Unprofessional conduct when applied to a chiropractic licensee or chiropractic facility includes, but is not limited to the following:

1. (1) engaging in sexual misconduct with a patient within the chiropractic/patient relationship; Sexual misconduct as used in this section means:

   1. (A) sexual impropriety, which includes any behavior, gestures, statements, or expressions through any medium of communication towards a patient which may reasonably be interpreted as inappropriately seductive, sexually suggestive or demeaning, such as:

      1. (i) inappropriate sexual comments about or to a patient or former patient including sexual comments about an individual's body which demonstrate a lack of respect for the patient's privacy;
      2. (ii) requesting unnecessary details of sexual history or sexual likes and dislikes from a patient;
      3. (iii) making a request to date a patient; and
      4. (iv) initiating conversation regarding the sexual problems, preferences, or fantasies of the licensee.

   2. (B) sexual intimacy, which includes engaging in any conduct that is intended to cause or reasonably interpreted to cause stimulation of a sexual nature, such as:

      1. (i) sexual intercourse;
      2. (ii) genital contact;
      3. (iii) touching breasts;
      4. (iv) masturbation; and
      5. (v) any bodily exposure by licensee of normally covered body parts.
   3. (C) It is a defense to a disciplinary action under paragraph (1) of this section if the patient was no longer emotionally dependent on the licensee when the sexual impropriety or intimacy began, and the licensee terminated his or her professional relationship with the person more than three months before the date the sexual impropriety or intimacy occurred.

   4. (D) It is not a defense under paragraph (1) of this section if the sexual impropriety or intimacy with the patient occurred:

      1. (i) with the consent of the patient;
      2. (ii) outside professional treatment sessions; or
      3. (iii) off the premises regularly used by the licensee for the professional treatment of patients.
   5. (E) Licensees must respect a patient's dignity at all times and should provide appropriate gowns and/or draping and private facilities for dressing and undressing.

2. (2) Intentional and/or Fraudulent charging or billing for services including, but not limited to the following:

   1. (A) exploiting patients through the fraudulent use of chiropractic services, which results, or is intended to result, in financial gain for a licensee or a third party. The rendering of chiropractic services becomes fraudulent when the services rendered or goods or appliances sold by a chiropractor to a patient are clearly excessive to the justified needs of the patient as determined by accepted standards of the chiropractic profession;
   2. (B) submitting a claim for chiropractic services, goods or appliances to a patient or a third-party payer which contains charges for services not actually rendered or goods or appliances not actually sold;
   3. (C) failing to disclose, upon request by a patient or patient's duly authorized representative, the full amount charged for any service rendered or goods supplied.
3. (3) physically harming or threatening to physically harm a patient or another person while in practice or under the guise of chiropractic licensure;
4. (4) exposing a patient to unsanitary conditions in practice whether by use of unsanitary equipment or poor facility maintenance;
5. (5) failure to supervise the duties of staff of a chiropractic facility which results in financial or physical harm to a patient or exposure of confidential patient records;
6. (6) failing to specify "chiropractic," "chiropractor," "D.C." or "Doctor of Chiropractic" in all advertising medium, including signs and letterheads;
7. (7) using "chiropractic," "chiropractor," "D.C." or "Doctor of Chiropractic" in any advertising medium for services that are outside the scope of practice;
8. (8) using "chiropractic," "chiropractor," "D.C." or "Doctor of Chiropractic" in advertising medium at any time while not holding a chiropractic license by the board;
9. (9) failure to respond to a board inquiry relating to licensure or practice, failure to comply with a board order or any other applicable law pursuant to the Chiropractic Act or board rules.

Source Note:The provisions of this §78.1 adopted to be effective January 29, 2015, 40 TexReg 379; amended to be effective June 1, 2017, 42 TexReg 2535.