Title 4 W. Va. C.S.R.

Chiropractic Examiners Chiropractic Examiners

Series 01 Regulation of Chiropractic Practice

W. Va. Code R. § 4-1-1 General

1.1. Scope. -- This rule provides for the regulation of the chiropractic profession to protect the health, safety and welfare of the public.

1.2. Authority. -- W. Va. Code §30-16-5.

1.3. Filing Date. -- April 1, 2014.

1.4. Effective Date. -- July 1, 2014.

1.5. Repeal and Replace. -- This rule repeals and replaces the Board of Chiropractic Examiners, 4 C.S.R. 1, filed June 9, 2005.

W. Va. Code R. § 4-1-2 Definitions

2.1. “Board” means the Board of Chiropractic as established by W. Va. Code §30-16-4.

2.2. “CCE or its successor” means the Council on Chiropractic Education, an accrediting agency recognized by the United States Department of Health, Education and Welfare as an agency for granting accreditation of chiropractic education.

2.3. “Chiropractic Assistant” means a health care worker who assists a licensed chiropractor in the provision of chiropractic services. A chiropractic assistant shall work under the general supervision of a licensed chiropractor in a manner consistent with W. Va. Code §30-16-1 et seq., and as further set forth in this rule.

2.4. “General supervision” means initial instruction as to delegated duties and established protocol followed by personal periodic inspection of patient care including periodic evaluation of the assistant’s performance by the supervising licensed chiropractor. The supervising licensed chiropractor need not be present or on the premises at all times where the chiropractic assistant is performing delegated duties.

2.5. “Professional Incompetence” means an act or omission which may subject the licensee to disciplinary action as it relates to the practice of chiropractic or criminal misconduct which reflects on the capacity of the licensee to safely engage in the practice of chiropractic.

2.6. A “pre-payment plan” is a contract between a chiropractor and a patient under which the patient agrees to pay for, and the chiropractor agrees to provide, a set number of chiropractic treatments in return for a sum certain.

W. Va. Code R. § 4-1-3 Qualifications for Receiving and Maintaining a License to Practice Chiropractic

3.1. In order to make application to practice chiropractic in this State, an individual shall:

3.1.a. Complete the application required by the Board and pay the appropriate fee.

3.1.b. Satisfy all of the licensure requirements set forth in W. Va. Code §30-16-6 et seq.

3.1.c. Achieve a passing score on all parts of the National Board of Chiropractic Examiners national examination as outlined in W. Va. Code §30-16-6 and -7.

3.1.d. After July 1, 2005, obtain a bachelor’s degree consisting of no less than one hundred twenty-eight semester hours from an accredited academic college or university with a minimum of sixty hours in basic sciences as mandated by the Council on Chiropractic Education. Upon written request, the Board shall provide the current basic science requirements mandated by the Council on Chiropractic Education.

3.1.d.1. Except as provided in subdivision 3.1.d.3, the licensee shall obtain a bachelor degree prior to matriculation to a chiropractic college.

3.1.d.2. The Board shall determine what schools are eligible to offer concurrent degree programs and establish the specific requirements of the approved concurrent degree programs. The Board shall make the concurrent degree requirements and approved schools available upon written request.

3.1.d.3. The Board may approve certain concurrent degree programs offered by appropriate accredited public and private colleges or universities working in conjunction with approved chiropractic colleges provided that:

3.1.d.3.a. The chiropractic school offering the degree of doctor of chiropractic meets the requirement set forth in W. Va. Code §30-16-6(b)(5);

3.1.d.3.b. The applicant for licensure has successfully completed all requirements of the approved concurrent degree program established by the Board, pursuant to section 3.1.d.2., and certifies the completion of such requirements to the Board, in the form prescribed by the Board, in addition to all other information required for licensure.

3.1.e. Satisfy all continuing education requirements.

3.1.e.1. All current licensees who intend to renew their license shall present evidence to the Board that the licensee has attended 18 hours of continuing education each year. Six of these hours may be attended through online courses, but the remaining twelve hours must be attended in person. The hours shall be sponsored through an approved chiropractic college. The Board may require that six (6) of the eighteen (18) hours pertain to certain subjects, such as communicable diseases, first aid, sexual boundaries, record keeping and other subjects that the Board considers appropriate. Any six-hour specific-continuing-education requirement shall not apply to doctors of chiropractic who certify in writing that they did not practice chiropractic in the State of West Virginia within the applicable reporting period.

Provided such doctors of chiropractic who so certify shall be required to attend 18 hours of non-specific continuing education to be completed prior to June 30 th . When the Board requires six hours of specific continuing education all licensees will be notified in the current annual renewal notice of the subject matter of the required continuing education. The licensee will be given until the next annual renewal period to complete the required hours. The programs shall be approved by the Board prior to their presentation. The programs shall be conducted by a faculty member of a Board approved CCE or its successor school or college, unless otherwise approved by the Board. The Board, at its discretion, may also approve programs conducted by recognized authorities from fields other than chiropractic.

3.1.e.2. The method of recording attendance at the seminars is the responsibility of the sponsoring group. The sponsoring group shall provide the Board with a list of those in attendance at the seminars.

3.1.e.3. Newly graduated doctors of chiropractic who receive their initial license in the year of their graduation are exempt from the requirements of subdivision 3.1.e.1 of this rule. However, they shall be required to meet all other aspects of license renewal as defined in W. Va. Code §30-16-15.

3.1.f. Remit to the Board, an annual license renewal fee. The annual renewal license fee and required continuing education hours are due on or before July 1. A licensee whose license renewal fee and required continuing education hours are postmarked after July 1 incurs a late fee.

3.1.g. Complete and submit a license renewal application as provided by the Board.

3.1.h. After a lapse of two (2) years, a license may be issued or reinstated only after the former certificate holder subsequent to the lapse has fulfilled all other requirements of licensure as set forth in W.

Va. Code §30-16-15(e) and/or has passed the National Special Purposes Examination for Chiropractic (SPEC) examination.

W. Va. Code R. § 4-1-4 Duties of a Licensee

4.1. A licensee shall not engage in clinical conduct outside the scope of chiropractic practice. The licensee shall maintain current knowledge of statutes, rules, and Board decisions regarding the practice of chiropractic.

4.1.a. A licensee shall maintain proper records on all patients, including family and staff members, and keep the records confidential. The records shall include:

4.1.a.1. A description of the patient’s chief complaint;

4.1.a.2. A history which includes any significant events related to the chief complaint;

4.1.a.3. A record of diagnostic and therapeutic procedures including: an examination and results of that examination, a diagnosis; a plan of care; including all therapeutic modalities utilized; frequency of treatment; any changes in the plan of care; as well as the reasons for changes; and a record of the patient’s response to treatment; and

4.1.a.4. A record of standing orders for delegated procedures as a written protocol to be used by chiropractic assistants.

4.1.a.5. A licensee shall release copies of medical records within 10 days of receipt of a written request from the patient.

4.1.b. A licensee shall maintain competence in the production and interpretation of x-rays. A licensee is competent if he or she:

4.1.b.1. Produces x-rays of diagnostic quality;

4.1.b.2. Uses appropriate shielding and collimation;

4.1.b.3. Exposes patients to radiation based on clinical necessity as documented by the patient’s record;

4.1.b.4. Produces written interpretation of x-rays, that are part of the patient’s record, and demonstrative of competence in reading films; and

4.1.b.5. Uses equipment that meets Board and manufacturer’s specifications for safety and use and that is properly maintained.

4.1.c. A licensee shall maintain competence in the application of chiropractic therapeutics and in the management of patient care. A licensee is competent if he or she:

4.1.c.1. Applies therapeutic modalities properly;

4.1.c.2. Applies a modality that is appropriate for the treatment of the patient as documented by the patient record; and

4.1.c.3. Provides Case Management that is supported by the patient’s record.

