A professional license investigation by the California Board of Chiropractic Examiners (BCE) is an administrative action commenced to determine whether a chiropractor has engaged in professional misconduct or violated the Chiropractic Initiative Act (CIA) or another California law. This process is a key enforcement process that allows the state to assess complaints and administer disciplinary actions from public censure to license suspension. Proven violations can lead to disciplinary action by the BCE, including a public reprimand, suspension, or even revocation of your chiropractic license.
To protect your chiropractic license, you should hire an experienced license defense attorney for the hearing process before the administrative body. Our office, the Kern County License Attorney, is one of the premier chiropractor license defense attorneys practicing in Kern County, California. We understand the Department of Consumer Affairs’ aggressive investigative strategies and the devastating implications of formal accusations. Please contact us to schedule your initial consultation and build a robust framework for your chiropractic license defense.
Handling California Board of Chiropractic Examiners (BCE) Investigations
The disciplinary process usually starts with a preliminary investigation by the board’s enforcement division. The Department of Consumer Affairs typically employs these investigators, and they are well-trained in the collection of evidence against health care providers.
You may be contacted by phone or letter asking to meet with them to discuss a recent patient complaint or billing issue. You must not speak to these investigators without your lawyer present. Anything you say at an informal interview can be used to build a case against you. The investigators may seem friendly, but ultimately, they aim to prove the allegations made by the complainant.
Your license defense lawyer should immediately take over all dealings with the board so that you avoid self-incrimination. Your attorney closely examines the scope of the BCE investigation process to ensure that the state does not breach your procedural rights during the investigation stage.
Responding to a Formal Accusation and the Notice of Defense
If the board deems that a complaint has sufficient merit, it will refer the matter to the Attorney General’s Office. The Deputy Attorney General will then prepare a formal accusation, which is a public document that specifies the legal charges against your license.
Once served with this document, the statutory time clock starts. You have a strict 15 days to respond with a Notice of Defense. If you miss this deadline, you will usually be entered with a default judgment, which will automatically result in the suspension of your chiropractic license. This notice ensures your unconditional right to an administrative hearing to answer the charges.
Your attorney should handle all the details of responding to the AG office’s chiropractic accusations, ensuring that your response is timely and properly filed. This step is essential because it is the point at which the private matter becomes a public fight for your livelihood.
Allegations that Lead to BCE Disciplinary Proceedings
The California BCE draws its powers from the Chiropractic Initiative Act of 1922 and the Business and Professions Code. These laws establish rules that you must observe to practice. The board monitors several general areas of conduct, and any perceived departure can result in serious penalties. These allegations are:
Gross Negligence and Standard of Care Violations
Charges of incompetence or gross negligence can damage your chiropractic reputation.
Gross negligence, according to the board, is a gross departure from the standard of care that a competent chiropractor would offer in the same situation. These can include allegations of the following:
- Inappropriate spinal manipulation that caused injury to the patient
- Failing to complete a required physical examination before starting treatment
- Failure to refer a patient for medical care when the patient’s condition is beyond a chiropractor’s scope of practice
Incompetence is a general lack of knowledge or skill in performing medical work.
When responding to these claims, use independent chiropractors to substantiate your treatment approach. Your lawyer can also thoroughly examine records to show you provided care that complied with professional standards, thereby countering the state’s allegation of clinical malpractice or technical incompetence.
Billing Insurance Fraud And Misrepresentation
The BCE is particularly concerned with financial integrity. In a chiropractic insurance fraud license defense case, the charges may involve allegations of the following:
- Billing for services not actually provided
- Upcoding services to receive higher reimbursements
- Treating patients with services that are not necessary
- kickback schemes involving referral fees
- False representation. For example, lying on your license renewal form or misleading a patient about the benefits of a treatment.
These matters may involve extensive reviews of your accounts and patient files. Therefore, your lawyer should provide a thorough defense by pointing out clerical oversights that could be interpreted as fraudulent practices. By highlighting that any billing errors were a result of administrative oversights, rather than an attempt to trick insurance companies, your lawyer defends your practice against the harsh consequences of fraudulent practices.
Boundary Violations and Criminal Convictions
The licensing board has a strict stance on sexual contact and relationships with patients. Sexual misconduct is one of the quickest ways to get your license revoked. Business and Professions Code sections 726 and 729 consider a sexual touching of a patient to be unprofessional and grounds for immediate revocation.
Even outside the clinic, your behavior is subject to scrutiny. If you are convicted of a crime, the board will determine if it is substantially relevant to your chiropractic practice. Many chiropractors face a DUI chiropractic license investigation in California. The board considers alcohol convictions to be evidence of poor judgment or substance abuse.
Pursuant to Title 16 of the California Code of Regulations, Section 321, the board uses specific criteria to determine whether a criminal conviction is substantially related to a chiropractor’s qualifications, functions, or duties. This assessment examines whether the offense demonstrates a present or potential unfitness to practice in a manner consistent with public health, safety, or welfare.
