CCLE QUESTIONS AND ANSWERS ALREADY PASSED, Exams of Commercial Law

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CCLE QUESTIONS AND ANSWERS

ALREADY PASSED

What can unlicensed individuals do? ✔✔a) Unlicensed individuals may take the history of a

patient. However, this activity is separate from the consultation

b) Unlicensed individuals may conduct standard neurological, orthopedic, physical and chiropractic examinations, except they may not perform such examinations which require diagnostic or analytic interpretations nor may they render a conclusion either verbally or in

writing regarding the patient's physical condition As an example, unlicensed individuals may not perform evaluations of heart or lung soundings.

c)Unlicensed individuals may administer physical therapy treatments as an adjunct to chiropractic adjustment, provided the physical therapy treatment is conducted under the adequate

supervision of a licensed Doctor of Chiropractic.

d) Unlicensed individuals may mark X-ray films administered by a Doctor of Chiropractic.

"Marking X-rays" is defined as drawing and measuring between reference points and making angular and linear measurements. Unlicensed individuals are not permitted to make any

diagnostic conclusions or chiropractic analytical listings,

Unlicensed individuals are NOT permitted to: ✔✔diagnose, analyze, or perform a chiropractic

adjustment.

An exemption is hereby created for student doctors participating in board approved preceptorship

programs.

After graduation when can you practice without a license? ✔✔Never

What is the cost of a License ✔✔In California, for example, an application costs $100, the initial

license costs $100, and the renewal fee costs $250 annually.

Where can a legal preceding against the California Board of Chiropractic be filled? ✔✔Sac, SF,

LA

What is the needed passing score for the NBCE for a CA license? ✔✔75 General score with no

more than two subjects below 60%

Which techniques can you practice with a California License? ✔✔The ones taught at

chiropractic school

Can you get a California reciprocal license if you are licensed elsewhere? ✔✔Yes. As long as

the qualifications are similar, you'll have to take one ethics exam, proof of licensure in other state and proof that license was not revoked and there are no outstanding claims of unprofessional conduct.

Causes for revoked/suspended license? ✔✔Fase ID

Felony

False Ad

Use of drugs that is public safety concern

Say you cure dx

Treat dx

If license is 2 years revoked/suspended - how long do you have to wait to get it re-issued? ✔✔ 2

years

When does a license become forfeited? ✔✔60 days past renewal

How do you renew license after renewal date but before 60 days has passed? ✔✔Application

$500 (double renewal fee)

When does a license become expired? ✔✔Last day of the birth month of licentiate

When do you receive a renewal notice from the board? ✔✔60 DAYS prior to the due date

What is the license yearly renewal fee? ✔✔$

Who at the state board do you contact regarding your license renewal, renewal notice,

application fee and revocation? ✔✔Board Secretary

What is the proper use of the title, doctor and Dr ✔✔Must have the word "Chiropractor" or DC

in the name. Ex: Dr. John Smith, D.C

Violation for use of the title doctor or Dr. improperly? ✔✔Misdemeanor

Fine $100- 750

up to 6 months in jail

or both

What part of the body are within the scope of chiropractic? ✔✔- spine

• joints
• muscles
• connective tissue

What additional told and methods can be used with chiropractic care? ✔✔air-cold-diet

exercise- heat- light

massage-physical culture- rest- ultrasound

water- physical therapy

When is it okay to diagnose using ultrasound? ✔✔When diagnosis NMSK (neuromuscular

skeletal)

When is it NOT okay to use ultrasound? ✔✔On a fetus, NEVER!

What can chiropractor use for diagnosis? ✔✔- XRAY

• THERMOGRAPHY
• U/S (NMSK Only)

Failure To Report (FTR): Physical Abuse ✔✔- Fine: $1,

• County Jail: 6 months
• Both

Failure To Report (FTR): Physical Abuse--> Death Results ✔✔- Fine: $5,

• County Jail: 3 years
• Both

Failure To Report: Financial Abuse ✔✔- Fine: <$1,

Failure To Report: Abuse if willful ✔✔Fine: <$5,

How long do you maintain Medical Records for? ✔✔Chiropractic Patient Records.

Each licensed chiropractor is required to maintain all active and inactive chiropractic patient records for FIVE years from the date of the doctor's last treatment of the patient unless state or federal laws require a longer period of retention.

