Nov 2015: TBCE Rules Proposals
Written by Editor   
Tuesday, November 24, 2015 11:59 AM

In November, the Texas Board of Chiropractic Examiners (TBCE) published additional proposed rules changes.  Additional comments on the proposed amended rules and/or a request for a public hearing on the proposed amended rule may be submitted to Bryan D. Snoddy, General Counsel, Texas Board of Chiropractic Examiners, 333 Guadalupe St, Tower III, Suite 825, Austin, Texas 78701; by fax to (512) 305-6705; or by e-mail to rules@tbce.state.tx.us, no later than 30 days from the date that this proposed amendment is published in the Texas Register [Editor's Note: This would be before the Christmas Holidays]

  • One proposal would require every facility to have an email registered with the TBCE and require notification of change within 5 business days.
  • Another proposal proposes a new §77.10, concerning Rules to Prevent Fraud. The proposed new rule is necessary in order to comply with Texas Occupations Code §201.1555 and to provide concise and clear guidance to the public and licensees.
  • A third proposal would require every individual licensee to have an email registered with the TBCE and require notification of change within 5 business days.
  • A final amendment proposes amending §78.8, concerning Complaint Procedures. The proposed amended rule is necessary in order to remove the requirement for a 120-day hearing that is not found within the Chiropractic Act or the Administrative Procedure Act.

The Texas Board of Chiropractic Examiners (Board) proposes amending §73.4, concerning Rules of Conduct for Facility Owners. The amendment will require the maintenance of electronic-mail addresses to enhance communication with the Board.

Specifically, the proposal is:

§73.4.Rules of Conduct for Facility Owners.

(a) An owner of an unregistered facility or a facility with an expired registration that continues to provide chiropractic services shall be subject to the same sanctions as a license holder who violates the Chiropractic Act or Board rules.

(b) No facility owner or employee, other than the primary treating doctor of chiropractic, shall control or attempt to control, in any way whatsoever, the professional judgment of such treating doctor with respect to patient care and treatment.

(c) A facility shall maintain a current street address with the board. A different mailing address may be provided in addition to the street address. A facility shall notify the board, in writing, of any change in street or mailing address or ownership within 30 days of the change. The notification shall be signed by the owner or authorized representative of the facility and must include the facility registration number.

(d) A facility shall maintain a current electronic mail address with the board. A facility shall notify the board, by electronic mail, of any change in the electronic mailing address within five (5) business days of the change. The notification must include the facility registration number.


The Texas Board of Chiropractic Examiners (Board) proposes the repeal of §77.10, concerning Rules to Prevent Fraud. The repeal is necessary in order to clarify, restructure and draft a new rule regarding concise and clear guidance to the public and licensees to comply with Texas Occupations Code §201.1555.

The Texas Board of Chiropractic Examiners (Board) then proposes a new §77.10, concerning Rules to Prevent Fraud. The proposed new rule is necessary in order to comply with Texas Occupations Code §201.1555 and to provide concise and clear guidance to the public and licensees.

Specifically the new proposal is:

§77.10.Rules to Prevent Fraud.

(a) Fraud Definition. Fraud is defined as an intentional misrepresentation where the following conditions are present:
(1) there must be a cause of deception;
(2) the act or acts must show an intentional misrepresentation of fact; and

(3) the provider must stand to gain financially from the deception and misrepresentation.

(b) Fraud Prevention.

(1) A registered chiropractic facilities must annually certify that it maintains policies and/or procedures that govern how it handles matters concerning at least the following topics on: Medicare, billing, records management, and continuity of operations/wind-down of facility operations.

(2) Chiropractic facilities are required to ensure that its employees have read, reviewed and been trained on each procedure or policy as applicable to the employee's job responsibilities within sixty (60) days of employment and every two (2) years thereafter while in the employ of the facility.

(3) Chiropractors that have been found in violation of any law or Board rule related to fraud may be required to take the jurisprudence examination at their own expense.

(4) The Enforcement Committee may require a chiropractic facility where a violation of any law or Board rule occurred involving fraud to submit to utilization and compliance reviews at the facility owner's expense. Additionally, the Enforcement Committee may require utilization and compliance reviews for chiropractic facilities that fail to maintain adequate policies and procedures.

(c) Incorporation by Reference. As part of its policy for the prevention of fraud, the Board incorporates by reference into this section the following rules under this title: §72.2, relating to Application for License; §75.5, relating to Continuing Education; §78.1, relating to Unprofessional Conduct; §78.2, relating to Proper Diligence and Efficient Practice of Chiropractic; §77.2, relating to Publicity; and §77.8, relating to Records and Documentation.

