IDFPR Puts Doctors On Notice: Spread COVID-19 Misinformation Or Quack Treatments And We Will Come After Your License

As I discussed in a post a few months back, physicians across the country are being called out for spreading misinformation and disinformation regarding COVID-19, vaccines, and the efficacy of other preventative measures such as masking. During the summer, the Federation of State Medical Boards (FSMB) issued a stern admonition about the misinformation epidemic among members of the profession, stating unequivocally that “Physicians who generate and spread COVID-19 vaccine misinformation or disinformation are risking disciplinary action by state medical boards, including the suspension or revocation of their medical license.”

Recently, the Illinois Department of Financial and Professional Regulation (IDFPR) explicitly confirmed that they see physician disinformation about COVID-19 as a serious ethics violation warranting equally serious disciplinary action. Illinois doctors who peddle information about the virus or vaccines that is not based on sound science risk losing their professional licenses and careers.

On November 5, 2021, IDFPR issued its “Notice that Advice or Treatment Regarding Covid-19 Must Conform with Evidence-Based Medicine and Standards of Care.” It began by reminding physicians that, as a general matter, “any advice or treatment provided to a patient must conform with evidence-based medicine and standards of care and that failure to do so may subject the individual to disciplinary action under the Medical Practice Act.”

The Department further noted that “Engaging in dishonorable, unethical, or unprofessional conduct of a character likely to deceive, defraud or harm the public” is a violation of the Medical Practice Act at 225 ILCS 60/22(A)(5). IDFPR makes it clear that it sees COVID-19 misinformation or the recommendation of unproven and unapproved treatments as conduct “likely to deceive, defraud, or harm the public.”

The notice calls out three specific forms of COVID-related misconduct that it views as possible ethical violations:

Issuing Mask Exemptions For Non-Patients

As kids returned to school this fall in districts with mask requirements, reports emerged about physicians issuing medical exemption notes to parents of schoolchildren with whom they did not have a doctor-patient relationship. For example, one Pennsylvania doctor who is vocally anti-mask is facing disciplinary action for posting a stock, four-page exemption letter on the homepage of his practice’s website that invited people to “print your own copy.”

IDFPR stated unequivocally that such conduct is a violation of the Medical Practice Act:

“A physician or other licensed healthcare professional who provides a mask exemption to an individual with whom they do not have a clinician-patient relationship and for whom they have not provided a medical diagnosis that justifies a mask exemption as put forth in the CDC guidelines, is in violation of their respective licensing Act and may be subject to disciplinary action by IDFPR.”

Ivermectin And Other Non-FDA Approved Treatments

Since the pandemic began, people from TV preachers to conspiracy theorists to herbalists to twice-impeached former presidents have peddled all kinds of snake oil for preventing or treating COVID-19. This includes the horse deworming medication Ivermectin.

Noting that the CDC has issued an official health advisory regarding severe illness associated with the use of products containing Ivermectin to prevent or treat COVID-19, IDFPR stated that  “A physician or other licensed healthcare professional who prescribes Ivermectin in a manner inconsistent with the CDC’s recommendations may be subject to discipline.”

COVID-19 Misinformation By Physicians

Finally, IDFPR voiced its strong support for FSMB’s statement on misinformation relating to COVID-19 as quoted above. It also announced that it would follow the joint statement from the American Board of Family Medicine, the American Board of Internal Medicine, and the American Board of Pediatrics about COVID-19 misinformation by physicians in which they concluded that “providing misinformation about a lethal disease is unethical, unprofessional and dangerous.”  That statement also said that the groups “want all physicians certified by our Boards to know that such unethical or unprofessional conduct may prompt their respective Boards to take action that could put their certification at risk.”

The IDFPR also encourages anyone who becomes aware of a licensed health professional’s dissemination of misinformation or practice inconsistent with current state and federal guidelines regarding COVID-19 to file a complaint.