What is considered to be an inactive patient? ✔✔>12 months since the last treatment

How long should you maintain the medical records for a minor? ✔✔>1 year after 18th birthday

What should you do if the Board requests medical records for an active patient? ✔✔Make

available immediately

What should you do if the BOARD requests an INACTIVE patient's medical records? ✔✔Make available within 10 days

What should you do if an active patient requests their medical records (written) ✔✔- 5 working

days to inspect

• 15 days for copy
• up to $0.25/pg
• Free copy for non profit HCP (WC, Medicare)

What should you do if the public benefit program requests medical records (written) ✔✔-

Summary made available within 30 days

• 1st copy is free

What is the penalty for false general advertising? ✔✔- misdemeanor

• 6 months in jail
• $2,500 fine
• Both

What is the penalty for medical record/licensing fraud? ✔✔- Felony

• $2,000-$6,000 fine
• imprisonment
• Both

What is the penalty for unearned rebates, refunds, discounts for referring patients? ✔✔- Public

offense

• Civil Penalties $5,
• 1 year in jail
• $50,000 fine

What is the penalty for referring to immediate family for money without written disclosure? ✔✔-

misdemeanor

• $15,000 violation

Referring to immediate family: Written Disclosure? ✔✔- Conspicuously displayed for all patients to see at both locations

• Written disclosure provided to patient being referred

Who is considered immediate family? ✔✔- spouse

• parents
• children
• spouses of children

What is the penalty for aiding and abetting? ✔✔- <$2,500 (1st offense)

• <$5,000/ subsequent offenses

What is the penalty for offering, accepting, commissioning, patronage dividend, unearned discount, etc ✔✔- 6 months in jail

• <$2,500 fine
• Both

What is the penalty for insurance fraud? ✔✔- Automatic suspension or revocation of license

• felony if WC or Medi-Cal Fraud

What safeguards must be in place to protect patient's electronic files? ✔✔1) Offsite backup storage system

2. Image mechanism that is able to copy signature documents

3. Mechanism to ensure that once a record is input, it is unalterable.

You are treating your friend's child and notice signs of child abuse but you brush them off. What are you now liable for as a penalty for not reporting child abuse? ✔✔Misdemeanor, $1,000 fine

and/or up to 6 months confinement in county jail.

A mandated reporter who fails to report an incident of known or reasonably suspected child abuse or neglect as required by this section is guilty of a misdemeanor punishable by up to six months confinement in a county jail or by a fine of one thousand dollars ($1,000) or by bothimprisonment and a fine.

How is child abuse defined? ✔✔Endangering a child or the health of a child.

When is a patient considered inactive? ✔✔Chiropractic patient records shall be classified as inactive when there has elapsed a period of more than 12 months since the date of the last patient treatment.

A DC recently got engaged and was celebrating. He got pulled over and charged w/DUI. What

action may the board take? ✔✔Board may charge DC w unprofessional conduct

A homeless child is NOT considered child abuse because? ✔✔For the purposes of this article,

the fact that a child is homeless or is classified as an unaccompanied youth, is not, in and of itself, a sufficient basis for reporting child abuse or neglect.

You have a current patient who had a box fall on them at work. They are filing this as a Worker's Comp case with work, but you adjust and collect your fee as normal...what potential

consequence is the doctor facing? ✔✔A fine up to 3X the amount unlawfully collected.

In what instances can a chiropractor's license be automatically suspended? ✔✔It shall constitute cause for automatic suspension of a license if a licensee has been convicted of any felony involving fraud in conjunction with providing benefits covered by worker's compensation insurance, or has been convicted of any felony involving Medi-Cal fraud.

What must be included in the naming of chiropractic corporations? ✔✔The name of a

chiropractic corporation shall contain the name or the last name of one or more of the present, prospective, or former shareholders, and shall include the word "chiropractic" and the word "corporation" or wording or abbreviations denoting corporate existence.

How many hours of CE are required annually and in what categories? ✔✔24 hours per year

2 hours in Ethics & Law

Minimum of 4 hours in any one of or a combination of:

• History Taking & Physical Examination Procedures
• Chiropractic Adjusting Techniques or Chiropractic Manipulation Techniques

• Proper and Ethical Billing and Coding.

How is a citation issued? ✔✔Citation must be served in person, signed by the executive officer,

and reference the law or code being violated.

You want to advertise that you are the best DC in town! Why is this not allowed and what are the

legal consequences? ✔✔Constitutes a fraudulent claim and is grounds for a license being

revoked/suspended.

A fraudulent claim: Makes a scientific claim that cannot be substantiated by reliable, peer reviewed, published scientific studies.

Makes a claim either of professional superiorityor of performing services in a superior manner, allowable only if that claim is relevant to the service being performed and can be substantiated with objective scientific evidence.

A chiropractor is found guilty of false advertisement. What is the penalty? ✔✔Section 17500

"False advertising in general" - Any violation of the provisions of this section is a misdemeanor punishable by imprisonment in the county jail not exceeding six months, or by a fine not exceeding two thousand five hundred dollars ($2,500), or by both that imprisonment and fine.

