iowa laws and rules review - Palmer College of Chiropractic

Transcription

Mary E. Frost, DC
PCC Homecoming 2015
IOWA LAWS AND RULES REVIEW
8/12/2015
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Iowa Laws and Rules: Board Website
http://www.idph.state.ia.us/Licensure/Chiropractic.aspx
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Iowa Laws and Rules
http://www.fclb.org/
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Iowa Laws and Rules
http://www.fclb.org/
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Iowa Laws and Rules
Where to find information about licensure, laws
and rules:
– Iowa Department of Professional Licensure
• http://www.idph.state.ia.us/Licensure/Chiropractic.aspx
• or FCLB.org will take you there with a few clicks
• Iowa Board of Chiropractic
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License look up
Renewal information
CE requirements for new DCs and renewals
Laws and rules
Disciplinary actions
– Also, I have linked to the laws and rules on each slide in
this presentation
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Iowa Laws and Rules
http://www.idph.state.ia.us/Licensure/Chiropractic.aspx?pg=FAQ
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Iowa Laws and Rules: FAQ
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Iowa Laws and Rules: FAQ
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Iowa Board of Chiropractic
http://www.idph.state.ia.us/Licensure/Chiropractic.aspx Ch. 40 & 151
Duties of the Board:
– “…evaluates the qualifications of applicants for licensure and grants licenses to
those who qualify”
– Develop a policy for continuing education guidelines
– “…establishes rules and regulations to ensure the integrity and competence of
licensed Chiropractors and investigates complaints for unprofessional
conduct”
– Discipline
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“The Board is the link between the consumer
and the licensed Chiropractor, as such,
promotes the public health, welfare and
safety”
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“Licensees are responsible for meeting all licensure
requirements and should review the rules carefully
and frequently. Select Laws and Rule listed on the
left and scroll through the Rules for detailed
information about Licensure Definitions, Licensure
Renewal, Reactivation and other important content
specific to this profession.”
Contact Information: (515) 281-4287
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Iowa Laws and Rules
Chapter 151: https://www.legis.iowa.gov/DOCS/ACO/IC/LINC/Chapter.151.pdf
“Chiropractic” defined:
– Persons publicly professing to be chiropractors or
publicly professing to assume the duties incident
to the practice of chiropractic.
– Persons who treat human ailments by the
adjustment of the neuromusculoskeletal
structures, primarily, by hand or instrument,
through spinal care.
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Iowa Laws and Rules
“Chiropractic” defined:
Persons utilizing differential diagnosis and
procedures related thereto, withdrawing or ordering
withdrawal of the patient’s blood for diagnostic
purposes, performing or utilizing routine laboratory
tests, performing physical examinations, rendering
nutritional advice, utilizing chiropractic
physiotherapy procedures, all of which are subject to
and authorized by section 151.8.
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Iowa Laws and Rules
License
– Every applicant for a license to practice chiropractic shall
do all of the following:
1. Present satisfactory evidence that the applicant possesses a
preliminary education equal to the requirements for
graduation from an accredited high school or other
secondary school.
2. Present a diploma issued by a college of chiropractic
approved by the board.
3. Pass an examination prescribed by the board.
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Iowa Laws and Rules
Approved college
1. A college of chiropractic shall not be approved
by the board as a college of recognized
standing unless the college requires for
graduation or for the receipt of any chiropractic
degree the completion of a course of study
covering a period of four academic years.
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Iowa Laws and Rules
2. An approved college of chiropractic may include but
is not limited to offerings of courses of study
• In procedures for withdrawing a patient’s blood
• Performing or utilizing laboratory tests
• Performing physical examinations for diagnostic purposes
• A chiropractor, employed by an approved college of chiropractic
and who has been trained to withdraw blood may withdraw blood
and instruct, and supervise a student in the withdrawing of blood.
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Iowa Laws and Rules
Operative surgery — drugs
• A license to practice chiropractic shall not authorize the
licensee to practice operative surgery or administer or
prescribe prescription drugs or controlled substances
which can only be prescribed by persons authorized by
law
Display of word “chiropractor”
• Every licensee shall place upon all signs used by the
licensee, and display prominently in the licensee’s
office the word “chiropractor”
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Iowa Laws and Rules
Training in procedures used in practice
1. A chiropractor shall not use in the chiropractor’s practice
the procedures otherwise authorized by law unless the
chiropractor has received training in their use by a college
of chiropractic offering courses of instructions approved
by the board or by curriculum taught on a postgraduate
level approved by the board.
