Overutilization of Practice

Overutilization of practice shall constitute “gross misconduct in the practice of the profession”, within the meaning of M.G.L. c. 112, § 61, and “unprofessional conduct”, within the meaning of M.G.L. c. 112, § 93, and shall constitute grounds for disciplinary action by the Board. Overutilization of practice is practice excessive in quality or amount to the needs of the patient. It may be determined from such sources as the patient's history, the patient’s subjective and objective presentation, and reasonable clinical judgment as well as other relevant information. (2) Any chiropractor who provides excessive treatment or issues excessive bills to a patient for the purpose of enabling the patient to incur medical treatment expenses in excess of the tort threshold established pursuant to M.G.L. c. 231, § 6D, shall be subject to disciplinary action by the Board. Such excessive treatment or excessive billing shall constitute “deceit” and “gross misconduct in the practice of the profession”, within the meaning of M.G.L. c. 112, § 61, and “unprofessional conduct”, within the meaning of M.G.L. c. 112, § 93. Such excessive treatment or excessive billing may also constitute a violation of 233 CMR 4.09, 4.10 or 4.11, and nothing in 233 CMR 4.08(2) shall be deemed to alter or modify any other provisions of 233 CMR 4.00. (3) For purposes of 233 CMR 4.08, “excessive treatment” shall include, but shall not be limited to: (a) Treatment which exceeds, in quality or amount, the documented and clinically reasonable Chiropractic needs of the patient; (b) Treatment which is unrelated to the diagnosed, or reasonably suspected, injury or condition incurred by the patient; or (c) Treatment which is provided solely for the purpose of enabling the patient to incur medical treatment expenses in excess of the tort threshold established by M.G.L. c. 231, § 6D. (4) For purposes of 233 CMR 4.08, “excessive billing” shall include, but shall not be limited to, bills for services which were not performed and/or bills which overstate the amount of time spent evaluating and/or treating the patient.