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<chapter num="09" heading="Monetary Penalties" title_num="10" subtitle_num="43">
  <regulation prefix="Regulation" num=".01" heading="Scope.">
    <text>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.</text>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Board” means the State Board of Chiropractic Examiners.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“License” means a license issued by the Board to practice chiropractic or to practice chiropractic with the right to practice physical therapy.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Licensee” means a chiropractor who is licensed by the Board to practice chiropractic or to practice chiropractic with the right to practice physical therapy.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Penalty” means monetary penalty.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Imposition of a Penalty — General.">
    <paragraph num="A.">
      <text>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:</text>
      <paragraph num="(1)">
        <text>Instead of, or in addition to, suspending the license; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>In addition to revoking the license.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>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.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Imposition of a Penalty on a Chiropractor.">
    <paragraph num="A.">
      <text>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:</text>
      <paragraph num="(1)">
        <text>Willfully fails to file or record a report as required by law; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>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.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>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:</text>
      <paragraph num="(1)">
        <text>Practices chiropractic under a false name or trade name;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Provides professional services while:</text>
        <paragraph num="(a)">
          <text>Under the influence of alcohol; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>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;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>Solicits or advertises in a false or misleading manner, or in any other manner not approved by the Board;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Abandons a patient;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Misrepresents the effectiveness of any treatment, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record the report;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Pays or agrees to pay a sum to an individual for bringing or referring a patient; or</text>
      </paragraph>
      <paragraph num="(8)">
        <text>Violates any rule or regulation adopted by the Board.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>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:</text>
      <paragraph num="(1)">
        <text>Fraudulently or deceptively obtaining or attempting to obtain a license for the applicant or licensee, or for another;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Fraudulently or deceptively using a license;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Impersonating another practitioner;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>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;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Unethically conducting the practice of chiropractic;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Being professionally, physically, or mentally incompetent;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Grossly and willfully:</text>
        <paragraph num="(a)">
          <text>Overcharging for professional services; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Submitting false statements to collect fees for which services are not provided;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(8)">
        <text>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;</text>
      </paragraph>
      <paragraph num="(9)">
        <text>Practicing chiropractic with an unauthorized individual or supervising or aiding an unauthorized individual in the practice of chiropractic;</text>
      </paragraph>
      <paragraph num="(10)">
        <text>Behaving immorally in the practice of chiropractic; or</text>
      </paragraph>
      <paragraph num="(11)">
        <text>Committing an act of unprofessional conduct in the practice of chiropractic.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Factors to be Considered in the Assessment of a Penalty.">
    <text>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:</text>
    <paragraph num="A.">
      <text>The extent to which the chiropractor derived any financial benefit from unprofessional or improper conduct;</text>
    </paragraph>
    <paragraph num="B.">
      <text>The willfulness of the unprofessional or improper conduct;</text>
    </paragraph>
    <paragraph num="C.">
      <text>The extent of actual or potential public harm caused by the unprofessional or improper conduct; and</text>
    </paragraph>
    <paragraph num="D.">
      <text>The cost of investigating and prosecuting the case against the chiropractor.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Payment of a Penalty.">
    <paragraph num="A.">
      <text>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.</text>
    </paragraph>
    <paragraph num="B.">
      <text>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.</text>
    </paragraph>
    <paragraph num="C.">
      <text>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.</text>
    </paragraph>
    <paragraph num="D.">
      <text>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.</text>
    </paragraph>
    <paragraph num="E.">
      <text>The Board shall pay all monies collected pursuant to these regulations into the State's General Fund.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health Occupations Article, §3-314, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date:</annotation>
    <annotation type="History" subtype="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)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02 amended effective January 2, 2017 (43:26 Md. R. 1446)</annotation>
  </annotations>
</chapter>