Connecticut Naturopathic Physician Continuing Education

• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to fee splits and kickbacks
• Explain the development of current fee-splitting laws
• Distinguish the letter of the law regarding fee-splitting and anti-kickback legislation from unprofessional conduct and consequent harms the statutes were enacted to discourage
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks
• Assess ones working knowledge regarding the process by which anti-referral safe harbors developed and how they operate

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the practice of forensic science
• Identify a new dimension of chiropractic practice that will minimize risks and failure in court appearances as a practitioner
• Construct skill sets in forensic examination and document review

• Acquire a current knowledge base relating to medicolegal issues
• Identify risks and liabilities that may be encountered by examiners with electronic communications
• Develop a level of understanding of the medicolegal system as it relates to Junk Science

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the ethical expert witness
• Introduce a new dimension of chiropractic practice that will minimize risks and failure in court appearances as an ethical expert witness.
• Encourage development and nurturing of skill sets in forensic examination and appearing as an expert witness through certification.
• Develop a level of understanding of the medicolegal system as it relates to the ethical expert witness.

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify Daubert criteria
• Discuss what each chiropractic expert should look for when preparing for the opposing attorney
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to Daubert challenges
• Encourage development and nurturing of skill sets in proving expert opinions

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify the basics of a deposition
• Discusses the tricky question types and suggested responses
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the deposition process
• Encourage development and nurturing of skill sets in responding to questions posed in a deposition

• Perform professional advertising and marketing that passes state and federal legal restriction.
• Comprehend requirements for advertising testimonials, press releases, television, radio, Internet, personal solicitation and other marketing initiatives.
• Comprehend the limits of commercial speech (advertising) within the arena of professional healthcare marketing and dissemination of information.
• Train staff and implement policies associated with marketing initiatives and materials vis-a-vis state rules, regulations and statutes.
• Comprehend issues associated with signage, listings, letterhead, and other matters of ostensible agency that may lead to liability.
• Administer professional marketing such that it neither misleads, confuses nor exploits members of the public.
• Discuss how nutritional supplementation labeling and HIPAA affects professional healthcare marketing efforts.
• Undertake a review of marketing materials and initiatives so as to ensure compliance with relevant state rules, regulations and statutes.
• Administer coverage decisions, professional referrals, and communicate same in a manner that limits professional liability.

• Analyze charges and documentation on a daily or per visit basis to ensure accuracy and compliance
• Compile accurate and comprehensive responses to documentation or record requests
• Recognize and avoid confusing HIPAA privacy issues that can cost you time and money
• Identify key areas that lack written policies causing increased risk in the practice
• Evaluate your current written procedures and appraise the need for additional content

Hour 1

• Identify various types of billing irregularities and impact on healthcare expenditures.
• Distinguish upcoding from bundling within the context of irregular billing schemes.
• Demonstrate how and when exceeding a state’s scope of practice becomes “the unauthorized practice of medicine.”
• Explain the restrictions states’ scopes of practice place on healthcare providers’ authority to treat and diagnose patients.
• Discuss how invoicing unrendered medical services impacts third-party payers.
• Interpret chiropractic boards’ positions on testimonial advertising and how best to comply.

Hour 2

• Identify what constitute a false claim under the False Claims Act.
• Discriminate a kickback from a self-referral.
• Trace how anti-kickback legislation arose and examine its prohibitions.
• Explain the enactment of Stark legislation arising on the heels of anti-kickback bans.
• Assess providing nutritional counsel within the context of “the practice of medicine.”
• Evaluate identity theft and its impact on patients, providers and the cost of healthcare.
• Discriminate between illegal copayment waivers from proper hardship waivers.
• Discuss court cases instancing successful prosecution of healthcare fraud.

