Refusal to issue or renew, revocation or suspension of license,grounds for, procedure--additional disciplinary actions.
332.321. 1. The board may refuse to issue or renew a permit orlicense required pursuant to this chapter for one or any combination ofcauses stated in subsection 2 of this section or the board may, as acondition to issuing or renewing any such permit or license, require aperson to submit himself or herself for identification, intervention,treatment or rehabilitation by the well-being committee as provided insection 332.327. The board shall notify the applicant in writing of thereasons for the refusal and shall advise the applicant of his or her rightto file a complaint with the administrative hearing commission as providedby chapter 621, RSMo.
2. The board may cause a complaint to be filed with theadministrative hearing commission as provided by chapter 621, RSMo, againstany holder of any permit or license required by this chapter or any personwho has failed to renew or has surrendered his or her permit or license forany one or any combination of the following causes:
(1) Use of any controlled substance, as defined in chapter 195, RSMo,or alcoholic beverage to an extent that such use impairs a person's abilityto perform the work of any profession licensed or regulated by thischapter;
(2) The person has been finally adjudicated and found guilty, orentered a plea of guilty or nolo contendere, in a criminal prosecutionpursuant to the laws of any state or of the United States, for any offensereasonably related to the qualifications, functions or duties of anyprofession licensed or regulated pursuant to this chapter, for any offensean essential element of which is fraud, dishonesty or an act of violence,or any offense involving moral turpitude, whether or not sentence isimposed;
(3) Use of fraud, deception, misrepresentation or bribery in securingany permit or license issued pursuant to this chapter or in obtainingpermission to take any examination given or required pursuant to thischapter;
(4) Obtaining or attempting to obtain any fee, charge, tuition orother compensation by fraud, deception or misrepresentation; or increasingcharges when a patient utilizes a third-party payment program; or forrepeated irregularities in billing a third party for services rendered to apatient. For the purposes of this subdivision, irregularities in billingshall include:
(a) Reporting charges for the purpose of obtaining a total payment inexcess of that usually received by the dentist for the services rendered;
(b) Reporting incorrect treatment dates for the purpose of obtainingpayment;
(c) Reporting charges for services not rendered;
(d) Incorrectly reporting services rendered for the purpose ofobtaining payment that is greater than that to which the person isentitled;
(e) Abrogating the co-payment or deductible provisions of athird-party payment contract. Provided, however, that this paragraph shallnot prohibit a discount, credit or reduction of charges provided under anagreement between the licensee and an insurance company, health servicecorporation or health maintenance organization licensed pursuant to thelaws of this state; or governmental third-party payment program; orself-insurance program organized, managed or funded by a business entityfor its own employees or labor organization for its members;
(5) Incompetency, misconduct, gross negligence, fraud,misrepresentation or dishonesty in the performance of, or relating to one'sability to perform, the functions or duties of any profession licensed orregulated by this chapter;
(6) Violation of, or assisting or enabling any person to violate, anyprovision of this chapter, or any lawful rule or regulation adoptedpursuant to this chapter;
(7) Impersonation of any person holding a permit or license orallowing any person to use his or her permit, license or diploma from anyschool;
(8) Disciplinary action against the holder of a license or otherright to practice any profession regulated by this chapter imposed byanother state, province, territory, federal agency or country upon groundsfor which discipline is authorized in this state;
(9) A person is finally adjudicated incapacitated or disabled by acourt of competent jurisdiction;
(10) Assisting or enabling any person to practice or offer topractice, by lack of supervision or in any other manner, any professionlicensed or regulated by this chapter who is not registered and currentlyeligible to practice pursuant to this chapter;
(11) Issuance of a permit or license based upon a material mistake offact;
(12) Failure to display a valid certificate, permit or license if sorequired by this chapter or by any rule promulgated hereunder;
(13) Violation of any professional trust or confidence;
(14) Use of any advertisement or solicitation that is false,misleading or deceptive to the general public or persons to whom theadvertisement or solicitation is primarily directed. False, misleading ordeceptive advertisements or solicitations shall include, but not be limitedto:
(a) Promises of cure, relief from pain or other physical or mentalcondition, or improved physical or mental health;
(b) Any misleading or deceptive statement offering or promising afree service. Nothing herein shall be construed to make it unlawful tooffer a service for no charge if the offer is announced as part of a fulldisclosure of routine fees including consultation fees;
(c) Any misleading or deceptive claims of patient cure, relief orimproved condition; superiority in service, treatment or materials; new orimproved service, treatment or material; or reduced costs or greatersavings. Nothing herein shall be construed to make it unlawful to use anysuch claim if it is readily verifiable by existing documentation, data orother substantial evidence. Any claim that exceeds or exaggerates thescope of its supporting documentation, data or evidence is misleading ordeceptive;
(d) Any announced fee for a specified service where that fee does notinclude the charges for necessary related or incidental services, or wherethe actual fee charged for that specified service may exceed the announcedfee, but it shall not be unlawful to announce only the maximum fee that canbe charged for the specified service, including all related or incidentalservices, modified by the term "up to" if desired;