A chiropractor makes sensational or fabulous statements - what is the consequence? ✔✔Chiro

Regulations: 311 "Advertisements" - False advertising is punishable by:

(a) Suspension of said licensee's right to practice in this State for a period not exceeding one (1) year.

(b) Placing said licensee upon probation.

(c) Taking such other action, excepting the revocation of said licensee's license, in relation to disciplining said licensee as the board in its discretion may deem proper.

You send out lab work for a patient and their results come back as HIV positive. How must you

respond? Tell them verbally? Give them written copy of lab results? ✔✔Health care

professionals must provide results in oral or written form if requested by the patient.

Results may be disclosed in electronic form if requested by patient or deemed most appropriate by doctor ordering labs.

Telephone is not considered an electronic form of disclosing lab results.

These conditions must be disclosed in oral or written form: HIV, hepatitis, drug abuse, skin biopsies, pap smear tests, products of conception, and bone marrow aspirations

You are doing a screening and offer a promotional deal of free exam. When you assess the patient in the office, you determine they need x-rays. This was not included in the promotional

deal they agreed to. Can you still take x-rays? Yes? No? Under what conditions? ✔✔Yes, as

long as the patient is informed before taking the x-rays.

Licensees may advertise that they will perform certain designated routine professional services free or at a discount if such advertising claims are truthful.

However, no charge shall be made for any other professional services rendered or commodities provided to a patient during any office visit in which free or discounted services are offered or provided unless, prior to the accrual of any charges, the patient shall have been informed of the cost of such additional services and/or commodities and shall have agreed to pay for them.

What must be in place in order to use before and after photos as a form of advertisement? ✔✔Must say what procedures were performed on that patient, otherwise it is a violation of this

subdivision

Any person so licensed who violates this section is guilty of a misdemeanor.

A bona fide mistake of fact shall be a defense to this subdivision, but only to this subdivision.

Any violation of this section by a person so licensed shall constitute good cause for revocation or suspension of his or her license or other disciplinary action.

How many days do you have to report a name change to the board? ✔✔Any licensee who shall

change his name according to the law, shall, within 10 days of such change, re-register his name with the Executive Officer of the board by submitting to the board office a written statement of the change and evidence of legal documentation. (i.e. a marriage certificate) with a $25 fee.

How many days do you have to report a change of address to the board? ✔✔Any licensee who

shall change his address according to the law, shall immediately notify the board at said office of any and all changes of place of practice address, giving both his old and his new address within 30 days of change.

Patient wants to review files - how many days do you have? ✔✔5 days from written request.

Patient requests files for government help (i.e.:food stamps), how are you obligated to respond?

✔✔Any patient or former patient or the patient's representative shall be entitled to a copy, at no charge, of the relevant portion of the patient's records, upon presenting to the provider a written request, and proof that the records are needed to support an appeal regarding eligibility for a public benefit program.

Although a patient shall not be limited to a single request, the patient or patient's representative shall be entitled to no more than one copy of any relevant portion of his or her record free of charge.

The health care provider shall ensure that the copies are transmitted within 30 days after receiving the written request.

Dr. lets their license go inactive for 2 years while she is living out of the state; how much must

she pay & how much CE does she need to complete in order to reactivate her license? ✔✔$

with 24 hours of CE.

(a) Annual license renewal for active and inactive licenses: $

(b) License restoration for forfeited and cancelled licenses: double the annual renewal fee

(c) Inactive to active status license renewal: same as the annual license renewal fee ($250)

To restore an inactive license to active status, a licensee shall complete and submit an "Inactive to Active Status Application" form, which is incorporated by reference, pay the appropriate fee specified in Section 370(c) prior to the expiration date of the license, and complete continuing education equivalent to that required for a single license renewal period. (24 hours)

Who sends the Letter of Admonishment for the abatement of something? ✔✔The Executive

Officer

It is illegal for a chiropractor to refer a patient to a PT clinic if ____. ✔✔Cannot refer to immediate family if they are getting financial interest - includes the licensee's spouse, children, parents, and the spouses of the licensee's children.Misdemeanor, fine of $5,000 for first offense.

A DC shares the same place of business with his wife, who owns an MRI office. How & when

should they inform patients of their relationship? ✔✔Have the information posted in a

conspicuous location and have the patient confirm in writing they have been made aware of this relationship.

A licensee who refers a person to, or seeks consultation from, an organization in which the licensee has a financial interest, other than as prohibited by subdivision (a), shall disclose the financial interest to the patient, or the parent or legal guardian of the patient, in writing, at the time of the referral or request for consultation.Violation = misdemeanor and may also be subject to civil penalties of up to $5,000 for each offense.

When can you waive a co-payment for a new patient? ✔✔After submitting each waiver in

writing to the insurance company.

You want to pay the insurance company as an incentive to have them turn around your accounts more quickly. Can you legally do this? ✔✔Yes, if agreement for payment is in a timely manner.