• Identify the 18 PHI Identifiers
• Awareness of other HIPAA related documentation and the appropriate retention period
• How to confirm retention period for healthcare records
• Recognize required security measures and their value to practice risk management
• Implement policy and protocol for compliant and secure disposal of records

• Be able to identify the definitions of Fraud, Waste and Abuse and how they may show up in day-to-day practice
• Become aware of the source of overpayments, including not-medically necessary care, maintenance care, and active treatment
• Apply the guidance from the OIG to your state and carrier regulations since they are a resource to these groups
• Recognize insufficient documentation and incorrect coding before the billing takes place
• Implement the action steps recommended by the OIG to eliminate incorrect documentation, billing and coding practices to reduce compliance risk

• Distinguish between fraud, waste and abuse
• Review and properly utilize your Medicare Local Coverage Articles (LCA)
• Integrate critical compliance requirements for minimum, mandatory, annual self-audits  
• Detect common billing protocols that are red-flags for third-party auditors and chiropractic boards of examiners

• Identify the expected standards of a compliant and complete patient medical record
• Audit documentation to ensure the most important details are present
• Analyze and correct for the four most commonly missed components of appropriate documentation
• Apply the federal requirements for Medicare documentation and use this knowledge to initial and routine patient visit documentation

• Assess limits of state, federal and board authority regarding the prohibition of solicitation of patients by, and on behalf of, chiropractors. 
• Explain distinctions between general marketing and intrusive solicitation, and the reasons for the regulation of each
• Demonstrate how the courts protect businesses’ right to advertise and how they discourage deceptive practices. 
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services. 
• Examine criminal and civil laws associated with overly aggressive chiropractic advertising.

• Classify circumstances that trigger Good Samaritan laws for chiropractors.
• Restate duties imposed upon people in the United States to render aid to others in dire circumstances.
• Compare a doctor’s versus a lay person’s duty to render aid to someone in distress.
• Explain principles and philosophical underpinning Good Samaritan laws.
• Discuss the Bystander Effect.and scientific studies that unearth reasons why people are reluctant to render aid/assistance to others in emergency situations.
• Summarize the role compensation, expecting to get paid, plays in the operation of Good Samaritan laws.
• Locate states that impose a duty to render assistance, and those states that remove Good Samaritan law protection from hospitals.
• Identify protections offered under various states’ Good Samaritan Laws.
• Express the relaxation of professional standards, and what behaviors are shielded from liability, under Good Samaritan laws.

• Recognize and execute the rules to avoid inducement violations
• Define what you CAN give away for a first visit that will not break the rules. 
• Implement compliant initial visit screening services as part of a new patient offer
• Apply risk management rules to avoid offering free services to some and not others
• Modify your current marketing strategy to attract new patients while being compliant

• Identify ethical and legal prohibitions against patient deception, misinformation, exaggerating healthcare cures, guaranteeing treatment results, and dishonesty.
• Distinguish between appropriate and inappropriate communications and medical file entries describing patients' healthcare prognoses and progress.
• Explain scientific literature linking patients' attitude and mental states to healthcare outcomes.
• Illustrate placebo-enhancing doctor-patient interactions that comply with states' prohibitions against deception and misinformation.
• Give examples where ethical patient encouragement authentically fosters positive mental states that promote desired patient outcomes.
• Express why patient communications must be consistent with medical file entries regarding prognoses and patient progress.
• Explain office procedures and staff training likely to optimize health-promoting ethical patient communication and the documentation thereof.

• Identify which portion of the complex regulation applies to their practice
• Recognize proper use of a Good Faith Estimate vs Balance Billing Protection form
• Formulate customized forms and training tools to meet regulatory guidelines
• Adopt best practices and regulation standards during the patient intake process

• Discuss the public’s increased use of health data-gathering devices and its effect on dispensing healthcare by professional healthcare providers.
• Identify sources for state authority to regulate the practice of healthcare in the various states.
• Explain states’ prohibition against the unauthorized practice of medicine and identify points where data collection and subsequent evaluation may encounter this prohibition.
• Compare courts’ interpretations of state scopes of practice laws as they relate to the various stages of a doctor-patient encounter.
• Distinguish data collection from activities that may include preliminary evaluation, diagnosis, and treatment - while identifying their relevance to state scopes of practice.
• Analyze how courts interpret activities that may constitute the unauthorized practice of medicine, as distinguished from those that do not.
• Discuss obligations to refer people to other healthcare providers based upon determinations and/or diagnoses related to observation, examination, and evaluation of collected data.
• Distinguish boundaries regarding data collection versus the unauthorized practice of medicine.
• Recognize the public's rights to information and free speech protections.

