MO Chiropractic Jurisprudence cheat sheet

Chiropractic is defined in Missouri law as the science and art of locating and correcting vertebral subluxations and other malpositions of articulations of the human body, with the adjustment performed by hand or instrument.

Practice without a valid Missouri chiropractic license is prohibited; the license must be issued by the Missouri Board of Chiropractic Examiners before any patient contact.

Applicants must be at least 21 years of age, of good moral character, and hold a diploma from a chiropractic college accredited by the Council on Chiropractic Education or an equivalent recognized accreditor.

The applicant must pass the National Board of Chiropractic Examiners examination (Parts I-IV) plus the Missouri jurisprudence examination before licensure.

Missouri requires submission of fingerprints for a criminal background check through the Missouri State Highway Patrol and FBI as part of initial licensure.

Chiropractors may not perform major surgery or prescribe or administer controlled substances or legend drugs; the scope is limited to adjustment, manipulative therapy, and adjunctive physical measures.

The Act authorizes the Board to adopt rules implementing the statute, and those rules carry the force of law when properly promulgated under chapter 536.

A chiropractic license is personal and nontransferable; practicing under another person's license or allowing another to use one's license is a violation.

The Board is created within the Division of Professional Registration of the Department of Commerce and Insurance and is funded through licensee fees rather than general revenue.

Members are appointed by the Governor with the advice and consent of the Senate; a majority must be licensed practicing chiropractors in Missouri.

Board members serve staggered terms, and a member may be removed by the Governor for misconduct, neglect of duty, or inability to perform the duties of office.

The Board elects its own officers, including a president and secretary, and adopts bylaws governing meetings and quorum requirements.

The Board's powers include examining applicants, issuing and renewing licenses, investigating complaints, and seeking injunctions against unlicensed practice.

The Board may subpoena records and witnesses and administer oaths in connection with investigations and contested case hearings.

Contested cases are governed by chapter 536; the Board's final decisions are subject to judicial review in the circuit court of Cole County or the county of the licensee's residence.

The Board must maintain records of its proceedings and make them available as required by the Missouri Sunshine Law, chapter 610.

Licenses are renewed biennially by the expiration date set by the Division of Professional Registration; the Board sets the renewal cycle and fee.

Renewal requires completion of continuing education as specified by Board rule, including a defined number of hours in chiropractic technique and jurisprudence topics.

Failure to renew by the deadline results in expiration; practicing on an expired license is unlicensed practice subject to discipline.

A late renewal may be permitted within a grace period upon payment of a delinquency fee, but the licensee may not practice after expiration until the license is reinstated.

Reinstatement of a lapsed license generally requires proof of continuing education for the lapsed period and payment of all accrued fees and penalties.

A license suspended or revoked for disciplinary reasons may be reinstated only by order of the Board after a petition showing rehabilitation and compliance with the disciplinary order.

Continuing education providers and courses must be approved by the Board; self-study and online hours are limited by rule.

Licensees must report name and address changes to the Board within the time required by rule so that renewal notices reach the licensee.

Grounds for discipline include fraud in obtaining a license, unprofessional conduct, incompetence, and violation of any provision of the practice act or Board rules.

Additional grounds include practicing while impaired by alcohol or drugs, aiding unlicensed practice, and failing to cooperate with a Board investigation.

Complaints are filed with the Board, which may conduct an investigation; the Board may dismiss a complaint or issue a complaint and notice of hearing.

Disciplinary proceedings are contested cases under chapter 536, with notice, an opportunity for hearing, and the right to counsel.

Available sanctions include reprimand, probation with conditions, suspension, revocation, and civil penalties; the Board may also require remedial education.

The Board may impose an emergency suspension when the public health, safety, or welfare requires immediate action, with a hearing to follow.

A licensee must respond to Board inquiries and produce patient records on request; failure to do so is itself a ground for discipline.

Disciplinary actions may be reported to national practitioner data banks and other state licensing boards as required by law.

Patient records must be legible, contemporaneous, and sufficient to identify the patient, document the examination, diagnosis, treatment plan, and the chiropractor's signature and date.

Records must be retained for the period required by Board rule and state law, and a patient is entitled to a copy upon request, subject to allowable fees.

Confidential patient information may not be disclosed without authorization except as required by law, court order, or public health reporting.

Advertising must be truthful and not misleading; claims of guaranteed cures, superiority over other licensees, or deceptive fee statements are prohibited.

Use of the title "doctor" or "Dr." is limited to the chiropractic degree context; a chiropractor may not represent that they hold a medical degree.

A chiropractor may not exploit the patient relationship for personal gain, engage in sexual misconduct with a patient, or abandon a patient without notice.

Fee splitting with unlicensed persons for patient referrals and paying commissions for solicitation are prohibited as unprofessional conduct.

Informed consent for treatment should be documented, and the chiropractor must refer patients whose conditions are outside the scope of chiropractic practice.

Chapter 331 governs chiropractors; chapter 334 governs other healing arts; chapter 536 governs administrative procedure and contested cases.

The Division of Professional Registration within the Department of Commerce and Insurance administers licensing for all Missouri health professions.

Under chapter 536, an agency must give notice of the issues, facts, and law involved before a contested case hearing.

The Missouri Administrative Hearing Commission hears certain disciplinary matters referred by licensing boards, and its decisions are subject to Board action.

The Sunshine Law, chapter 610, requires open meetings and public records, with exceptions for confidential investigative and patient information.

Rulemaking follows the notice-and-comment process in chapter 536; emergency rules are limited in duration and must be followed by permanent rules.

Judicial review of agency decisions is deferential; courts affirm findings supported by competent and substantial evidence on the whole record.

Statutes of limitation for professional discipline generally run from the act or from discovery, and continuing violations may toll the period.

Chiropractors must report reportable communicable diseases to the local public health authority or the Department of Health and Senior Services as required by 19 CSR 20-20.

Reportable conditions include tuberculosis, sexually transmitted infections, hepatitis, and other diseases listed in the state reportable disease rule.

Reporting must be timely, typically within the timeframe specified by rule, and must protect patient confidentiality outside the required disclosure.

A chiropractor who reasonably suspects child abuse or neglect must report to the Children's Division of the Department of Social Services.

Elder abuse or neglect of a resident in a long-term care facility must be reported to the Department of Health and Senior Services.

A licensee who is impaired by alcohol or drugs, or who has a condition that impairs practice, must refrain from practice and may self-report to the Board or a peer assistance program.

A chiropractor with knowledge that another licensee is impaired or practicing incompetently may report to the Board; good-faith reports are protected.

Failure to make a required public health or abuse report is a ground for discipline and may carry separate statutory penalties.