(e) Any announcement in any form including the term "specialist" orthe phrase "limited to the specialty of" unless each person named inconjunction with the term or phrase, or responsible for the announcement,holds a valid Missouri certificate and license evidencing that the personis a specialist in that area;
(f) Any announcement containing any of the terms denoting recognizedspecialties, or other descriptive terms carrying the same meaning, unlessthe announcement clearly designates by list each dentist not licensed as aspecialist in Missouri who is sponsoring or named in the announcement, oremployed by the entity sponsoring the announcement, after the followingclearly legible or audible statement: "Notice: the following dentist(s)in this practice is (are) not licensed in Missouri as specialists in theadvertised dental specialty(s) of ...........";
(g) Any announcement containing any terms denoting or implyingspecialty areas that are not recognized by the American Dental Association;
(15) Violation of the drug laws or rules and regulations of thisstate, any other state or the federal government;
(16) Failure or refusal to properly guard against contagious,infectious or communicable diseases or the spread thereof;
(17) Failing to maintain his or her office or offices, laboratory,equipment and instruments in a safe and sanitary condition;
(18) Accepting, tendering or paying "rebates" to or "splitting fees"with any other person; provided, however, that nothing herein shall be soconstrued as to make it unlawful for a dentist practicing in a partnershipor as a corporation organized pursuant to the provisions of chapter 356,RSMo, to distribute profits in accordance with his or her stated agreement;
(19) Administering, or causing or permitting to be administered,nitrous oxide gas in any amount to himself or herself, or to another unlessas an adjunctive measure to patient management;
(20) Being unable to practice as a dentist, specialist or hygienistwith reasonable skill and safety to patients by reasons of professionalincompetency, or because of illness, drunkenness, excessive use of drugs,narcotics, chemicals, or as a result of any mental or physical condition.In enforcing this subdivision the board shall, after a hearing before theboard, upon a finding of probable cause, require the dentist or specialistor hygienist to submit to a reexamination for the purpose of establishinghis or her competency to practice as a dentist, specialist or hygienist,which reexamination shall be conducted in accordance with rules adopted forthis purpose by the board, including rules to allow the examination of thedentist's, specialist's or hygienist's professional competence by at leastthree dentists or fellow specialists, or to submit to a mental or physicalexamination or combination thereof by at least three physicians. Oneexaminer shall be selected by the dentist, specialist or hygienistcompelled to take examination, one selected by the board, and one shall beselected by the two examiners so selected. Notice of the physical ormental examination shall be given by personal service or registered mail.Failure of the dentist, specialist or hygienist to submit to theexamination when directed shall constitute an admission of the allegationsagainst him or her, unless the failure was due to circumstances beyond hisor her control. A dentist, specialist or hygienist whose right to practicehas been affected pursuant to this subdivision shall, at reasonableintervals, be afforded an opportunity to demonstrate that he or she canresume competent practice with reasonable skill and safety to patients.
(a) In any proceeding pursuant to this subdivision, neither therecord of proceedings nor the orders entered by the board shall be usedagainst a dentist, specialist or hygienist in any other proceeding.Proceedings pursuant to this subdivision shall be conducted by the boardwithout the filing of a complaint with the administrative hearingcommission;
(b) When the board finds any person unqualified because of any of thegrounds set forth in this subdivision, it may enter an order imposing oneor more of the following: denying his or her application for a license;permanently withholding issuance of a license; administering a public orprivate reprimand; placing on probation, suspending or limiting orrestricting his or her license to practice as a dentist, specialist orhygienist for a period of not more than five years; revoking his or herlicense to practice as a dentist, specialist or hygienist; requiring him orher to submit to the care, counseling or treatment of physicians designatedby the dentist, specialist or hygienist compelled to be treated; orrequiring such person to submit to identification, intervention, treatmentor rehabilitation by the well-being committee as provided in section332.327. For the purpose of this subdivision, "license" includes thecertificate of registration, or license, or both, issued by the board.
3. After the filing of such complaint, the proceedings shall beconducted in accordance with the provisions of chapter 621, RSMo. Upon afinding by the administrative hearing commission that the grounds, providedin subsection 2, for disciplinary action are met, the board may, singly orin combination:
(1) Censure or place the person or firm named in the complaint onprobation on such terms and conditions as the board deems appropriate for aperiod not to exceed five years; or
(2) Suspend the license, certificate or permit for a period not toexceed three years; or
(3) Revoke the license, certificate, or permit. In any order ofrevocation, the board may provide that the person shall not apply forlicensure for a period of not less than one year following the date of theorder of revocation; or
(4) Cause the person or firm named in the complaint to makerestitution to any patient, or any insurer or third-party payer who shallhave paid in whole or in part a claim or payment for which they should bereimbursed, where restitution would be an appropriate remedy, including thereasonable cost of follow-up care to correct or complete a procedureperformed or one that was to be performed by the person or firm named inthe complaint; or
(5) Request the attorney general to bring an action in the circuitcourt of competent jurisdiction to recover a civil penalty on behalf of thestate in an amount to be assessed by the court.
