A: Chiropractic physicians who have graduated from an accredited US chiropractic school apply through the STATE OF UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING through this link:

Chiropractic Physician

A: Chiropractic physicians have the right to call themselves Dr. This question refers to staff, including nurses, nurse practitioners and such. For clarification of the following: The last few lines of 58-67-102(17)(a)(iv) apply only to a person who has an MD degree, but is not licensed in Utah. X does not fall within that category. However, the lines before the word “provided” still apply to X. Therefore, X may not use the designation “Dr.” by itself if it would cause a reasonable person to believe he/she is a physician. X can still use “Dr.” because he/she does have a doctorate degree. But X must include additional information so that a reasonable person would understand that he/she is not an MD, but has a PhD in nursing.

Index Utah Code, Title 58 Occupations and Professions, Chapter 67, Utah Medical Practice Act, Part 1 General Provisions, Section 102, Definitions. (Superseded 7/1/2018)

(17)“Unprofessional conduct” is as defined in Sections 58-1-501 and 58-67-502, and as may be further defined by division rule.
(12) (a) “Practice of medicine” means: (i) to diagnose, treat, correct, administer anesthesia, or prescribe for any human disease, ailment, injury, infirmity, deformity, pain or other condition, physical or mental, real or imaginary, including to perform cosmetic medical procedures, or to attempt to do so, by any means or instrumentality, and by an individual in Utah or outside the state upon or for any human within the state; (ii) when a person not licensed as a physician directs a licensee under this chapter to withhold or alter the health care services that the licensee has ordered; (iii) to maintain an office or place of business for the purpose of doing any of the acts described in Subsection (12)(a) whether or not for compensation; or (iv) to use, in the conduct of any occupation or profession pertaining to the diagnosis or treatment of human diseases or conditions in any printed material, stationery, letterhead, envelopes, signs, or advertisements, the designation “doctor,” “doctor of medicine,” “physician,” “surgeon,” “physician and surgeon,” “Dr.,” “M.D.,” or any combination of these designations in any manner which might cause a reasonable person to believe the individual using the designation is a licensed physician and surgeon, and if the party using the designation is not a licensed physician and surgeon, the designation must additionally contain the description of the branch of the healing arts for which the person has a license, provided that an individual who has received an earned degree of doctor of medicine degree but is not a licensed physician and surgeon in Utah may use the designation “M.D.” if it is followed by “Not Licensed” or “Not Licensed in Utah” in the same size and style of lettering

(4) An advertisement for a health care provider’s services that includes the health care provider’s name shall identify the license type, as used by the division, under which the health care provider is practicing. (Added 111717 Allyson Pettley DOPL)

A: R156-1-308d. Waiver of Continuing Education Requirements – Renewal Requirements.
(1)(a) In accordance with Subsection 58-1-203(1)(g), a licensee may request a waiver of any continuing education requirement established under this title or an extension of time to complete any requirement on the basis that the licensee was unable to complete the requirement due to a medical or related condition, humanitarian or ecclesiastical services, extended presence in a geographical area where continuing education is not available, etc.
(b) A request must be submitted no later than the deadline for completing any continuing education requirement.
(c) A licensee submitting a request has the burden of proof and must document the reason for the request to the satisfaction of the Division.
(d) A request shall include the beginning and ending dates during which the licensee was unable to complete the continuing education requirement and a detailed explanation of the reason why. The explanation shall include the extent and duration of the impediment, extent to which the licensee continued to be engaged in practice of his profession, the nature of the medical condition, the location and nature of the humanitarian services, the geographical area where continuing education is not available, etc.
(e) The Division may require that a specified number of continuing education hours, courses, or both, be obtained prior to reentering the practice of the profession or within a specified period of time after reentering the practice of the profession, as recommended by the appropriate board, in order to assure competent practice.
(f) While a licensee may receive a waiver from meeting the minimum continuing education requirements, the licensee shall not be exempted from the requirements of Subsection 58-1-501(2)(i), which requires that the licensee provide services within the competency, abilities and education of the licensee. If a licensee cannot competently provide services, the waiver of meeting the continuing education requirements may be conditioned upon the licensee limiting practice to areas in which the licensee has the required competency, abilities and education.

(Added 06/26-17- Allyson Pettley, Bureau Manager, Division of Occupational and Professional Licensing, (801) 530-6179)

A: Since 1990, the Insurance Department has produced a relative value study (RVS) to determine the reasonable value of medical expenses for automobile personal injury protection (no-fault) coverage, as required by Subsection 31A-22-307(2) of the Utah Code. The study is updated every two years.

Through 2011, the Department published the Relative Value Study book. In 2013, the book was replaced by Rule R590-267, Personal Injury Protection Relative Value Study Rule. Enforcement of the rule began January 1, 2014.

