- § 700
- § 701
- § 702
- § 703
- § 704
- § 705
- § 706
- § 707
- § 708
- § 709
- § 710
- § 711
- § 712
- § 713
- § 714
- § 715
- § 716
- § 717
- § 718
- § 719
Professions and Occupations
CHAPTER 7. Board of Chiropractic
The primary objective of the Board of Chiropractic, to which all other objectives and purposes are secondary, is to protect the general public, specifically those persons who are the direct recipients of services regulated by this chapter, from unsafe practices and from occupational practices which tend to reduce competition or fix the price of services rendered.
The secondary objectives of the Board are to maintain minimum standards of practitioner competency and to maintain certain standards in the delivery of services to the public. In meeting its objectives, the Board shall develop standards assuring professional competence; shall monitor complaints brought against practitioners regulated by the Board; shall adjudicate at formal hearings; shall promulgate rules and regulations; and shall impose sanctions where necessary against licensees or former licensees.
Throughout the history of chiropractic, there have been distinct philosophical approaches to chiropractic. No action, rule, standard or requirement shall be imposed or interpreted which would restrict a practitioner from licensure as long as the practitioner complies with this chapter.64 Del. Laws, c. 413, § 2; 70 Del. Laws, c. 514, § 1;
(a) For purposes of this chapter:
(1) “Board” means the State Board of Chiropractic.
(2) “Chiropractic” means a system of health care based on the principle that interference with the transmission of nerve impulses may cause pain or disease.
(3) “Chiropractic supportive care” means continuous, interval-based treatment that is medically necessary for patients diagnosed with chronic pain or disease, which maintains function or prevents or slows deterioration. “Chiropractic supportive care” includes treatment for patients who must resume care because the patient’s chronic pain or disease regresses or worsens after the withdrawal of treatment.
(4) “Chiropractor” or “doctor of chiropractic” or “chiropractic physician” means an individual licensed to practice chiropractic under this chapter.
(5) “Medically necessary” means providing health-care services or products that a prudent physician would provide to a patient for the purpose of diagnosing or treating an illness, injury, disease or its symptoms in a manner that is all of the following:
a. In accordance with generally-accepted standards of chiropractic practice.
b. Consistent with the symptoms or treatment of the condition.
c. Not solely for anyone’s convenience.
(6) “Physician” means an individual who possesses a valid State of Delaware license as either of the following:
a. A doctor of chiropractic.
b. A physician, under Chapter 17 of this title.
(7) “Protective hairstyle” includes braids, locks, and twists.
(8) “Race” includes traits historically associated with race, including hair texture and a protective hairstyle.
(9) “Substantially related” means the nature of criminal conduct, for which the person was convicted, has a direct bearing on the fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of chiropractic.
(b) The practice of chiropractic includes the use of recognized diagnostic and treatment methods, as taught by chiropractic colleges or approved by the Board, and includes all of the following:
(1) Diagnosing and locating misaligned, fixated, or displaced vertebrae, including subluxation complex and other neuromusculoskeletal and soft tissue structures, using x-rays and other diagnostic test procedures.
(2) Treatment, through manipulation or adjustment of the spine and other neuromusculoskeletal and soft tissue structures.
(3) Chiropractic supportive care.
(4) The use of adjunctive procedures not otherwise prohibited by this chapter.
(c) Except as otherwise provided in this chapter, the practice of chiropractic does not include the use of any of the following:
(1) Prescription medications.
(3) Obstetrical or gynecological examinations or treatment.
(d) Chiropractors shall perform all examinations and procedures in accordance with the protocol and procedures as taught by chiropractic colleges or approved by the Board.41 Del. Laws, c. 261, § 8; 24 Del. C. 1953, § 701; 70 Del. Laws, c. 514, § 2; 80 Del. Laws, c. 80, § 8; 82 Del. Laws, c. 261, §§ 6, 16; 83 Del. Laws, c. 13, §§ 17, 18; 83 Del. Laws, c. 52, § 8; 83 Del. Laws, c. 433, § 7; 83 Del. Laws, c. 526, § 1;
(a) There is created a State Board of Chiropractic, which shall administer and enforce this chapter, and which shall consist of 7 members appointed by the Governor, who are residents of this State; 4 of whom shall be licensed to practice chiropractic in this State; and 3 public members. A public member shall not be nor ever have been a chiropractor, nor a member of the immediate family of a chiropractor; shall not have been employed by a chiropractor; shall not have had a material financial interest in the providing of goods and services to chiropractors; nor have been engaged in an activity directly related to chiropractic. Such public member shall be accessible to inquiries, comments and suggestions from the general public.
(b) Except as provided in subsection (c) of this section, each member shall serve for a term of 3 years, and may succeed himself or herself for 1 additional term; provided, however, that where a member was initially appointed to fill a vacancy, such member may succeed himself or herself for only 1 additional full term. Any person appointed to fill a vacancy on the Board shall hold office for the remainder of the unexpired term of the former member. Persons who are members of the Board on July 17, 1996, shall complete their terms of office.
