Petitioner: DEPARTMENT OF HEALTH, BOARD OF CHIROPRACTIC MEDICINE
Respondent: MARC ALAN RACHBIND, D.C.
Judges: JOHN G. VAN LANINGHAM
Agency: Department of Health
Locations: Lauderdale Lakes, Florida
Filed: Aug. 27, 2013
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Tuesday, December 3, 2013.
Latest Update: Dec. 23, 2024
STATE OF FLORIDA
BOARD OF CHIROPRACTIC MEDICINE
DEPARTMENT OF HEALTH,
PETITIONER,
Vv. CASE NO. 2010-16467
MARC ALAN RACHBIND, D.C.,
RESPONDENT.
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ADMINISTRATIVE COMPLAINT
Petitioner, Department of Health, by and through its undersigned
counsel, files this Administrative Complaint before the Board of Chiropractic
Medicine against Respondent, Marc Alan Rachbind, D.C. 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 order, Respondent was licensed to
practice chiropractic medicine in the State of Florida, having been issued
license number CH 6704 on or about January 13, 1994,
3. Respondent's address of record is Past Office Box 7636, Fort
DOH v. Marc Alan Rachbind, D.C. 1
Case No, 2010-16467
Lauderdale, Florida 33338.
4. On or about June 16, 2010, Patient M.A., a 48 year-old female,
presented to the Respondent for treatment of injuries suffered during an
’ automobile accident on the same date.
5. Patient M.A. complained of neck, lower back, and right knee
pain.
7 6 Respondent conducted an initial examination of Patient M.A.
7, Respondent recorded several orthopedic tests as positive
without specifying what particular finding rendered the test positive.
8. Respondent recorded the following orthopedic tests as positive
with respect to Patient M.A.’s right knee: Patella Grind, McMurray’s,
Apley’s Compression, Apley’s Distraction, Abduction Stress, and Adduction
Stress.
. 9 In light of the patient’s subjective complaints and the positive
orthopedic findings, Respondent should have ordered diagnostic testing of
the patient's right knee.
10. Respondent recorded the following orthopedic test as positive
with respect to Patient M.A.’s cervical spine: Foraminal Compression,
Foraminal Distraction, Shoulder Depression, Soto-Hall, and Lindner’s.
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Case No. 2010-16467
11. In light of the patient’s subjective complaints and the positive
orthopedic finding, Respondent should have ordered diagnostic testing of
the patient’s cervical spine.
12. Patient M.A. returned to Respondent to receive treatment on or
about the following dates: June 17, 18, 21, 22, 24, 25, 28, 29, July 2, 5,
6; August 2, 3, 4, 9, 10, 11, 16, 18, 19, 23, 26, 26, 31; and September 1,
3, 7, 8, 9, 2010.
13. Patient M.A. was generally provided with some combination of
the following treatments on each date of service: chiropractic adjustment,
extremity adjustment, electrical muscle stimulation, ultrasound, traction,
manual therapy, and kinetic activities.
14. The daily treatment notes for Patient M.A. failed to adequately
describe Patient M.A.’s objective symptoms or subjective complaints.
15. The daily treatment notes failed to adequately describe the
treatment provided to Patient M.A. For instance, the treatments notes
generally failed to indicate the anatomical areas treated, the length of time
for each treatment, the settings used for electrical muscle stimulation and
ultrasound, the type of chiropractic adjustment provided, or the type of
manual therapy provided.
DOH v. Marc Alan Rachbind, D.C. 3
Case No. 2010-16467
16. The daily treatment notes for Patient M.A. failed to justify the
medical necessity of the treatment provided to Patient M.A.
17. The daily treatment notes failed to explain the almost one
month gap in treatment involving Patient M.A. from approximately July 6,
2010, until approximately August 2, 2010.
18. Respondent billed for Patient M.A.’s initial evaluation using CPT
Code 99204.