For example, a driving under the influence conviction is heavily scrutinized to determine if there is an ongoing pattern of chemical dependency. If facing a DUI charge, seek a lawyer’s help to mount a strong defense by showing the board evidence of rehabilitation and that one mistake away from the office does not reflect on your professional competency. Your personal choices should not become a barrier to your professional future.
The Disciplinary Process from Investigation to OAH Hearing
If your case is not dismissed early, it will move on to an administrative hearing. This hearing is held at the Office of Administrative Hearings (OAH) by an Administrative Law Judge. There will be no jury, and the judge will decide the case and issue a proposed verdict. Crucially, the burden of proof rests entirely on the BCE, and the standard of proof required to suspend or revoke a professional license is clear and convincing evidence to a reasonable certainty.
This is a significantly higher legal standard than the preponderance-of-the-evidence standard used in most civil lawsuits. The state’s representative must present highly credible, unambiguous evidence showing that the alleged violations are highly probable, rather than merely more likely true than not. The board will be represented by a Deputy Attorney General who will examine witnesses and introduce exhibits to establish that you are guilty of a violation.
You can cross-examine their witness, call your own witnesses, and produce exhibits. This OAH hearing chiropractor trial is a highly technical legal proceeding. Due to the complexity of the hearings, let your lawyer handle all stages of the case, including discovery, witness preparation, and the final submissions to the judge. Your lawyer can vigorously negotiate a stipulated settlement if it is in your best interest, so you can retain your license on probation rather than risk a trial.
Offering Mitigating Factors at Hearings
Even if the board establishes that you committed an error, you still have the right to offer evidence that may reduce your penalty. These are called mitigating factors, and they help to save your license. The court considers a number of factors, including the following:
- The amount of time you have been in practice without discipline
- Your cooperation with the board investigation
- The measures you have taken to avoid future mistakes
To evaluate rehabilitation, the board relies on California Code of Regulations Title 16, Section 321.1, which outlines specific rehabilitation criteria. The board considers the nature and severity of the acts, the total time elapsed since the misconduct, compliance with any court-ordered sanctions, and evidence of expungements under Penal Code Section 1203.4.
Work with your lawyer to gather rehabilitation evidence, such as character references, evidence of ongoing education, and community service. When substance abuse is involved, your lawyer can offer evidence of successful treatment and recovery. In this way, you can demonstrate to the judge and to the board that you remain a safe and competent practitioner. This approach is critical to getting the board to impose a disciplinary penalty that enables you to practice reasonably.
BCE Disciplinary Categories and Potential Penalties
The BCE follows disciplinary categories to help guide its decisions. These categories and penalties are based on the seriousness of the offense and provide a range of penalties that may apply. Category One offenses are the least serious, and Category Four offenses almost always lead to license revocation. These guidelines are followed by the board, but are not mandatory.
Citations, Fines, and Public Reprimands
The board can issue a citation and fine for administrative violations. This is sometimes touted as a “lesser” discipline, but it remains on your public record and can be viewed by prospective patients and employers. A chiropractor’s public reprimand is a public warning letter from the board outlining your infraction. While this sanction does not limit your practice, it may harm your reputation and your ability to get referrals.
Probation and Temporary Suspensions
If the board believes your misconduct is serious enough to warrant discipline but thinks you can continue to practice safely, they may put you on probation. This can include a stayed revocation, where the board revokes your license, but suspends the revocation so long as you comply with certain conditions. These may include drug testing, supervision, and regular check-ins with a probation officer. Probation may last for years, and compliance is ongoing.
Typical probation conditions for California chiropractors include:
- Submitting detailed quarterly practice reports
- Permitting random physical office inspections by designated board monitors
- Completing board-approved billing or ethics courses
- Paying the board’s investigative costs
If the underlying offense involved alcohol or substance abuse, the board will also mandate biological fluid testing, medical evaluations, and mandatory enrollment in a formal substance abuse recovery monitoring program. More immediate is a BCE filing for an interim suspension. This is an interim suspension order to prevent you from practicing while the case is ongoing. This is usually reserved for cases where the board feels you are a serious and present threat.
License Revocation and Appeals
The most serious penalty the board can issue is a revoked chiropractic license in California. In this case, you are no longer able to practice chiropractic care in the state. If the board renders a final decision that you believe is not fair or legal, you can appeal. This involves filing a Writ of Mandamus in the Superior Court, requesting a judge to review the record for errors.
Get a Chiropractic License Defense Attorney Near Me
To safeguard your chiropractic license, it is critical to take swift action if you are being investigated by the state or accused of wrongdoing. The Board of Chiropractic Examiners (BCE) places the safety of the public at the forefront, and if you do not put up an aggressive fight, you may lose your license.
Effective legal representation will help you challenge unwarranted claims, secure the most lenient probationary conditions, and protect your reputation in the Kern County health community. Time is of the essence in these administrative hearings, and delays can result in a waiver of your right to a hearing.
Kern County License Attorney provides free consultations and has a wealth of experience in all facets of criminal law and license defense. Our office is committed to standing up for clients facing allegations to ensure your constitutional rights are protected throughout the proceedings. Give us a call at 661- 558-1950 to book a consultation and ensure you receive the best possible representation.