The Texas Board of Chiropractic Examiners (Board) proposes amending §75.1, concerning Notification and Change of Address. The proposed amended rule will assist the Board in serving the public, stakeholders and licensees. The amendment will require the maintenance of electronic-mail addresses to enhance communication with the Board.

Specifically, the amendment is:

§75.1.Notification and Change of Address.

(a) Licensees shall maintain a current physical home and business address with the Board. In addition, a different mailing address may be provided beyond that of the home and business address. Within 30 days of a change in any of these addresses, a licensee shall notify the Board of the change in writing via U.S. mail, electronic-mail, facsimile, or other written communication. The notification of address change shall clearly and legibly identify the licensee, the address to be changed, the license number(s) associated with the address, and shall be signed by the licensee(s). A change of address submitted through any of the online registration portals, including Texas.gov, is not valid and must be submitted in writing as indicated within this rule.

(b) The notification shall be signed by the licensee and must include the license number.

(c) A licensee shall maintain a current electronic mail address with the board. A licensee shall notify the board, by electronic mail, of any change in the electronic mailing address within five (5) business days of the change. The notification must include the license number.


The Texas Board of Chiropractic Examiners (Board) proposes amending §78.8, concerning Complaint Procedures. The proposed amended rule is necessary in order to remove the requirement for a 120-day hearing that is not found within the Chiropractic Act or the Administrative Procedure Act.

Specifically the amendment is:

§78.8.Complaint Procedures.

(a) Filing complaints. A person who has a complaint about a licensee, facility or CRT may file a complaint with the board in person at the board's office, or in any written form, including submission of a completed complaint form. The board adopts the following form in both English and Spanish as its official complaint form which shall be available from the board upon request. A complaint shall contain information necessary for the proper processing of the complaint by the board, including:

Figure: 22 TAC §78.8(a) (No change.)

(1) complainant's name, address and phone number;
(2) name, address and phone number of the chiropractor, chiropractic facility, CRT or other person, firm or corporation, if known, against whom the complaint is made;
(3) date, time and place of occurrence of alleged violation; and

(4) complete description of incident giving rise to the complaint.

(b) Categories of complaints and investigation.

(1) The board shall distinguish between categories of complaints as follows:

(A) consumer and patient complaints against chiropractors, CRTs, or chiropractic facilities regarding alleged violations of state law, including the Texas Chiropractic Act, or board rules or orders;

(B) alleged unauthorized practice of chiropractic by unlicensed individuals, unregistered facilities or CRTs, or by a licensee, facility or CRT while a suspension order or restrictive sanction by the board is in effect;

(C) licensure, registration or reinstatement applications;

(D) alleged advertising violations by chiropractors or chiropractic facilities.

(2) The board shall prioritize complaints for purposes determining the order in which complaints are investigated, taking into account the seriousness of the allegations made in a complaint and the length of time a complaint has been pending.

(A) The board shall create and maintain a written list of the categories of complaints in order from the most serious to least serious violations of the Texas Chiropractic Act or administrative rules. The list shall also cite the specific rules and statutes that may have been violated, and the fines or other penalties that may be assessed.

(B) The board shall have this list available at the board office and on the board website for interested parties.

(C) The board shall use this list to set priorities for the investigation of complaints against licensees with the most serious complaints being of the highest priority.

(3) All complaints or reports of alleged violations will be investigated by the board. However, anonymous complaints may not be investigated if insufficient information is provided or the allegations are vague, appear to lack a credible or factual foundation, or cannot be proved for lack of a witness or other evidence. The executive director of the board will determine whether or not an anonymous report will be logged in as a complaint for investigation. A complaint shall not be dismissed without appropriate consideration. The board and a complainant shall be advised of a dismissal of a complaint.

(4) The board staff may initiate an investigation, including the filing of a complaint, on an individual or facility regulated by the board for compliance with the law or board rules or order.

(c) Enforcement Committee.

(1) The President shall appoint an Enforcement Committee to consider all complaints filed with the board. The Executive Director under the direction of the Enforcement Committee chair shall supervise all investigations.

(2) The Enforcement Committee shall have the power to issue subpoenas and subpoenas duces tecum to compel the attendance of witnesses and the production of books, records, and documents, to issue commissions to take depositions, to administer oaths and to take testimony concerning all matters within the assigned jurisdiction.

(3) The Enforcement Committee shall determine the disposition of a complaint as provided in this subsection and §78.9 and §78.10 of this title (relating to Disciplinary Guidelines and Schedule of Sanctions, respectively). The Enforcement Committee may delegate the authority to close certain complaints to the Executive Director.

(4) The Enforcement Committee may schedule an informal conference in a case in order to hear from the complainant and the respondent, in person, or if it believes a conference may facilitate the resolution of the case. A respondent, although not required, is urged to attend the informal conference. A complainant will be given notice of the conference and invited to attend. A complainant is not required to attend an informal conference.