 Part 1

• Discuss the costs of fraud and financial crime
• Review the technology trajectory and how this affects fraud
• Quote Honesty studies
• Identify behaviors related to cheating

Part 2

• Review the criminological and behavioral theories of fraud in healthcare
• Explain key aspects of the psychological of fraud
• Identify aspects of sociology related to fraud
• Examine: Biological school of criminology

Part 3

•  Examine victimology and victim behavior
• Discuss internal fraud and trends
• Examine opportunity reduction
• Be aware of red flag and fraud indicators

 Part 4

• Apply human based preventative and detection strategies to avoid fraud
• Use technology based preventative and detection strategies to avoid fraud
• Use vulnerability assessment preventative and detection strategies

• Compare the various Responsibilities that patients owe to the doctor-patient relationship
• Describe the doctor-patient relationship as a dynamic one that relies on the active participation of patient and doctor alike, and enlists aspects of trust in order for the interaction to render optimal benefits.
• Recognize how the Hippocratic Oath contributed significantly to the development of chiropractic patient rights
• Discuss the historical evolution of Patients' Rights in the United States and their application to chiropractic
• Explain the various Patients’ Rights
• Present case studies to illustrate how patient rights and responsibilities can be applied in practice.
• Analyze how Patient Obligations contribute to the success of the doctor-patient interaction and can favorably impact patient outcomes.
• Explain how chiropractors’ efforts to enhance profitability could negatively impact both public perception and the bottom line.

• Appreciate the significance of Artificial Intelligence (AI) in transforming the healthcare industry.
• Recognize the potential benefits of AI in improving diagnosis accuracy and treatment outcomes.
• Identify how AI can streamline administrative processes, such as scheduling appointments, billing, forms, and managing patient records.
• Explore compliance with laws and regulations when using AI and chatbots in advertising, including rules around data collection and use
• Understand the challenges of determining who owns the copyright for content generated by AI systems
• Evaluate the importance of keeping up-to-date with technological advancements in healthcare for quality patient care and practice management
• Comprehend the challenges regarding patient data privacy and security associated with AI.

• Recognize different forms of social media and how clinics can benefit from using social media
• Appreciate the risks of using social media and how to avoid any pitfalls
• Develop policy and procedures to protect patient information when using social media
• Ability to identify commonly overlooked risks when communicating to patients on third-party software platforms

• Distinguish Constitutionally-protected expression contributing to a healthy marketplace, from defamatory reviews that damage doctors and impede intelligent consumer activity.
• Explain what triggers patient complaints and discuss how their constructive information improves healthcare services.
• Identify how patient complaints can compromise doctors’ health, devastate their businesses, impede professional performance, and compromise patient outcomes.
• Express how doctors may shape doctor-patient relationships so as to reduce the likelihood and frequency of patient complaints.
• Illustrate how a doctor's proactive remedial behavior can mitigate the incidence and severity of formal disciplinary actions and litigation generally.
• Explain the power traditionally ascribed to word-of-mouth recommendations and how current social media review systems leverage this power.
• Discuss how the Consumer Review Fairness Act restricts prohibitions against posting negative reviews.
• Describe how a complaint navigates a state Board disciplinary process and factors regarding appeal.
• Illustrate the financial and reputational costs that attend doctors responding to negative complaints and/or initiating litigation against patients.

