total 18 hours continuing education due for the 2011 license renewal must be:
· reviewed and approved by the LA Board of Chiropractic Examiners,
· the 6 RM CE hours must contain at least 3 hours of record keeping or documentation and
· must be earned in the 2010 calendar year.
This requirement will remain in effect for the RM renewal requirements and RM renewal years until further notice!
X-Ray Employee Credentials: Prior to hiring an employee as a chiropractic x-ray technician, it is strongly urged that each licensee check the potential employees credentials and verify with the employee as well as the Board that the person holds a valid and active x-ray proficiency certificate issued by the Board.
Delinquent License Renewal Fee & Possible Subsequent Fine: Any license renewal received (postmarked) after December 31st of each year shall be delinquent. The current delinquent fee shall be imposed and therefore due before the license will be renewed. The date the completed renewal is received at the Board office will be the date the license goes back into effect. Subsequently, the Boards Complaint Committee will review the delinquent license renewals and make an informal inquiry through the Complaints process. If warranted, further delinquent fee/fine penalties may be imposed.
Patient Referrals: It has come to the Boards attention that there are companies attempting to provide chiropractors with sales lead information regarding new patients. This information is provided to the chiropractor for a fee. It is the Boards opinion that this violates LSA R.S. 37: 1745 which prohibits chiropractors from paying for referrals. Any chiropractor using these services will be considered to be violating the law.
Claims Review: Claims Review work performed by out of state practitioners who are commenting on the appropriateness of care is deemed practicing chiropractic and therefore a LA chiropractic license is required.
Address Change Requirements: The Board will be actively enforcing the "address change requirements" as contained in LA statutes and regulations. A complaint will be initiated on any licensee who does not file an address change with the Board office.
CE Seminar Providers: Requests for CE seminar review applications must be received in the same calendar year which the course is given.
CE Requirements Change: Effective 08/01/2017, Act 255 signed by Gov. John Bel Edwards, will require ALL licensees will be required to provide a total of at least 15 hours of CE annually, with 3 of the 15 hours to be "risk management" hours and 1 of the 3 hours of RM to be "ethics" training.
Record Keeping: A patient's chart is used to document the condition and care of the patient. A provider is responsible for contemporaneously documenting the patient's condition and care and is responsible for maintaining this record for a period of six years from the date the patient is last treated. X-ray films should be maintained for a minimum period of three years from the date a patient is last treated or longer if requested in writing by the patient. The provider shall comply with the patient's authorization to provide those records or copies of them to those who the patient designates as authorized to inspect or receive them. Failure to comply with Louisiana's laws and rules may result in disciplinary action.
The LA Board of Chiropractic Examiners, from its meeting of 04/11/2019, expressly retracts any prior statements or positions made relative to CBD oil that would conflict with the LA Board of Pharmacys Revised Guidance Document re Cannabidiol (CBD) Oil. Contained below are excerpts from the LA Board of Pharmacys Revised Guidance Document issued 02/19/2019 re Cannabidiol (CBD) Oil:
The 2018 Farm Bill created federal recognition for hemp as an agricultural commodity and authorized its use in compliance with the provisions of that law. That law also amended the federal controlled substances law to except the tetrahydrocannabinol (THC) found in hemp from the listing of THC in Schedule 1 of the federal list of controlled substances. The Pharmacy Board noted the recent federal legislation but also noted that the LA Legislature has not yet adopted state law to recognize hemp, nor has the state Legislature created an exemption for the THC founding hemp from the THC which appears in Schedule 1 of the state list of controlled substances. Further, there is no differentiation in the source of CBD.
.The sale of CBD oil by its licensees would constitute a violation of he state controlled substance law and place them at risk for criminal and/or administrative sanctions.
The Board continues to receive questions about cannabidiol (CBD) oil, derived from hemp or derived from marijuana. Act 261 of the 2015 Legislature, which established the state medical marijuana program, made no exception for possession or sale of CBD oil in the definition of marijuana. All marijuana products shall comply with the rules adopted for the state medical marijuana program; they must have a known source as well as known quantities of active ingredients. Further, they may only be dispensed by marijuana pharmacies licensed by the LA Board of Pharmacy. Since marijuana is listed in Schedule 1 of the states list of controlled substances, no one, including board licensees, may possess or sell CBS oil. Violations of the LA Revised Statutes or the LA Administrative Code can subject a person to criminal and/or administrative action.