4.1.d. The licensee shall properly train and supervise his or her staff that is engaged in patient care. A licensee who fails to do so is subject to disciplinary action.

W. Va. Code R. § 4-1-5 Disciplinary Actions

5.1. A licensee shall report a misdemeanor or felony conviction or plea bargain within 30 days of the conviction or plea not withstanding whether the licensee has filed or intends to file an appeal relating to any such conviction or plea. A licensee shall again notify the Board within thirty days of any court’s decision regarding the result of any such appeal. A conviction or plea to a misdemeanor or felony charge shall constitute an “adverse action” pursuant to W. Va. Code §30-16-11(a)(22). The Board shall review the conduct involved in the criminal proceedings to determine if the conduct poses a threat to the public and take appropriate disciplinary action.

5.2. Sexual misconduct may include, doctor/patient relations, whether or not initiated by, or consented to, by the patient, and engaging in any conduct with a patient that is sexual or may be reasonably interpreted as sexual. A licensee shall not use fraud, deception, misrepresentation or force for the purpose of engaging in sexual contact with a patient in the clinical setting. Patient consent is not a legal defense. A licensee may not have consensual sexual relations with a former patient until six months after the termination of doctor/patient relationship.

5.3. A licensee shall not engage in clinical activities outside of the scope of chiropractic practice.

5.4. A licensee may not represent to the public, the possession of special skill, training, knowledge, equipment or qualifications unless the Board recognizes the training or certification on which the representation is based.

W. Va. Code R. § 4-1-6 Advertising

6.1. False and deceptive or misleading advertising is prohibited.

6.2. Advertisements offering free or discounted services shall include the licensee’s usual charge for the service.

6.2.a. In the case where a licensee is offering any service without charge, the advertisement shall state that there is no charge.

6.2.b. Diagnostic services offered without charge, or at discounted fees such as exams or x-rays, shall be medically necessary and sufficient to reach a diagnosis. X-rays shall be diagnostically complete.

6.2.c. Patients receiving free or discounted services shall sign a disclosure statement which clearly describes the service, and which informs the patient of services for which there is a charge. When the advertisement offers free or discounted services for a period of time, the patient shall sign a disclosure statement which clearly states when the free or discounted service ends. The disclosure statements are

part of the patient’s medical records, and the licensee shall include them in any submission of the claims to the party responsible for bill payment. The licensee shall disclose the normal charges for services before services were rendered.

6.2.d. No licensee may engage in, or knowingly authorize others to engage in, solicitation by telephone, mail, in-person solicitations or otherwise, which involve undue influence coercion, intimidation, misrepresentation, invasion of the privacy of the person being contacted, or unreasonable interference in the doctor-patient relationship.

6.2.e. Solicitation which does not involve undue influence, coercion, intimidation, misrepresentation, invasion of the privacy of the person being contacted, or unreasonable interference in the chiropractic-patient relationship is permissible.

6.2.f. A licensee may not offer consumer solicitations that require an immediate response or a response within ten days to an offer at the time of the solicitation.

6.2.g. A licensee may not offer free or discounted services which exclude or limit certain classifications of patients.

6.2.h. A licensee shall not advertise or offer a service as free or discounted then change or switch this advertised service to something different for an additional charge or add an additional service for an extra charge during this same office visit.

6.3. Advertising that guarantees any cure is prohibited.

6.4. Advertising that makes claims of professional superiority or uniqueness which can not be substantiated by authoritative and objective evidence deemed professionally appropriate by the Board is prohibited.

6.5. Advertising shall always clearly state that the services are being offered by a chiropractor, doctor of chiropractic, chiropractic physician or D.C.

W. Va. Code R. § 4-1-7 Testimonials

7.1. A licensee may use a testimonial for advertising if the basis for the statements in the testimonial is documented, signed by the patient, and made part of the permanent record.

7.2. Before testimonials can be used for advertising, the licensee shall inform patients that the testimonials are to be used publicly and told how they will be used.

W. Va. Code R. § 4-1-8 Abusive Billing Practices

8.1. A licensee shall not engage in fraud, misrepresentation or deception in business affairs relating to the practice of chiropractic.

8.2. A licensee shall not engage in abusive billing practices which include, but are not limited to:

8.2.a. Filing claims for services not rendered;

8.2.b. Filing claims which misrepresent the service performed;

8.2.c. Filing multiple claims for a single service when not required for proper coordination of insurance benefits.

8.2.d. Failing to disclose pertinent information on a claim form; and

8.2.e. Increasing charges when a patient uses a third party payment program.

W. Va. Code R. § 4-1-9 Pre-Payment Plans

9.3. Certain restrictions shall apply to billing practices involved in pre-payment plans.

9.3.a. The sole purpose behind pre-payment plans must be to provide, in good faith, an affordable healthcare plan to the patient. In offering a pre-payment plan, a chiropractor must, in good faith, explain to the patient the scope of the plan, the patient’s rights and responsibilities under the plan, the cost of the plan, and the treatment that will be rendered under the plan.

9.3.b. Any contract for a pre-payment plan must contain, in writing, the following provisions:

9.3.b.1. The pre-payment plan must note the severity of pain from which the patient is suffering at the time the patient enters into the agreement;

9.3.b.2. There shall be a ten (10) day period during which the patient may withdraw from the pre-payment plan without penalty;

9.3.b.3. The pre-payment plan shall state specifically and unambiguously the total cost that the patient will incur under the plan, as well as an estimate of the total cost that the patient would have incurred had the patient sought treatment outside of a pre-payment plan;

9.3.b.4. The pre-payment plan shall specifically describe which chiropractic services are included in the plan and which services are excluded. This description shall include the time frame and the number of visits that are covered by the plan. The plan shall also identify how absences of care will be treated under the plan;

9.3.b.5. The pre-payment plan shall describe how other care shall be handled under the plan if the patient has a subsequent injury that is covered by insurance;

9.3.b.6. The pre-payment plan shall have a clear exit provision that identifies the circumstances under which the plan may be terminated and how any amounts owed for treatment rendered will be billed to the patient;

9.3.c. A signed copy of the pre-payment plan shall be maintained in the patient’s treatment file.

W. Va. Code R. § 4-1-10 Unlawful Referral

10.1. A licensee may not receive payment for referral of a patient to or from another facility, health care provider, business, or professional entity.

10.2. A licensee shall not refer a patient to a facility in which he or she has a financial interest, unless the patient is informed of the relationship. This prohibition does not include an ownership interest in a building in which space is leased to a clinical laboratory, pharmacy, or physician at the prevailing rate under a lease arrangement that is not conditional upon the income or gross receipts of the clinical laboratory, pharmacy, or physician.

W. Va. Code R. § 4-1-11 Unlawful Inducement

11.1. A licensee shall not offer payment to a patient as an inducement to enter or continue care.

W. Va. Code R. § 4-1-12 Investigation and Formal Hearings

12.1. Upon receipt of a complaint or report, or knowledge of a violation in W. Va. Code §30-16-1 et seq. or the rules of the Board, the Board may initiate an investigation to determine whether probable cause exists to substantiate charges. The Board shall give initial notice to the licensee which shall include:

12.1.a. Notice that the Board has received a complaint, report, or knowledge of a possible act of misconduct;

12.1.b. The name of the complainant and a simple statement of the allegations which form the

basis of the complaint; and

12.1.c. A request for a written response from the licensee.

12.2. The Board may form an investigative committee, composed of person(s) designated by the Board to conduct the probable cause inquiry.

12.2.a. The full Board shall be screened from any knowledge of complaint and identities of the licensee during the investigative procedure.

12.2.b. Board members who have any involvement with the case before charges are brought shall not participate in the final adjudication of the case.

12.2.c. After the investigation, the investigative committee shall make a recommendation to the Board which may accept or reject the investigative committee’s recommended action.

