Lapsed License, Pending Renewal, and Continuing Education Audit
A chiropractor licensed in New Hampshire for 12 years allowed her license to expire on June 30, 2024. She continued seeing 15 to 20 patients per week in her Nashua office for 11 months, believing a grace period applied. She completed 36 hours of continuing education during the biennium: 12 hours of online marketing and practice-management webinars, 8 hours of self-study reading without quizzes, 10 hours of technique seminars, and 6 hours of ethics. She now applies for renewal and asks whether the Board will simply accept the 36 hours, whether she can keep practicing while the application is pending, and what penalties she faces. She has no prior discipline. Her office manager tells her that because she paid the renewal fee late, the license is 'probably retroactive.'
1. Can she lawfully continue treating patients while her renewal application is pending? Explain under New Hampshire licensure law.
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No. A license is either active or it is not; a pending renewal application is not a license. Practicing on an expired license is unlicensed practice under RSA 316-A and can be charged as a violation even if the chiropractor paid a late fee. The 'grace period' belief is not a defense unless a rule expressly creates one; the Board's renewal rule should be checked, but a lapse of nearly a year is not a routine late renewal. She should stop seeing patients immediately, notify the Board, and apply for reinstatement or renewal as the Board requires. Continuing to treat while the application is pending adds violations and undermines mitigation.
2. How should the Board evaluate the 36 continuing education hours?
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The Board will apply the continuing education rule, not just add hours. The rule typically sets a biennial total and limits or excludes categories such as marketing, practice management, and unstructured self-study. Twelve hours of marketing webinars likely do not count as clinical chiropractic continuing education. Eight hours of self-study without an assessment may not count. Ten technique hours and six ethics hours are more likely countable, subject to caps and provider approval. So 36 hours is not automatically sufficient, and the countable total may be below the requirement. She should document attendance and be prepared for an audit; the Board may require additional continuing education.
3. What range of disciplinary outcomes is realistic, and what mitigating factors matter?
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A realistic range includes a reprimand and fine for unlicensed practice, with suspension stayed and probation; a short suspension; plus additional continuing education and an audit. Factors: 11 months of practice and 15 to 20 patients per week is substantial; no prior discipline; whether she self-reports and stops immediately; whether she cooperates and corrects advertising; whether any patient harm or insurance billing occurred. The Board will also consider whether she misrepresented her license status to patients or insurers. The office manager's 'retroactive' advice is not a legal defense.