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Title: Section 510.3 - Authorization.

510.3 Authorization. (a) Prior authorization is not required for chiropractic services.

(b) Patients shall have free choice of chiropractors qualified in accord with section 510.1 of this Part.

(c) The chiropractor shall submit to the social services district a treatment plan, as outlined under subdivision (d) of this section, in all instances of more than three visits by or to a patient for a given illness. Such treatment plan shall be submitted prior to the fourth visit but further treatment may be continued as necessary unless consultation between chiropractor and medical director indicates other course.

(d) The treatment plan shall follow a form prescribed by the State Department of Health and shall indicate the following:

(1) Patient's subjective complaints:

(i) present complaint and nature of symptoms;

(ii) other symptoms observed which may indicate therapeutic requirements beyond statutory scope of chiropractic.

(2) Present medical care or referral:

(i) whether patient is under concurrent care of a physician or another complaint (giving physician's name and address); or

(ii) whether attending chiropractor is referring patient for concurrent medical care (giving physician's name and address).

(3) Chiropractic care:

(i) the type of distortion, misalignment or subluxation identified by chiropractic analysis;

(ii) the type of treatment planned for patient and estimate of number of visits and time required therefor.

(e) A progress report or amendment of the treatment plan shall be submitted with each bill or at least once monthly.

(f) Where a treatment plan is required and has not been submitted, or has been submitted but disapproved by the medical director, no further treatment under the medical assistance program is authorized. However, after receipt of notice of disapproval of a treatment plan, a chiropractor may file an application in writing with the health commissioner, within 30 days, for review of the disapproval. The health commissioner may request the advice of an appropriate committee of chiropractors before rendering his decision upon the application.



VOLUME C (Title 18)