12.3. At the conclusion of the investigatory process, if the Board finds probable cause that a violation of the statute, rules, or ethical standards governing the practice of chiropractic has occurred the Board may initiate a formal hearing.

12.4. All contested hearings shall be held pursuant to the procedures outlined in W. Va. Code §29A- 5-1, et seq.

12.5. The Board shall send notice of the disciplinary hearing to all parties at least 30 days prior to the hearing. The notice shall cite the specific rules, and laws which form the basis of the complaint.

W. Va. Code R. § 4-1-13 Appeal

13.1. The licensee may appeal a final Board decision to a circuit court of proper jurisdiction as provided in W. Va. Code §30-1-9.

W. Va. Code R. § 4-1-14 Chiropractic Assistants

14.1. A licensed chiropractor may employ chiropractic assistants to perform operational functions as well as selective and delegated tasks upon the prior approval of the supervising licensed chiropractor.

Tasks which may be delegated to a chiropractic assistant include but are not limited to the following: set up and administration of electrical muscle stimulation, ultrasound, traction, massage, diathermy, hydrocollation, cryotherapy, blood pressure examination, range of motion examination and obtaining and recording patient histories.

14.2. The licensed chiropractor shall ensure that a chiropractic assistant receives proper training before beginning his or her duties. The licensed chiropractor shall annually reevaluate each chiropractic assistant to ensure that the chiropractic assistant is competent and qualified to perform the assigned duties and is in compliance with subsection 14.3. The licensed chiropractor may provide the required training or may require that the chiropractic assistant acquire the required training from a program accredited by the Council on Chiropractic Education (CCE) or the West Virginia Board of Chiropractic. The licensed chiropractor shall document each annual review and all training received by each chiropractic assistant employed and keep the documentation in the chiropractic assistant’s employee file.

14.3. The licensed chiropractor that is responsible for assigning duties to a chiropractic assistant is solely responsible for determining that the chiropractic assistant is competent to perform the assigned duties. Further, no licensed chiropractor shall assign any duties to a chiropractic assistant until the licensed chiropractor is assured through personal observation and training that the chiropractic assistant is fully competent and completely qualified to perform the assigned duties.

W. Va. Code R. § 4-1-15 Physiotherapeutic Devices; Electrodiagnostic Devices; Certifications; and Specialty Practice

15.1. Annually the Board shall prepare a schedule of physiotherapeutic devices, electrodiagnostic devices and areas of specialty practice and certifications that are approved by the Board. Upon written request, the Board shall provide the current schedule of approved physiotherapeutic devices, electrodiagnostic devices and areas of specialty practice and certifications that are approved by the Board.

15.2. Within this schedule the Board shall set forth the type of training required, the minimum number of hours required, whether an examination is required and any other prerequisite training required before a licensee may utilize certain physiotherapeutic devices, electrodiagnostic devices or claim an area of special practice or certification.

15.3. A licensee who has not met the requirements set for by the Board for the use of physiotherapeutic devices, electrodiagnostic devices, specialty practice or certification shall be prohibited from utilizing such devices or asserting such specialty or certification in accordance with W. Va. Code

§30-16-20.

W. Va. Code R. § 4-1-16 Chiropractic Corporations, Partnerships and Other Business Organizations

16.1. An individual licensed to practice chiropractic within this state may practice as a sole proprietor, as a partner with other duly licensed chiropractors and as a shareholder, member or employee of a chiropractic corporation or a professional limited liability company.

16.2. No individual licensed to practice chiropractic within this state may be employed by or practice pursuant to a contractual agreement with an individual that is not licensed to practice chiropractic in this state.

16.3. No individual licensed to practice chiropractic in this state may be employed by or practice pursuant to a contractual agreement with a partnership that includes an individual or corporation not licensed to practice chiropractic in this state.

16.4. Any licensee that is a shareholder, member or employee of a corporation or limited liability company or any licensee practicing pursuant to a contractual agreement with any corporation or limited liability company shall disclose such business arrangement on a form prescribed by the Board along with the licensee’s annual renewal application. In the interest of protecting the public, the Board may request such additional information from the licensee or the business entities disclosed before grating approval of the requested business arrangement. Unless annual approval is granted by the Board, the licensee will be prohibited from practicing chiropractic in the business arrangement requested.

16.5. Upon written request from the Board, a spouse or personal representative of a deceased chiropractor or deceased shareholder of a chiropractic corporation shall have a period of time not to exceed twelve months from the date of death to sell or transfer the deceased chiropractor’s practice or dispose of the deceased shareholder’s stock. At all times during this transition period all chiropractic services offered to the public must be rendered by a chiropractor in compliance with these rules and duly licensed in accordance with W. Va. Code §30-16-1 et seq.

16.6. A chiropractor duly licensed to practice in this state and a corporation approved by the Board may employ other healthcare providers licensed pursuant to Chapter 30 of the West Virginia Code so long as the employment of the healthcare provider is not inconsistent with the practice act regulating the healthcare provider so employed.

Series 02 Procedures Of The WV Board Of Chiropractic Examiners

W. Va. Code R. § 4-2-1 General

1.1. Scope. -- These procedures establish the organization, operation and licensing of chiropractors by the West Virginia Board of Chiropractic Examiners.

1.2. Authority. -- W. Va. Code '30-16-1 et. seq.

1.3. Filing Date. -- October 26, 1987.

1.4. Effective Date. -- November 25, 1987.

W. Va. Code R. § 4-2-2 Hearings

2.1. Any party who demands a hearing to have determined any constitutional rights, legal rights, duties, interests or privileges of specific parties as required by law shall specify in writing the grounds relied upon as a basis for the relief request.

2.2. When the Chairman or his authorized designee is presented with a demand for a hearing as described in subsection (1) of this rule, he shall schedule a hearing within forty-five (45) days of receipt by him of such written demand unless postponed to a later date by mutual agreement. However, if the chairman or his designee shall determine that the hearing demanded would either involve an exercise of authority in excess of that available to him under law, or would serve no useful purpose, he shall, within forty-five (45) days of receipt of such demand, enter an order refusing to grant the hearing as requested, incorporating therein his reason(s) for such refusal. Appeal may be taken from such order as provided by W. Va. Code '29A-5-4.

2.3. Charges may be instituted against any chiropractic physician by the Board and shall be noted in the official minutes of the Board. Charges may be based upon information indicating that there are reasonable causes for believing that said chiropractic physician may have engaged in such conduct or be in such condition that his license should be placed on probation or limited or restricted, or have his license suspended or revoked for one or more of the grounds set forth in the Chiropractic Practice Act, or these regulations.

2.4. Upon the receipt of a demand for a hearing as described in subsection (a) of this rule, or where a hearing is otherwise required, the Chairman or his designee shall as soon thereafter as possible provide the party making such demand and the party charged with a violation of licensing provisions of the law or regulations promulgated by the Board with Notice of Hearing (assuming an order has not been entered denying a hearing as provided in subsection (b) of this Rule). Said notice shall be served upon the respondent at least thirty (30) days prior to the hearing date. Said notice shall contain the following information:

a. The date, time and place of the hearing;

b. A short plain statement of the matters asserted or charged;

c. A statement of intention to appoint a hearing examiner.

The compliant shall be issued in the name of the Board as an agency of the State of West Virginia and designate the Board as "Petitioner" and shall designate the chiropractic physician being proceeded against as "Respondent." The Petitioner shall set out the substance of each offense charged with sufficient particularity to reasonably apprise the respondent of the nature, time, and place of the conduct or condition complained of therein. The Board may amend the complaint as it deems proper.

Upon proper motion, a more definite statement of the matters asserted or charged shall be provided to the respondent or his counsel, at least fifteen (15) days prior to the hearing date.

W. Va. Code R. § 4-2-3 Hearing Shall Be Conducted As Follows

3.1. Any party to a hearing shall have the right to be represented by an attorney at law, duly qualified to practice in the State of West virginia.