4. If the board concludes that a dentist or dental hygienist hascommitted an act or is engaging in a course of conduct that would begrounds for disciplinary action and constitutes a clear and present dangerto the public health and safety, the board may file a complaint before theadministrative hearing commission requesting an expedited hearing andspecifying the conduct that gives rise to the danger and the nature of theproposed restriction or suspension of the dentist's or dental hygienist'slicense. Within fifteen days after service of the complaint on the dentistor dental hygienist, the administrative hearing commission shall conduct apreliminary hearing to determine whether the alleged conduct of the dentistor dental hygienist appears to constitute a clear and present danger to thepublic health and safety that justifies that the dentist's or dentalhygienist's license be immediately restricted or suspended. The burden ofproving that a dentist or dental hygienist is a clear and present danger tothe public health and safety shall be upon the Missouri dental board. Theadministrative hearing commission shall issue its decision immediatelyafter the hearing and shall either grant to the board the authority tosuspend or restrict the license or dismiss the action.
5. If the administrative hearing commission grants temporaryauthority to the board to restrict or suspend a dentist's or dentalhygienist's license, the dentist or dental hygienist named in the complaintmay request a full hearing before the administrative hearing commission. Arequest for a full hearing shall be made within thirty days after theadministrative hearing commission issues a decision. The administrativehearing commission shall, if requested by a dentist or dental hygienistnamed in the complaint, set a date to hold a full hearing under chapter621, RSMo, regarding the activities alleged in the initial complaint filedby the board. The administrative hearing commission shall set the date forfull hearing within ninety days from the date its decision was issued.Either party may request continuances, which shall be granted by theadministrative hearing commission upon a showing of good cause by eitherparty or consent of both parties. If a request for a full hearing is notmade within thirty days, the authority to impose discipline becomes finaland the board shall set the matter for hearing in accordance with section621.110, RSMo.
6. If the administrative hearing commission dismisses withoutprejudice the complaint filed by the board under subsection 4 of thissection or dismisses the action based on a finding that the board did notmeet its burden of proof establishing a clear and present danger, suchdismissal shall not bar the board from initiating a subsequent action onthe same grounds in accordance with this chapter and chapters 536 and 621,RSMo.
7. Notwithstanding any other provisions of section 332.071 or of thissection, a currently licensed dentist in Missouri may enter into anagreement with individuals and organizations to provide dental health care,provided such agreement does not permit or compel practices that violateany provision of this chapter.
8. At all proceedings for the enforcement of these or any otherprovisions of this chapter the board shall, as it deems necessary, select,in its discretion, either the attorney general or one of the attorneygeneral's assistants designated by the attorney general or other legalcounsel to appear and represent the board at each stage of such proceedingor trial until its conclusion.
9. If at any time when any discipline has been imposed pursuant tothis section or pursuant to any provision of this chapter, the licenseeremoves himself or herself from the state of Missouri, ceases to becurrently licensed pursuant to the provisions of this chapter, or fails tokeep the Missouri dental board advised of his or her current place ofbusiness and residence, the time of his or her absence, or unlicensedstatus, or unknown whereabouts shall not be deemed or taken as any part ofthe time of discipline so imposed.
(1987) In order to discipline dentist for misrepresentation under this section proof that the misconduct giving rise to the misrepresentation must be intentional. Missouri Dental Board v. Bailey, 731 S.W.2d 272 (Mo.App.W.D.).
Refusal to issue or renew, revocation or suspension of license,grounds for, procedure--additional disciplinary actions.
332.321. 1. The board may refuse to issue or renew a permit orlicense required pursuant to this chapter for one or any combination ofcauses stated in subsection 2 of this section or the board may, as acondition to issuing or renewing any such permit or license, require aperson to submit himself or herself for identification, intervention,treatment or rehabilitation by the well-being committee as provided insection 332.327. The board shall notify the applicant in writing of thereasons for the refusal and shall advise the applicant of his or her rightto file a complaint with the administrative hearing commission as providedby chapter 621, RSMo.
