STATE OF FLORIDA BOARD OF CHIROPRACTIC MEDICINE DEPARTMENT OF HEALTH, PETITIONER, v. . CASE NO. 2014-05653 CRAIG SAMUEL ADERHOLDT, D.C. RESPONDENT. / ADMINISTRATIVE COMPLAINT Petitioner, Department of Health (“Department”), by and through its undersigned counsel, files this Administrative Complaint before the Board of Chiropractic Medicine (Board”) against Respondent, Craig Samuel Aderholdt, D.C. (Respondent”). In support, Petitioner alleges: 1. Petitioner is the state department charged with regulating the practice of Chiropractic Medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 460, Florida Statutes. 2. — At all times material to this Complaint, Respondent was licensed to practice chiropractic medicine in the State of Florida, having been issued License Number CH 7814. 3. Respondent’s address of record is 5221 26th Street West, . Bradenton, Florida 34207. 4. From on or about March 2013, through on or about April 2013, (treatment period’), Respondent treated Patient P.D., a then, sixty-two- year-old female for back pain. 5. Respondent informed Patient P.D. that he could help with Patient P.D.’s back pain through utilizing VAX-D therapy. 6. Respondent required Patient P.D. to pay five thousand, five hundred dollars ($5,500.00) for treatment in advance. 7. Onor about March 8, 2013, Patient P.D. completed a Care Credit application that was approved dollars ($5,500.00). in the amount five thousand, five hundred 8. Respondent informed Patient P.D. that his office would submit claims to Patient P.D.’s insurand¢e provider for reimbursement of some of the costs associated with Patient PJ 9. On one or more reimbursement by Patient P. treatment of Patient P.D. D.’s treatment. occasion, Respondent's office received a D.’s insurance provider for Respondent's 10. On one or more occasion, Patient P.D. requested that Respondent reimburse her for the payments made to Respondent by Patient P.D.’s insurance provider. 11. Respondent failed to provide Patient P.D. with any form of reimbursement. 12. On or about March 6, 2013, Respondent utilized billing code 99204, a code that documents a new patient comprehensive examination. 13. For the same day, Respondent utilized billing code 99212, a code that documents that Respondent conducted a focused exam on Patient P.D. 14. Billing code 99204, is a comprehensive examination code inclusive of everything that Respondent needed to know to prepare a plan for Patient P.D. 15. Billing code 99204 |s a comprehensive code that precludes the need for the additional billing code of 99212 to be utilized by Respondent on the same encounter date. COUNT I 16. Petitioner re-alleges and incorporates paragraphs one (1) through ten (10), as if fully setiforth herein. 17. Section 460.413(1)(k), Florida Statutes (2012-2013), provides that making misleading, deceptive, untrue, or fraudulent representations in the practice of chiropractic medicine or employing a trick or scheme in the practice of chiropractic medicine when such trick or scheme fails to conform to the generally prevailing standards of treatment in the chiropractic medical community shall be grounds for discipline. 18. Respondent violated section 460.413(1)(k), Florida Statutes in the following ways: a. by representing to] Patient P.D. that his office would submit claims to Patient P.D.’s insurande provider for reimbursement of some of the costs associated with Patient P.D.’s treatment; b. by failing to provide Patient P.D. with any form of reimbursement he obtained from Patient P.D.’s| insurance provider; and, c. by utilizing billing cades 99204 and 99212 on the same day when billing code 99204 is a comprehensive examination code that precludes the need for the additional billing code of 99212 to be utilized by Respondent on the same encounter date for Patient P.D. 19. Based on the foregoing, Respondent violated section 460.413(1)(k), Florida Statutes, when he made a misleading, deceptive, untrue, or fraudulent representation to Patient P.D. in the practice of chiropractic which failed to conform to the prevailing standard of treatment in the chiropractic medical community. COUNT II 20. Petitioner re-alleges and incorporates paragraphs one (1) through four (4), and eleven (4/1) through fourteen (14), as if fully set forth herein. 21. Section 460.413(1)(r), Florida Statutes (2012-2013), provides in pertinent part that gross or repeated malpractice or the failure to practice chiropractic medicine at a level of care, skill, and treatment which is recognized by a reasonably prudent chiropractic physician as being acceptable under similar conditions and circumstances shall be grounds for discipline. 22, Respondent failed to practice chiropractic medicine at a level of care, and/or skill, and/or treatment which is recognized by a reasonably prudent chiropractic physician as being acceptable under similar conditions and circumstances by utilizing day when billing code 99204 precludes the need for the add billing codes 99204 and 99212 on the same is a comprehensive examination code that tional billing code of 99212 to be utilized by Respondent on the same encounter date for Patient P.D. 23. Based on the foregoing, Respondent violated section 460.413(1)(r), Florida Statutes, when he failed to practice chiropractic medicine at a level of care and/or skill recognized as acceptable by a prudent chiropractic physician as being acceptable under similar conditions when Respondent utilized billing code 99204 and 99212 for the same patient on the same encounter date. . WHEREFORE, the Petitioner respectfully requests that the Board of Chiropractic Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief: that the Board of Chiropractic Medicine deems appropriate. {Remainder of Page Intentionally Left Blank} SIGNED this Ao day of yoae , 2018. Celeste Philip, M.D., M.P.H. Surgeon General and Secretary, Derrick J. McBurrows Assistant General Counsel DOH Prosecution Services Unit DEPARTS SE. HEALTH 4052 Bald Cypress Way, Bin C-65 CLERK ang geen, ‘CLERK he Froricla 32399-3265 DATE orida bar JUN 2 0 2018 Phone 850-558-9906 FAX 850-245-4684 derrick. mcburrows@flhealth.gov PCP Date: 6-19-18 PCP Panel Members: Fox and Vogel NOTI CE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and a witnesses and to have subp ument, to call and cross-examine ena and subpoena duces tecum issued on his or her behalf if a hearing is requested. A request or petition for an administrative hearing must be in writing and must be received by the Department within 21 days from the day Respondent received the Administrative Complaint, pursuant to Rule 28-106.111(2), Florida Administrative Code. If Respondent fails to request a hearin Administrative Complaint, within 21 days of receipt of this espondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule 28-106.1 request for an administrat the material facts or cha Complaint must conform Administrative Code. Please be advised th 1(4), Florida Administrative Code. Any ive proceeding to challenge or contest rges contained in the Administrative to Rule 28-106.2015(5), Florida at mediation under Section 120.573, Florida Statutes, is not available for administrative disputes involving this agency action. NOTICE REGARD Respondent is placed costs related to the investi Pursuant to Section 456.0 ING ASSESSMENT OF COSTS on notice that Petitioner has incurred ation and prosecution of this matter. 2(4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a may include attorney hours and costs, on to any other discipline imposed. disciplinary matter, which on the Respondent in addit

Docket for Case No: 18-004487PL

Orders for Case No: 18-004487PL