(c) A person who has never served on the Board may be appointed to the Board 2 consecutive times, but no such person shall thereafter be eligible for 2 consecutive appointments. No person who has been twice appointed to the Board, or who has served on the Board for 6 years within any 9-year period, shall again be appointed to the Board until an interim period of at least 1 term has expired since such person last served.
(d) Any act or vote by a person appointed in violation of subsection (c) of this section shall be invalid. An amendment or revision of this chapter is not sufficient cause for any appointment or attempted appointment in violation of subsection (c) of this section, unless such amendment or revision amends this section to permit such an appointment.
(e) A member of the Board shall be suspended or removed by the Governor for misfeasance, nonfeasance or malfeasance. A member subject to disciplinary proceedings shall be disqualified from Board business until the charge is adjudicated or the matter is otherwise concluded. A Board member may appeal any suspension or removal to the Superior Court.
(f) No member of the Board of Chiropractic, while serving on the Board, shall be an officer of a local or state professional chiropractic association or have a financial interest in any chiropractic college or school.
(g) Vacancies occurring on the Board by reason of the death of any member or the member’s incapacity, neglect or refusal to act or by removal or in any other way, including those specified in this chapter shall be filled by the Governor.
(h) Each Board member shall be reimbursed for all expenses involved in each meeting, including travel, and in addition shall receive compensation per meeting attended in an amount determined by the Division in accordance with Del. Const. art. III, § 9.
(i) The provisions set forth for “employees” in Chapter 58 of Title 29 shall apply to all members of the Board and to all agents appointed or otherwise employed by the Board.41 Del. Laws, c. 261, §§ 1, 2; 24 Del. C. 1953, §§ 702, 703; 64 Del. Laws, c. 413, § 3; 67 Del. Laws, c. 368, § 5; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, §§ 3-6; 81 Del. Laws, c. 85, § 4;
(a) The Board annually shall elect a president and secretary. Each officer shall serve for 1 year and shall not succeed himself or herself in the same office.
(b) The Board shall hold a regularly scheduled business meeting at least once in each quarter of a calendar year and at such other times as the President deems necessary, or at the request of a majority of Board members.
(c) A majority of the members shall constitute a quorum for the purpose of transacting business. No disciplinary action shall be taken without the affirmative vote of 4 members of the Board. Any member who fails to attend 3 consecutive meetings, or who fails to attend at least 1/2 of all regular business meetings during any calendar year, shall automatically upon such occurrence be deemed to have resigned from office and a replacement shall be appointed.
(d) Minutes of all meetings shall be recorded, and copies of the minutes shall be maintained by the Division of Professional Regulation. At any hearing where evidence is presented, the hearing shall be recorded. Transcripts shall be made at the request and expense of any party.41 Del. Laws, c. 261, § 3; 24 Del. C. 1953, § 704; 50 Del. Laws, c. 325, § 1; 64 Del. Laws, c. 413, § 3; 65 Del. Laws, c. 331, §§ 1, 2; 65 Del. Laws, c. 355, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, §§ 7, 41;
All complaints shall be received and investigated by the Division of Professional Regulation in accordance with § 8735 of Title 29. The Division shall be responsible for issuing a final written report at the conclusion of its investigation. The Board president shall assign a member of the Board to assist the Division of Professional Regulation with the investigation of the technical aspects of the complaint and shall not discuss any matter of fact or law regarding such investigation with any Board member prior to the final decision of the Board. Such member shall recuse himself or herself from the deliberations on the complaint at any hearing regarding the complaint. If it is determined that a practitioner should be subject to a disciplinary hearing, the Board shall conduct such hearing in accordance with this chapter and the Administrative Procedures Act [Chapter 101 of Title 29].
When it is determined that an individual is engaging in the practice of chiropractic or is using the title “chiropractor” and is not licensed under the laws of this State, the Board shall notify the office of the Attorney General for appropriate action.64 Del. Laws, c. 413, § 3; 65 Del. Laws, c. 331, § 3; 65 Del. Laws, c. 355, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, § 8;
(a) If a complaint is filed with the Board pursuant to § 8735 of Title 29, alleging violation of this chapter, the Board shall set a time and place to conduct a hearing on the complaint. Notice of the hearing shall be given and the hearing conducted in accordance with the Administrative Procedures Act, Chapter 101 of Title 29.
(b) All hearings shall be informal without use of the rules of evidence. If the Board finds, by a majority vote of all members, that the complaint has merit, the Board shall take such action permitted under this chapter as it deems necessary. The Board’s decision shall be in writing and shall include its reasons for such decision. A copy of the decision shall be mailed immediately to the complainant, and to the practitioner. The Board’s decision shall become effective on the thirtieth day after the date it is mailed or served on the practitioner.