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Iowa Laws and Rules
2. Any chiropractor licensed as of July 1, 1974, may use the
procedures authorized by law if the chiropractor files with
the board an affidavit that the chiropractor has completed
the necessary training and is fully qualified in these
procedures and possesses that degree of proficiency and
will exercise that care which is common to physicians in
this state.
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Iowa Laws and Rules
3. A chiropractor using the additional procedures
and practices authorized by this chapter shall be
held to the standard of care applicable to any
other health care practitioner in this state.
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Iowa Laws and Rules
Revocation or suspension of license
A entry to practice as a chiropractor may be revoked or suspended when the licensee is
guilty of the following acts or offenses:
1. Fraud in procuring a license
2. Professional incompetency
3. Knowingly making misleading, deceptive, untrue or
fraudulent representations in the practice of the licensee’s
profession or engaging in unethical conduct or practice
harmful or detrimental to the public. Proof of actual injury
need not be established
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Iowa Laws and Rules
4. Habitual intoxication or addiction to the use of drugs.
5. Conviction of a felony related to the profession or
occupation of the licensee or the conviction of any felony
that would affect the licensee’s ability to practice as a
professional chiropractor. A copy of the record of
conviction or plea of guilty shall be conclusive evidence.
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Iowa Laws and Rules
6. Fraud in representations as to skill or ability.
7. Use of untruthful or improbable statements in
advertisements.
8. Willful or repeated violations of the provisions of this
chapter or chapter 272C.
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Iowa Laws and Rules: Case Study 1
http://www.idph.state.ia.us/Licensure/Actions.aspx?board=Chiropractic
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Iowa Laws and Rules
Education requirements
– A person who is an applicant for a license to practice chiropractic shall
only be required to be tested for the adjunctive procedures specified in
section 151.1, subsection 3 which the person chooses to utilize.
–
A person licensed to practice chiropractic shall only be required to complete continuing
education requirements for the adjunctive procedures specified in section 151.1,
subsection 3 which the person chooses to utilize.
– A person who is an applicant for a license to practice chiropractic or a person licensed to
practice chiropractic shall not be required to utilize any of the adjunctive procedures
specified in section 151.1, subsection 3 to obtain a license or continue to practice
chiropractic, respectively.
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Iowa Laws and Rules
Rules
The board shall adopt rules necessary to administer section
151.1
– To protect the health, safety, and welfare of the public, including rules
governing the practice of chiropractic and defining any terms, whether
or not specified in section 151.1, subsection 3.
– Such rules shall not be inconsistent with the practice of chiropractic
– Shall not expand the scope of practice of chiropractic or authorize the
use of procedures not authorized by this chapter
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Iowa Laws and Rules
Temporary certificate
– The board may, in its discretion, issue a temporary
certificate for one year authorizing the certificate holder to
practice chiropractic
• If, in the opinion of the board, a need exists and the person possesses the
qualifications..
• No requirements of the law pertaining to regular permanent licensure are
mandatory for the temporary certificate except as specifically designated by the
board
• The granting of a temporary certificate does not in any way indicate that the person
is eligible for regular licensure or that the board is obligated to issue the person a
regular license
– The fee for the temporary certificate shall be based on the administrative
costs of issuing the certificates
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Iowa Laws and Rules
Chapter 41: https://www.legis.iowa.gov/law/administrativeRules/rules?agency=645&chapter=41
Chiropractic License
• Persons licensed to practice chiropractic shall keep
their license publicly displayed in the primary place
of practice
• Licensees are required to notify the board of
chiropractic of changes in residence or place of
practice within 30 days after the change of address
occurs
Do it in writing, make a copy and keep it
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Iowa Laws and Rules
License Renewal
– Iowa issues a chiropractic license for 2 years and
expiration occurs June 30 of even-numbered years
– So from July 1, 2014- June 30, 2016 is the current
biennium
 New licensees with in this period are required to have
2 hours of Iowa laws and rules in order to renew for
the 1st time
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Iowa Laws and Rules
– For chiropractors who have already renewed
their license once in Iowa, only 1 hour of Iowa
laws and rules is required
• You can still get general CE for the additional hour
here today
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Iowa Laws and Rules
License Renewal
– Active license is a license that is current and has
not expired
– Grace period is the 30-day period following
expiration of a license when the license is still
considered to be active. In order to renew a
license during the grace period, a licensee is
required to pay a late fee
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Iowa Laws and Rules
Chapters 41 & 44 :
https://www.legis.iowa.gov/law/administrativeRules/rules?agency=645&chapter=41
What is required for renewal?