(5) Informal conferences shall not be deemed to be meetings of the board.

(6) In a case where the Enforcement Committee has made a finding of a violation for which a sanction should be imposed, the committee may direct staff to offer an agreed order to the respondent in an effort to resolve the case informally. If an agreed order is not accepted by the respondent or no agreed order is offered, the case will be referred to the SOAH for formal hearing. The Enforcement Committee shall present an agreed order to the board for its approval once it has been signed by the respondent. Should the board amend the proposed order, the executive director shall contact the respondent to seek concurrence. If the respondent does not concur, the Enforcement Committee shall determine whether negotiations on an agreed order should continue or to refer the case for formal hearing.

(d) Commencement of formal hearing proceedings. Board staff shall commence formal hearing proceedings by filing the case with the SOAH and by giving notice to the respondent as provided §79.2 of this title (relating to Commencement of Enforcement Proceedings).

(e) Recission of probation.

(1) The board may at any time while an individual or facility is on probation upon majority vote rescind the probation and enforce the board's original action suspending such license or registration for violation of the terms of the probation or for other good cause as the board in its discretion may determine. Violations of probation shall be referred to the Enforcement Committee for action under this section. Probation shall not be rescinded without notice and an opportunity for a hearing on whether or not the probation has been violated.

(2) The board shall maintain a chronological and alphabetical listing of licensees, facilities, and CRTs, who have had their license or registration, suspended or revoked, and shall monitor compliance with each order. Any noncompliance observed as a result of monitoring shall be referred to the Enforcement Committee for action under this section.

(f) Reinstatement. An individual or chiropractic facility whose license or registration has been revoked for a period of more than one year may, after the expiration of at least one year from the date that such revocation became final, apply to the board, on forms provided by the board, for reinstatement. In considering the reinstatement of a revoked license or registration, the board in its discretion may:

(1) deny reinstatement; or
(2) grant reinstatement:
(A) without condition;
(B) with probation for a specified period of time under specified conditions; or

(C) with or without reexamination or additional training.

(g) Temporary suspension upon threat to public. The Enforcement Committee or the board, with a two-thirds vote, may temporarily suspend a license to practice chiropractic in the State of Texas if the committee or the board determines from the preponderance of the evidence or information presented to it that continued practice by the licensee constitutes a continuing or imminent threat to the public welfare. The purpose of a temporary suspension is to protect the public until a preliminary hearing can be held.

(1) Such suspension may occur without notice or hearing if at the time the suspension is ordered, a hearing on whether a disciplinary proceeding should be initiated is scheduled not later than the 14th day after the date of suspension.

(A) The purpose of the 14-day hearing is to provide the licensee with notice and an opportunity to review the Board's evidence or information, to present evidence, raise defenses, and to be heard.

(B) At the 14-day hearing, the only issue presented is whether the temporary suspension should be dissolved or kept in place. If the administrative law judge finds that the Board has competent evidence or information that continued practice by the licensee constitutes a continuing or imminent threat to the public welfare, then the administrative law judge may issue an order keeping the temporary suspension in place pending the initiation of other disciplinary proceedings against the licensee.

[(C) If a temporary suspension is ordered, the Board shall initiate other disciplinary proceedings within 120 days of the date of the order of temporary suspension. If criminal action is pending against the licensee, a final hearing on such disciplinary proceedings may be deferred until such time as the criminal action is finally adjudicated.]

(2) A second hearing on the suspended license shall be held not later than the 60th day after the date the suspension was ordered. This 60-day hearing shall determine whether the suspension shall remain in effect pending the initiation, prosecution, and final determination of other disciplinary proceedings against the licensee. If the 60-day hearing is not held in the time required, the license is reinstated without further action of the board or committee.

(3) A hearing held under this subsection shall be conducted by the SOAH.

(4) The licensee will be notified of a suspension and any hearing scheduled under this subsection by certified mail to the address on file with the Board and by facsimile and/or email if such numbers or addresses are known to the Board. The notice sent by certified mail is legal notice under this section.

(5) The suspension shall remain in effect pending further action by the board unless an administrative law judge, the committee, or the board orders the suspension rescinded after hearing.

(6) The licensee shall not practice chiropractic during the duration of the suspension.

(7) During the suspension the enforcement and investigatory processes will continue.

(8) The licensee may waive either the 14-day or 60-day hearing or may agree that such hearings can be held beyond the statutory deadlines. The temporary suspension shall remain in effect until a hearing is held or is otherwise dissolved.

(h) Alternative Methods of Service. Upon agreement of the party to be notified, the Board may utilize electronic means sent to the current electronic-mail or telecopier number of the party's attorney of record or of the party if the party is not represented by counsel.