MD Chiro Juris cheat sheet

COMAR Title 10.43 is the State Board of Chiropractic Examiners subtitle; the governing statute is the Maryland Chiropractic Act, Health Occupations Article, Title 3.

Health Occupations §3-101 et seq. establishes the Board; the Board adopts regulations in COMAR 10.43.01 through 10.43.06, covering licensure, practice standards, and discipline.

The Board consists of licensed chiropractors and consumer members appointed by the Governor; a majority of the professional members must be actively practicing in Maryland.

A license issued under the Act is renewable and is subject to the Board's continuing education and fee requirements; the license is not transferable to another person.

Unlicensed practice of chiropractic is a criminal offense under the Health Occupations Article; the Board may seek injunctive relief against an unlicensed practitioner.

The Board may issue a cease-and-desist order and impose a civil penalty for unlicensed practice without first exhausting administrative remedies.

Regulations require licensees to report to the Board within a defined period any change of name or address appearing on the license.

The Board's regulations are published in COMAR and are available through the Maryland Division of State Documents; the Act controls where a regulation conflicts.

Applicants must be at least 18 years old, of good moral character, and hold a chiropractic degree from a college accredited by the Council on Chiropractic Education (CCE) or its equivalent.

Applicants must pass the National Board of Chiropractic Examiners (NBCE) examinations, Parts I, II, III, and IV, or the equivalent as determined by the Board.

Maryland requires a jurisprudence examination covering the Chiropractic Act and COMAR 10.43 before initial licensure.

A criminal history records check, including FBI fingerprinting, is required for initial licensure under Health Occupations Article §3-302.1.

Licenses renew biennially; the renewal deadline is set by the Board, and a late fee applies to a renewal filed after the expiration date.

Continuing education: licensees must complete 40 hours per two-year renewal cycle, including a Board-specified number of hours in ethics and record keeping.

A license that has lapsed may be reinstated within a Board-defined grace period upon payment of renewal and late fees plus proof of continuing education; beyond that period, reinstatement requires Board approval.

Licensees must display the license at the practice location and produce it on request of the Board or an authorized agent.

The practice of chiropractic is the detection and correction of subluxations and the adjustment or manipulation of the articulations of the human body, including the spine.

Chiropractors may use physical therapy modalities, including heat, cold, ultrasound, electrical stimulation, and therapeutic exercise, as adjuncts to chiropractic adjustment.

A chiropractor may perform dry needling only after completing Board-approved training; the training must include anatomy, contraindications, and supervised clinical practice.

Dry needling is the insertion of filiform needles into myofascial trigger points; it is distinct from acupuncture, which is regulated separately under the Acupuncture Act.

Chiropractors may not perform surgery, prescribe controlled substances, or administer drugs except as authorized by law; the scope is limited to non-invasive and manual modalities.

A chiropractor may order and interpret diagnostic imaging, including plain film radiography, and may refer to other providers for advanced imaging.

Chiropractors may not perform spinal manipulation under anesthesia or use investigational procedures outside Board-approved standards.

A chiropractor must refer a patient to an appropriate provider when the condition is outside the chiropractic scope of practice.

The Board may discipline a licensee for unprofessional conduct, including fraud, deception, gross negligence, and practicing while impaired by drugs or alcohol.

Grounds for discipline include conviction of a crime involving moral turpitude, obtaining a license by fraud, and aiding unlicensed practice.

Patient records must be legible, contemporaneous, and retained for at least 5 years after the last treatment date; records for minors must be retained until age 21.

Records must document the chief complaint, history, examination findings, diagnosis, treatment plan, informed consent, and progress notes.

A chiropractor must maintain patient confidentiality and may disclose records only with patient authorization or as required by law.

Disciplinary sanctions include reprimand, probation, suspension, revocation, and civil penalties; the Board may also require remedial education or a practice monitor.

A licensee must report to the Board within 30 days any adverse action taken against the license by another jurisdiction.

The Board may impose an emergency suspension if continued practice poses an imminent danger to the public; a hearing follows within a Board-defined period.

The Board investigates complaints and may issue subpoenas for records and testimony during an investigation.

A licensee may be represented by counsel at a Board hearing and may present evidence and cross-examine witnesses.

A final order of the Board may be appealed to the circuit court for the county where the licensee resides, under the Maryland Administrative Procedure Act.

The Board may impose a civil penalty in addition to, or instead of, suspension or revocation, as authorized by the Health Occupations Article.

A licensee who fails to comply with a Board order is subject to further discipline, including revocation of the license.

The Board publishes disciplinary actions and maintains a public record of license status.

The Board may require a licensee to complete a professional assessment or treatment program as a condition of reinstatement.

Practicing on a suspended or revoked license is unlicensed practice and is subject to criminal penalties.

Advertising must be truthful and not misleading; a chiropractor may not claim a specialty unless certified by a recognized board.

A chiropractor may not guarantee a cure or use testimonials that imply a guaranteed result.

A chiropractor must obtain informed consent before initiating treatment and must document the consent in the record.

A chiropractor must maintain a sterile technique for dry needling and must dispose of needles in a sharps container.

A chiropractor may not practice under a name other than the name on the license without Board approval.

A chiropractor must maintain professional liability insurance as a condition of active practice.

A chiropractor must provide a patient with a copy of the record on request and may charge a reasonable fee for copying.

A chiropractor must report suspected child abuse or neglect to the appropriate authority as required by Maryland law.