(657): (b) To encourage the prompt payment of health or medical care claims, health care providers are hereby expressly authorized to grant discounts in health or medical care claimswhen payment is made promptly within time limits prescribed by the health care providers or institutions rendering the service or treatment.

How must your license be displayed in practice? ✔✔License must be in a conspicuous place in

the doctor's primary practice.

Cannot be a copy of license, does not need to be available immediately upon request.

A chiropractor wants to create a chiropractic corporation with an acupuncturist, massage therapist, and naturopath. In what way must the shares be split up to be legal? ✔✔The following

licensed persons may be shareholders, officers, directors, or professional employees of the professional corporations so long as the sum of all shares owned by those licensed persons does not exceed 49 percent of the total number of shares of the professional corporation so designated herein

i.e. a DC has to hold the majority of shares in a chiropractic corporation

A new patient is primarily Spanish speaking. You are obligated to:

a. provide a translator of her language

b. document her principle language in the file

c. provide her with forms in her language ✔✔document her principle language in the file

Who determines if treatment is excessive? ✔✔Determined by the community of fellow

licensees. Excessive treatment is considered unprofessional conduct for a chiropractor.

What is the consequence of being charged with excessive treatment? ✔✔Unprofessional Conduct + Misdemeanor and shall be punished by a fine of $100 - $600 or by imprisonment for a term of 60 - 180 days, or both a fine and imprisonment.

Your CA is the last one in the office and has sexual events with the last patient. The patient files

a complaint. Who is responsible? ✔✔YOU!

DC is responsible for all activities that happen in the office, even when outside business hours or not present.

Every licensee is responsible for the conduct of employees or other persons subject to his supervision in his place of practice, and shall insure that all such conduct in his place of practice conforms to the law and to the regulations herein.

A husband & wife are both DCs and practice in the same office on different days. The business is all in the husbands name. The wife has an affair with a patient. Who is liable? ✔✔The

husband because the practice is in his name and the wife for sexual misconduct.

Every licensee is responsible for the conduct of employees or other persons subject to his supervision in his place of practice, and shall insure that all such conduct in his place of practice conforms to the law and to the regulations herein.

What happens to a practice once a DC dies? ✔✔The unlicensed heirs or trustees of the

chiropractor must dispose of the practice within 6 months.

At all times during that period the practice must be supervised by a licensed chiropractor.

The board will consider a petition to extend this period if it is submitted within 4 months after the death or the declaration of incompetence of the licensee, including identification of any extenuating circumstances that will prevent compliance.

When is it legal for a DC to promise a job after graduation to a student? ✔✔Promising a job to

an unlicensed student is prohibited. This restriction does not apply to students and doctors who

participate in preceptorship programs sponsored by chiropractic institutions holding status with the Council on Chiropractic Education or seeking such status.

An insurance company requests your records of a patient, which of the following needs to be included?

a. drugs & alcohol

b. HIV

c. history of mental illness

d. hepatits ✔✔c. history of mental illness

CA chapter shall not require a health care provider to permit inspection or provide copies of alcohol and drug abuse records.Communicable diseases are part of the doctor-patient confidentiality.

A DC wants to hire an unlicensed person to help with adjunctive PT. What must be done to be

compliant? ✔✔DC must provide adequate supervision in accordance with board regulations

What can an unlicensed individual do?

a. take history

b. heart sounds

c. consultation

d. mark x-rays

e. find listings ✔✔a. take history

A patient you are treating has a car accident and is also working with a lawyer for the insurance

claim. They notice an error in their file. How can this be amended? ✔✔Submit 250 word

addendum for each mistake which becomes part of their permanent record.

Dr. A & B are long time friends and are the only 2 doctors in the corporation. Dr. A dies, to whom are his shares transferred?

a. Dr. B only

b. to Dr. A's wife

c. to Dr. B and the corporation ✔✔c. to Dr. B and the corporation

Thermography can be used by a DC for:

a. relief of mm. spasm

b. treating calcification of bone

c. diagnosing a musculoskeletal complaint

d. deep heat to break tissue of adhesion ✔✔c. diagnosing a musculoskeletal complaint

A duly licensed chiropractor may make use of x-ray and thermography equipment for the purposes of diagnosis but not for the purposes of treatment. A duly licensed chiropractor may make use of diagnostic ultrasound equipment for the purposes of neuromuscular skeletal diagnoses.

Laser can be used for?

a. pain relief & tissue healing

b. allergies & ablation (surgical removal of tissue) ✔✔a. pain relief & tissue healing

§ 302.5. Use of Laser Use of laser must be properly approved or cleared by the FDA. This excludes laser ablation or surgical procedures, and laser treatment of allergies.