19. CPT is a listing of descriptive terms and identifying codes for
reporting medical services and procedures. The purpose of CPT is to
provide a uniform language that accurately describes medical, surgical, and
diagnostic services, and thereby serves as an effective means for reliable
nationwide communication among physicians and other healthcare
providers, patients, and third parties. CPT is the most widely accepted
medical nomenclature used to report medical procedures and services
under public and private health insurance programs,
20. In order to justify the use of the CPT Code 99204, a new
patient visit must involve all of the three following items: a comprehensive
history; a comprehensive examination, and medical decision making of
moderate complexity.
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Case No, 2010-16467
21. The June 16, 2010, initial examination recorded by Respondent
was insufficient to justify the use of CPT Code 99204,
22. Respondent’s license to practice chiropractic medicine was
delinquent from April 1, 2010, until approximately August 27, 2010.
23. Respondent practiced chiropractic medicine on one or more
patients, on one or more occasions without an active chiropractic license,
including when he treated Patient M.A. between April 1, 2010 and August
27, 2010.
Count One-Record Keeping Violations
24. Petitioner re-alleges and incorporates paragraphs one (1)
through twenty-three (23), as if fully stated herein.
25. Section 460.413(1)(m), Florida Statutes (2009-2010), provides
that failing to keep legibly written chiropractic medical records that identify
clearly by name and credentials the licensed chiropractic physician
rendering, ordering, supervising, or billing for each examination or
treatment procedure and that justify the course of treatment of the patient,
including, but not limited to, patient histories, examination results, X rays,
and diagnosis of a disease, condition, or injury is grounds for disciplinary
action by the Board of Chiropractic Medicine.
DOH v. Marc Alan Rachbind, D.C. 5
Case No. 2010-16467.
26. Section 460.413(1)(ff}, Florida Statutes (2009-2010), subjects a
chiropractor to discipline for violating any provision of this chapter, or
chapter 456, or any rules adopted pursuant thereto.
27. Rule 64B2-17.0065, Florida Administrative Code (F.A.C.) (2009-
2010), sets forth the minimal recordkeeping standards as set forth below in
pertinent part:
a. Rule 64B2-17,0065(3), F.A.C. states that medical
records shall be legibly maintained and shall contain sufficient
information to identify the patient, support the diagnosis, justify
the treatment and document the course and results of
treatment accurately, by including, at a minimum, patient
histories; examination results; test results; records of drugs
dispensed or administered; reports of consultations and
hospitalizations; and copies of records or reports or other
documentation obtained from other health care practitioners at
~ the request of the physician and relied upon by the physician in
determining the appropriate treatment of the patient. Initial
and follow-up services (daily records) shall consist of
documentation to justify care. If abbreviations or symbols are
used in the daily recordkeeping, a key must be provided.
b. Rule 64B2-17.0065(4), F.A.C., states that all patient
records shall include a patient history; symptomatology and/or
wellness care; examination finding(s), including X-rays when
medically or clinically indicated; a diagnosis; a prognosis;
assessment(s); a treatment plan; and, treatments provided.
C. Rule 64B2-17.0065(5), F.A.C., states all entries
made into the medical records shall be accurately dated. The
treating physician must be readily identifiable either by
signature, initials, or printed name on the record. Late entries
are permitted, but must be cleariy and accurately noted as late
entries and dated accurately when they are entered into the
record,
DOH v. Marc Alan Rachbind, D.C. 6
Case No. 2010-16467
d. Rule 64B2-17.0065(6), F.A.C., states that once a
treatment plan is established, daily records shall include: (a)
Subjective complaint(s); (b) Objective finding(s); (c)
Assessment(s); (d) Treatment(s) provided, and (e) Periodic
reassessments as indicated.