3.2. The board may be represented by the Office of the Attorney General.

3.3. The rules of evidence as applied in civil cases in the circuit courts of this State shall be followed.

3.4. Hearings conducted by the Board or by a hearing examiner appointed by the Board, upon a complaint issued by the Board, are a continuance of the investigation designated to enable the Board to properly discharge its administrative functions and authority. The purpose of such hearing is to afford the Respondent an opportunity, in person or by counsel or other representative, to respond to the complaint, to present his position, to present evidence in support of his contention, to examine and cross-examine evidence and witnesses produced in support of the complaint and to argue orally at the hearing.

3.5. The hearing shall be held at such time and place as is designated by the Board, but no hearing shall be conducted unless and until at least thirty (30) days written notice thereof has been served upon the Respondent in person or by registered mail.

3.6. The hearing shall not be open to the general public unless the Respondent makes and files a written request therefor with the Board or with the hearing examiner.

3.7. The purpose of the hearing shall be to further inquire into the matters set forth in the complaint or any amended complaint, and to record evidence and arguments in support of the same and in opposition thereto, so that the Board may determine all issues.

3.8. The hearing may be conducted by a Board member, or by a hearing examiner appointed by the Board.

3.9. A record of the hearing shall be prepared under the supervision of the Board, if the hearing is conducted by it, or by a hearing examiner who conducts the hearing on behalf of the Board.

3.10. Documentary evidence may be received in the form of copies or excerpts or by incorporation by reference.

3.11. Initially, the Board shall be given an opportunity to present evidence, including testimony, papers, records, agency staff memoranda and documents in the possession of the Board, in support of its position.

3.12. Every party shall have the right of cross-examination of witnesses who testify, and following the conclusion of the Boards presentation, shall have the right to submit rebuttal evidence.

3.13. The Board shall have the right to cross-examine witnesses providing rebuttal testimony.

3.14. Following the presentation of all evidence, every party, including the board, shall have the right to offer argument, not to exceed ten (10) minutes for each presentation.

3.15. The state or local organization which represents the profession to which the Respondent belongs may intervene in any hearing for the purpose of assisting in the prosecution of the complaint, or may with the consent of the Respondent, intervene for the purpose of assisting the Respondent in contesting the complaint.

3.16. Hearing examiners are not authorized or empowered to suspend or revoke any licensor to place any licensee or probation. The function of a hearing examiner is to preside at the hearing and to cause to be prepared a record of the hearing so that the Board can discharge its functions. The hearing examiner shall prepare recommended findings of fact and conclusions of law for submission to the Board.

3.17. Summons and subpoenas may be issued by the Chairman of the Board and by hearing examiners appointed by the Board.

3.18. The Board or its hearing examiner may institute proceedings in circuit courts to punish persons for contemptuous or contumacious conduct directed to the Board or to its hearing examiner in the course of hearings.

3.19. The Respondent shall serve his answer within thirty (30) days after service of the complaint upon him. Upon failure of the Respondent to respond to the complaint as required, all of the allegations set out therein as to conduct or conditions of the Respondent may be taken by the Board as confessed by the Respondent.

3.20. Hearings may be continued from one day to another, or adjourned to a later date or a different place by announcement thereof or by appropriate notice to all parties.

3.21. A continuance may be granted by the Chairman or his designee for good cause shown. A written notice of continuance shall be filed at least five (5) days prior to the hearing date.

W. Va. Code R. § 4-2-4 Transcription of Reported Testimony and Evidence

4.1. All testimony, evidence, arguments and rulings on the admissibility of testimony and evidence shall be reported by stenographic notes and characters or by mechanical means.

4.2. Upon request to the Board by any party to the hearing, all reported materials shall be transcribed and a copy thereof furnished to such party at his expense.

4.3. In all cases where a hearing examiner is appointed, all reported materials shall be transcribed and forwarded to the Chairman. A party who requests a copy of a transcript prepared pursuant to this subsection shall be furnished a copy at his expense.

4.4. The Board shall have the responsibility to make arrangements for the transcription of the reported testimony and evidence. In the event transcription is required pursuant to this Section, it shall accomplished within a reasonable time.

4.5. Upon the motion of the Board or any party assigning error in any part of the transcript, the Board through the Chairman, shall settle all differences, and shall direct the transcript be corrected and revised so as to make it conform to the whole truth.

W. Va. Code R. § 4-2-5 Submission of Proposed Findings of Fact and Conclusions of Law

5.1. Any party may submit Proposed Findings of Fact and Conclusions of Law within thirty (30) days of the conclusion of a hearing, or in the event the proceedings of a hearing are transcribed, within twenty (20) days from the date the final transcript is available to all parties and to all members of the Board. Transcripts of the hearings shall be provided to all members of the Board for review at least ten (10) days before the vote on the Proposed Findings of Fact and Conclusions of Law is called.

W. Va. Code R. § 4-2-6 Hearing Examiner

6.1. The Chairman, with the approval of a majority of the Board, may appoint a hearing examiner who shall be empowered to subpoena witnesses and documents, administer oaths and affirmations, examine witnesses under oath, rule on evidentiary questions, hold conferences for the settlement or simplification of issues by consent of the parties and otherwise conduct hearings as provided in section 3 herein. If a hearing examiner is appointed under this rule, he shall make proposed Findings of Fact and Conclusions of Law.

6.2. The Chairman, with the approval of a majority of the Board, may appoint one (1) or more members of the Board to serve as hearing examiners for the purpose of conducting any hearing on behalf of the Board. The hearing examiner shall submit written Findings of Fact and Conclusions of Law to the Board pursuant to W. Va. Code '29A-5-3, and the Board may adopt, modify or reject such Findings of Fact and Conclusions of Law.

W. Va. Code R. § 4-2-7 Conferences: Informal Disposition of Cases

7.1. At any time prior to the hearing or thereafter, the Chairman, or his duly appointed hearing examiner may hold conferences for the following purposes:

a. To dispose of procedural requests of similar matters;

b. To simplify or settle issues by consent of the parties;

c. To provide for the informal disposition of cases by stipulation, agreed settlement or consent order.

7.2. The Chairman, or duly appointed hearing examiner may cause such conferences to be held on his own motion or by the request of a party.

W. Va. Code R. § 4-2-8 Depositions

8.1. Evidentiary depositions may be taken and read into evidence as in civil actions in the circuit courts of this State.

W. Va. Code R. § 4-2-9 Subpoenas

9.1. The Chairman or his designee shall have the power to issue subpoenas or subpoenas duce tecum pursuant to the provisions set forth in W. Va. Code '29A-5-1.

9.2. Written requests for the issuance of subpoenas or subpoenas duces tecum as provided in WV 4CSR2-9 shall be made no later than ten (10) days before a scheduled hearing.

W. Va. Code R. § 4-2-10 Orders

10.1. Any final order entered by the Chairman or his designee following a hearing conducted pursuant to these rules, shall be made pursuant to the provisions of W. Va. Code '29A-5-3. Such orders shall be entered within forty-five (45) days following the submission of all documents and materials necessary for the proper disposition of the case, including transcripts, and shall contain Findings of Fact and Conclusions of Law.

10.2. The Findings of Fact and Conclusions of Law must be approved by a majority of the Board either by a poll or vote at a regular meeting, before a final order is entered. A copy of the final order approved by a majority of the Board shall be served upon the Respondent within five (5) days after entry by the Board, by means of registered or certified mail sent to the party or his counsel.

W. Va. Code R. § 4-2-11 Appeal

11.1. An appeal from any final order entered in accordance with these regulations shall comply with the provisions of W. Va. Code '29A-5-4.

4CSR2

Series 03 Contested Case Hearing Procedure

W. Va. Code R. § 4-3-1 General

1.1. Scope. -- These procedural rules establish procedures for the adjudication of contested case hearings before the Board.

