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Seven Things To Know When You Receive A Notice Of Investigation From The Department Of Health

Chiropractors Not Allowed to Work for Clinics Owned by Non-Chiropractors in Florida, with Limited Exceptions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Apparently there are many chiropractic physicians and other medical business owners who are unaware of the prohibition provided in Florida law against a chiropractor providing services for a business owned by non-chiropractors.  By non-chiropractor, this means anyone who does not have a current, active Florida chiropractic physician’s license.

The prohibition for chiropractors was passed into law in Florida originally in 2007. The law was amended in 2012. There had previously been similar prohibitions that applied to dentists and optometrists. To read the article I wrote on these issues, click here.

What’s the Purpose of This Law?

Found in Section 460.4167, Florida Statutes, the law states that a person (which includes a corporation or limited liability company), may not engage the services of a chiropractor as either an employee or an independent contractor to provide chiropractic services, except under a limited set of circumstances.  To see the complete text of Section 460.4167, Florida Statutes, click here.

The purpose of the Florida Legislature in passing this law is set forth within the law itself.  Subsection 4 of the law states:

The purpose of this section is to prevent a person other than the licensed chiropractic physician from influencing or otherwise interfering with the exercise of the chiropractic physician’s independent professional judgment.  In addition to the acts specified [elsewhere in the statute], . . . a person or entity other than [the ones excepted] . . . may not employ or engage a chiropractic physician licensed under this chapter.

Exceptions to the Law.

There are, of course, exceptions stated in this law for organizations that are allowed to employ or contract with chiropractors.  These include:

1. Business entities owned solely by chiropractors (licensed in Florida) and their immediate family members.

2. Business entities owned by medical, osteopathic or podiatric physicians licensed in Florida.

3. Business entities owned by hospitals.

4. A clinic that trains chiropractic students that is affiliated with an accredited chiropractic college.

5. A public or private college or university.

6. A business entity that is owned by a corporation that is tax exempt under certain Internal Revenue Service regulations (not-for-profit corporation).

7. A publicly traded corporation.

8. An insurance company licensed in Florida.

9. An HMO or prepaid health clinic (as set forth in chapter 641, Florida Statutes).

10. A clinic licensed as a Health Care Clinic under Florida Statutes, which provides chiropractic services by a licensed Florida chiropractor and also provides other health care services by medical doctors or osteopathic physicians, the medical director of which is licensed under chapter 458 (medical doctors) or chapter 459 (osteopathic physicians), Florida Statutes.

Special Exception for Clinics Licensed Under Florida’s Health Care Clinic Licensure Act.

This last exception, one for clinics licensed under Florida’s Health Care Clinic Licensure Act (Section 400.990, Florida Statutes), that provides perhaps the broadest exception.  A clinic that is properly licensed by the Florida Agency for Health Care Administration (AHCA), and meets the other requirements of the law, can be legally owned by non-chiropractors or non-physicians, and chiropractors may legally contract with or be employed by them.  The safeguard is that the licensing requirements in Section 400.990 must be met, and physician services other than just chiropractic services must be performed at the clinic.

However, even under the exception provided by the Health Care Clinic Act, any agreement or other arrangement with the chiropractic physician whereby the other person (or an entity) provides the chiropractor with chiropractic equipment or chiropractic materials must contain a provision whereby the chiropractic physician expressly maintains complete care, custody and control of the equipment or practice.

To see the complete text of the Florida Health Care Clinic Act, click here.

Violating the Law Jeopardizes Your Professional License.

If the business entity, clinic or group does not fall squarely within one of the exceptions listed above, the chiropractor may not legally be employed by or provide chiropractic services for it.  The penalties for violating this law include:

1. Prosecution for a felony in the third degree.

2. Any contracts associated with the services are void.

3. Disciplinary action against health care licensees pursuant to chapter 456 or chapter 460, Florida Statutes.

4. By implication, since any contracts in violation are void, then any fees or bills for   services in violation of the act are also void.

Don’t jeopardize your professional license, your reputation, your assets or your liberty by risking a violation of this act.  Consult with an experienced health lawyer on any such business venture or proposal.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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(revised 4/10/2013)
This article is for information and educational purposes only and does not constitute legal
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