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TBCE proposes broader rule on prepaid treatment, memberships and financial arrangements; seeks public comment
Summary
The board voted to propose an amendment (retitled 'financial arrangements and prepayment of services') to cover memberships, concierge and prepaid models, require written disclosures including cancellation policies, and clarify refund/proration; the rule will go to public comment after staff inserts language addressing cancellation 'by any reasonable method.'
The Texas Board of Chiropractic Examiners voted on May 28 to send a revised rule to the public-comment stage that expands current prepaid-treatment-plan regulations to cover membership, subscription, concierge and other prepayment models.
Dr. Michael Henry, chair of the rules committee, explained the change is intended to bring the board’s rules up to date with business models that have proliferated since the existing prepaid rule was adopted. The proposal retitles the provision "financial arrangements and prepayment of services" and adds required written disclosures for any prepayment model, including the nature of services, handling of durable goods, cancellation policies, and refund or pro rata calculations.
"We wanted to create a rule that gave our enforcement committee a little more oversight over other kinds of business practices," Dr. Henry said, noting the rule aims to protect patients while avoiding overly prescriptive requirements.
Board members and stakeholders focused on cancellation language: members asked staff to add "by any reasonable method" and to clarify that losing a prepaid discount should not be treated as a penalty. Dr. Scott Kelly, who registered for public comment, sought clarification on what constitutes a penalty versus the loss of a bulk discount; enforcement staff said returning the pro rata amount for services not used (and removing the discount) is the current enforcement approach.
The board directed staff to incorporate revisions (including suggested language to clarify cancellation mechanics) and to publish the proposal for public comment. No final rule was adopted at this meeting; the public-comment period will inform any final edits and potential adoption at a future meeting.
Why it matters: The change targets consumer-protection gaps in new practice models (membership and subscription arrangements) that were not contemplated in the older prepaid-treatment-plan rule. Clear disclosure requirements will give enforcement a written record to evaluate whether arrangements are deceptive, coercive, or unfair.
What’s next: Staff will add clarifying language to the proposed text, send the proposal to the register for public comment, and return with public feedback and potential edits at a future meeting.