(c) Where either the complainant or the practitioner is in disagreement with the action of the Board, either person may appeal the Board’s decision to the Superior Court within 30 days of service, or of the postmarked date of the copy of the Board’s decision. Upon such appeal, the Court shall hear the evidence on the record, and any stay of the Board’s decision shall be granted according to the Administrative Procedures Act [Chapter 101 of Title 29].64 Del. Laws, c. 413, § 3; 65 Del. Laws, c. 331, §§ 4-6; 70 Del. Laws, c. 135, §§ 1, 2; 70 Del. Laws, c. 514, § 9;
(a) The Board shall have the authority and the duty to:
(1) Formulate rules and regulations with appropriate notice to those affected where such notice can reasonably be given;
(2) Designate the application form to be used by applicants, and to process all applications;
(3) Grant licenses to, and renew licenses of, all persons who meet the qualifications for licensure;
(4) Designate the national written examination to be taken by all persons applying for licensure, except those applicants who qualify for licensure by reciprocity;
(5) Grant licenses to all persons who meet the qualifications for licensure;
(6) Refer all complaints from practitioners and the public to the Division of Professional Regulation for investigation pursuant to § 8735 of Title 29; and assign a member of the Board to assist the Division in an advisory capacity with the investigation of the technical aspects of the complaint;
(7) Investigate complaints of unauthorized practice of chiropractic;
(8) Determine whether or not a practitioner shall be the subject of a disciplinary hearing, and if so, to conduct such hearing in accordance with this chapter and the Administrative Procedures Act [Chapter 101 of Title 29];
(9) Where it has been determined after a disciplinary hearing that penalties or sanctions should be imposed, to designate and impose the appropriate sanction or penalty after time for appeal has lapsed;
(10) Provide for the rules for continuing chiropractic education; and
(11) Bring proceedings in the courts for the enforcement of this chapter.
(b) The Board may require by subpoena the attendance and testimony of witnesses and production of paper, records or other such evidence.
(c) The members of the Board shall not be subject to, and shall be immune from, claims, suits, liability, damages or any other recourse, civil or criminal, arising from any act or proceeding, decision or determination undertaken or performed, or recommendation made, so long as such member of the Board acted in good faith and without malice in carrying out the responsibilities, authority, duties, powers and privileges of the offices conferred by law upon them under this chapter or any other provisions of the Delaware or federal law or rules or regulations or duly adopted rule or regulation of the Board. Good faith is presumed unless otherwise proven and malice is required to be proven by the complainant.
(d) No member of the Board shall in any manner whatsoever discriminate against any applicant or person holding or applying for a license to practice chiropractic by reason of sex, race, color, creed or national origin.
(e) No member shall participate in any action of the Board involving directly or indirectly any person related in any way by blood or marriage to said member.
(f) The Board of Chiropractic shall promulgate regulations specifically identifying those crimes, which are substantially related to the practice of chiropractic.41 Del. Laws, c. 261, § 7; 24 Del. C. 1953, § 706; 64 Del. Laws, c. 413, § 3; 70 Del. Laws, c. 514, §§ 10-14; 72 Del. Laws, c. 125, §§ 1, 2; 74 Del. Laws, c. 262, § 16;
(a) An applicant who is applying for licensure as a doctor of chiropractic under this chapter shall submit evidence, verified by oath and satisfactory to the Board, that such person:
(1) Has received a degree of “Doctor of Chiropractic” from a school or college fully accredited by an accrediting agency recognized by the U.S. Department of Education.
(2) Shall provide proof satisfactory to the Board that the applicant has successfully passed Parts I, II, III, IV and the physiotherapy section of the National Board of Chiropractic Examiners’ examination.
(3) Has not been the recipient of any administrative penalties regarding the applicant’s practice of chiropractic, including fines, formal reprimands, license suspensions or revocation (except for license revocations for nonpayment of license renewal fees), probationary limitations and has not entered into any “consent agreements” which contain conditions placed by a Board on the applicant’s professional conduct and practice, including any voluntary surrender of a license. The Board may determine, after a hearing, whether such administrative penalty is grounds to deny licensure.
(4) Does not have any impairment related to drugs, alcohol, or a finding of mental incompetence by a physician qualified by specialty or experience to make a professional diagnosis regarding mental capacity, that would limit the applicant’s ability to undertake the practice of chiropractic in a manner consistent with the safety of the public.
(5) Does not have a criminal conviction record, nor pending criminal charge relating to an offense that is substantially related to the practice of chiropractic. If however, after considering the factors set forth under § 8735(x)(3) of Title 29 through a hearing or review of documentation the Board determines that granting a waiver would not create an unreasonable risk to public safety, the Board, by an affirmative vote of a majority of the quorum, shall waive this paragraph (a)(5). Applicants who have criminal conviction records or pending criminal charges shall require appropriate authorities to provide information about the record or charge directly to the Board.
(6) Notwithstanding the time limitation set forth in § 8735(x)(4) of Title 29, has not been convicted of a felony sexual offense.