1.2. Authority. -- W. Va. Code ''30-16-1 et seq., 30-1-1 et seq. and 29A-5-1 et seq.

1.3. Filing Date. -- May 5, 1993 .

1.4. Effective Date. -- June 10, 1993.

W. Va. Code R. § 4-3-2 Definitions

The following words and phrases as used in these rules shall have the following meanings, unless the context otherwise requires:

2.1. "Board" means the West Virginia Board of Chiropractic Examiners.

2.2. The term "demanding party" means an individual who has been denied a license to practice chiropractic medicine by the Board and who, as a result, demands that a hearing be held before the Board on the issue of such denial.

2.3. The term "charged party" means an individual who holds a license to practice chiropractic medicine issued by the Board and who has been charged by the Board as described in 3.4 of these rules.

2.4. The term "licensee" means an individual who holds a license to practice chiropractic medicine issued by the Board.

W. Va. Code R. § 4-3-3 Hearing Procedures

3.1. Any person denied a license by the Board who believes such denial was in violation of W. Va. Code ''30-1-1 et seq. and/or 30-16-1 et seq. shall be entitled to a hearing on the action denying such license.

3.2. Any person who desires a hearing for the reason described in subsection 3.1 of this section must present a written demand for such to the Board.

3.3. When the president of the Board or his or her authorized designee is presented with such a demand for a hearing, he or she shall schedule a hearing within forty-five (45) days of receipt by him or her of such written demand, unless postponed to a later date by mutual agreement.

3.4. Charges may be instituted against any chiropractor by the Board when reasonable cause exists for believing that the chiropractor may have engaged in conduct or be in such condition that his or her license should be suspended, revoked or otherwise disciplined for one or more of the grounds set forth in W. Va. Code '30-16-1 et seq. or the Board's legislative rules. Charges may be based upon information received by way of a verified written complaint filed with the Board and further information gathered by the Board in the process of investigating such complaint. Charges may also be based upon information received solely through investigative activities undertaken by the Board.

3.5. Charges instituted against a licensee as described in subsection 3.4 of this section shall be set forth in a Complaint and Notice of Hearing issued in the name of the Board as the agency of the State regulating the practice of chiropractic medicine. Such Complaint and Notice of Hearing shall designate the Board as the "Complainant", and shall designate the chiropractor involved in the proceeding as the "Respondent"; shall set out the substance of each offense charged with sufficient particularity to reasonably apprise the Respondent of the nature, time and place of the conduct or condition complained of therein; shall state the date, time and place for the hearing; and, shall contain a statement of intention by the Board to appoint a hearing examiner.

3.6. Upon receipt of a demand for a hearing described in subsections 3.1 and 3.2 of this section, the president or his or her designee shall provide the demanding party, with a Complaint and Notice of Hearing issued in the name of the Board as the agency of the State regulating the practice of registered professional nursing. Such Complaint and Notice of Hearing shall designate the demanding party as the "Complainant" and shall designate the Board as the "Respondent"; shall set out the substance of each and every reason that the Board has denied the demanding party a license with sufficient particularity to reasonably apprise the demanding party of the nature, time and place of the conduct or condition at issue therein; shall state the date, time and place for the hearing; and, shall contain a statement of intention by the Board to appoint a hearing examiner.

3.7. The Board may amend the charges set forth in a Complaint and Notice of Hearing as it deems proper.

3.8. A Complaint and Notice of Hearing shall be served upon the demanding or charged party at least thirty (30) days prior to the date of hearing.

3.9. Upon written motion received by the Board no later than twenty (20) days prior to the date of hearing, a more definite statement of the matters charged or the reasons stated for denial of licensure shall be provided to the demanding or charged party or his or her counsel, at least fifteen (15) days prior to the hearing date.

3.10. Hearings shall be conducted as follows:

a. Any party to a hearing shall have the right to be represented by an attorney-at-law, duly qualified to practice law in the State of West Virginia.

b. The Board may be represented by the West Virginia Attorney General's office.

c. Irrelevant, immaterial, or unduly repetitious evidence shall be excluded from the hearing. Furthermore, the rules of evidence as applied in civil cases in the circuit courts of this State shall be followed. However, when necessary to ascertain facts not reasonably susceptible of proof under those rules, evidence not admissible thereunder may be admitted, except where precluded by statute, if it is of a type commonly relied upon by reasonably prudent persons in the conduct of their affairs.

d. The rules of privilege recognized by the law of this State shall be followed.

e. Objections to evidentiary offers shall be noted in the record. Any party to the hearing may vouch the record as to any excluded testimony or other evidence.

f. Any party to a hearing may appear with witnesses to testify on his or her behalf; may be heard in person, by counsel or both; may present such other evidence in support of his or her position as deemed appropriate by the Board or its designated hearing examiner; and, when appropriate, may cross-examine witnesses called by the Board in support of the charges or in defense of its decision to deny licensure.

g. The hearing shall be held at such time and place as is designated by the Board, but no hearing shall be conducted unless and until at least thirty (30) days written notice thereof has been served upon the charged or demanding party and/or his or her attorney in person; or if he or she cannot be found, by delivering such notice at his or her usual place of abode, and giving information of its purport, to his wife or her husband, or to any other person found there who is a member of his or her family and above the age of sixteen years; or if neither his wife or her husband nor any such person can be found there, and he or she cannot be found, by leaving such notice posted at the front door of such place of abode; or if he or she does not reside in this State, such notice may be served by the publication thereof once a week for three successive weeks in a newspaper published in this State; or such notice may by served by registered or certified mail.

h. The hearing shall be open to the general public.

i. Members of the Board and its officers, agents and employees shall be competent to testify at the hearing as to material and relevant matters: Provided, that no member of the Board who testifies at such hearing shall thereafter participate in the deliberations or decisions of the Board with respect to the case in which he or she so testified.

j. The hearing may be conducted by one or more Board members or by a hearing examiner appointed by the Board.

k. A record of the hearing, including the complaint(s), if applicable, the notice of hearing, all pleadings, motions, rulings, stipulations, exhibits, documentary evidence, evidentiary depositions and the stenographic report of the hearing, shall be made and a transcript thereof maintained in the Board's files. Upon request, a copy of the transcript shall be furnished to any party at his or her expense.

l. Documentary evidence may be received in the form of copies or excerpts or by incorporation by reference.

m. Where a hearing is held upon the instance of the Board after charges have been brought against a licensee pursuant to subsections 3.4 and 3.5 of this section, the Board shall have the burden of proof and shall present its evidence and/or testimony in support of the charges first.

n. Where a hearing is held upon demand under the provisions of subsections 3.1, 3.2, 3.3 and 3.6 of this section, the demanding party shall have the burden of proof and shall therefore be required to present his or her evidence first.

o. Following the conclusion of the Board's presentation of evidence in accordance with subsection 3.10.(m) of this section, the Respondent or charged party shall have the right to submit his or her evidence in defense.

p. Following the conclusion of the demanding party's presentation of evidence in accordance with subsection 3.10.(n) of this section, the Board shall have the right to submit its evidence in defense.

q. The Board may call witnesses to testify in support of its decision to deny licensure or in support of the charges instituted against a licensee; may present such other evidence to support its position; and, may cross-examine witnesses called by the demanding party or charged party in support of his or her position.

r. All parties shall have the right to offer opening and closing arguments, not to exceed ten (10) minutes for each presentation.

s. Hearings held by the Board as a result of charges instituted against a licensee may be continued or adjourned to a later date or a different place by the Board or its designee by appropriate notice to all parties.

t. Motions for a continuance of a hearing may be granted upon a showing of good cause. Motions for continuance must be in writing and received in the office of the Board no later than seven (7) days prior to the hearing date. In determining whether good cause exists, consideration will be given to the ability of the party requesting the continuance to proceed effectively without a continuance. A motion for a continuance filed less than seven (7) days from the date of hearing shall be denied unless the reason for the motion could not have been ascertained earlier. Motions for continuance filed prior to the date of hearing may be ruled on by the Executive Secretary or Assistant Executive Secretary of the Board or designated hearing examiner. All other motions for continuance shall be ruled on by the Board member(s) or the hearing examiner presiding over the hearing.

u. All motions related to a case set for hearing before the Board, except motions for continuance and those made during the hearing, shall be in writing and shall be received in the office of the Board at least ten (10) days before the hearing. Prehearing motions shall be heard at a prehearing conference or at the hearing prior to the commencement of testimony. The Board member(s) or the hearing examiner presiding at the hearing shall hear the motions and the response from the non-moving party and shall rule on such motions accordingly.