28. Respondent violated Section 460.413(1)(m), Florida Statutes,
Section 460.413(1)(ff), Florida Statutes, and/or Rule 64B2-17.0065, F.A.C.,
in the following ways:
a) By failing to record and/or maintain documentation sufficient
enough to justify using CPT Code 99204 for Patient M.A.’s_ initial
examination;
b) By failing to record and/or maintain daily treatment notes that
adequately described Patient M.A.’s objective symptoms and subjective
complaints;
c) By failing to record and/or maintain daily treatment notes that
adequately described the treatment provided to Patient M.A.;
d) By failing to explain Patient M.A.’s almost one month treatment
gap from July 6, 2010, until August 2, 2010;
e) By failing to document the findings that rendered several
orthopedic tests positive;
DOH v. Marc Alan Rachbind, D.C. 7
Case No. 2010-16467
f) By failing to document providing or ordering diagnostic testing
of Patient M.A.’s right knee;
g) By failing to document providing or ordering diagnostic testing
of Patient M.A.‘s cervical spine;
h) By failing to record and/or maintain sufficient records that
justified the care rendered to Patient M.A.;
29. Based on the foregoing, Respondent violated Section
460.413(1)(m), Florida Statutes , Section 460.413(1)(ff), Florida Statutes,
and/or Rule 64B2-17.0065, F.A.C. by failing to sufficient medical records.
Count Two- Financial Exploitation
30. Petitioner re-alleges and incorporates paragraphs one (1)
through twenty-three (23), as if fully set forth herein.
31. Section 460.413(1)(n), Florida Statutes (2009-2010), subjects a
chiropractor to discipline for exercising influence on the patient or client in
such a manner as to exploit the patient or client for financial gain of the
licensee or of a third party which shall include but not be limited to, the
-promation or sale of services, goods, or appliances, or drugs.
32. Rule 642B2-17.005(1), F.A.C. (2009-2010), states that the
DOH v. Marc Alan Rachbind, D.C. 8
Case No. 2010-16467
overutilization of chiropractic services or practice by exercising influence on
a patient in such a manner as to exploit the patient for financial gain of a
licensee or a third party is prohibited by Section 460.413(1)(n), Florida
Statutes.
33. Rule 64B2-17.005(3)(a), F.A.C. (2009-2010), states that
overutilization occurs when the written chiropractic records, required to be
kept by subsection 460.413(1)(m), Florida Statutes, do not justify or
substantiate the quantity or number of chiropractic services, practices
rendered, or goods or appliances sold by a chiropractic physician to a
patient.
34. Respondent violated Section 460.413(1)(n), Florida Statutes,
through one or more of the following:
a) When he billed Patient M.A.’s insurance company for the initial
examination using CPT Code 99204: or,
b) By billing for care provided to Patient M.A. that was. not
justified by the medical records.
35. Based on the foregoing, Respondent violated Section
460.413(1)(n), Florida Statutes (2009-2010).
DOH v. Marc Alan Rachbind, D.C, 9
Case No, 2010-16467
Count. Three- Practicing with a Delinquent License
36. Petitioner re-alleges paragraphs one (1) through twenty-three
(23), as if fully set forth within this paragraph.
37. Section 460.413(1)(fP), Florida Statutes (2009-2010), subjects a
chiropractic physician to discipline for violating any provisions of Chapter
460.
38. Section 460.411(1)(a), Florida Statutes (2009-2010), provides
practicing or attempting to practice chiropractic medicine without an active
license or with a license fraudulently obtained constitutes a violation of
Chapter 460.
| 39. Respondent practiced or attempted to practice chiropractic
medicine without an active license when he practiced chiropractic medicine
on one or more patients, on one or more occasions between April 1, 2010,
and August 27, 2010, including when he treated Patient M.A. between April
1, 2010, and August 27, 2010.
40. Based on the foregoing, Respondent violation Section
460.413(1)(fA), Florida Statutes (2009-2010), by violating any provision of
Chapter 460, specifically Section 460.411(1)(a), Florida Statutes (2009-
2010).
DOH v. Marc Alan Rachbind, D.C. 10
Case No. 2010-16467
Count Four- Violation of the Standard of Care
41. Petitioner re-alleges paragraphs one (1) through twenty-three
(23), as if fully set forth within this paragraph.
42. Section 460.413(1)(r), Florida Statutes (2009-2010), subjects a
chiropractic physician to discipline for 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.