2. The board may cause a complaint to be filed with theadministrative hearing commission as provided by chapter 621, RSMo, againstany holder of any permit or license required by this chapter or any personwho has failed to renew or has surrendered his or her permit or license forany one or any combination of the following causes:
(1) Use of any controlled substance, as defined in chapter 195, RSMo,or alcoholic beverage to an extent that such use impairs a person's abilityto perform the work of any profession licensed or regulated by thischapter;
(2) The person has been finally adjudicated and found guilty, orentered a plea of guilty or nolo contendere, in a criminal prosecutionpursuant to the laws of any state or of the United States, for any offensereasonably related to the qualifications, functions or duties of anyprofession licensed or regulated pursuant to this chapter, for any offensean essential element of which is fraud, dishonesty or an act of violence,or any offense involving moral turpitude, whether or not sentence isimposed;
(3) Use of fraud, deception, misrepresentation or bribery in securingany permit or license issued pursuant to this chapter or in obtainingpermission to take any examination given or required pursuant to thischapter;
(4) Obtaining or attempting to obtain any fee, charge, tuition orother compensation by fraud, deception or misrepresentation; or increasingcharges when a patient utilizes a third-party payment program; or forrepeated irregularities in billing a third party for services rendered to apatient. For the purposes of this subdivision, irregularities in billingshall include:
(a) Reporting charges for the purpose of obtaining a total payment inexcess of that usually received by the dentist for the services rendered;
(b) Reporting incorrect treatment dates for the purpose of obtainingpayment;
(c) Reporting charges for services not rendered;
(d) Incorrectly reporting services rendered for the purpose ofobtaining payment that is greater than that to which the person isentitled;
(e) Abrogating the co-payment or deductible provisions of athird-party payment contract. Provided, however, that this paragraph shallnot prohibit a discount, credit or reduction of charges provided under anagreement between the licensee and an insurance company, health servicecorporation or health maintenance organization licensed pursuant to thelaws of this state; or governmental third-party payment program; orself-insurance program organized, managed or funded by a business entityfor its own employees or labor organization for its members;
(5) Incompetency, misconduct, gross negligence, fraud,misrepresentation or dishonesty in the performance of, or relating to one'sability to perform, the functions or duties of any profession licensed orregulated by this chapter;
(6) Violation of, or assisting or enabling any person to violate, anyprovision of this chapter, or any lawful rule or regulation adoptedpursuant to this chapter;
(7) Impersonation of any person holding a permit or license orallowing any person to use his or her permit, license or diploma from anyschool;
(8) Disciplinary action against the holder of a license or otherright to practice any profession regulated by this chapter imposed byanother state, province, territory, federal agency or country upon groundsfor which discipline is authorized in this state;
(9) A person is finally adjudicated incapacitated or disabled by acourt of competent jurisdiction;
(10) Assisting or enabling any person to practice or offer topractice, by lack of supervision or in any other manner, any professionlicensed or regulated by this chapter who is not registered and currentlyeligible to practice pursuant to this chapter;
(11) Issuance of a permit or license based upon a material mistake offact;
(12) Failure to display a valid certificate, permit or license if sorequired by this chapter or by any rule promulgated hereunder;
(13) Violation of any professional trust or confidence;
(14) Use of any advertisement or solicitation that is false,misleading or deceptive to the general public or persons to whom theadvertisement or solicitation is primarily directed. False, misleading ordeceptive advertisements or solicitations shall include, but not be limitedto:
(a) Promises of cure, relief from pain or other physical or mentalcondition, or improved physical or mental health;
(b) Any misleading or deceptive statement offering or promising afree service. Nothing herein shall be construed to make it unlawful tooffer a service for no charge if the offer is announced as part of a fulldisclosure of routine fees including consultation fees;
(c) Any misleading or deceptive claims of patient cure, relief orimproved condition; superiority in service, treatment or materials; new orimproved service, treatment or material; or reduced costs or greatersavings. Nothing herein shall be construed to make it unlawful to use anysuch claim if it is readily verifiable by existing documentation, data orother substantial evidence. Any claim that exceeds or exaggerates thescope of its supporting documentation, data or evidence is misleading ordeceptive;
(d) Any announced fee for a specified service where that fee does notinclude the charges for necessary related or incidental services, or wherethe actual fee charged for that specified service may exceed the announcedfee, but it shall not be unlawful to announce only the maximum fee that canbe charged for the specified service, including all related or incidentalservices, modified by the term "up to" if desired;
(e) Any announcement in any form including the term "specialist" orthe phrase "limited to the specialty of" unless each person named inconjunction with the term or phrase, or responsible for the announcement,holds a valid Missouri certificate and license evidencing that the personis a specialist in that area;
(f) Any announcement containing any of the terms denoting recognizedspecialties, or other descriptive terms carrying the same meaning, unlessthe announcement clearly designates by list each dentist not licensed as aspecialist in Missouri who is sponsoring or named in the announcement, oremployed by the entity sponsoring the announcement, after the followingclearly legible or audible statement: "Notice: the following dentist(s)in this practice is (are) not licensed in Missouri as specialists in theadvertised dental specialty(s) of ...........";
(g) Any announcement containing any terms denoting or implyingspecialty areas that are not recognized by the American Dental Association;
(15) Violation of the drug laws or rules and regulations of thisstate, any other state or the federal government;
(16) Failure or refusal to properly guard against contagious,infectious or communicable diseases or the spread thereof;
(17) Failing to maintain his or her office or offices, laboratory,equipment and instruments in a safe and sanitary condition;
(18) Accepting, tendering or paying "rebates" to or "splitting fees"with any other person; provided, however, that nothing herein shall be soconstrued as to make it unlawful for a dentist practicing in a partnershipor as a corporation organized pursuant to the provisions of chapter 356,RSMo, to distribute profits in accordance with his or her stated agreement;
(19) Administering, or causing or permitting to be administered,nitrous oxide gas in any amount to himself or herself, or to another unlessas an adjunctive measure to patient management;
(20) Being unable to practice as a dentist, specialist or hygienistwith reasonable skill and safety to patients by reasons of professionalincompetency, or because of illness, drunkenness, excessive use of drugs,narcotics, chemicals, or as a result of any mental or physical condition.In enforcing this subdivision the board shall, after a hearing before theboard, upon a finding of probable cause, require the dentist or specialistor hygienist to submit to a reexamination for the purpose of establishinghis or her competency to practice as a dentist, specialist or hygienist,which reexamination shall be conducted in accordance with rules adopted forthis purpose by the board, including rules to allow the examination of thedentist's, specialist's or hygienist's professional competence by at leastthree dentists or fellow specialists, or to submit to a mental or physicalexamination or combination thereof by at least three physicians. Oneexaminer shall be selected by the dentist, specialist or hygienistcompelled to take examination, one selected by the board, and one shall beselected by the two examiners so selected. Notice of the physical ormental examination shall be given by personal service or registered mail.Failure of the dentist, specialist or hygienist to submit to theexamination when directed shall constitute an admission of the allegationsagainst him or her, unless the failure was due to circumstances beyond hisor her control. A dentist, specialist or hygienist whose right to practicehas been affected pursuant to this subdivision shall, at reasonableintervals, be afforded an opportunity to demonstrate that he or she canresume competent practice with reasonable skill and safety to patients.
