The Lapsed License and the January Schedule
Dr. L is a Minnesota-licensed chiropractor in a solo clinic. Her license renewal was due December 31. She paid the fee online but did not complete the continuing education her renewal notice said she still owed; the Board portal showed the renewal as incomplete. On January 6 she saw 14 patients, including a workers' compensation patient, and submitted insurance claims. On January 9 the clinic manager tells her the Board website lists her license as expired. Dr. L says there is a 30-day grace period and that she can keep treating while she finishes the hours. She also asks whether her unlicensed front-desk employee can perform 'routine adjustments' on established patients while Dr. L is at a seminar. The clinic has a signed office policy saying patients must be seen within 24 hours of calling.
1. May Dr. L continue treating patients after the renewal was not completed? Explain the legal and practical consequences of the January 6 visits and claims.
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No. A Minnesota chiropractic license authorizes practice only while it is active. If the Board record shows the license expired because renewal requirements were not met, Dr. L has no authority to adjust, examine, or hold herself out as a licensed chiropractor. She should not assume a grace period; any late-renewal or reinstatement window must come from the Board's current statutes, rules, or a written Board order, not from office custom. The January 6 visits are a serious problem: services were rendered and insurance claims submitted while the license was inactive. She should stop seeing patients immediately, contact the Board, complete the outstanding continuing education, file the correct reinstatement application, pay all fees and late charges, and provide a written explanation of the January visits. She should also correct or withdraw the claims and notify the insurer if required. Continuing to treat would compound unlicensed practice with potential insurance fraud and could support discipline even if she later reinstates.
2. What should Dr. L do about the front-desk employee performing adjustments?
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She must not allow it. An adjustment is within the practice of chiropractic and may be performed only by a licensed chiropractor. An unlicensed employee cannot perform 'routine adjustments' on established patients, even under Dr. L's general supervision, and Dr. L's presence elsewhere does not cure the problem. Delegable tasks are non-clinical: scheduling, intake paperwork, collecting fees, and similar administrative functions. If the employee has performed any adjustments, Dr. L should stop the practice, document what occurred, notify her malpractice carrier and the Board as appropriate, and review delegation policies with all staff. Supervising unlicensed clinical care is itself a ground for discipline and creates patient-safety and billing problems.
3. Outline a corrective plan for the clinic, including patient communication and recordkeeping.
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The plan should begin with a hard stop on clinical care until the license is active again. The clinic should identify every patient seen after expiration, notify them that services were provided during a licensing lapse, and arrange continuity through a properly licensed covering chiropractor or medical referral. It should keep the original appointment and billing records, add dated addenda describing the corrective steps, and avoid altering original entries. The clinic should contact the Board in writing, complete CE, submit reinstatement materials, and keep proof of each step. Staff should receive written training that only licensed providers perform examinations and adjustments and that the front desk cannot give clinical advice. Finally, Dr. L should audit insurance claims submitted during the lapse, correct them, and document refunds or revised billing. The key reasoning is that patient protection, candor with the Board, and accurate records matter more than preserving the January revenue.