(7) Has submitted, at the applicant’s expense, fingerprints and other necessary information in order to obtain the following:
a. A report of the applicant’s entire criminal history record from the State Bureau of Identification or a statement from the State Bureau of Identification that the State Central Repository contains no such information relating to that person.
b. A report of the applicant’s entire federal criminal history record pursuant to the Federal Bureau of Investigation appropriation of Title II of Public Law 92-544 (28 U.S.C. § 534). The State Bureau of Identification shall be the intermediary for purposes of this section and the Board of Chiropractic shall be the screening point for the receipt of said federal criminal history records.
c. An applicant may not be licensed to practice chiropractic until the applicant’s criminal history reports have been produced. An applicant whose record shows a prior criminal conviction related to the practice of chiropractic may not be licensed by the Board unless a waiver is granted pursuant to paragraph (a)(5) of this section.
(b) An applicant, who has received a degree of “Doctor of Chiropractic” or its equivalent from a foreign school, college or university, shall submit a certified copy of the applicant’s school, college or university record for evaluation by the Board.
(c) Where the Board has found to its satisfaction that an applicant has been intentionally fraudulent, or that false information has been intentionally supplied, it shall report its findings to the Attorney General for further action.
(d) Where the application of a person has been refused or rejected and such applicant feels that the Board has acted without justification; has imposed higher or different standards for the applicant than for other applicants or licensees; or has in some other manner contributed to or caused the failure of such application, the applicant may appeal to the Superior Court.
(e) All individuals licensed to practice chiropractic in this State shall be required to be fingerprinted by the State Bureau of Identification, at the licensee’s expense, for the purposes of performing subsequent criminal background checks. Licensees shall submit by January 1, 2016, at the applicant’s expense, fingerprints and other necessary information in order to obtain a criminal background check.41 Del. Laws, c. 261, § 3; 24 Del. C. 1953, § 707; 50 Del. Laws, c. 325, § 2; 53 Del. Laws, c. 147, § 1; 64 Del. Laws, c. 413, § 3; 65 Del. Laws, c. 331, § 7; 69 Del. Laws, c. 398, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, §§ 15-17; 72 Del. Laws, c. 125, § 3; 74 Del. Laws, c. 262, §§ 17, 18; 75 Del. Laws, c. 436, §§ 5, 6; 77 Del. Laws, c. 199, §§ 5, 6; 78 Del. Laws, c. 44, §§ 9, 10; 79 Del. Laws, c. 277, § 2; 83 Del. Laws, c. 433, § 7; 83 Del. Laws, c. 526, § 2; 84 Del. Laws, c. 233, § 50;
The amount to be charged for each fee imposed under this chapter shall approximate and reasonably reflect all costs necessary to defray the expenses of the Board, as well as the proportional expenses incurred by the Division of Professional Regulation in its services on behalf of the Board. There shall be a separate fee charged for each service or activity, but no fee shall be charged for an activity not specified in this chapter. The application fee shall not be combined with any other fee or charge, except as specifically set forth herein. At the beginning of each calendar year the Division of Professional Regulation, or any other state agency acting in its behalf, shall compute, for each separate service or activity, the appropriate fee for the coming year.41 Del. Laws, c. 261, § 4; 24 Del. C. 1953, § 709; 53 Del. Laws, c. 108, § 7; 64 Del. Laws, c. 413, § 3; 65 Del. Laws, c. 331, § 10; 65 Del. Laws, c. 355, § 1; 70 Del. Laws, c. 514, § 21; 72 Del. Laws, c. 125, § 6;
(a) Each person, who has been admitted to practice in this State by reciprocity, or who has otherwise qualified for a license shall, prior to practicing in this State, file for and obtain an occupational license from the Division of Revenue in accordance with Chapter 23 of Title 30. The Board shall forthwith issue a license to each person who has qualified for same under this chapter and who has complied with all rules and regulations of the Board.
(b) Upon payment of the renewal fee and upon submission of proof of satisfactory completion of continuing education requirements, each license shall be renewed biennially in such manner as is determined by the Division of Professional Regulation. The Board shall, in its rules and regulations, determine the period of time within which a practitioner may still renew the license; provided, however, that such period shall not exceed 1 year. At the expiration of the period designated by the Board, the license shall be deemed to be lapsed and not renewable, unless the former licensee reapplies under the same conditions which govern reciprocity; provided, however, that the former licensee shall also pay a reinstatement fee in an amount which is determined by the Division of Professional Regulation.
(c) Any licensee may, upon the licensee’s written request, be placed in an inactive status not to exceed 5 years. The renewal fee of such person shall be prorated in accordance with the amount of time such person was inactive. Such person may reenter practice upon notification to the Board of that person’s intent to do so, provided said person has satisfied all continuing education requirements prescribed by the Board.