IDFPR’s firm stand against COVID-19 misinformation should put all Illinois medical professionals on notice that their words about COVID vaccines have consequences, not only to the health and well-being of the general public, but to their careers and reputations as well.

Faith v. Phony: How Should Employers Evaluate Employees’ Claimed “Religious” Objections to COVID-19 Vaccination Mandates?

Questioning the legitimacy of someone’s faith or religious beliefs is a tricky business. But employers across the country, from major corporations to local governments, have to deal with such deeply personal inquiries with increasing frequency as many employees and job candidates opposed to COVID-19 vaccine mandates seek “religious exemptions” from having to get the shot.

Recognizing the uncomfortable and somewhat perilous task faced by employers when such claims arise, the Equal Employment Opportunity Commission (EEOC) released new guidance on October 25, 2021, specifically addressing how employers should evaluate requests for religious exemptions from vaccine mandates. The new Section L of the EEOC’s omnibus COVID-19 page supplements previous direction about employer obligations regarding claimed religious objections to vaccinations.

The Basis for Religious Exemption Claims

The basis for religious exemptions to employer COVID-19 vaccine mandates is found in Title VII of the Civil Rights Act of 1964. Title VII requires an employer, upon receiving notice, to reasonably accommodate an employee whose “sincerely held religious belief, practice, or observance” conflicts with a job requirement, such as a company-wide vaccination mandate, unless providing the accommodation would create an undue hardship for the employer.

Accordingly, the threshold question for employers when an employee advises them of their request for a “religious accommodation” to an employer COVID-19 vaccine requirement is determining whether the objection to getting the shot is, in fact, based on a “sincerely held religious belief.”

What Is a “Religious Belief”?

The definition of “religion” under Title VII not only includes widely recognized faiths like Christianity, Judaism, Islam, or Hinduism, but it also protects nontraditional religious beliefs that may be unfamiliar to employers. However, as the EEOC clarifies, “social, political, or economic philosophies, as well as mere personal preferences, are not religious beliefs protected by Title VII.”

Therefore, employers are free to disregard exemption requests premised on concerns about “personal freedom,” the underlying legal legitimacy of vaccine mandates, or conspiracy-laden claims about microchips, magnetism, or other disinformation about COVID vaccines.

How To Determine Whether an Employee’s Religious Belief Is “Sincerely Held”

As the EEOC notes, “Whether or not a religious belief is sincerely held by an applicant or employee is rarely at issue in many types of Title VII religious claims.” But the reluctance of many workers to get vaccinated or their refusal to comply with employer or government vaccine mandates has made this very much an issue.

That’s because many employees who refuse to get vaccinated against COVID-19 for non-religious reasons are trying to incincerely and improperly shoehorn those objections  into Title VII’s religious protections. As the New York Times recently reported, “Vaccine-resistant workers are sharing tips online for requesting exemptions to the requirements on religious grounds; others are submitting letters from far-flung religious authorities who have advertised their willingness to help.”

This puts employers in the delicate position of questioning the sincerity of an employee’s faith and religion. According to the EEOC, an employee’s sincerity in holding a religious belief is “largely a matter of individual credibility.” When evaluating that credibility, the EEOC says that employers can consider the following “factors that – either alone or in combination – might undermine an employee’s credibility”:

  • Whether the employee has acted in a manner inconsistent with the professed belief (although employees need not be scrupulous in their observance).
  • Whether the accommodation sought is a particularly desirable benefit that is likely to be sought for nonreligious reasons; whether the timing of the request renders it suspect (e.g., it follows an earlier request by the employee for the same benefit for secular reasons).
  • Whether the employer otherwise has reason to believe the employee is not seeking the accommodation for religious reasons.

Employers can ask an employee to explain how their claimed religious beliefs conflict with a COVID-19 vaccine mandate. The EEOC advises that employers:

“Should not assume that an employee is insincere simply because some of the employee’s practices deviate from the commonly followed tenets of the employee’s religion, or because the employee adheres to some common practices but not others. No one factor or consideration is determinative, and employers should evaluate religious objections on an individual basis.