W. Va. Code R. § 4-3-4 Transcription of Testimony and Evidence

4.1. All testimony, evidence, arguments and rulings on the admissibility of testimony and evidence shall be recorded by stenographic notes and characters or by mechanical means.

4.2. All recorded materials shall be transcribed. The Board shall have the responsibility to make arrangements for the transcription of the recorded testimony and evidence.

4.3. Upon the motion of the Board or any party assigning error or omission in any part of any transcript, the Board or its appointed hearing examiner shall settle all differences arising as to whether such transcript truly discloses what occurred at the hearing and shall direct that the transcript be corrected and/or revised as appropriate so as to make it conform to the truth.

4.4. A transcript of the hearing shall be provided to all members of the Board for review at least ten (10) days before the vote is taken on its decision in any licensure or licensure disciplinary matter.

W. Va. Code R. § 4-3-5 Submission of Proposed Findings of Fact and Conclusions of Law

Any party may submit proposed findings of fact and conclusions of law at a time and manner designated by the Board or its duly appointed hearing examiner.

W. Va. Code R. § 4-3-6 Hearing Examiner

6.1. The Board may appoint a hearing examiner who shall be empowered to subpoena witnesses and documents, administer oaths and affirmations, examine witnesses under oath, rule on evidentiary matters, hold conferences for the settlement or simplification of issues by consent of the parties, cause to be prepared a record of the hearing so that the Board is able to discharge its functions and otherwise conduct hearings as provided in 19 CSR 5-3.10 herein.

6.2. Hearing examiners appointed by the Board are not authorized or empowered to grant, suspend, revoke or otherwise discipline any license.

6.3. The hearing examiner shall prepare recommended findings of fact and conclusions of law for submission to the Board. The Board may adopt, modify or reject such findings of fact and conclusions of law.

W. Va. Code R. § 4-3-7 Conferences: Informal Disposition of Cases

7.1. At any time prior to the hearing or thereafter, the Board, its designee or its duly appointed hearing examiner may hold conferences for the following purposes:

a. To dispose of procedural requests, prehearing motions or similar matters;

b. To simplify or settle issues by consent of the parties; or c. To provide for the informal disposition of cases by stipulation or agreement.

7.2. The Board or its appointed hearing examiner may cause such conferences to be held on its own motion or by the request of a party.

7.3. The Board may also initiate or consider stipulation or agreement proposals with regard to the informal disposition of cases and may enter into such stipulations and/or agreements without conference.

W. Va. Code R. § 4-3-8 Depositions

Evidentiary depositions may be taken and read or otherwise included into evidence as in civil actions in the circuit courts of this State.

W. Va. Code R. § 4-3-9 Subpoena

9.1. Subpoenas to compel the attendance of witnesses and subpoenas duces tecum to compel the production of documents may be issued by the Board, its Executive Secretary, its Assistant Executive Secretary, and by the hearing examiner appointed by the Board. Such subpoenas shall be issued pursuant to W. Va. Code '29A-5-l(b).

9.2. Written requests by a party for the issuance of subpoenas or subpoenas duces tecum as provided in subsection 9.1. of this section must be received by the Board no later than ten (10) days before a scheduled hearing. Any party requesting the issuance of subpoenas or subpoenas duces tecum shall see that they are properly served in accordance with W. Va. Code '29A-5-l(b).

W. Va. Code R. § 4-3-10 Orders

10.1. Any final order entered by the Board following a hearing conducted pursuant to these rules shall be made pursuant to the provisions of W. Va. Code ''29A-5-3 and 30-1-8(d). Such orders shall be entered within forty-five (45) days following the submission of all documents and materials necessary for the proper disposition of the case, including transcripts, and shall contain findings of fact and conclusions of law.

10.2. The findings of fact and conclusions of law must be approved by a majority of the Board either by a poll or vote at a regular meeting, before a final order is entered. A copy of the final order approved by a majority of the Board shall be served upon the demanding or charged party and/or his attorney of record, if any, within five (5) days after entry by the Board by personal service or by registered or certified mail.

W. Va. Code R. § 4-3-11 Appeal

An appeal from any final order entered in accordance with these rules shall comply with the provisions of W. Va. Code '30-1-9.

4CSR3

Series 04 Formation And Approval Of Professional Limited Liability Companies

W. Va. Code R. § 4-4-1 General

1.1. Scope. -- This legislative rule addresses procedures for the formation and approval of professional limited liability companies for chiropractic physicians.

1.2. Authority. -- W. Va. Code '31B-13-1304.

1.3. Filing Date. -- March 29, 1999.

1.4. Effective Date. -- March 29, 1999.

W. Va. Code R. § 4-4-2 Definitions

2.1. Board. - The West Virginia Board of Chiropractic Examiners, established in W. Va. Code '30-16-4.

2.2. Professional limited liability company. - a limited liability company organized under Chapter 31B of the W.Va. Code for the purpose of rendering a professional service.

2.3. Professional services. - The services rendered under W. Va. Code ''30-16-1 et seq., by Chiropractic Physicians.

W. Va. Code R. § 4-4-3 Procedures for Formation and Approval of Professional Limited Liability Companies for Chiropractic Physicians. Fees

3.1. Chiropractic Physicians licensed to practice chiropractic in an active status in this State who desire to render chiropractic professional services as a limited liability company shall comply with the provisions of W. Va. Code ''31B-1301 et seq. No professional limited liability company shall have as a member anyone other than a person who is duly licensed or otherwise legally authorized to render the professional services for which the professional limited liability company was organized.

3.2. The name of a professional limited liability company shall contain the words Aprofessional limited liability company@ or the abbreviation AP.L.L.C.@ or AProfessional L.L.C.@

3.3. Every professional limited liability company shall file with the Board at the time of formation, and on an annual basis on or before the first day of July the list of names of its members, and written documentation that the professional limited liability company carries at least one million dollars of professional liability insurance, together with an initial filing fee of $100 or an annual renewal fee of $100.

3.3.a. The requirement of carrying one million dollars of professional liability insurance is satisfied if the professional limited liability company provides one million dollars of funds specifically designated and segregated for the satisfaction of judgments against the company members or any of its professional or nonprofessional managers or employees arising out of the performance of professional services to patients or clients of the company, by:

(1) Deposit in trust or in bank escrow of cash, bank certificates of deposit or United States treasury obligation; or (2) A bank letter of credit or insurance company bond.

3.4. Every limited liability company formed prior to the effective date of this rule whose members are chiropractic physicians licensed under the provisions of W. Va. Code ''30-16-1 et seq. shall re-form and re-file pursuant to the provisions of W. Va. Code ''31B-1301 et seq. and of this rule.

3.5. Every professional limited liability company shall file with the Board a copy of the annual report required to be filed with the Secretary of State under W. Va. Code '31B-2-211. The copy of the annual report, and a copy of any corrected annual report filed with the secretary of state, shall be filed with the Board on or before the first day of July on an annual basis.

3.6. Every professional limited liability company in compliance with all the provisions of this rule shall be approved by and remain approved by the Board.