(d) A former licensee who has been penalized for the violation of a provision of this chapter, or whose license has been suspended or revoked, and who subsequently is permitted to apply for reinstatement shall apply for a new license, successfully complete the examination required by the Board, and shall pay all appropriate fees before the former licensee may be relicensed.41 Del. Laws, c. 261, § 4; 24 Del. C. 1953, § 710; 53 Del. Laws, c. 108, § 8; 64 Del. Laws, c. 413, § 3; 65 Del. Laws, c. 331, §§ 11, 12; 65 Del. Laws, c. 355, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, §§ 22-25; 72 Del. Laws, c. 125, §§ 4, 6;
(a) Upon payment of the appropriate fee and submission and acceptance of a written application on forms provided by the Board, the Board shall grant a license to each applicant, who shall present proof of current licensure in good standing in another state, the District of Columbia or territory of the United States, whose standards for licensure are substantially similar to those of this State.
(b) An applicant, who is currently licensed in another state, the District of Columbia or territory of the United States, whose standards for licensure are not substantially similar to those of this State, shall present proof of current licensure in good standing in another state, the District of Columbia or territory of the United States, and in addition the applicant shall meet 1 of the following criteria:
(1) Shall have graduated from an accredited or Board-approved school of chiropractic after July 1, 1997, and shall provide documentation of successful completion of Parts I, II, II, IV and the physiotherapy section of the National Board of Chiropractic Examiners’ examination;
(2) Shall have graduated from an accredited or Board-approved school of chiropractic, prior to July 1, 1997, but after January 31, 1991, and shall provide documentation of successful completion of Parts I, II, III of the National Board of Chiropractic Examiners’ examination; or
(3) Shall have graduated from an accredited or Board-approved school of chiropractic, prior to January 31, 1991, and shall provide documentation of successful completion of Parts, I, II, III of the National Board of Chiropractic Examiners’ examination; or Parts I and II of the National Board of Chiropractic Examiners’ examination and the Special Purpose Examination for Chiropractic (SPEC) approved by the National Board of Chiropractic Examiners.
(c) Notwithstanding the provisions of paragraph (b)(1), (2), or (3) of this section, if the applicant has successfully passed those examinations that were available at the time of the applicant’s graduation from a board-approved school of chiropractic and application for original licensure, the Board shall accept proof of successful completion of those examinations in lieu of the provisions of paragraph (b)(1), (2), or (3) of this section. If no examinations were available at the time of the applicant’s graduation from a board-approved school of chiropractic, the Board shall accept proof of active practice in another jurisdiction for the past 5 years in lieu of the provisions of paragraph (b)(1), (2), or (3) of this section.
(d) For all applicants licensure in good standing is defined in § 707(a)(3), (4), and (5) of this title. The applicant is responsible for providing proof of licensure in good standing in all states in which that applicant is or has been licensed.41 Del. Laws, c. 261, § 5; 24 Del. C. 1953, § 711; 53 Del. Laws, c. 108, § 9; 64 Del. Laws, c. 413, § 3; 65 Del. Laws, c. 331, § 13; 67 Del. Laws, c. 24, § 8; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, § 26; 72 Del. Laws, c. 125, §§ 5, 6; 75 Del. Laws, c. 436, § 7; 79 Del. Laws, c. 169, § 3;
(a) Practitioners regulated under this chapter shall be subject to those disciplinary actions set forth in this section if, after a hearing, the Board finds the practitioner guilty of unprofessional conduct as defined in subsection (b) of this section.
(b) Unprofessional conduct is hereby defined as any of the following acts:
(1) Use of any false, fraudulent or forged statement or document or use of any fraudulent, deceitful, dishonest or unethical practice in connection with any licensing requirements of this chapter;
(2) Conviction of a crime that is substantially related to the practice of chiropractic;
(3) Any dishonorable or unethical conduct likely to deceive, defraud or harm the public;
(4) The wilful violation of the confidential relations and communications of a patient;
(5) The practitioner has employed or knowingly cooperated in fraud or materiel deception in order to be licensed, or be otherwise authorized to practice chiropractic;
(6) Has excessively used or abused drugs (including alcohol, narcotics or chemicals);
(7) Practice of chiropractic under a false or assumed name;
(8) Use, distribution or prescription for use of dangerous or narcotic drugs;
(9) Solicitation or acceptance of a fee from a patient or other person by fraudulent representation that a manifestly incurable condition can be permanently cured;
(10) Knowing or intentional performance of any act which, unless authorized by the Board of Chiropractic, assists an unlicensed and unauthorized person to practice chiropractic;
(11) The failure to provide adequate supervision to a person working under the practitioner’s direction;
(12) Misconduct, incompetence or gross negligence in the practice of chiropractic;
(13) Wilful failure to divulge to the Board or any committee or representative thereof, upon its request, information relevant to authorization or competence to practice chiropractic;
(14) The violation of this chapter or the violation of an order or regulation of the Board;
(15) Charging a grossly exorbitant fee for professional services rendered;
(16) Suspension, revocation or refusal to grant a license to practice chiropractic or other disciplinary action taken by the appropriate licensing authority in another state or territory; provided, however, that the underlying grounds for such action in another state or territory have been presented to the Board by either certified record or live testimony and the Board has determined that the facts found by the appropriate authority in the other state constitute unprofessional conduct as that term is defined in paragraphs (b)(1) through (15) of this section;
(17) Engaging directly or indirectly in the division, transferring, signing, rebating or refunding of fees received for professional services or profiting by means of a credit or other valuable consideration such as wages, an unearned commission, discount or gratuity with any person who referred a patient, or with any relative or business associate of the referring person. Nothing in this paragraph shall be construed as prohibiting the members of any regularly or properly organized entity recognized under Delaware law and comprised solely of chiropractors from making any division of their total fees among themselves as they determine by contract necessary to defray their joint operating costs. This paragraph shall not apply to chiropractic positions held by chiropractors employed by or contracted with a Delaware licensed medical doctor or doctor of osteopathy that works in the State a minimum of 10 hours per week. It will also not apply to any Delaware-licensed hospitals. The estate of a licensed chiropractor shall have 1 year to divest of the chiropractic business.