– Board may or may not notify you to renew, it is
solely your responsibility to know the law and
follow it
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Iowa Laws and Rules
Chapters 41 & 44 :
What is required for renewal?
– 60 hours of CE during every 2 year period starting
July 1st of even numbered years
• at least 36 hours of continuing education credit that
directly relates to the clinical case management of
chiropractic patients
• At least 20 of the 36 hours must be live
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Iowa Laws and Rules
Chapters 41 & 44 :
What does the board consider live?
– Beginning with the July 1, 2014- June 30, 2016
renewal cycle, at least 20 of these hours shall be
earned by completing program in which an
instructor conducts the class employing a
traditional, in-person, classroom-type
presentation and the licensee is in attendance
in the same room as that instructor.
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Iowa Laws and Rules
Chapters 41 & 44 :
So 20 of the 36 hours has to be in the classroom
with the instructor- this is a change since the last
renewal period
What does this mean for me?
You can expect proctors to monitor your time carefully
while at any CE classes
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Iowa Laws and Rules
Chapters 41 & 44 :
• The remaining 16 hours may be obtained by
independent study, including any on-line instruction
– So what should you do if you are uncertain about
whether hours will count toward the 36 hours of
clinical case management of chiropractic patients
or 20 hours of in-class, clinical case management
of chiropractic patients?
• ASK, research and think
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Iowa Laws and Rules
Chapters 41 & 44 :
Other CE requirements
– A minimum of two hours per biennium in professional
boundaries regarding ethical issues related to professional
conduct that may include but are not limited to sexual
harassment, sensitivity training and ethics
– Two hours of CE credit at the time of the first biennial
renewal period and one hour every biennial renewal
period after that in the content areas of Iowa
Administrative Code 645 -- Chapters 40 through 46 and
Iowa Code Chapter 151
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Iowa Laws and Rules
Chapters 41 & 44 :
Other CE requirements
– And mandatory training once every 5 years in abuse
reporting (child and dependent adult abuse) OR complete
a waiver stating why you would be exempt from this
training
• Training course has to be approved by IDPH
– If certified and practicing acupuncture, a minimum of 12
hours of CE must be completed during the biennial period
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Iowa Laws and Rules
Chapters 41 & 44 :
To renew license- complete renewal application
and attestation of completed 60 hours of CE
and pay the fee before June 30, 2016
• Can renew online, but do not check the option
stating that CE has been completed unless you have
completed it
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Case Update:
8. Respondent is hereby CITED for a violation of Iowa Administrative
Code rule 43.11 (9) and WARNED that her failure to comply with the laws
governing the practice of chiropractic license, including suspension or
revocation.
9. Respondent shall provide the Board verification of the completion
of the twenty-two hour medical ethics and boundaries course offered at
the University of California, Irvine School of Medicine within six (6)
months of this O rder. This course is provided by “Professional Boundaries,
Inc.” These continuing education hours shall not count toward the
Respondent’s continuing education requirement. Respondent is
responsible for all costs of the program.
Cost for the program: $1875
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10. Respondent shall be assessed a civil penalty in the amount of
$1000. The civil penalty shall be made payable to the Treasurer of Iowa,
mailed to the administrator of the Board, and deposited into the State
General Fund.
11. Any failure by Respondent to comply with the terms and
conditions of the O rder may subject Respondent to further licensee
disciplinary action by the Board. The Settlement Agreement and Final
O rder constitute the resolution of a contested case proceeding.
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12. Respondent agrees that the State’s counsel may present this
Settlement Agreement and Final O rder to the Board ex parte.
13. Respondent understands that this O rder is a public record and is,
therefore, subject to inspection and copying by members of the public.
14. This O rder shall be part of Respondent’s permanent record and
shall be considered by the Board in determining the nature and severity of
any disciplinary action to be imposed in the event of future violations.
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Iowa Laws and Rules
Chiropractic Ethics
– 43.2(1) These principles are intended to aid chiropractic
physicians individually and collectively in maintaining a
high level of ethical conduct.
– These are standards by which a chiropractic physician
may determine the propriety of the chiropractic
physician’s conduct in the chiropractic physician’s
relationship with patients, with colleagues, with
members of allied professions, and with the public.
