As a chiropractic physician, you may think of compliance as something reserved for large hospitals or medical systems
But in today’s regulatory environment, even the smallest chiropractic practice must operate with a solid, well-resourced compliance program. It’s not just about avoiding fines—it’s about safeguarding your license, protecting your team and building trust with your patients.
What does “adequately resourced” really mean?
It doesn’t mean you need a full-time compliance officer on staff or an in-house legal team. It means your practice has the right systems, policies and accountability measures in place to ensure you’re practicing within state and federal regulations—especially when it comes to licensure, HIPAA, billing and patient documentation. A proactive compliance program allows you to identify and correct issues before they turn into liabilities.
Licensure: Monitor renewals like your license depends on it—because it does
DCs and team members with licensure, such as physical therapists or nurse practitioners in integrated practices, must remain in good standing by adhering to a compliance program. That means tracking renewal deadlines and continuing education requirements carefully.
We recommend maintaining a shared licensure log that’s reviewed monthly. Include license numbers, renewal dates and CEU status. Also, establish a written policy for what to do if a provider’s license lapses—because no provider should ever treat patients without an active license.
HIPAA and beyond: Patient privacy is a team responsibility
HIPAA compliance goes far beyond not discussing patients in public spaces. It includes securing digital records, limiting internal access to PHI, maintaining breach response protocols and training your staff regularly.
A chiropractic compliance program should include:
- Written privacy policies (HIPAA and state-specific)
- Annual privacy and security training for all team members
- A clear plan for handling breaches and patient complaints
Billing practices: Clean claims and compliance go hand-in-hand
Whether you’re billing insurance, Medicare or offering cash-based care, documentation and transparency are key elements in your chiropractic compliance program. Every patient encounter must be supported by accurate SOAP notes, consent to treatment and proper coding. If you’re providing time-of-service discounts or financial hardship policies, those need to be compliant with anti-kickback and inducement laws.
Run internal audits regularly. If a mistake is found, such as an overbilling or coding error, specifics in your compliance program should guide you through correction, notification and refund if needed. This is especially critical for providers enrolled in Medicare or those offering services governed by the No Surprises Act.
Patient intake: Get it right from the start
Your intake paperwork is your first line of legal defense, and it’s often where chiropractic compliance programs fall short. Make sure your forms include:
- Informed consent for chiropractic care and any adjunctive therapies
- Disclosure of risks, benefits and alternatives
- HIPAA acknowledgment
- State-specific disclosures (e.g., California’s Notice to Consumers)
If your practice offers telehealth or remote consultations, you’ll also need consent forms that specifically authorize this mode of delivery.
Final thoughts on the importance of your chiropractic compliance program
A compliance program isn’t just about checking boxes—it’s about operating with integrity and professionalism. Regulators increasingly expect even small healthcare providers (DCs) to demonstrate that their compliance program is appropriately scaled, staffed and enforced.
Mark Sanna, DC, ACRB LEVEL II, FICC, is the CEO of Breakthrough Coaching, a practice management company that guides chiropractic and multidisciplinary practices in building compliance systems that not only meet requirements—but also enhance your reputation and reduce risk. He is a Board member of the Foundation for Chiropractic Progress, a member of the Chiropractic Summit and a member of the Chiropractic Future Strategic Plan Leadership Committee. Sanna is the author of “Cracking the Code: Marketing Chiropractic—How Chiropractors Align Spines and Minds,” available on amazon.com. on amazon.com. To learn more, call 800-723-8423 or visit mybreakthrough.com.