• Evaluate sample forms including contract, informed consent, treatment plan and intake - and draft forms that clearly distinguish between standard care and potential contractual guarantees.
• Identify the key elements that can transform a doctor's statement into a contractual guarantee (e.g., specific results, use of positive language like "cure" or "fix").
• Define the concept of a doctor-patient contract and distinguish it from the standard of care in medical malpractice.
• Describe the legal ramifications of a doctor breaching a contract with a patient (e.g., damages, potential for longer statute of limitations compared to malpractice).
• Analyze case studies to identify instances where a doctor's communication with a patient may have created a contractual obligation.
• Effectively communicate treatment options and limitations to patients, avoiding language that could be misconstrued as a contractual guarantee.
• Apply your knowledge of doctor-patient contracts to real-world scenarios, such as consultations, advertising materials, and treatment plans.
• Critically assess the advantages and disadvantages of relying on formal contracts in the doctor-patient relationship.

• Explain the anatomy and functionality of healthy soft tissue components
• Explain the effects of injury on soft tissue
• Define effects of injured soft tissue on functionality of the spine and extremities
• Discuss patterns of musculoskeletal relationships of recruiting other structures after injury and their effects on functionality
• Describe various methods of treatment for dysfunctional soft tissue
• Explain relationship of injured tissue to its surrounding structures, its effects and treatment
• Explain compensation and recruitment of healthy tissue to the broader scope of complications and the effective treatment of primary and now secondary effects of injury
• Describe rehabilitation exercises in relation to proprioception

• This contains all courses with the educational objectives listed from Soft Tissue Injuries 101 to Soft Tissue Injuries 104 

• Explain the types of soft tissue
• Demonstrate and discuss diagnostic evaluation of soft tissue injury
• Explain pain patterns of neurological injury for differential diagnosis
• Discuss types of soft tissue injuries
• Evaluate soft tissue changes associated with pain
• Discuss the mechanisms of healing soft tissue injuries
• Describe diagnostic tools in determining soft tissue injuries
• Explain the use of ice and heat in soft tissue injuries
• Demonstrate and discuss stretching; passive, active and postfacilitation
• Demonstrate and discuss somatic technique
• Demonstrate and discuss strain/counterstrain
• Demonstrate and discuss friction massage
• Demonstrate and discuss Postisometric relaxation
• Demonstrate and discuss electrical muscle stimulation and ultrasound
• Demonstrate and discuss triggerpoint ultrasound in treatment
• Discuss massage therapy
• Demonstrate and discuss myofascial release
• Demonstrate and discuss active release
• Demonstrate and discuss Neuromuscular Therapy (NMT)
• Discuss cold laser therapy
• Demonstrate and discuss exercise rehabilitation and muscle strengthening
• Discuss mobilization and manipulation

• Explain the structural anatomy of the shoulder and its soft tissue
• Explain the functional anatomy of the shoulder and its soft tissue.
• Demonstrate the active and passive examination of the shoulder and soft tissue.
• Describe pathological conditions of the bony structures, joints, ligaments, tendons, bursa and muscles of the shoulder
• Describe sports injures to the shoulder.
• Describe injuries to the nerves, blood vessels and fascia of the shoulder.
• Demonstrate soft tissue treatments for pathological conditions of the bony structures, joints, ligaments, tendons, bursa and muscles of the shoulder.
• Demonstrate soft tissue treatments for the nerves, blood vessels and fascia of the shoulder.
• Define functional relationships of the shoulder with associated regions

• Explain the structural anatomy of the elbow, wrist, and hand and associated soft tissue
• Explain the functional anatomy of the elbow, wrist, and hand and associated soft tissue
• Demonstrate the passive examination of the elbow, wrist, and hand and associated soft tissue
• Demonstrate the active examination of the elbow, wrist, and hand and associated soft tissue
• Describe pathological conditions of the bony structures, joints, ligaments, tendons, muscles, fascia, bursa and nerves of the elbow, wrist, and hand
• Demonstrate soft tissue treatments for pathological conditions of the bony structures of the elbow, wrist and hand
• Demonstrate soft tissue treatments for the joints, ligaments, tendons, muscles, fascia, bursa and nerves of the elbow, wrist and hand
• Define functional relationships between the elbow, wrist and hand and with other regions