43. Respondent failed to practice chiropractic medicine at the level
of care, skill and treatment which is recognized by a reasonably prudent
chiropractic physician as being acceptable under similar conditions and
circumstances through one or more of the following:
a) By failing to order diagnostic testing of Patient M.A.’s right
knee; or,
b) By failing to order diagnostic testing of Patient M.A.’s cervical
spine.
44. Based on the foregoing, Respondent violated Section
460.413(1)(r), Florida Statutes (2009-2010).
DOH v. Mare Alan Rachbind, D.C. tt
Case No. 2010-16467
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 deems appropriate.
SIGNED this _ [= dayof___ J. , 2012.
John H. Armstrong, MD
Surgeon General and Secretary of Health
EA OK
Tobe
Assistant Genéral Counsel
Fla. Bar No. 0542131
Florida Department of Health
DEPART or HEALTH Office of the General Counsel
DEPUTY CLERK 4052 Bald Cypress Way, Bin C-65
CLERK Angel Sanders Tallahassee, Florida 32399-3265
DATE jayne @ 2.2002 Telephone: (850) 245-4640 x. 8176
Facsimile: (850) 245-4683
Email: tobey_schultz@doh.state.fl.us
PCP: 5/31/12
PCP Members: Dr. Hoffman & Dr. Harding
DOH v, Marc Alan Rachbind, D.C. 12
Case No. 2010-16467
NOTICE 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 argument, to call and cross-examine
witnesses and to have subpoena and subpoena duces tecum
issued on his or her behalf if a hearing is requested.
NOTICE REGARDING ASSESSMENT OF COSTS
Respondent is placed on notice that Petitioner has incurred
costs related to the investigation and prosecution of this matter.
Pursuant to Section 456.072(4), Florida Statutes, the Board shall
assess costs related to the investigation and prosecution of a
disciplinary matter, which may include attorney hours and costs,
on the Respondent in addition to any other discipline imposed.
DOH v, Marc Alan Rachbind, D.C. 13
Case No. 2010-16467
Docket for Case No: 13-003259PL
Issue Date |
Proceedings |
Dec. 03, 2013 |
Order Closing File and Relinquishing Jurisdiction. CASE CLOSED.
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Dec. 03, 2013 |
Joint Motion to Relinquish Jurisdiction filed.
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Nov. 14, 2013 |
Petitioner's Notice of Serving Responses to Respondent's First Request for Interrogatories and Production of Documents filed.
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Oct. 24, 2013 |
Notice of Serving Answers to Interrogatories filed.
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Oct. 24, 2013 |
Response to Request to Produce filed.
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Oct. 17, 2013 |
Respondent's First Request to Produce filed.
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Oct. 17, 2013 |
Notice of Serving Interrogatories filed.
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Oct. 14, 2013 |
Response to Request for Admissions filed.
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Sep. 17, 2013 |
Order Granting Continuance and Re-scheduling Hearing by Video Teleconference (hearing set for January 15, 2014; 9:00 a.m.; Lauderdale Lakes, FL).
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Sep. 16, 2013 |
Notice of Non-objection to Respondent's Motion to Continue filed.
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Sep. 16, 2013 |
Motion to Continue filed.
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Sep. 10, 2013 |
Notice of Serving Petitioner's First Request for Production, First Request For Interrogatories, and First Requests For Admissions to Respondent filed.
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Sep. 06, 2013 |
Notice of Co-Counsel Appearance (Tari Rossitto-Van Winkle) filed.
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Sep. 05, 2013 |
Notice of Co-Counsel Appearance (Sharmin Hibbert) filed.
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Sep. 04, 2013 |
Joint Response to Initial Order filed.
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Sep. 04, 2013 |
Order of Pre-hearing Instructions.
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Sep. 04, 2013 |
Notice of Hearing by Video Teleconference (hearing set for November 4, 2013; 9:00 a.m.; Lauderdale Lakes and Tallahassee, FL).
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Aug. 27, 2013 |
Initial Order.
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Aug. 27, 2013 |
Answer to Administrative Complaint filed.
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Aug. 27, 2013 |
Administrative Complaint filed.
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Aug. 27, 2013 |
Agency referral filed.
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