Healthcare businesses in Florida are highly regulated and chiropractic offices are no exception. Whether you’re currently a solo practitioner or have several medically integrated locations, here are some of the top laws you should be aware when operating a chiropractic business in Florida:

1. Who Can Legally Own a Florida Chiropractic Practice?
   

Chiropractors need to be cognizant as to who their business partners are, as Florida Statute §460.4167 and Chapter 400 Part X govern who can legally own and operate chiropractic practices in Florida.

If a chiropractic business is not owned solely by a Florida licensed chiropractor or other Florida licensed physicians, a Health Care Clinic License may be required. Additionally, a Health Care Clinic License may be required for medically integrated chiropractic practices depending on structure.

Operating a healthcare business in Florida without a Health Care Clinic License, if needed, can result in felony criminal prosecution and/or civil monetary penalties.

2. Can Chiropractic Offices Offer Medical Services?

By aligning with other types of medical professionals, a chiropractic practice can become multi-disciplinary and offer services outside the scope of a chiropractic physician that patients may be receiving elsewhere.

There are several regulations to consider when looking to medically integrate.

First and foremost, one needs to ensure that the individual offering medical services is qualified to do so, which typically requires an MD, DO, APRN or PA, and that any requisite supervision of mid-level practitioners and written protocols are in place.

Additionally, there are certain self-referral regulations for medical services – such as the Federal Stark Law or Florida’s Patient Self-Referral Act of 1992 – that may limit practitioner’s ability to both prescribe for and provide certain ‘designated health services’ (such as PT and DME), depending on the payor involved.

3. What Ways Can Chiropractors Compliantly Engage with Marketers?

The Federal Anti-Kickback Statute and Florida’s Patient Brokering Act prohibit providing or receiving anything of value in exchange for the referral of business, with violations that can result in felony criminal prosecution and/or civil monetary penalties.

The activities implicated by these regulations expand far beyond medical professionals being paid to refer patients, and extend to relationships with non-professional marketers without prescription authority that may be generating business.

There are exceptions to this statute that chiropractors need to closely analyze their current or prospective marketing practices against to ensure compliance.

For example, bona fide W2 employees of the chiropractic practice are exempt from such referral compensation prohibitions under the Federal Anti-Kickback Statute and can be compensated in a manner that takes into account business generated. Additionally, there are statutorily recognized business practices – known as Safe Harbors (such as the Personal Services and Management Contracts Safe Harbor) that are applicable to marketing relationships with independent contractors that if abided by can safeguard against prosecution for non-compliance.

4. Advertising Requirements.

While Florida chiropractors enjoy a wide scope of practice, they must abide by some particular advertising requirements. Some examples of false, fraudulent, deceptive or misleading advertisements set forth by the Board of Chiropractic Medicine under Fla. Admin. Code Ch.64B2-15 include, but are not limited to, those that:

• Contain any representation which identifies the chiropractic practice being advertised by a name which does not include the terms “chiropractor,” “chiropractic,” or some easily recognizable derivative thereof;
• Fail to conspicuously identify the chiropractor or chiropractors referred to in the advertising as a chiropractor or chiropractors;
• Create false, or unjustified expectations of beneficial treatment or successful cures;
• Contain representations relating to the quality of the chiropractic services offered; and
• Advertise free services (i.e., x-rays, examination, etc.) or services for a specific charge when in fact the chiropractor is transmitting a higher charge for the advertised service to a third party payor for payment.

Consequences of non-compliance can be dire, resulting in fines, loss of licensure, or even criminal prosecution. Chiropractors and practice owners should be sure to analyze applicable laws before diving in and have strong contracts in place to help protect them.