Professional ethics, advertising, and fee-splitting/billing prohibitions
This domain tests ethical practice standards, truthful advertising, and the prohibitions on fee splitting and fraudulent billing. Exam questions often present a business arrangement or advertisement and ask whether it violates Ohio law.
Ethics and advertising
Ohio chiropractors must practice ethically and advertise truthfully. Advertising may not be false, misleading, or deceptive; may not guarantee results or claim a cure; may not claim superiority over other providers; and must not use patient testimonials in a misleading way. Websites and social media count as advertising. Licensees must not solicit patients in a manner that exploits vulnerable persons.
Fee splitting and billing
ORC 4734.24 and Board rules prohibit fee splitting: paying or receiving any commission, rebate, or percentage of fees for patient referrals. Rent based on a percentage of gross receipts may also be problematic if tied to referrals. Billing must be accurate; billing for services not rendered, upcoding, or submitting false claims is prohibited. Financial relationships with referral sources must be disclosed and must not influence clinical judgment.
Worked example
A chiropractor agrees to pay a marketer $50 for each new patient who signs a treatment plan. That is an improper fee split or compensation for referral, even if labeled “marketing.” A compliant arrangement would pay for advertising services not contingent on patient volume or referrals.
Traps
Percentage-based rent can be a fee-splitting trap if it varies with referrals. “Free” advertising must disclose conditions. Testimonials cannot imply guaranteed outcomes. Billing for a service bundled into another code can be fraudulent.