Fourteen Months Lapsed, Six Cash Visits, and an Insurer Inquiry
Dr. L is a Louisiana-licensed chiropractor who moved to Texas for 18 months. Her Louisiana license expired 14 months ago. She returned last month, rented a treatment room three days a week, and has seen six former patients for lumbar and cervical adjustments, charging $65 per visit in cash. She documented the visits in her old electronic record system under the original license number. She has completed 12 hours of continuing education since expiration but has not taken a jurisprudence examination or submitted a reinstatement application. She now wants to renew online, backdate her CE, and "just pay the late fee." A patient's insurer has asked for her current license number, and one patient complained of increased neck pain after an adjustment. She asks whether she can keep treating while the application is pending and whether the six visits can be characterized as "consultations" rather than treatment.
1. May Dr. L continue seeing patients while her license is expired or her reinstatement application is pending?
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No. A Louisiana chiropractic license must be active before the licensee performs chiropractic treatment. An expired license is not a grace period, and a pending application does not create interim authority unless the Board has issued a specific temporary or provisional authorization. Seeing patients for adjustment while lapsed can be treated as unlicensed practice and as a ground for discipline, regardless of whether the patients were former patients or paid cash.
She should stop treating immediately, cancel or reschedule appointments, and arrange coverage by an actively licensed chiropractor if patients need continuity. She should not describe the six visits as "consultations" to avoid licensure requirements; the record shows adjustments, fees, and a treatment purpose. Recharacterizing treatment after the fact could be viewed as falsification and insurance misrepresentation. The safer course is to disclose the lapse to the Board, cooperate with any inquiry, and correct the record only by an honest addendum explaining the licensure status-not by altering the original entries.
2. What is the proper reinstatement path, and how should she handle the CE and records issues?
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She should apply for reinstatement under the Board's rules rather than assume ordinary online renewal is available after a lengthy lapse. Reinstatement commonly requires a formal application, fee, evidence of continuing education, and possibly examination or other conditions set by the Board; the exact requirements should be confirmed with the Board because they can change. She should not backdate CE or claim credits she did not complete. If her 12 hours are short of the requirement, she should complete additional approved hours and document them honestly.
For the records, she should preserve the original entries and the audit trail. An addendum may explain that the license was expired during the visits, but the original documentation should not be rewritten. She should also determine whether any insurer was billed during the lapse and correct any claim that represented her as licensed. Because a patient has reported increased neck pain, she should document that complaint, perform an appropriate evaluation within whatever authority she has, and refer if needed. Legal counsel is prudent before submitting explanations to the Board or an insurer.
3. How should she respond to the insurer's request for a license number and to the patient's complaint of increased neck pain?
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She must respond truthfully. Providing an expired license number, using another provider's number, or implying current licensure would be misrepresentation and could support fraud or disciplinary findings. If she submitted claims during the lapse, she should not conceal that fact; she should consult counsel and the insurer's correction process. A careful response identifies her actual license status, explains any corrective action, and avoids speculative excuses.
The patient complaint requires a clinical and documentation response. She should record the patient's symptoms, the timing relative to treatment, any examination findings, and the advice given, including referral if the symptoms suggest a complication. She should not alter prior notes or pressure the patient to withdraw the complaint. If she is not currently licensed, she should not provide further treatment; continuity should be arranged with a licensed provider. The combination of lapsed licensure, cash visits, and an adverse symptom report makes early legal and Board-directed transparency more defensible than trying to manage the problem informally.