(a) In any proceeding pursuant to this subdivision, neither therecord of proceedings nor the orders entered by the board shall be usedagainst a dentist, specialist or hygienist in any other proceeding.Proceedings pursuant to this subdivision shall be conducted by the boardwithout the filing of a complaint with the administrative hearingcommission;
(b) When the board finds any person unqualified because of any of thegrounds set forth in this subdivision, it may enter an order imposing oneor more of the following: denying his or her application for a license;permanently withholding issuance of a license; administering a public orprivate reprimand; placing on probation, suspending or limiting orrestricting his or her license to practice as a dentist, specialist orhygienist for a period of not more than five years; revoking his or herlicense to practice as a dentist, specialist or hygienist; requiring him orher to submit to the care, counseling or treatment of physicians designatedby the dentist, specialist or hygienist compelled to be treated; orrequiring such person to submit to identification, intervention, treatmentor rehabilitation by the well-being committee as provided in section332.327. For the purpose of this subdivision, "license" includes thecertificate of registration, or license, or both, issued by the board.
3. After the filing of such complaint, the proceedings shall beconducted in accordance with the provisions of chapter 621, RSMo. Upon afinding by the administrative hearing commission that the grounds, providedin subsection 2, for disciplinary action are met, the board may, singly orin combination:
(1) Censure or place the person or firm named in the complaint onprobation on such terms and conditions as the board deems appropriate for aperiod not to exceed five years; or
(2) Suspend the license, certificate or permit for a period not toexceed three years; or
(3) Revoke the license, certificate, or permit. In any order ofrevocation, the board may provide that the person shall not apply forlicensure for a period of not less than one year following the date of theorder of revocation; or
(4) Cause the person or firm named in the complaint to makerestitution to any patient, or any insurer or third-party payer who shallhave paid in whole or in part a claim or payment for which they should bereimbursed, where restitution would be an appropriate remedy, including thereasonable cost of follow-up care to correct or complete a procedureperformed or one that was to be performed by the person or firm named inthe complaint; or
(5) Request the attorney general to bring an action in the circuitcourt of competent jurisdiction to recover a civil penalty on behalf of thestate in an amount to be assessed by the court.
4. If the board concludes that a dentist or dental hygienist hascommitted an act or is engaging in a course of conduct that would begrounds for disciplinary action and constitutes a clear and present dangerto the public health and safety, the board may file a complaint before theadministrative hearing commission requesting an expedited hearing andspecifying the conduct that gives rise to the danger and the nature of theproposed restriction or suspension of the dentist's or dental hygienist'slicense. Within fifteen days after service of the complaint on the dentistor dental hygienist, the administrative hearing commission shall conduct apreliminary hearing to determine whether the alleged conduct of the dentistor dental hygienist appears to constitute a clear and present danger to thepublic health and safety that justifies that the dentist's or dentalhygienist's license be immediately restricted or suspended. The burden ofproving that a dentist or dental hygienist is a clear and present danger tothe public health and safety shall be upon the Missouri dental board. Theadministrative hearing commission shall issue its decision immediatelyafter the hearing and shall either grant to the board the authority tosuspend or restrict the license or dismiss the action.
5. If the administrative hearing commission grants temporaryauthority to the board to restrict or suspend a dentist's or dentalhygienist's license, the dentist or dental hygienist named in the complaintmay request a full hearing before the administrative hearing commission. Arequest for a full hearing shall be made within thirty days after theadministrative hearing commission issues a decision. The administrativehearing commission shall, if requested by a dentist or dental hygienistnamed in the complaint, set a date to hold a full hearing under chapter621, RSMo, regarding the activities alleged in the initial complaint filedby the board. The administrative hearing commission shall set the date forfull hearing within ninety days from the date its decision was issued.Either party may request continuances, which shall be granted by theadministrative hearing commission upon a showing of good cause by eitherparty or consent of both parties. If a request for a full hearing is notmade within thirty days, the authority to impose discipline becomes finaland the board shall set the matter for hearing in accordance with section621.110, RSMo.