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Iowa Laws and Rules
Chiropractic Ethics
– The principal objective of the chiropractic profession is to
render service to humanity with full respect for the dignity
of the person. 43.2(2)
– Chiropractic physicians should strive continually to improve
chiropractic knowledge and skill, and should make
available to their patients and colleagues the benefits of
their professional attainments. 43.2(3)
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Iowa Laws and Rules
Chiropractic Ethics
– 43.2(3) Chiropractic physicians should strive continually to
improve chiropractic knowledge and skill, and should make
available to their patients and colleagues the benefits of
their professional attainments.
– 43.2(4) A chiropractic physician should practice a method
of healing founded on a scientific basis, and should not
voluntarily associate professionally with anyone who
violates this principle.
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Iowa Laws and Rules
Chiropractic Ethics
– The chiropractic profession should safeguard the public
and itself against chiropractic physicians deficient in moral
character or professional competence. Chiropractic
physicians should observe all laws, uphold the dignity and
honor of the profession and accept its self-imposed
disciplines. They should expose, without hesitation, illegal
or unethical conduct of fellow members of the profession.
43.2(5)
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Case Update:
5. Respondent has chosen not to contest the allegations in the
Statement of Charges and acknowledges that the allegations, if
proven in a contested case proceeding, would constitute grounds
for the discipline agreed to in this Order.
6. Respondent agrees to VOLUNTARILY SURRENDER
his chiropractic license.
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Iowa Laws and Rules
Record keeping
– Chiropractic physicians shall maintain clinical records in a
manner consistent with the protection of the welfare of the
patient
– Records shall be timely, dated, chronological, accurate,
signed or initialed, legible, and easily understandable
– Records should be dated when the note
was written or file was amended!
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Iowa Laws and Rules
Utilization Review
If your records are reviewed by the Utilization Review
Committee (appointed by the board) here is what
they are looking for…
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Iowa Laws and Rules
43.3(4) Types of cases reviewed shall include:
a. Utilization.
(1) Frequency of treatment;
(2) Amount of treatment;
(3) Necessity of service;
(4) Appropriateness of treatment.
b. Usual and customary service.
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Iowa Laws and Rules
43.3(5) Criteria for review may include but are not limited to:
a. Was diagnosis compatible and consistent with information?
b. Were X-ray and other examination procedures adequate, or
were they insufficient or unrelated to history or diagnosis?
c. Were clinical records adequate, complete, and of sufficient
frequency?
d. Was treatment consistent with diagnosis?
e. Was treatment program consistent with scientific knowledge
and with academic and clinical training provided in accredited
chiropractic colleges?
f. Were charges reasonable and customary for the service?
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Iowa Laws and Rules
Billing Procedures
– Chiropractic physicians shall maintain accurate
billing records for each patient
– Records may be stored on paper or electronically
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Iowa Laws and Rules
Billing Procedures
– The records shall contain all of the following:
–
–
–
–
–
–
–
–
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Name, date of birth and address
Diagnosis indicated with description or ICD code
Services provided with description or CPT code
Dates of services provided
Charges for each service provided
Payments made for each service and indication of the party providing payment
Dates payments are made
Balance due for any outstanding charges
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Iowa Laws and Rules
Billing Procedures
43.11(3)
Upon signed request of the patient, the chiropractic
physician shall furnish billing records or copies of the records
as directed by the patient within 30 days.
The chiropractic physician may charge a reasonable fee for
duplication of records, but may not refuse to transfer records
for nonpayment of any fees.
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Iowa Laws and Rules
Billing
– Chiropractic physicians shall not knowingly:
• Increase charges when a patient utilizes a third-party payment
program
• Report incorrect dates or types of service on any billing documents
• Submit charges for services not rendered
• Submit charges for services rendered which are not documented in
a patient’s record
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Iowa Laws and Rules
Billing
– 43.11(4) Each chiropractic physician is responsible
for the accuracy and validity of billings submitted
under the chiropractic physician’s name.
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Iowa Laws and Rules
Billing
– 43.11(6) A chiropractic physician has a right to
review and correct all billings submitted under the
chiropractic physician’s name or identifying
number(s). Signature stamps or electronically
generated signatures shall be utilized only with the
authorization of the chiropractic physician whose
name or signature is designated. Such authorization
may be revoked at any time in writing by the
chiropractic physician.
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Iowa Laws and Rules
• Billing (con’t.)