The rule contains seven conversion factors that are updated every two years. These factors are to be multiplied against appropriate CPT or dental code unit values found in the 2015 Relative Values for Physicians (RVP), and the 2015 Relative Values for Dentists (RVD) publications. Both of these publications are adopted by this rule. Contact information for the purchase of these publications can be found within the rule.

Optum is offering a 50% discount on the RVP to customers with a Utah address. To obtain the discount:

go online to https://www.optumcoding.com/Campaign/?sourcecode=UTAH2015 or www.optumcoding.com and use the promo code UTAH2015 at checkout; or
call Optum at 800-464-3649, choose option 1, and reference the promo code UTAH2015.

James D. Knight DC (Added 022117)

Added 011318:  The Utah Insurance Department is sending this message to all P&C insurers, providers and billing agencies as a courtesy.

Changes to Utah Insurance rule R590-267, Personal Injury Protection Relative Value Study Rule, have been made effective. The amendment updates RVD and RVP editions and adds conversion factors that are effective beginning January 1, 2018.

You can see the changes at the links below:
R590-267, Personal Injury Protection Relative Value Study Rule. Filing Form.
Rule changes put into effect 01-01-2018.

Steve Gooch, Public Information Officer
Utah Insurance Department
State Office Building, Room 3110 | 350 North State Street | Salt Lake City, UT 84114
P: 801-538-3803 | sgooch@utah.gov

A: The UCPA adopted the Croft Guidelines for Diagnosis and Treatment of Whiplash Injuries October 2001 and re-certified adoption fall 2011, which are found on this link: http://personalinjurytraininginstitute.com/croft-guidelines/. (Added October 19, 2016 rc)

A: I did a search of the Utah Department of Insurance website to see if there were any laws regarding appropriate discounts for Time of Service fees. I was not able to locate any. As such, offices are advised to stick to federal guidance from the Office of the Inspector General which says 5% to 15% is appropriate. Nonetheless, if doctors want to offer fees that are discounted even further, they are free to do so. They just need to be prepared to defend why they went beyond the federal suggestions, should they ever be accused of offering a dual fee schedule. A Discount Medical Plan Organization, such as ChiroHealthUSA is a safe, compliant alternative. Evan M. Gwilliam, DC MBA BS CPC CCPC CPC-I QCC MCS-P CPMA CMHP-ChiroCode (Added 021717.)

A: Patients have a right to access their information, for various reasons (moving, a second opinion, or for legal action, etc). You should provide patients with copies of their records, while retaining the originals in your office. You are the custodian of those x-rays.

When a patient requests a release of their x-ray records. You may create a copy through multiple methods. Taking a high quality picture of the film or other form of digital copy can be done in the office. You may also send the originals to a facility that can make copies such as a hospital radiology department. There will usually be a minimal fee for these copies. You may charge a fee for this service depending on your office policy. (Christopher Duncan DC, Added September 7, 2016.)

A: Here are some laws which may help you:
58-1-501.6 Health care provider advertisements and disclosure — Unprofessional conduct. For purposes of this section:
(1) (a) “Advertisement” includes: (i) billboards; (ii) written documents such as: (A) brochures; (B) pamphlets; (C) direct mail solicitations; (D) radio, television, and telephone solicitation scripts; and (E) telephone directories; (iii) media, including television, radio, and Internet websites; and (iv) any other means of promotion intended to directly or indirectly induce a person to enter into an agreement for services with a health care provider. (b) “Advertisement” does not include materials that provide information about health care provider networks established by health insurance carriers.
(2) “Health care provider” means a natural person who is: (a) defined as a health care provider in Section 78B-3-403; and (b) licensed under this title.
(3) (a) This section does not provide authority for a health care provider to advertise the services offered by the health care provider. (b) If a health care provider’s licensing authority and professional ethics permit the health care provider to advertise, the provisions of this section apply to any advertisement for the health care provider’s services, on or after July 1, 2011.
(4) An advertisement for a health care provider’s services that includes the health care provider’s name shall identify the license type, as used by the division, under which the health care provider is practicing.

R156-73-501. Unprofessional Conduct. “Unprofessional conduct” includes:
(2) engaging in advertising which is misleading because of omission of necessary material information, which contains false or misleading statements, or which otherwise operates to deceive; (3) engaging in or abetting deceptive or fraudulent billing practices;
(8) advertising acupuncture services or practicing clinical acupuncture techniques beyond the scope of the certification held; (9) advertising as an “acupuncturist” either verbally or in print.

If you have something specific you want to know, contact: Allyson Pettley, Bureau Manager, Division of Occupational and Professional Licensing, at: (801) 530-6179. (Admin Added 081416.)