6. If the administrative hearing commission dismisses withoutprejudice the complaint filed by the board under subsection 4 of thissection or dismisses the action based on a finding that the board did notmeet its burden of proof establishing a clear and present danger, suchdismissal shall not bar the board from initiating a subsequent action onthe same grounds in accordance with this chapter and chapters 536 and 621,RSMo.
7. Notwithstanding any other provisions of section 332.071 or of thissection, a currently licensed dentist in Missouri may enter into anagreement with individuals and organizations to provide dental health care,provided such agreement does not permit or compel practices that violateany provision of this chapter.
8. At all proceedings for the enforcement of these or any otherprovisions of this chapter the board shall, as it deems necessary, select,in its discretion, either the attorney general or one of the attorneygeneral's assistants designated by the attorney general or other legalcounsel to appear and represent the board at each stage of such proceedingor trial until its conclusion.
9. If at any time when any discipline has been imposed pursuant tothis section or pursuant to any provision of this chapter, the licenseeremoves himself or herself from the state of Missouri, ceases to becurrently licensed pursuant to the provisions of this chapter, or fails tokeep the Missouri dental board advised of his or her current place ofbusiness and residence, the time of his or her absence, or unlicensedstatus, or unknown whereabouts shall not be deemed or taken as any part ofthe time of discipline so imposed.
(1987) In order to discipline dentist for misrepresentation under this section proof that the misconduct giving rise to the misrepresentation must be intentional. Missouri Dental Board v. Bailey, 731 S.W.2d 272 (Mo.App.W.D.).
Refusal to issue or renew, revocation or suspension of license,grounds for, procedure--additional disciplinary actions.
332.321. 1. The board may refuse to issue or renew a permit orlicense required pursuant to this chapter for one or any combination ofcauses stated in subsection 2 of this section or the board may, as acondition to issuing or renewing any such permit or license, require aperson to submit himself or herself for identification, intervention,treatment or rehabilitation by the well-being committee as provided insection 332.327. The board shall notify the applicant in writing of thereasons for the refusal and shall advise the applicant of his or her rightto file a complaint with the administrative hearing commission as providedby chapter 621, RSMo.
2. The board may cause a complaint to be filed with theadministrative hearing commission as provided by chapter 621, RSMo, againstany holder of any permit or license required by this chapter or any personwho has failed to renew or has surrendered his or her permit or license forany one or any combination of the following causes:
(1) Use of any controlled substance, as defined in chapter 195, RSMo,or alcoholic beverage to an extent that such use impairs a person's abilityto perform the work of any profession licensed or regulated by thischapter;
(2) The person has been finally adjudicated and found guilty, orentered a plea of guilty or nolo contendere, in a criminal prosecutionpursuant to the laws of any state or of the United States, for any offensereasonably related to the qualifications, functions or duties of anyprofession licensed or regulated pursuant to this chapter, for any offensean essential element of which is fraud, dishonesty or an act of violence,or any offense involving moral turpitude, whether or not sentence isimposed;
(3) Use of fraud, deception, misrepresentation or bribery in securingany permit or license issued pursuant to this chapter or in obtainingpermission to take any examination given or required pursuant to thischapter;
(4) Obtaining or attempting to obtain any fee, charge, tuition orother compensation by fraud, deception or misrepresentation; or increasingcharges when a patient utilizes a third-party payment program; or forrepeated irregularities in billing a third party for services rendered to apatient. For the purposes of this subdivision, irregularities in billingshall include:
(a) Reporting charges for the purpose of obtaining a total payment inexcess of that usually received by the dentist for the services rendered;
(b) Reporting incorrect treatment dates for the purpose of obtainingpayment;
(c) Reporting charges for services not rendered;
(d) Incorrectly reporting services rendered for the purpose ofobtaining payment that is greater than that to which the person isentitled;
(e) Abrogating the co-payment or deductible provisions of athird-party payment contract. Provided, however, that this paragraph shallnot prohibit a discount, credit or reduction of charges provided under anagreement between the licensee and an insurance company, health servicecorporation or health maintenance organization licensed pursuant to thelaws of this state; or governmental third-party payment program; orself-insurance program organized, managed or funded by a business entityfor its own employees or labor organization for its members;
(5) Incompetency, misconduct, gross negligence, fraud,misrepresentation or dishonesty in the performance of, or relating to one'sability to perform, the functions or duties of any profession licensed orregulated by this chapter;
(6) Violation of, or assisting or enabling any person to violate, anyprovision of this chapter, or any lawful rule or regulation adoptedpursuant to this chapter;
(7) Impersonation of any person holding a permit or license orallowing any person to use his or her permit, license or diploma from anyschool;
(8) Disciplinary action against the holder of a license or otherright to practice any profession regulated by this chapter imposed byanother state, province, territory, federal agency or country upon groundsfor which discipline is authorized in this state;