– Chiropractic physicians shall not knowingly:
• Bill patients or make claims under a third-party payer
contract for chiropractic services that have not been
performed
• Bill patients or make claims under a third-party payer
contract in a manner which misrepresents the nature of
the chiropractic services that have been performed
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D. FACTUAL CIRCUMSTANCES
1. Respondent is a licensed chiropractor in the State of Iowa.
2. On March 26, 2012, Respondent notified the Board of a federal
investigation of her clinics, which Respondent claimed was completed and
determined to be unfounded.
3. On April 24, 2012, the Board requested a copy of the final decision in
the federal investigation along with a letter of explanation providing the details
of what the investigation entailed within fourteen days.
4. On May 14, 2012, Respondent provided a letter but did not provide a
copy of the final decision.
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5. After an additional request from the Board, Respondent submitted an
unsigned copy of her Agreement for Pretrial Diversion with the United States
Attorney.
6. The Board thereafter requested a signed copy and additional narrative.
7. Respondent never complied with these requests. The Respondent
additionally failed to disclose an Addendum to Agreement for Pretrial
Diversion, which was executed on June 19, 2012.
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8. The Agreement for Pretrial Diversion was the culmination
in the federal investigation of Respondent's billing practices. As
part of the Agreement, Respondent agreed to pay $16,490.54 to
the United States and the State of Iowa as restitution for
economic losses to the Iowa Medicaid program and $21,981.17 to
Wellmark Blue Cross Blue Shield of Iowa for economic losses.
9. The federal investigation revealed that on numerous
occasions, Respondents billed for services not provided to
patients. For example, Respondent billed for mechanical traction
when Respondent's clinic did not have a mechanical traction
table.
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occasions, Respondent billed Medicaid for services or conditions
not covered by the program.
occasions, Respondent documented patient complaints that were
inconsistent with patient's oral complaints.
12. On August 2, 2014, Respondent entered into an agreement
with the Iowa Department of Human Services, Iowa Medicaid
Enterprise suspending her participation in the Iowa Medicaid
program for twenty-five years.
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C. STATUTES AND RULES INVOLVED
Count I
Respondent is charged with engaging in unethical conduct or practice harmful
or detrimental to the public in violation of Iowa Code section 147.55(3) and
Iowa Administrative Code rule 645—45.2(3).
Count II
Respondent is charged with making misleading, deceptive, untrue or
fraudulent representations in the practice of the profession in violation of Iowa
Code section 147.55(3) and Iowa Administrative Code rule 645—45.2(3).
Count III
Respondent is charged with acceptance of any fee by fraud or
misrepresentation in violation of Iowa Code 147.55(9) and Iowa
Administrative Code rule 645—45.2(9).
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Count IV
Respondent is charged with violation of a law or regulation of this state,
namely Iowa Administrative Code rule 645—43.11(7), in violation of Iowa
Code section 147.55(9) and Iowa Administrative Code rule 45.2(12).
Count V
Respondent is charged with violation of a law or regulation of this state as
demonstrated by her settlement agreement with the Iowa Department of
Human Services in violation Iowa Code section 147.55(9) and Iowa
Administrative Code rule 645-45.2(12).
Count VI
Respondent is charged with failing to cooperate with a board investigation in
violation of Iowa Code section 147.55(9) and Iowa Administrative Code rule
645-45-2(i8).
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This case is scheduled for a hearing before the board
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Iowa Laws and Rules
• Chiropractic Assistants
– Effective July 1, 2009
• The supervising chiropractic physician shall ensure that a chiropractic
assistant has completed a chiropractic assistant training program
•
A chiropractic assistant training program shall include training and
instruction on the use of chiropractic physiotherapy procedures related to
services to be provided by the chiropractic assistant
•
Any chiropractic assistant training program shall be provided by an
approved CCE-accredited chiropractic college or a chiropractic state
association.
