Ethics Wk 5-7

t/f: doctors of chiropractic are free to choose their patients

true

Statutes = _____

laws

Rules = ______

regulations

Ethics = ____ standards

professional

Autonomy means:

-self naming

-the right to make one's own decisions

-the naming of automobiles

-your name is your destiny

the right to make one's own decisions

t/f: a chiropractor may terminate a doctor-patient relationship immediately if the patient becomes difficult

false

A DC who chooses to withdraw from a case:

a. May do so, so long as the DC has made arrangements for continuity of care

b. May do so at any time, for any reason

c. May not do so until all the visits in the treatment plan are complete

d. May do so, provided verbal notice is given

a. May do so, so long as the DC has made arrangements for continuity of care

t/f: injury to a patient must occur for disciplinary action for unprofessional conduct

false

injury to a patient does not need to occur, can include failure to meet minimum standards, willful disregard for patient safety

Common board actions that can happen if there is unprofessional conduct

revocation of license

suspension

conditions (supervision, courses)

limitations (scope restriction)

civil penalties (fines)

public record (permanent)

Discharge checklist that a DC must go through when terminating care

1. Does patient need continued care

2. offer appropriate referrals

3. provide written notice with timeframe

4. arrange transfer of records (if requested)

5. document discharge (reasons and steps)

6. notify other providers

7. maintain tone of professionalism and respect

_____ competent care improves outcomes- the DC should consider religious beliefs, cultural health practices, language

culturally

Ethics or Law?

internal, aspirational; developed by the profession; protects the profession; breaking = professional reputation risk and potential disciplinary consequences

ethics

(ethics protects the profession)

Ethics or Law?

external, enforceable, written into statutes, focused on protection of the public, breaking = legal consequences

law

(law protects the patients/people)

Informed consent is based on _____ autonomy, not provider authority

patient

Informed consent is a _____, not a form. It must involve disclosure of:

-risks, benefits, alternatives, potential consequences of refusal

process

Negligent non-disclosure is a _____ issue

malpractice

Is this fee splitting?

A DC pays a personal injury attorney $200 for each client sent to their clinic

Yes

payment is for referral, not for services

Is this fee splitting?

A clinic offers gym staff $20 per new patient referral

Yes

kickbacks for referrals violate ethical rules

Is this acceptable ethically?

Marketing collaboration with sharped ad costs (but not based on per-referral volume)

Yes

as long as no referral-based payments

Is this unethical?

a chiropractor posts a tiktok of a patient getting adjusted with their verbal consent, but without a written release

yes it is unethical even with verbal consent, it is not enough under HIPAA

written authorization is required

posting adjustments risks violating dignity and professionalism standards

Are pre-pay plans legal in MN?

yes, but they are highly regulated

Requirements of a pre-pay plan in MN?

-clear written agreement

-no more than 50 visits per contract

-must detail refund/reimbursement policies

-escrow account

-quarterly account reconciliation

Is this unethical?

a doctor dates a former patient two weeks after discharge

it depends; in MN theres a mandatory 2 year no-contact period before starting a romantic or sexual relationship with a former patient

Which of the following is NOT a requirement for a complaint chiropractic pre-pay plan in MN?

a. 50 visit cap per plan

b. written refund policy

c. right to rescind within 3 days

d. flat monthly billing without service tracking

d. flat monthly billing without service tracking

Can you market personal injury services via mailers?

Yes, if clearly labeled as advertising

What are the 3 conditions of pre-pay plan legality?

escrow account

reimbursement terms

50 visit limit

What must a pre-pay contract include?

services, costs, refund/mod policy, 3 day rescission, zero-balance notice

If doing a prepay plan, there should be an ____ account set up that bears interest and holds the prepaid funds. This account allows money to be drawn as services are actually provided.

escrow

How often should a pre-paid plan be audited for balances, service delivery and escrow account reconciliation?

quarterly audits should take place

What type of refund policy should be included with prepaid plans?

clear, pro-rata refund policy (patient's get back money that was not used)

What type of cancellation policy should be held in place with a prepaid plan?

3 day right of rescission

patients may cancel within 3 business days for a full refund

(this right cannot be waived)

Which entity primarily advances the profession rather than regulates it?

Legislature

State association

Board

Appellate court

State association

A chiropractor follows a rule created by a licensing board. This is:

Administrative regulation

Ethical guidance

Common law

Statute

administrative regulation

A court decision interpreting chiropractic scope is an example of:

Statute

Administrative rule

Ethical guidance

Common law

common law

A law passed restricting chiropractic procedures is:

Common law

Administrative rule

Statute

Ethical guidance

Statute

Statute = Legislature makes the law

Administrative rule = Agency explains/enforces the law

Common law = Courts interpret the law

Ethics = Professional standards (not legally binding by themselves)

A chiropractor ignores a board rule but follows the ACA Code of Ethics. This means they are:

Ethically compliant and legally compliant

Fully compliant

Ethically aligned but potentially in legal violation

Protected from discipline

Ethically aligned but potentially in legal violation

A referral letter can protect you from _____ ______ and establishes medical necessity of the referral; it also serves as legal documentation in audits or complaints

fraud allegations

What is considered fraud in healthcare?

requires intent to deceive

involves false or misleading statements

victim relies on false info

results in financial gain or legal advantage

t/f: not all mistakes = fraud, meaning that the intent behind it matters

true

This is what prosecutors or licensing boards must typically show for elements of fraud:

1. false statement of a material fact was made

2. the person knew it was false

3. there was an intent to deceive

4. victim relied on the false statement

5. victim suffered harm, loss, or gave up a legal right as a result

You accidentally billed the wrong code and immediately corrected it. Is this:

a. fraud

b. negligence

c. administrative error

d. insurance abuse

c. administrative error

Action can be taken for fraud against:

-patients

-third party payers

-state and federal programs (Medicare, Medicaid, Medical Assistance)

t/f: fraud requires intent but poor records make you look guilty

true