The Expired License and the CE Audit
Dr. Alvarez has held a Maine chiropractic license for 12 years. Her license expired on September 30 because she forgot to renew while caring for a family member. On October 14, a long-standing patient with acute torticollis calls the office. Dr. Alvarez sees the patient, performs a cervical adjustment, and bills the insurer under her old license number. The office manager later receives a continuing education audit notice covering the prior two-year cycle. Dr. Alvarez has certificates for 18 hours, including a 2-hour ethics course, but no CPR card. She asks whether she can backdate the renewal, continue treating patients while the application is pending, and submit the 18 hours now. The patient improves and files no complaint. A former employee mentions the lapse to the Board.
1. May Dr. Alvarez examine, adjust, and bill the October 14 patient under her expired license? Explain the licensure and billing consequences.
Read the worked answer
No. A Maine chiropractic license must be active whenever the licensee performs the statutory scope of practice. The expiration date is not a grace period; seeing the patient and performing a cervical adjustment on October 14 was unlicensed practice even though the patient was established and improved. Billing under the old license number compounds the problem because it misrepresents licensure status to the insurer and may constitute insurance fraud. The emergency exception is narrow and does not cover routine acute torticollis. She should have referred the patient or arranged coverage by an active licensee. She must stop treating immediately, self-report to the Board, apply for reinstatement, and correct any claim. The Board may impose discipline, conditions, or a civil penalty; backdating the license is not permitted.
2. The CE audit requests certificates and a CPR card. Dr. Alvarez has 18 hours, including 2 hours of ethics, but no CPR card. How should she respond, and what should she do before seeking reinstatement?
Read the worked answer
She must respond truthfully and on time. She should send the certificates she actually has, explain the missing CPR card, and not fabricate or backdate documents. She should compare her 18 hours against the current Board CE rule, including any specific subject requirements, and complete the deficiency before applying for reinstatement. If CPR is a separate requirement, she should complete an accepted course and provide proof. She should ask the Board in writing whether late completion is acceptable and disclose the October 14 treatment. Voluntary remediation and candor mitigate but do not erase the lapse; the Board will weigh the deficiency and the unlicensed practice together.
3. A former employee has told the Board about the lapse. What should Dr. Alvarez do about the investigation and the former employee?
Read the worked answer
She should not retaliate against the former employee or ask staff to change records. She should preserve the appointment schedule, billing records, and CE file; obtain legal advice; and respond to Board inquiries completely and by the deadline. A written narrative should acknowledge the expired license, the single treatment, the billing error, and the corrective steps. She should not contact the patient to discourage a complaint. Cooperation and remediation are considered; concealment or alteration of records is an independent violation and can support more severe discipline.