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Iowa Laws and Rules
• Chiropractic Assistants
– Effective July 1, 2009
• A chiropractic physician shall not delegate to the chiropractic assistant the
following:
1. Services outside the chiropractic physician’s scope of
practice
2. Initiation, alteration, or termination of chiropractic
treatment programs
3. Chiropractic manipulation and adjustments
4. Diagnosis of a condition
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Iowa Laws and Rules
https://www.legis.iowa.gov/law/administrativeRules/rules?agency=645&chapter=45&pubDate=07-22-2015
Discipline Methods
1. Revocation of license
2. Suspension of license until further order of
the board or for a specific period
3. Prohibit permanently, until further order of the
board, or for a specific period the licensee’s
engaging in specified procedures, methods, or
acts
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Iowa Laws and Rules
Discipline Methods
4. Probation
5. Require additional education or training
6. Require a re-examination (board)
7. Order a physical or mental evaluation, or order
alcohol and drug screening within a time
specified by the board
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Iowa Laws and Rules
Discipline Methods
8. Impose civil penalties not to exceed $1000
9. Issue a citation and warning
10. Such other sanctions allowed by law as may be
appropriate
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D. FACTUAL CIRCUMSTANCES
1. Respondent offered employees free chiropractic services as a benefit
of employment. If the employee had health insurance that covered the
services, Respondent would bill the insurance company but would not
charge the employee the required copayment.
2. Respondent reused stimulation pads on multiple patients without
properly sanitizing the pads.
3. Respondent discussed a patient’s HIV status at a local bar with two
of his employees. The conversation was overheard by others.
4. Respondent employed unlicensed individuals to perform massage
therapy services.
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C. STATUTES AND RULES INVOLVED
Count I
Respondent is charged with acceptance of any fee by fraud
or misrepresentation in violation of Iowa Code section
147.55(8), (9), and 645 Iowa Administrative Code rule
45.2(9).
Count II
Respondent is charged with negligence in the practice of
the profession in violation of Iowa Code section 147.55(9)
and 645 Iowa Administrative Code rule 45.2(10).
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Count III
Respondent is charged with violation of a regulation or law of this state,
another state, or the United States, which relates to the practice of the
profession, in violation of Iowa Code section 147.55(9) and 645 Iowa
Administrative Code rule 45.2(12).
Count IV
Respondent is charged with betrayal of a professional confidence in
violation of Iowa Code section 147.55(9) and 645 Iowa Administrative
Code Rule 45.2(28)(c).
Count V
Respondent is charged with permitting an unlicensed employee or person
under the licensee’s control to perform activities requiring a license in
violation of Iowa Code section 147.55(9) and 645 Iowa Administrative
Code rule 45.2(27).
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7. Respondent understands that this Order is a public record and is,
therefore, subject to inspection and copying by members of the public.
8. This Order shall be part of Respondent’s permanent record and shall
be considered by the Board in determining the nature and severity of
any disciplinary action to be imposed in the event of future violations.
9. This Settlement Agreement and Final Order is subject to approval of
the Board. If the Board fails to approve this Settlement Agreement and
Final Order, it shall be of no force or effect to either party.
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10. Respondent admits to Counts II, III, and V as set forth
in the Notice of Hearing and Statement of Charges.
Respondent admits to the factual allegations set forth in
the Notice of Hearing and Statement of Charges with the
following revision to paragraph D(3)—Respondent
discussed confidential information with his employees at
an office meeting at a local restaurant/bar.
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11. Respondent is hereby CITED for billing insurance
companies without collecting the required copayment in
connection with the treatment of employees, for reusing
equipment on multiple patients that was not properly
sanitized, for discussing confidential information in public,
employing unlicensed individuals to perform services that
require a license and WARNED that his failure to comply
with the laws governing the practice of chiropractic in Iowa
could result in further discipline against his Iowa
chiropractic license, including suspension or revocation.
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12. Respondent shall be assessed a civil penalty in the
amount of $1000. The civil penalty shall be paid within
thirty days from the date this agreement is accepted by the
Board. The civil penalty shall be made payable to the
Treasurer of Iowa, mailed to the administrator of the
Board, and deposited into the State General Fund.
8/12/2015
88
13. Respondent shall provide the Board verification of the
completion of 20 hours of continuing education meeting
the standards set forth in 645 Iowa Administrative Code
chapter 44 in the areas of HIPAA and billing practices
within one year from the date this agreement is accepted by
the Board. These hours shall not count toward
Respondent’s continuing education renewal requirements.
Respondent is responsible for all costs associated with the
continuing education.
8/12/2015
89
14. Any failure by Respondent to comply with the terms and
conditions of this Order may subject Respondent to further
licensee disciplinary action by the Board.
15. The Board’s approval of this Settlement Agreement and
Final Order shall constitute a FINAL ORDER of The
Board.
8/12/2015
90
Thank you for your attention
8/12/2015
91

iowa laws and rules review - Palmer College of Chiropractic

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