1. A. A chiropractor shall:

   1. (1) Use professional judgment in the use of evaluation and treatment procedures;
   2. (2) Decline to administer treatment if the chiropractor believes that a treatment is contraindicated or unjustified;

   3. (3) Terminate a professional relationship with a patient in an appropriate manner, such as:

      1. (a) Providing the patient with sufficient notice to permit the patient to obtain the services of another professional;
      2. (b) Assisting the patient by providing referrals if appropriate; or
      3. (c) Continuing to provide emergency treatment to the patient if treatment is required before a reasonable time has passed to allow the patient to obtain the services of another health care provider;

   4. (4) Maintain a written record of treatment of the patient under the chiropractor's care for at least:

      1. (a) 5 years after the termination of treatment; and
      2. (b) 5 years after the patient becomes 18 years old, if applicable;
   5. (5) Make the written records of treatment available to the patient upon request, in compliance with applicable laws for disclosure of medical records;
   6. (6) Make arrangements for another professional to provide for the needs of the patient during anticipated absences when the chiropractor is unavailable to the patient;
   7. (7) Make referrals only to other qualified and duly licensed health care providers;
   8. (8) Accurately inform the patient, other health care professionals, and the public of the limitations of the practice of chiropractic;
   9. (9) Adequately assess the patient to determine if contraindications against chiropractic treatment exist and refer the patient to an appropriate health care practitioner;
   10. (10) Exercise independent professional judgment in the treatment or evaluation of the patient regardless of whether the patient was referred by another health care provider;

   11. (11) Ensure clear and concise professional communications with patients regarding:

       1. (a) Nature and duration of treatment;
       2. (b) Diagnoses;
       3. (c) Costs;
       4. (d) Billing; and
       5. (e) Insurance; and
   12. (12) Administer fair and equitable fees to patients regardless of status or insurance.

2. B. A chiropractor may not:

   1. (1) Accept a client for treatment, or continue unnecessary treatment, when the patient cannot be reasonably expected to benefit from the treatment;
   2. (2) Receive remuneration from, or provide remuneration to, or split a fee, for either making or accepting a referral of the patient to or from another health care provider;
   3. (3) Make a guarantee or promise about the efficacy of a particular treatment, the chiropractor's practice, or the result of a treatment unless supported by scientific principles accepted by the profession; or

   4. (4) Exploit the professional relationship by:

      1. (a) Continuing treatment unnecessarily; or

      2. (b) Charging for a service:

         1. (i) Not provided; or
         2. (ii) Different from those actually provided.

Authority: Health Occupations Article, §§1-212, 3-205, and 3-313, Annotated Code of Maryland

Effective date: January 9, 2000 (26:27 Md. R. 2015)

Regulation .03B, D amended effective October 22, 2007 (34:21 Md. R. 1915)

Regulation .03C amended effective January 6, 2014 (40:26 Md. R. 2164)

Regulation .03D amended effective October 22, 2007 (34:21 Md. R. 1915); June 13, 2011 (38:12 Md. R. 705)

Regulation .04A amended effective October 22, 2007 (34:21 Md. R. 1915)

Regulation .05B amended effective January 6, 2014 (40:26 Md. R. 2164)

Regulation .05C adopted effective January 6, 2014 (40:26 Md. R. 2164)

Regulation .06D amended effective January 6, 2014 (40:26 Md. R. 2164)

Regulation .06G adopted effective October 22, 2007 (34:21 Md. R. 1915)

Regulation .07 amended effective June 13, 2011 (38:12 Md. R. 705)

Chapter and Subtitle renamed and recodified from COMAR 10.43.14 to COMAR 10.43.13, Board of Chiropractic Examiners, Code of Ethics, effective January 2, 2017 (43:26 Md. R. 1446)

Regulation .06B amended effective December 30, 2019 (46:26 Md. R. 1165)