(c) Where a practitioner fails to comply with the Board’s request that the practitioner attend a hearing, the Board may petition the Superior Court to order such attendance, and the said Court or any judge assigned thereto shall have the jurisdiction to issue such order.
(d) Subject to subchapter IV of Chapter 101 of Title 29, no license shall be restricted, suspended or revoked by the Board; and no practitioner’s right to practice shall be limited by the Board, until such practitioner has been given notice, and an opportunity to be heard in accordance with the Administrative Procedures Act [Chapter 101 of Title 29].
(e) The Board may impose any of the following sanctions, partially, singly or in combination, when it finds that 1 of the conditions or violations set forth in subsection (b) of this section applies to a practitioner regulated under this chapter:
(1) Restrict the license of a practitioner;
(2) Publicly censure a practitioner;
(3) Issue a public letter of reprimand;
(4) Place a practitioner on probationary status, and require the practitioner to:
a. Report regularly to the Board upon the matters which are the basis for the probation;
b. Limit all practice and professional activities to those areas prescribed by the Board; and/or
c. Continue or renew the practitioner’s professional education until the required degree of skill has been attained in those areas which are the basis of the probation;
(5) Suspend any practitioner’s license;
(6) Revoke a practitioner’s license; or
(7) The Board shall permanently revoke the license to practice chiropractic of a person who is convicted of a felony sexual offense.
(f) The Board may withdraw or reduce conditions of probation when it finds that the deficiencies which required such action have been remedied.
(g) Where the Board has placed a practitioner on probationary status under certain restrictions or conditions, and the Board has determined that such restrictions or conditions are being or have been violated by the practitioner it may, after a hearing on the matter, suspend or revoke the practitioner’s license.
(h) In the event of a formal or informal complaint concerning the activity of a licensee that presents a clear and immediate danger to the public health, safety or welfare, the Board may temporarily suspend the person’s license, pending a hearing, upon the written order of the Secretary of State or the Secretary’s designee, with the concurrence of the Board chair or the Board chair’s designee. An order temporarily suspending a license may not be issued unless the person or the person’s attorney received at least 24 hours’ written or oral notice before the temporary suspension so that the person or the person’s attorney may file a written response to the proposed suspension. The decision as to whether to issue the temporary order of suspension will be decided on the written submissions. An order of temporary suspension pending a hearing may remain in effect for no longer than 60 days from the date of the issuance of the order unless the temporarily suspended person requests a continuance of the hearing date. If the temporarily suspended person requests a continuance, the order of temporary suspension remains in effect until the hearing is convened and a decision is rendered by the Board. A person whose license has been temporarily suspended pursuant to this section may request an expedited hearing. The Board shall schedule the hearing on an expedited basis, provided that the Board receives the request within 5 calendar days from the date on which the person received notification of the decision to temporarily suspend the person’s license.
(i) As a condition to reinstatement of a suspended license, or removal from probationary status, the Board may impose such disciplinary or corrective measures as are authorized under this chapter.41 Del. Laws, c. 261, § 7A; 42 Del. Laws, c. 199, § 2; 24 Del. C. 1953, § 712; 50 Del. Laws, c. 325, § 3; 64 Del. Laws, c. 413, § 3; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, §§ 27-34; 72 Del. Laws, c. 125, § 6; 74 Del. Laws, c. 262, § 19; 79 Del. Laws, c. 98, § 1; 79 Del. Laws, c. 213, § 2; 79 Del. Laws, c. 277, § 2; 83 Del. Laws, c. 433, § 7;
(a) Except as provided under subsection (b) of this section, no person may practice chiropractic in this State who has not been licensed in accordance with this chapter.