3.7. If any person ceases to be a member of any professional limited liability company, they shall notify the Board in writing within twenty days that the person has ceased to be a member of the professional limited liability company. The fact that a person ceases to be a member of a professional limited liability company shall not affect the approval of the professional limited liability company by the Board, provided that the Board determines that the professional limited liability company remains in compliance with all the provisions of this rule.

W. Va. Code R. § 4-4-4 Notification of Non-compliance, Cessation of Rendering Professional Services

4.1. If the Board determines that a professional limited liability company is not in compliance with all the provisions of this rule and should cease rendering professional services in the State, the Board shall notify the professional limited liability company in writing, and upon receipt of the written notice, the professional limited liability company shall cease rendering professional services in the State.

W. Va. Code R. § 4-4-5 Chiropractic Physician-Patient Relationships

5.1. The provisions of this rule shall not be construed to alter or affect the chiropractic physician-patient relationship.

4CSR4

Series 05 Disciplinary And Complaint Procedures For Chiropractors

W. Va. Code R. § 4-5-1 General

1.1. Scope. -- This rule specifies the procedure for the investigation and resolution of complaints against chiropractors and those persons or corporations rendering chiropractic services.

1.2. Authority. -- W. Va. Code §30-16-5(3).

1.3. Filing Date. -- November 28, 2000.

1.4. Effective Date. -- December 29, 2000.

1.5. This series replaces 4CSR1-13.

W. Va. Code R. § 4-5-2 Application

2.1. This rule applies to all chiropractors and persons or corporations providing chiropractic services.

W. Va. Code R. § 4-5-3 Definitions

The following words and phrases as used in this rule have the following meanings, unless the context otherwise requires:

3.1. "Applicant" means any person making application for an original or renewal license or a temporary license to practice chiropractic.

3.2. "Board" means the West Virginia Board of Chiropractic.

3.3. "License" means a license or temporary permit issued by the Board to practice chiropractic.

3.4. "Chiropractor" means a practitioner of chiropractic.

3.5. "Investigative Officer" means a person licensed to practice chiropractic in this state, and is appointed by the Board of Chiropractic for the purpose of reviewing complaints against chiropractors.

W. Va. Code R. § 4-5-4 Causes for Denial, Probation, Limitation, Discipline, Suspension or Revocation of License

4.1. The Board may deny an application for license, place a chiropractor on probation, limit or restrict the same, suspend a license or revoke any license issued by the Board, upon satisfactory proof that a licensee has been convicted of a felony or is, in his or her professional capacity, engaged in conduct, practices or acts constituting professional negligence or a willful departure from accepted standards of professional conduct in violation of W. Va. Code §30-16-11.

W. Va. Code R. § 4-5-5 Disposition of Complaints

5.1. Any person, firm, corporation, member of the Board, or public officer may make a complaint to the Board which charges a chiropractor with a violation of W. Va. Code §30-16-11 or the Legislative

Rule 4CSR1-13. The Board may provide a form for that purpose, but a complaint may be filed in any written form. In addition to describing the alleged violation which prompted the complaint, the complaint must contain the following:

5.1.1. The name and address of the chiropractor against whom the complaint is lodged;

5.1.2. The date of care;

5.1.3. The name of any person who may have treated the patient after the alleged incident; and,

5.1.4. The name of any health care institution in which the patient was an inpatient or outpatient after or during the alleged incident.

5.2. A complaint against a chiropractor will allege that such person has been convicted of a felony or is in his or her professional capacity, engaging in conduct, practices or acts constituting professional negligence or a willful departure from accepted standards of professional conduct in violation of W. Va.

Code §30-16-11 or the Legislative Rule 4CSR1-13.

5.3. Complainants are immune from liability for the allegations contained in their complaints filed with the Board unless the complaint is filed in bad faith or for a malicious purpose.

5.4. The Board will maintain a complaint log which records the receipt of each complaint, its nature and its disposition.

5.5. The Board will maintain a separate file on each complaint received, and each file will have a number assigned to it.

5.6. Upon receipt of a complaint, the Board will issue one of the following acknowledgments to the complainant:

5.6.1. That the matter will be reviewed by the Board;

5.6.2. That the complaint is outside the jurisdiction of the Board, with suggestions as to how the complainant might best obtain a resolution of his or her problem; or,

5.6.3. That more information will be required in order to adequately review the individual complaint.

5.7. The Board will send a copy of the complaint, including any supportive documentation, by certified mail to the chiropractor in question for his or her written comment, and he or she must submit a written response to the Board within thirty (30) days of the date of the correspondence, or waive the right to do so.

5.8. Requests for comment on complaints sent to the chiropractor or applicants will be considered properly served when sent to their last known address. It is the responsibility of the chiropractor or applicants to keep the Board informed of his or her current address.

5.9. Upon receipt of a chiropractor's comments in response to a complaint, the Board will promptly send a copy of the response, including any supporting documentation, to the complainant.

5.10. After receipt and review of a complaint, unless the complaint is determined to fall within the provisions of subdivision 5.6.2 of this rule, the Board will conduct or authorize any reasonable inquiry or investigation it considers necessary to determine the truth and the validity of the allegations in the complaint. The review of complaints and any view or investigation may, at the discretion of the Board, be assigned to a committee of the Board.

5.11. At any point in its investigation of a complaint the Board may, at its discretion, assign the matter to an investigative officer for review and investigation.

5.12. Upon receipt of a complaint, the investigative officer must, within sixty (60) days, review and investigate the complaint and provide the Board with a report. The report must include a statement of the allegations, a statement of facts, and an analysis of the complaint including a description of the care provided, the records reviewed and a statement of the investigative officer's findings and recommendations. The investigative officer will, upon request, be afforded an opportunity to have an investigation interview with the licensee or applicant in question or other involved parties. A report of the investigation interview will be placed in the investigation file.

5.13. To facilitate the disposition of a complaint, the Board or the committee may request any person to attend an informal conference, or to appear at a regular meeting of the Board, at any time prior to the Board entering any order with respect to the complaint. The Board or the committee must give notice of the conference. The notice must include a statement of issues to be informally discussed.

Statements made at a conference may not be introduced at any subsequent hearing on the merits without the consent of all parties to the hearing. Failure to attend a conference will not prejudice any party to the case.

5.14. The Board, its president, the investigating committee or chairperson may issue subpoenas and subpoenas duces tecum to complete the Board's investigation and to determine the truth or validity of complaints. The investigative officer may request the Board or its president to issue a subpoena or subpoena duces tecum. Any subpoena request must be accompanied by a brief statement explaining the need for the subpoena.

5.15. At any point in the course of an investigation or inquiry into a complaint, the Board may determine that there is not and will not be sufficient evidence to warrant further proceedings, or that the complaint fails to allege misconduct for which a chiropractor may be sanctioned by the Board: Any review or investigation of a complaint assigned to a committee or an investigative officer. The committee or investigative officer will make their respective findings and recommendations to the Board prior to the Board dismissing the complaint.

W. Va. Code R. § 4-5-6 Contested Case Hearings

6.1. The Board may refuse to renew a license or suspend, such if it determines there is probable cause to believe that a chiropractor's practices or acts constitute an immediate danger to the public.

W. Va. Code R. § 4-5-7 Appeals

7.1 Any applicant who has had his or her application for a license denied by order of the Board may appeal the order within thirty (30) days of that action in accordance with the contested case hearing procedures set forth in W. Va. Code §29A-6-1 et seq. or 4CSR3-11 of the Board. Provided, that the appeal will not include cases in which the Board denies a license after an examination to test the knowledge or the ability of the applicant where the controversy concerns whether the examination was fair or whether the applicant passed the examination.

Series 06 Fees Pertaining to the Practice of Chiropractic

W. Va. Code R. § 4-6-1 General

1.1. Scope. -- This rule provides for the fees that shall apply to the practice of chiropractic in the State of West Virginia.