If you are a business owner and have questions about how to address religious or other objections to your company’s COVID-19 vaccination policies, please give me a call at 312-236-2433 or fill out my online form to arrange for your free initial consultation.

What Illinois Medical Practice Owners Need to Know About Pritzker’s Vaccination Mandate For Healthcare Workers

There is no more debate for healthcare workers in Illinois about whether to get vaccinated against COVID-19 (not that there should have been any debate), at least if they want to continue working. On August 26, 2021, Gov. J.B. Pritzker issued Executive Order 2021-20, which mandates that almost all healthcare professionals and staff in the state must get their shots, subject to certain narrow exceptions. The Order took effect immediately. Physicians and medical practice owners need to understand the governor’s vaccination mandate for their staff to ensure compliance. Here is what physician/owners need to know:

Physicians and medical practice owners need to understand the governor’s vaccination mandate for their staff to ensure compliance. Here is what physician/owners need to know:

All “Health Care Workers” Must Receive At Least One Dose By Sept. 5

The Order requires all “Health Care Workers” to:

  • receive at least the first dose of a two-dose COVID-19 vaccine series or a single-dose COVID-19 vaccine by September 5, 2021, and
  • be fully vaccinated against COVID-19 within 30 days following administration of their first dose in a two-dose vaccination series.

“Health Care Workers” and “Health Care Facilities” Covered By The Vaccine Mandate

As defined in the governor’s order, “Health Care Workers” covered by the vaccine mandate are those who:

  • are employed by, volunteer for, or contract to provide services for a Health Care Facility, or are employed by an entity that is contracted to provide services to a Health Care Facility, and
  • are in close contact (fewer than 6 feet) with other persons in the facility for more than 15 minutes at least once a week on a regular basis as determined by the Health Care Facility.

With the exception of state-owned or operated facilities, almost any facility or office that provides medical care is a “Health Care Facility” whose workers, as defined above, must get vaccinated. This includes:

  • physician offices
  • dental offices
  • ambulatory surgical treatment centers
  • hospices
  • hospitals
  • free-standing emergency centers
  • urgent care facilities
  • birth centers
  • post-surgical recovery care facilities
  • end-stage renal disease facilities
  • long-term care facilities (including skilled and intermediate long-term care facilities)
  • Specialized Mental Health Rehabilitation Facilities
  • assisted living facilities
  • supportive living facilities
  • medical assistance facilities
  • mental health centers
  • outpatient facilities
  • rehabilitation facilities
  • residential treatment facilities
  • adult day care centers

Unvaccinated Workers Barred From Premises Until Tested

As of September 5, 2021, covered Health Care Facilities must ban from their premises any Health Care Worker who has not provided proof (CDC vaccination card, photo of card, or documentation from a health care provider) that they have been fully vaccinated unless they submit to testing as follows:

  • Health Care Workers who are not fully vaccinated against COVID-19 must be tested for COVID-19 weekly, at a minimum.
  • Such testing for Health Care Workers who are not fully vaccinated against COVID-19 must be conducted on-site at the Health Care Facility or the Health Care Facility must obtain proof or confirmation from the Health Care Worker of a negative test result obtained elsewhere.

Those With Medical and Religious Exemptions From Vaccination Mandate Still Require Weekly Testing

Consistent with federal law, the Order provides medical, religious, and Americans With Disabilities Act exemptions, though any workers who qualify for an exemption must submit to weekly testing.

To qualify for a vaccination exemption, a worker must demonstrate that:

  • vaccination is medically contraindicated, including any individual who is entitled to an accommodation under the Americans with Disabilities Act or any other law applicable to a disability-related reasonable accommodation, or
  • vaccination would require the individual to violate or forgo a sincerely held religious belief, practice, or observance. 