(b) Under rules and regulations adopted by the Board under this section and § 717 of this title, an individual licensed to practice chiropractic in any other state, district, or foreign country may consult with a chiropractor of this State licensed under this chapter. Consultations under this subsection are limited to examination, recommendation, or testimony in litigation.41 Del. Laws, c. 261, § 6; 42 Del. Laws, c. 199, § 1; 24 Del. C. 1953, § 713; 64 Del. Laws, c. 413, § 3; 70 Del. Laws, c. 514, §§ 35, 36; 72 Del. Laws, c. 125, § 6; 83 Del. Laws, c. 526, § 3;
(a) No person shall represent himself or herself to the public as a doctor of chiropractic, or display any sign or advertise in any manner as being a doctor of chiropractic or chiropractic physician without first obtaining from the Board the license or licenses required under this chapter.
(b) Where the Board has determined that person is practicing chiropractic within this State without having lawfully obtained a license therefor, or that a person previously licensed is unlawful practicing although the person’s license has been suspended or revoked, the Board shall formally warn such person in writing. If the offense continues, the Board shall make a formal complaint to the Attorney General. The complaint shall include all evidence known to, or in the possession of, the Board.
(c) Where a person not currently licensed as a chiropractic is tried and convicted of unlawfully practicing chiropractic in violation of this chapter such offender shall, upon the first offense, be fined $500 or imprisoned not less than 1 month nor more than 1 year, or both, and upon a second or any subsequent offense, shall be fined not less than $1,000 and imprisoned not less than 6 months nor more than 1 year, or both, and shall pay all cost; provided, however, that where it is alleged that such violation has resulted in injury to any person, the offender shall be charged and tried under the applicable provisions of Title 11.
(d) The Superior Court shall have jurisdiction of violations of this chapter.41 Del. Laws, c. 261, § 9A; 42 Del. Laws, c. 199, § 3; 24 Del. C. 1953, § 714; 64 Del. Laws, c. 413, § 3; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, §§ 37, 38; 72 Del. Laws, c. 125, § 6;
Chiropractic practitioners shall observe and be subject to all state and municipal regulations relating to the control of contagious and infectious diseases and any and all matters pertaining to public health, reporting to the proper health officer the same as other practitioners.41 Del. Laws, c. 261, § 9; 24 Del. C. 1953, § 715; 72 Del. Laws, c. 125, § 6;
Whoever files or attempts to file as that person’s own the diploma, certificate or license of another or a forged, false affidavit of identification or qualification is guilty of a felony and shall be fined not less than $500 nor more than $2,000 and imprisoned not more than 5 years.41 Del. Laws, c. 261, § 7A; 42 Del. Laws, c. 199, § 2; 24 Del. C. 1953, § 712; 50 Del. Laws, c. 325, § 3; 64 Del. Laws, c. 413, § 3; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, § 39; 72 Del. Laws, c. 125, § 6;
(a) (1) For purposes of disability insurance, standard health and accident, sickness, and all other such insurance plans, whether or not they are considered insurance policies, and contracts issued by health service corporations and health maintenance organizations, if the chiropractor is authorized by law to perform a particular service, all of the following apply:
a. The chiropractor is entitled to compensation for that chiropractor’s services under the plan or contract.
b. The plan or contract may not have annual or lifetime numerical limits on chiropractic visits for the treatment of back pain.
c. 1. The plan or contract may not deny coverage for chiropractic supportive care on the basis that the chiropractic supportive care constitutes maintenance therapy.
2. Paragraph (a)(1)c.1. of this section applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2023.
(2) This subsection applies to a plan of health insurance or health benefits delivered or issued under any of the following:
a. Title 18.
b. Chapter 52 of Title 29.
c. Section 505(3) of Title 31.
(3) This subsection may not be waived by contract. A contractual arrangement in conflict with this subsection or that purports to waive any requirements of this subsection is void.
(b) Nothing in this section prevents the operation of reasonable and nondiscriminatory cost containment or managed care provisions, including deductibles, coinsurance, allowable charge limitations, coordination of benefits and utilization review. Any copayment or coinsurance amount must be equal to or less than 25% of the fee due or to be paid to the chiropractor under the policy, contract, or certificate for the treatment, therapy, or service provided.
(c) The Insurance Commissioner shall adopt regulations necessary for the administration, effectuation, investigation, and enforcement of this section, including the establishment of appropriate utilization review standards.
(d) (1) For purposes of this subsection:
a. 1. “Carrier” means any entity that provides health insurance in this State.
2. “Carrier” includes an insurance company, health service corporation, health maintenance organization, and any other entity providing a plan of health insurance or health benefits subject to state insurance regulation under Title 18.
3. “Carrier” also includes any third-party administrator, as defined under § 102 of Title 18, or other entity that adjusts, administers, or settles claims in connection with health benefit plans.
