WSR 19-13-081
PERMANENT RULES
DEPARTMENT OF HEALTH
(Chiropractic Quality Assurance Commission)
[Filed June 17, 2019, 4:18 p.m., effective July 18, 2019]
Effective Date of Rule: Thirty-one days after filing.
Purpose: WAC 246-808-320 Protected health information (formerly Privileged communications), 246-808-330 Discontinuation of care (formerly Patient abandonment), 246-808-350 Unethical requests, 246-808-360 Patient welfare, 246-808-390 Illegal practitioners and 246-808-520 Identification, the chiropractic quality assurance commission (commission) adopted revisions of these sections to update, consolidate, clarify, and modernize the language of these rules. The commission is also repealing WAC 246-808-370 Patient disclosure and 246-808-380 Degree of skill, after incorporating the rule language into the adopted amended sections.
Citation of Rules Affected by this Order: Repealing WAC 246-808-370 and 246-808-380; and amending WAC 246-808-320, 246-808-330, 246-808-350, 246-808-360, 246-808-390, and 246-808-520.
Statutory Authority for Adoption: RCW 18.25.0171 and 18.130.050.
Adopted under notice filed as WSR 18-24-122 on December 5, 2018.
A final cost-benefit analysis is available by contacting Robert Nicoloff, Executive Director, P.O. Box 47858, Olympia, WA 98504-7858, phone 360-236-4924, fax 360-236-2360, TTY 360-833-6388 or 711, email cqac@doh.wa.gov, web site www.doh.wa.gov/CQAC.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 6, Repealed 2.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 6, Repealed 2.
Date Adopted: January 10, 2019.
Aaron W. Chan, DC, Chair
Chiropractic Quality Assurance Commission
AMENDATORY SECTION(Amending WSR 96-16-074, filed 8/6/96, effective 9/6/96)
WAC 246-808-320((Privileged communications.))Protected health information.
((A chiropractor shall not, without the consent of the patient, reveal any information acquired in attending such patient, which was necessary to enable the chiropractor to treat the patient. This shall not apply to the release of information in an official proceeding where the release of information may be compelled by law.))A chiropractor shall comply with the provisions of the Federal Health Insurance Portability and Accountability Act, 42 U.S.C. Sec. 1302(a) and 42 U.S.C. Sec. 1302d-1320d-9, the Health Information Portability and Accountability Act (HIPAA), 45 C.F.R. Parts 160, 162, and 165.
AMENDATORY SECTION(Amending WSR 96-16-074, filed 8/6/96, effective 9/6/96)
WAC 246-808-330((Patient abandonment.))Discontinuation of care.
((The chiropractor shall always be free to accept or reject a particular patient, bearing in mind that whenever possible a chiropractor shall respond to any reasonable request for his/her services in the interest of public health and welfare.))If a chiropractor chooses to discontinue care, the chiropractor shall:
(1) Advise the patient in writing and document in the patient record that the chiropractor is terminating the doctor-patient relationship; and
(2) Advise the patient to seek any future treatment from another chiropractor or health care provider.
AMENDATORY SECTION(Amending WSR 96-16-074, filed 8/6/96, effective 9/6/96)
WAC 246-808-350Unethical requests.
A chiropractor shall not ((assist in any immoral practice such as aiding))aid a patient in the pretense ((of disability in order to avoid jury or military duty,)) or the concealment of a physical condition or disability ((in order to secure favorable insurance)).
AMENDATORY SECTION(Amending WSR 96-16-074, filed 8/6/96, effective 9/6/96)
WAC 246-808-360Patient welfare.
The health and welfare of the patient shall always be paramount((, and expectation of remuneration or lack thereof shall not in any way affect the quality of service rendered the indigent patient)).
(1) A chiropractor owes their patient(s) the highest degree of skill and care.
(2) Absolute honesty shall characterize all transactions with patients.
(3) A chiropractor shall act in the best interest of the patient and not in the interest of any other party.
(4) A chiropractor shall provide evaluations, opinions, and recommendations that are unbiased.
(5) A chiropractor shall neither intentionally exaggerate nor minimize the gravity of the patient's condition, nor offer any false hope or prognosis.
(6) A chiropractor shall provide the highest quality of services regardless of expectation of reimbursement or lack thereof, including care provided to an indigent patient.
AMENDATORY SECTION(Amending WSR 96-16-074, filed 8/6/96, effective 9/6/96)
WAC 246-808-390Illegal practitioners.
A chiropractor((s)) shall safeguard their profession by exposing those who ((might attempt to)) practice without proper credentials((, and by reporting violations of the laws regulating chiropractic to the proper authorities)). This is in addition to mandatory reporting rules adopted by the secretary of health.
AMENDATORY SECTION(Amending WSR 96-16-074, filed 8/6/96, effective 9/6/96)
WAC 246-808-520Identification.
(1) ((A))When using their name, a licensed chiropractor must clearly identify oneself as a chiropractor on ((his/her))their office signs, web site, business cards, letterhead, electronic and other media with the use of one or more of the following: Doctor of chiropractic; D.C.; D.C., Ph.C.; chiropractor; or chiropractic physician consistent with RCW 18.25.090.
(2) ((All identification of chiropractic practice shall be presented))A chiropractor shall identify and present their chiropractic practice in a dignified manner, and ((shall not be))not in a sensational or misleading way.
(3) A chiropractor practicing in a multidisciplinary setting must identify oneself as a chiropractor.
(4) Nothing in this section prohibits the use of a business name that does not include one of the terms in subsection (1) of this section.
REPEALER
The following sections of the Washington Administrative Code are repealed:
WAC 246-808-370
Patient disclosure.
WAC 246-808-380
Degree of skill.