The Order does not specify what consequences or penalties could be imposed on medical practices for violation of the vaccine mandate, but it does authorize state agencies to “promulgate emergency rules as necessary to effectuate this Executive Order.” Accordingly, practices should establish clear policies and protocols for ensuring that their staff is fully vaccinated, as well as implement a testing program for unvaccinated workers. They should also be prepared to send home any employee who does not comply with the Order.

If you are a medical practice owner and have questions about the governor’s vaccination mandate for your employees, please give me a call at 312-236-243 or fill out my online form to arrange for your free initial consultation.

What NOT To Do When Reopening Your Medical Practice in Illinois

 

We are now in Phase 3 of Gov. JB Pritzker’s five-phase Restore Illinois plan. For medical practices throughout the state, this means that many individuals who have delayed or deferred elective procedures, screenings, and other non-COVID-19 visits are now scheduling these visits. For physicians and staff at medical offices, returning to the routine care and treatment of patients will be anything but routine.

Healthcare providers across the country have been modifying their policies, practices, and procedures to comply with state and local requirements for the protection of both patients and staff. In Illinois, that means following safety guidance from the Illinois Department of Public Health. Additionally, the Centers for Disease Control & Prevention (CDC) has issued its “Framework for Healthcare Systems Providing Non-COVID-19 Clinical Care During the COVID-19 Pandemic” to help guide clinicians in their decision-making.

But on a more granular level, the modifications that practices must make to their clinical care and general operation can be quite extensive and require planning, thoughtfulness, and diligence in both formulation and execution. To help guide physicians in this regard. The American Medical Association (AMA) has compiled a reopening guide with actionable information, proposed best practices a checklist, and other resources to ensure that medical practices are ready to reopen.

Among the resources provided by the AMA is a list of mistakes that practices should avoid when reopening. Not only can such missteps put the health and safety of patients and staff at risk, but they can also draw the scrutiny of authorities who will not hesitate to intervene if a practice is not following required precautions.

Some “don’t’s” physicians should avoid when reopening, per the AMA, include:

  • Don’t jump the gun. Stay in line with the latest requirements and limitations issued by the governor, IDPH, and local authorities. These change frequently with events, so it is imperative that you keep continuously abreast of what is and isn’t permitted in terms of patient care and office safety.
  • Don’t assume your supply chain will return to normal. Assess your practice’s current inventory and future needs for personal protective equipment and order enough to have on hand when reopening.
  • Don’t allow non-patient visitors. Clearly post on your website and practice door your revised visitor policy. Reroute vendors, salespeople, educators, and service providers (other than caregivers) to phone or videoconference communication.
  • Don’t presume that your obligations as an employer are the same. In addition to new safety precautions and procedures for you and your staff, the pandemic has changed the rights of employees and the obligations of employers in several respects. From paid sick leave and family medical leave to ADA issues and more, practices should consult with experienced counsel to ensure that they avoid any exposure related to their employment practices.

Louis Fine: Chicago Professional License Defense Attorney

This is an unprecedented and challenging time for everyone, including and perhaps especially, for medical professionals. During this crisis, I remain committed to being a resource, counselor, and advocate for all Illinois licensees as they navigate the rapidly changing legal, regulatory, and practical landscape.

If you have questions or concerns about your professional license or COVID-19, please contact me immediately. Call (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Pritzker Indicates That IDFPR Will Take Action Against Professional Licensees Who Jump The Gun On Reopening

After over two months on personal and professional lockdown, we all want things to return to some semblance of “normal” at the earliest opportunity, while also remaining cognizant of the continuing public health risks posed by COVID-19. Business owners and service providers, including those who hold professional licenses, are desperate to get back to work and bring in income after sitting idle for what seems like forever.

But we are currently only in phase two of Gov. JB Pritzker’s administration five-phase “Restore Illinois” plan. This means that, depending on the course of the virus in the coming weeks, most businesses will continue to remain shuttered or extremely limited in operations for weeks to come, at minimum.

That’s not good enough for many professionals and business owners, especially in less hard-hit areas Downstate. From bars to salons to retail stores, many folks are defying public health orders and are opening their doors despite the prohibitions against doing so. But if you hold a professional license and start serving customers, clients, or patients in violation of the state’s current rules, you could be putting your professional license at risk.