4. “Carrier” does not mean a plan of health insurance or health benefits designed for issuance to persons eligible for coverage under Titles XVIII, XIX, and XXI of the Social Security Act (42 U.S.C. §§ 1395 et seq., 1396 et seq. and 1397aa et seq.), known as Medicare, Medicaid, or any other similar coverage under state or federal governmental plans.
b. “Medicare” means the federal Medicare Program (U.S. Public Law 89-97, as amended) (42 U.S.C. § 1395 et seq.).
(2) A carrier shall reimburse services provided by a chiropractor at a reimbursement rate that is not less than the Medicare reimbursement rate for comparable services.
(3) If a comparable Medicare reimbursement rate is not available, a carrier shall reimburse for services provided by a chiropractor at the rates generally available under Medicare for services such as office visits or prolonged preventive services.
(4) The Medicare reimbursement rate provisions under paragraphs (d)(2) and (d)(3) of this section do not apply to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, disability income, or other limited benefit health insurance policies.
(5) This subsection may not be waived by contract. A contractual arrangement in conflict with this subsection or that purports to waive any requirements of this subsection is void.
(6) This subsection applies to an individual or group health insurance policy, plan, or contract that is delivered, issued for delivery, or renewed by a carrier on or after January 1, 2022.24 Del. C. 1953, § 717; 54 Del. Laws, c. 147, § 2; 69 Del. Laws, c. 168, § 1; 69 Del. Laws, c. 393, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 514, § 40; 72 Del. Laws, c. 125, § 6; 77 Del. Laws, c. 462, § 3; 78 Del. Laws, c. 165, § 1; 81 Del. Laws, c. 430, § 2; 83 Del. Laws, c. 136, § 1; 83 Del. Laws, c. 526, § 4;
(a) Any chiropractor who is duly licensed as a chiropractic practitioner under this chapter shall be deemed competent to offer opinions in the courts, administrative agencies and other tribunals of this State as to matters of causation, within the scope of chiropractic practice, provided the testimony is offered to a reasonable degree of chiropractic certainty and there is otherwise an adequate foundation for the admission of this testimony.
(b) Any chiropractor duly licensed under this chapter shall also be deemed competent to offer opinions in the courts, administrative agencies and other tribunals of this State as to matters of permanent impairment or disability, provided the testimony is within the scope of chiropractic practice, is offered to a reasonable degree of chiropractic certainty and there is otherwise an adequate foundation of the admission of this testimony.
(c) No Doctor of Chiropractic shall be permitted to offer chiropractic opinions for the purpose of determining eligibility for health insurance policy benefits relating to chiropractic care in the State unless the Doctor of Chiropractic is duly licensed and actively practicing in the State. For purposes of this subsection, a Doctor of Chiropractic shall be considered “actively practicing” if that Doctor of Chiropractic maintains an office in the State for treatment of patients and is engaged in the practice of chiropractic in the State more than an average of 10 hours per week. For purposes of this section “insurance policy” shall include without limitation all health plans and policies for the payment for, provision of or reimbursement for chiropractic or medical services, supplies or both issued by health insurers, health service corporations or managed care organizations.74 Del. Laws, c. 5, § 1; 70 Del. Laws, c. 186, § 1; 75 Del. Laws, c. 380, § 1;
Should any section or provision of this chapter be decided by the court to be unconstitutional or invalid, such decision shall not affect the validity of this chapter as a whole or any other part thereof.75 Del. Laws, c. 380, § 2;
(a) A parent, guardian or other caretaker, or an adult staff member, shall be present when a person licensed under this chapter provides outpatient treatment to a minor patient who is disrobed or partially disrobed or during an outpatient physical examination involving the breasts, genitalia or rectum, regardless of sex of the licensed person and patient, except when rendering care during an emergency. When using an adult staff member to observe the treatment or examination, the adult staff member shall be of the same gender as the patient when practicable. The minor patient may decline the presence of a third person only with consent of a parent, guardian or other caretaker. The minor patient may request private consultation with the licensee without the presence of a third person after the physical examination.
(b) When a minor patient is to be disrobed, partially disrobed or will undergo a physical examination involving the breasts, genitalia or rectum, a person licensed under this chapter shall provide notice to the person providing consent to treatment of the rights under this section. The notice shall be provided in written form or be conspicuously posted in a manner in which minor patients and their parent, guardian or other caretaker are made aware of the notice. In circumstances in which the posting or the provision of the written notice would not convey the right to have a chaperone present, the person licensed shall use another means to ensure that the person understands the right under this section.
(c) For the purposes of this section, “minor” is defined as a person 15 years of age or younger, and “adult staff member” is defined as a person 18 years of age or older who is acting under the direction of the licensed person or the employer of the licensed person or who is otherwise licensed under this chapter.
(d) The person licensed under this chapter that provides outpatient treatment to a minor pursuant to this section shall, contemporaneously with such treatment, note in the child’s medical record the name of each person present when such treatment is being provided.79 Del. Laws, c. 169, § 2;