North Carolina Administrative Code › Title 21 - OCCUPATIONAL LICENSING BOARDS AND COMMISSIONS › Chapter 10 - CHIROPRACTIC EXAMINERS › Section .0200 - PRACTICE OF CHIROPRACTIC › Section 10 .0211 - AGREEMENTS TO PROVIDE FINANCE OR MANAGEMENT SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Purpose and extent of rule.
				G.S.
				90-157.3 limits the "ownership" of a
				chiropractic practice to licensed chiropractors. However, in addition to the
				treatment of patients, operating a chiropractic practice involves the
				procurement of financing, office space, equipment, supplies and personnel, as
				well as the creation and implementation of advertising and marketing
				strategies, billing procedures and other management functions. It is common in
				many chiropractic offices for one or more of these operating components to be
				outsourced. The purpose of this Rule is to define the extent to which a
				chiropractor licensed and practicing in North Carolina may enter into a
				financing or management services agreement with a vendor who is not a North
				Carolina-licensed chiropractor while remaining in compliance with the ownership
				limitations imposed by
				G.S.
				90-157.3. This Rule does not apply to
				contracts exclusively between or among North Carolina-licensed
				chiropractors.
(b) Review of
				agreements. No person shall be required to submit a financing or management
				services agreement to the Board for advance approval. The Board shall review
				existing or proposed agreements only upon request of one or more of the parties
				or as part of a disciplinary investigation. In order to protect pricing
				information, trade secrets and similar proprietary information, the Board shall
				maintain the confidentiality of any agreement under review. The review shall be
				completed within 90 days of submission, and any agreement not disapproved
				within 90 days shall be deemed approved.
(c) Prohibited provisions. Beginning July 1,
				2012, the following contractual provisions, singly or in combination, shall be
				deemed by the Board to violate
				G.S.
				90-157.3:
(1) Any provision or series of provisions
				that creates a partnership between the chiropractor and the vendor to engage in
				the practice of chiropractic in contravention of
				G.S.
				90-157.3(a). When reviewing
				contracts for compliance with this section, the Board shall apply the rules for
				determining the existence of a partnership set forth in
				G.S.
				59-37 and the ordinary legal definition of
				partnership, as follows: "a partnership is a combination by two or more persons
				of their property, effects, labor, or skill in a common business or venture,
				under an agreement to share the profits and losses in equal or specified
				proportions;"
(2) Ownership or
				control of patient records by the vendor or any party other than the
				chiropractor;
(3) Control by the
				vendor over the hiring and firing of any personnel who provide clinical
				services to patients;
(4) Any
				requirements imposed by the vendor that affect the chiropractor's exercise of
				professional judgment in creating treatment plans and delivering clinical
				services to patients;
(5) Control
				by the vendor over the transfer of ownership interests in the practice, but
				this prohibition shall not prevent the vendor from terminating the agreement if
				the chiropractor transfers ownership of the practice without the vendor's
				consent;
(6) Any attempt to
				transfer legal liability from the chiropractor to the vendor for the content of
				advertising or the implementation of any marketing program undertaken to
				promote the practice.