# COMAR Title 10 — Maryland Department of Health ## Subtitle 43 — Board of Chiropractic Examiners ### Chapter 09 — Monetary Penalties **Authority:** Health Occupations Article, §3-314, Annotated Code of Maryland **Administrative History:** Effective date: **Administrative History:** Chapter and Subtitle renamed and recodified from COMAR 10.43.10 to COMAR 10.43.09, Board of Chiropractic Examiners, Monetary Penalties, effective January 2, 2017 (43:26 Md. R. 1446) **Administrative History:** Regulation .02 amended effective January 2, 2017 (43:26 Md. R. 1446) #### Regulation .01 Scope. *COMAR 10.43.09.01* This chapter establishes standards for the imposition of penalties not exceeding $5,000 against any chiropractor in the State if, after a hearing, the Board finds that there are grounds under Health Occupations Article, §3-313, Annotated Code of Maryland, to suspend or revoke a license. #### Regulation .02 Definitions. *COMAR 10.43.09.02* A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Board” means the State Board of Chiropractic Examiners. (2) “License” means a license issued by the Board to practice chiropractic or to practice chiropractic with the right to practice physical therapy. (3) “Licensee” means a chiropractor who is licensed by the Board to practice chiropractic or to practice chiropractic with the right to practice physical therapy. (4) “Penalty” means monetary penalty. #### Regulation .03 Imposition of a Penalty — General. *COMAR 10.43.09.03* A. Imposition of a Penalty After a Hearing. If, after a hearing under Health Occupations Article, §3-315, Annotated Code of Maryland, the Board finds that there are grounds under Health Occupations Article, §3-313, to suspend or revoke a license, the Board may impose a penalty of not more than $5,000: (1) Instead of, or in addition to, suspending the license; or (2) In addition to revoking the license. B. Imposition of a Penalty Without a Hearing. If, after disciplinary procedures have been brought against a licensee, the licensee waives the right to a hearing required under this subtitle, and if the Board finds that there are grounds under Health Occupations Article, §3-313, Annotated Code of Maryland, to reprimand the licensee, place the licensee on probation, or suspend or revoke a license, the Board may impose a penalty not exceeding $5,000 for each violation in addition to reprimanding, placing the licensee on probation, or suspending or revoking the license. #### Regulation .04 Imposition of a Penalty on a Chiropractor. *COMAR 10.43.09.04* A. The Board may impose a penalty of not less than $100 or more than $2,000 on a chiropractor found guilty of any of the following, if the chiropractor: (1) Willfully fails to file or record a report as required by law; or (2) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive. B. The Board may impose a penalty of not less than $300 or more than $3,500 on a chiropractor found guilty of any of the following, if the chiropractor: (1) Practices chiropractic under a false name or trade name; (2) Provides professional services while: (a) Under the influence of alcohol; or (b) Using any narcotic or controlled dangerous substance as defined in Criminal Law Article, Title 5, Subtitle 4, Annotated Code of Maryland, or other drug that is in excess of therapeutic amounts, or without valid medical indication; (3) Solicits or advertises in a false or misleading manner, or in any other manner not approved by the Board; (4) Abandons a patient; (5) Misrepresents the effectiveness of any treatment, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain; (6) Willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record the report; (7) Pays or agrees to pay a sum to an individual for bringing or referring a patient; or (8) Violates any rule or regulation adopted by the Board. C. The Board may impose a penalty of not less than $500 or more than $5,000 on a chiropractor found guilty of any of the following: (1) Fraudulently or deceptively obtaining or attempting to obtain a license for the applicant or licensee, or for another; (2) Fraudulently or deceptively using a license; (3) Impersonating another practitioner; (4) Having been convicted of or pleading guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether any appeal or other proceeding is pending to have the conviction or plea set aside; (5) Unethically conducting the practice of chiropractic; (6) Being professionally, physically, or mentally incompetent; (7) Grossly and willfully: (a) Overcharging for professional services; or (b) Submitting false statements to collect fees for which services are not provided; (8) Having been disciplined by a licensing or disciplinary authority of any other state or country or convicted by a court of any state or country for an act that would be grounds for disciplinary action under Health Occupations Article, §3-313, Annotated Code of Maryland; (9) Practicing chiropractic with an unauthorized individual or supervising or aiding an unauthorized individual in the practice of chiropractic; (10) Behaving immorally in the practice of chiropractic; or (11) Committing an act of unprofessional conduct in the practice of chiropractic. #### Regulation .05 Factors to be Considered in the Assessment of a Penalty. *COMAR 10.43.09.05* In those cases in which the Board determines that the imposition of a penalty is appropriate, the Board shall take into consideration the following factors, without limitations, in determining the amount of penalty: A. The extent to which the chiropractor derived any financial benefit from unprofessional or improper conduct; B. The willfulness of the unprofessional or improper conduct; C. The extent of actual or potential public harm caused by the unprofessional or improper conduct; and D. The cost of investigating and prosecuting the case against the chiropractor. #### Regulation .06 Payment of a Penalty. *COMAR 10.43.09.06* A. A chiropractor shall pay to the Board a penalty imposed under these regulations as of the date the Board's order is issued, unless the Board's order specifies otherwise. B. Filing an appeal under State Government Article, §10-215, Annotated Code of Maryland, or Health Occupations Article, §3-316, Annotated Code of Maryland, does not automatically stay payment of a penalty imposed by the Board pursuant to these regulations. C. If a chiropractor fails to pay, in whole or in part, a penalty imposed by the Board pursuant to these regulations, the Board may not restore, reinstate, or renew a license until the penalty has been paid in full. D. In its discretion, the Board may refer all cases of delinquent payment to the Central Collection Unit of the Department of Budget and Fiscal Planning to institute and maintain proceedings to ensure prompt payment. E. The Board shall pay all monies collected pursuant to these regulations into the State's General Fund.