1.2. Authority. -- W. Va. Code 30-16-5.

1.3. Filing Date. -- April 6, 2022.

1.4. Effective Date. -- July 1, 2022.

1.5. Sunset Provision. -- This rule shall terminate and have no further force or effect on August 1, 2027.

W. Va. Code R. § 4-6-2 Fees

2.1. The annual renewal fee for chiropractors practicing in West Virginia is $261, out of state or retired chiropractors is $130.

2.2. If the license renewal requirements are postmarked after July 1, there is a $175 late fee.

2.3. If the license renewal requirements are postmarked after July 31, there is an additional $175 reinstatement fee.

2.4. The fee for each application for approval for articles of incorporation is $130 per request. The initial filing fee for a chiropractic corporation or a professional limited liability company is $130 and an annual renewal fee of $130.

2.5. The examination fee is $130 per applicant and a fee of $45 per applicant for reexamination.

2.6. The initial licensing fee is $45 per licensee.

2.7. The fee for requests for continuing education courses is $87 per course.

2.8. The application fee for preceptorship approval is $45 per student.

2.9. There is a fee of $218 per request for address listings.

Series 08 Consideration of Prior Criminal Convictions in Initial Licensure Determinations

W. Va. Code R. § 4-8-1 General

1.1. Scope. -- This rule establishes procedures for consideration of prior criminal convictions in initial licensure determinations.

1.2. Authority. -- W. Va. Code §30-1-24, and W. Va. Code §30-16-5.

1.3. Filing Date. -- June 27, 2025.

1.4. Effective Date. -- June 27, 2025.

1.5. Sunset Provision. -- This rule shall terminate and have no further force or effect on August 1, 2030.

W. Va. Code R. § 4-8-2 Definitions

2.1. “Board” means the Chiropractic Board established pursuant to W. Va. Code §30-16-1 et seq.

2.2. “Initial” means obtaining a license in West Virginia for the practice of chiropractic for the first time.

2.3. “License” or “licensure” means the official authorization by the Board to engage in the practice of chiropractic.

2.4. “Unreversed”, as that term refers to a criminal conviction, means that a conviction has not been set aside, vacated, pardoned, or expunged.

W. Va. Code R. § 4-8-3 Rational nexus to the practice of chiropractic

3.1. The Board may not disqualify an applicant from initial licensure because of a prior criminal conviction that remains unreversed unless that conviction is for a crime that bears a rational nexus to the practice of chiropractic. In determining whether a criminal conviction bears a rational nexus to a chiropractor, the Board shall consider at a minimum:

3.1.a. The nature and seriousness of the crime for which the individual was convicted;

3.1.b. The passage of time since the commission of the crime;

3.1.c. The relationship of the crime to the ability, capacity, and fitness required to perform the duties and discharge the responsibilities of a licensed chiropractor; and

3.1.d. Any evidence of rehabilitation or treatment undertaken by the individual.

W. Va. Code R. § 4-8-4 Application after denial

4.1. Notwithstanding any other provision of the W. Va. Code to the contrary, if an applicant has been denied licensure because of a prior criminal conviction, the Board shall permit the applicant to apply for initial licensure if:

4.1.a. A period of five years has elapsed from the date of conviction or the date of release from incarceration, whichever is later;

4.1.b. The individual has not been convicted of any other crime during the period of time following the disqualifying offense; and

4.1.c. The conviction was not for an offense of a violent or sexual nature: Provided. That a conviction for an offense of a violent or sexual nature may subject an individual to a longer period of disqualification from licensure, to be determined by the Board on a case by case basis.

W. Va. Code R. § 4-8-5 Petition for licensure eligibility determination

5.1. An individual with a criminal record who has not previously applied for licensure may petition the Board at any time for a determination of whether the individual’s criminal record will disqualify the individual from obtaining a license.

5.2. The petition shall be submitted on an application form prescribed by the Board and shall include sufficient details about the individual’s criminal record to enable the Board to identify the jurisdiction where the conviction occurred, the date of the conviction, the date of the release from incarceration if applicable, and the specific nature of the conviction.

5.3. The applicant may submit the petition for licensure eligibility evidence of rehabilitation, letters of reference, and any other information the applicant deems relevant to show fitness and the ability to practice chiropractic.

5.4. The Board shall provide the determination within 60 days of receiving the petition from the applicant.

Series 09 Chiropractic Telehealth Practice

W. Va. Code R. § 4-9-1 General

Scope. -- This rule provides for the regulation of Chiropractic Interstate Telehealth Practitioners.

Authority. -- W. Va. Code §30-1-26 et seq.

Filing Date. -- April 1, 2022 Effective Date. -- June 30, 2022 Sunset Provision. -- This rule shall terminate and have no further force or effect on August 1, 2027.

1.6. Applicability. -- This rule applies to doctors of chiropractic licensed to practice in other jurisdictions who seek to provide limited interstate telehealth services in West Virginia.

W. Va. Code R. § 4-9-2 Definitions

2.1. “Board” or “Board of Chiropractic” means the West Virginia Board of Chiropractic established pursuant to W. Va. Code §30-16-1 et seq.

2.2. “Health care practitioner” means a person authorized to practice chiropractic under W. Va. Code §30-16-1 et seq.

2.3. “Interstate telehealth services” means the provision of telehealth services to a patient located in West Virginia by a health care practitioner located in any other state or commonwealth of the United States.

2.4. “Registration” means an authorization to practice chiropractic under W. Va. Code §30-16-1 et seq. for the limited purpose of providing interstate telehealth services.

2.5. “Telehealth services” means the use of synchronous or asynchronous telecommunications technology or audio only telephone calls by a health care practitioner to provide chiropractic services for assessment, intervention and/or consultation. The term does not include internet questionnaires, email messages, or facsimile transmissions, nor does it include promoting or soliciting patients.

4CSR9

W. Va. Code R. § 4-9-3 Application for Registration and Annual Review

3.1 To be eligible for registration, the registrant shall:

3.1.1. Submit a registration application to the Board on a form approved by the Board located at www.boc.wv.gov;

3.1.2. Pay the appropriate registration fee as required in W. Va. Code §30-16-10 et seq., and Fees Pertaining to the Practice of Chiropractic, 4CSR6;

3.1.3. Hold a valid, active chiropractic license issued by another state licensing authority or board;

3.1.4. Hold license(s) in good standing in all states in which he/she is currently licensed; and

3.1.5. Not currently be under investigation or subject to an administrative complaint.

3.2. The registration of out-of-state telehealth practitioner shall expire annually on the 30th day of June.

3.3. A registrant requesting renewal of a registration shall:

3.3.1. Pay the registration renewal fees as stated in Regulation of Chiropractic Practice, 4CSR1, and Fees Pertaining to the Practice of Chiropractic, 4CSR6.

3.3.2. Submit a renewal application to the Board on a form approved by the Board located at www.boc.wv.gov on or before June 30th.

W. Va. Code R. § 4-9-4 Standard of Care, Administrative Discipline, and Restrictions on Registration

4.1. The Standard of Care for the Provision of Telehealth Services by registrants under this rule shall require the registrants to follow the scope of practice stated in W. Va. Code §30-16-3 et seq., §30-16-18, §30-16-20, and §30-16-21; however, the standard of care does not include the review of non-patient information relating to the duration and necessity of chiropractic care that affects the course of care, the treatment plan, or payment, and reimbursement, concerning chiropractic patients residing in the State of West Virginia. It also does not permit the promotion or practice of functional medicine as a specialty, nor allow any disease-based treatment.

4.1.1. A registration issued pursuant to this rule does not authorize a health care professional to practice from a physical location within this state without first obtaining licensure by the Board of Chiropractic.

4.1.2. A healthcare professional who registers to provide telehealth services pursuant to this rule shall immediately notify the Board of any restrictions placed on the individual’s license to practice in any state or jurisdiction.