(9) A person is finally adjudicated incapacitated or disabled by acourt of competent jurisdiction;
(10) Assisting or enabling any person to practice or offer topractice, by lack of supervision or in any other manner, any professionlicensed or regulated by this chapter who is not registered and currentlyeligible to practice pursuant to this chapter;
(11) Issuance of a permit or license based upon a material mistake offact;
(12) Failure to display a valid certificate, permit or license if sorequired by this chapter or by any rule promulgated hereunder;
(13) Violation of any professional trust or confidence;
(14) Use of any advertisement or solicitation that is false,misleading or deceptive to the general public or persons to whom theadvertisement or solicitation is primarily directed. False, misleading ordeceptive advertisements or solicitations shall include, but not be limitedto:
(a) Promises of cure, relief from pain or other physical or mentalcondition, or improved physical or mental health;
(b) Any misleading or deceptive statement offering or promising afree service. Nothing herein shall be construed to make it unlawful tooffer a service for no charge if the offer is announced as part of a fulldisclosure of routine fees including consultation fees;
(c) Any misleading or deceptive claims of patient cure, relief orimproved condition; superiority in service, treatment or materials; new orimproved service, treatment or material; or reduced costs or greatersavings. Nothing herein shall be construed to make it unlawful to use anysuch claim if it is readily verifiable by existing documentation, data orother substantial evidence. Any claim that exceeds or exaggerates thescope of its supporting documentation, data or evidence is misleading ordeceptive;
(d) Any announced fee for a specified service where that fee does notinclude the charges for necessary related or incidental services, or wherethe actual fee charged for that specified service may exceed the announcedfee, but it shall not be unlawful to announce only the maximum fee that canbe charged for the specified service, including all related or incidentalservices, modified by the term "up to" if desired;
(e) Any announcement in any form including the term "specialist" orthe phrase "limited to the specialty of" unless each person named inconjunction with the term or phrase, or responsible for the announcement,holds a valid Missouri certificate and license evidencing that the personis a specialist in that area;
(f) Any announcement containing any of the terms denoting recognizedspecialties, or other descriptive terms carrying the same meaning, unlessthe announcement clearly designates by list each dentist not licensed as aspecialist in Missouri who is sponsoring or named in the announcement, oremployed by the entity sponsoring the announcement, after the followingclearly legible or audible statement: "Notice: the following dentist(s)in this practice is (are) not licensed in Missouri as specialists in theadvertised dental specialty(s) of ...........";
(g) Any announcement containing any terms denoting or implyingspecialty areas that are not recognized by the American Dental Association;
(15) Violation of the drug laws or rules and regulations of thisstate, any other state or the federal government;
(16) Failure or refusal to properly guard against contagious,infectious or communicable diseases or the spread thereof;
(17) Failing to maintain his or her office or offices, laboratory,equipment and instruments in a safe and sanitary condition;
(18) Accepting, tendering or paying "rebates" to or "splitting fees"with any other person; provided, however, that nothing herein shall be soconstrued as to make it unlawful for a dentist practicing in a partnershipor as a corporation organized pursuant to the provisions of chapter 356,RSMo, to distribute profits in accordance with his or her stated agreement;
(19) Administering, or causing or permitting to be administered,nitrous oxide gas in any amount to himself or herself, or to another unlessas an adjunctive measure to patient management;
(20) Being unable to practice as a dentist, specialist or hygienistwith reasonable skill and safety to patients by reasons of professionalincompetency, or because of illness, drunkenness, excessive use of drugs,narcotics, chemicals, or as a result of any mental or physical condition.In enforcing this subdivision the board shall, after a hearing before theboard, upon a finding of probable cause, require the dentist or specialistor hygienist to submit to a reexamination for the purpose of establishinghis or her competency to practice as a dentist, specialist or hygienist,which reexamination shall be conducted in accordance with rules adopted forthis purpose by the board, including rules to allow the examination of thedentist's, specialist's or hygienist's professional competence by at leastthree dentists or fellow specialists, or to submit to a mental or physicalexamination or combination thereof by at least three physicians. Oneexaminer shall be selected by the dentist, specialist or hygienistcompelled to take examination, one selected by the board, and one shall beselected by the two examiners so selected. Notice of the physical ormental examination shall be given by personal service or registered mail.Failure of the dentist, specialist or hygienist to submit to theexamination when directed shall constitute an admission of the allegationsagainst him or her, unless the failure was due to circumstances beyond hisor her control. A dentist, specialist or hygienist whose right to practicehas been affected pursuant to this subdivision shall, at reasonableintervals, be afforded an opportunity to demonstrate that he or she canresume competent practice with reasonable skill and safety to patients.