In recent days, Pritzker has made it clear that he will turn up the heat on those businesses that open prematurely. This includes professional licensees.  At his May 14th daily COVID-19 briefing, Pritzker sternly issued the following warning:

“For the small minority of businesses that choose to ignore the medical doctors and the data and to ignore your legal obligations for the residents of your communities, there will be consequences. Businesses that ignore the executive orders, that ignore the law, will be held accountable by our department of Professional Regulation. There are enforcement mechanisms here that we will be using against them.”

“Practicing Beyond the Scope Permitted By Law”

The Illinois Department of Financial and Professional Regulation (IDFPR) has not as of yet issued any statements relating to the governor’s comments or provided any detail as to what actions they plan on taking, if any, against licensees who provide services to the public in violation of applicable laws and orders. However, it seems clear that they have the power to sanction licensees for such transgressions, including suspending their licenses.

All Illinois professional licensing acts enumerate scores of reasons a licensee can face disciplinary action, as do the administrative rules that apply to each act. Violating applicable laws or orders, or putting the health and safety of the public at risk, generally can constitute bases for sanctions against a licensee.

For example, the administrative rules that govern barbers, hairstylists, nail salons, and other cosmetologists provide that IDFPR “may suspend or revoke a license, refuse to issue or renew a license, or take other disciplinary action based upon its findings of dishonorable, unethical or unprofessional conduct… which is interpreted to include, but is not limited to, the following acts or practices:

  • Engaging in conduct likely to deceive, defraud or harm the public, or demonstrating a willful disregard for the health, welfare or safety of a client or student.  Actual injury need not be established;
  • Practicing or offering to practice beyond the scope permitted by law, or accepting and performing professional responsibilities that the licensee knows or has reason to know that he/she is not competent to perform;

Again, it remains unclear how aggressively IDFPR will pursue licensees who violate COVID-19 restrictions before they are lifted. Hopefully, it will be a moot point soon enough. But until then, licensees should be aware that they may be putting their business or career at long-term risk for short-term gain.

Louis Fine: Chicago Professional License Defense Attorney

This is an unprecedented and challenging time for everyone, including licensed professionals. During this crisis, I remain committed to being a resource, counselor, and advocate for all Illinois licensees as they navigate the rapidly changing legal, regulatory, and practical landscape.

If you have questions or concerns about your professional license or COVID-19, please contact me immediately. Call (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Pritzker Executive Order Gives Hospitals and Healthcare Workers Immunity From Civil Liability During COVID-19 Crisis

With Illinois hospitals and healthcare workers overwhelmed on the front lines of the COVID-19 pandemic, and with freshly minted doctors and retired healthcare professionals being called into the fight, Gov. JB Pritzker signed an Executive Order providing them with immunity from civil liability for “rendering assistance” during the crisis.

Executive Order 2020-19, issued on April 1, 2020, directs “all Health Care Facilities, Health Care Professionals, and Health Care Volunteers, as defined in Section 1 of the order, to render assistance in support of the State’s response to” the COVID-19 disaster proclamation. It provides that all such facilities, professionals, and volunteers:

“shall be immune from civil liability for any injury or death alleged to have been caused by any act or omission… which injury or death occurred at a time when [the hospital, professional, or volunteer] was engaged in the course of rendering assistance to the State by providing health care services in response to the COVID-19 outbreak, unless it is established that such injury or death was caused by gross negligence or willful misconduct”

As defined in the order, “health care facilities” include “any government-operated site providing health care services established for the purpose of responding to the COVID-19 outbreak,” such as the field hospital recently established at McCormick Place. The order also covers hospitals, skilled and intermediate care nursing facilities, skilled and intermediate facilities under the ID/DD Community Care Act, skilled mental health rehabilitation facilities, kidney disease treatment centers, emergency medical service providers, outpatient surgery centers, and institutions that provide major medical diagnostic equipment, among others.