(a) In any proceeding pursuant to this subdivision, neither therecord of proceedings nor the orders entered by the board shall be usedagainst a dentist, specialist or hygienist in any other proceeding.Proceedings pursuant to this subdivision shall be conducted by the boardwithout the filing of a complaint with the administrative hearingcommission;
(b) When the board finds any person unqualified because of any of thegrounds set forth in this subdivision, it may enter an order imposing oneor more of the following: denying his or her application for a license;permanently withholding issuance of a license; administering a public orprivate reprimand; placing on probation, suspending or limiting orrestricting his or her license to practice as a dentist, specialist orhygienist for a period of not more than five years; revoking his or herlicense to practice as a dentist, specialist or hygienist; requiring him orher to submit to the care, counseling or treatment of physicians designatedby the dentist, specialist or hygienist compelled to be treated; orrequiring such person to submit to identification, intervention, treatmentor rehabilitation by the well-being committee as provided in section332.327. For the purpose of this subdivision, "license" includes thecertificate of registration, or license, or both, issued by the board.
3. After the filing of such complaint, the proceedings shall beconducted in accordance with the provisions of chapter 621, RSMo. Upon afinding by the administrative hearing commission that the grounds, providedin subsection 2, for disciplinary action are met, the board may, singly orin combination:
(1) Censure or place the person or firm named in the complaint onprobation on such terms and conditions as the board deems appropriate for aperiod not to exceed five years; or
(2) Suspend the license, certificate or permit for a period not toexceed three years; or
(3) Revoke the license, certificate, or permit. In any order ofrevocation, the board may provide that the person shall not apply forlicensure for a period of not less than one year following the date of theorder of revocation; or
(4) Cause the person or firm named in the complaint to makerestitution to any patient, or any insurer or third-party payer who shallhave paid in whole or in part a claim or payment for which they should bereimbursed, where restitution would be an appropriate remedy, including thereasonable cost of follow-up care to correct or complete a procedureperformed or one that was to be performed by the person or firm named inthe complaint; or
(5) Request the attorney general to bring an action in the circuitcourt of competent jurisdiction to recover a civil penalty on behalf of thestate in an amount to be assessed by the court.
4. If the board concludes that a dentist or dental hygienist hascommitted an act or is engaging in a course of conduct that would begrounds for disciplinary action and constitutes a clear and present dangerto the public health and safety, the board may file a complaint before theadministrative hearing commission requesting an expedited hearing andspecifying the conduct that gives rise to the danger and the nature of theproposed restriction or suspension of the dentist's or dental hygienist'slicense. Within fifteen days after service of the complaint on the dentistor dental hygienist, the administrative hearing commission shall conduct apreliminary hearing to determine whether the alleged conduct of the dentistor dental hygienist appears to constitute a clear and present danger to thepublic health and safety that justifies that the dentist's or dentalhygienist's license be immediately restricted or suspended. The burden ofproving that a dentist or dental hygienist is a clear and present danger tothe public health and safety shall be upon the Missouri dental board. Theadministrative hearing commission shall issue its decision immediatelyafter the hearing and shall either grant to the board the authority tosuspend or restrict the license or dismiss the action.
5. If the administrative hearing commission grants temporaryauthority to the board to restrict or suspend a dentist's or dentalhygienist's license, the dentist or dental hygienist named in the complaintmay request a full hearing before the administrative hearing commission. Arequest for a full hearing shall be made within thirty days after theadministrative hearing commission issues a decision. The administrativehearing commission shall, if requested by a dentist or dental hygienistnamed in the complaint, set a date to hold a full hearing under chapter621, RSMo, regarding the activities alleged in the initial complaint filedby the board. The administrative hearing commission shall set the date forfull hearing within ninety days from the date its decision was issued.Either party may request continuances, which shall be granted by theadministrative hearing commission upon a showing of good cause by eitherparty or consent of both parties. If a request for a full hearing is notmade within thirty days, the authority to impose discipline becomes finaland the board shall set the matter for hearing in accordance with section621.110, RSMo.
6. If the administrative hearing commission dismisses withoutprejudice the complaint filed by the board under subsection 4 of thissection or dismisses the action based on a finding that the board did notmeet its burden of proof establishing a clear and present danger, suchdismissal shall not bar the board from initiating a subsequent action onthe same grounds in accordance with this chapter and chapters 536 and 621,RSMo.
7. Notwithstanding any other provisions of section 332.071 or of thissection, a currently licensed dentist in Missouri may enter into anagreement with individuals and organizations to provide dental health care,provided such agreement does not permit or compel practices that violateany provision of this chapter.
8. At all proceedings for the enforcement of these or any otherprovisions of this chapter the board shall, as it deems necessary, select,in its discretion, either the attorney general or one of the attorneygeneral's assistants designated by the attorney general or other legalcounsel to appear and represent the board at each stage of such proceedingor trial until its conclusion.
9. If at any time when any discipline has been imposed pursuant tothis section or pursuant to any provision of this chapter, the licenseeremoves himself or herself from the state of Missouri, ceases to becurrently licensed pursuant to the provisions of this chapter, or fails tokeep the Missouri dental board advised of his or her current place ofbusiness and residence, the time of his or her absence, or unlicensedstatus, or unknown whereabouts shall not be deemed or taken as any part ofthe time of discipline so imposed.
(1987) In order to discipline dentist for misrepresentation under this section proof that the misconduct giving rise to the misrepresentation must be intentional. Missouri Dental Board v. Bailey, 731 S.W.2d 272 (Mo.App.W.D.).