Health care professionals for purposes of the order include “all licensed or certified health care or emergency medical services workers” providing services at a health care facility in response to the COVID-19 outbreak or “are working under the direction of the Illinois Emergency Management Agency or the Department of Public Health in response to the Gubernatorial Disaster Proclamations.”

Health care volunteers are defined as volunteers or unlicensed medical or nursing students who are working under IEMA or DPH in response to the governor’s disaster proclamation.

The order cites several statutory bases for the grant of immunity, including the Illinois Emergency Management Agency Act, the Good Samaritan Act, and the Emergency Medical Services Systems Act.

The immunity provided through the governor’s order is just one of several steps that Illinois has taken to make it easier for desperately needed physicians and health care workers to participate in the COVID-19 battle, including expedited healthcare license reinstatement and streamlined out-of-state licensing.

Louis Fine: Chicago Professional License Defense Attorney

This is an unprecedented and challenging time for everyone, including licensed professionals. During this crisis, I remain committed to being a resource, counselor, and advocate for all Illinois licensees as they navigate the rapidly changing legal, regulatory, and practical landscape.

If you have questions or concerns about your professional license or how these variances and other COVID-19 changes affect you, please contact me immediately. Call (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

URGENT COVID-19 Professional Licensing Update

Pritzker Paves Way for Expedited Healthcare License Reinstatement

IDFPR Issues Emergency Variances and Extensions

With the vast majority of Illinois residents working from home – or not working at all – because of the COVID-19 pandemic, the Illinois Department of Financial and Professional Regulation (IDFPR) has announced several variances and extensions that impact all 1.3 million Illinoisans with professional licenses. It is likely that these first five variances, issued on March 18th, 2020, will not be the last.

Healthcare Workers: Expedited Reinstatement and Streamlined Out-of-State Licensing

In fact, at his Saturday, March 21st daily coronavirus press conference, Gov. JB Pritzker issued a plea to retired healthcare workers to join the fight against the virus, indicating that the state would expedite licensing and waive fees for any healthcare professionals seeking reinstatement. “Applications will be processed on an expedited basis, and we’ll be coordinating with hospitals and health care sites throughout the state to deploy these re-enlisted medical professionals to the frontlines,” Pritzker said.

Today, March 23rd, IDFPR announced several actions to implement this directive. Specifically:

  • Physicians whose licenses are expired or inactive for less than three years can temporarily restore their license, for no fee or continuing education requirement, to work under the direction of Illinois Emergency Management Agency (“IEMA”) and the Illinois Department of Public Health (“IDPH”) or in a long-term care facility, hospital, or federally qualified health center (“FQHC”). Application for physician reinstatement can be found here.
  • Physician Assistants whose licenses are inactive or in non-renewed status for less than three years can also temporarily restore their license, for no fee or continuing education requirement, to work under the direction of IEMA and IDPH or in a long-term care facility, hospital, or FQHC. Applications for reinstatement can be found here.
  • Licensed practical nurses, registered professional nurses, advanced practice registered nurses, and respiratory care therapists whose licenses are inactive or in nonrenewed status for less than five years can also temporarily restore their license, for no fee or continuing education requirement, to work under the direction of IEMA and IDPH or in a long-term care facility, hospital, or FQHC. Applications for reinstatement can be found here.
  • Out-of-State physicians, nurses, physician assistants, pharmacists, and respiratory care therapists may practice in Illinois if they are licensed in another state and are in good standing. These licensees must be operating under the authority of IEMA/IDPH or at a long-term care facility, hospital or FQHC, and must meet the standards of care mandated by the respective health care acts. They must provide contact information and dates of arrival and departure on forms provided by IDFPR. This temporary practice approval expires on September 30, 2020. Applications for an Out-of-State Temporary Practice Permit can be found here.

In addition to these healthcare-focused changes, other COVID-19 variances issued by IDFPR include:

Upcoming License Renewal Extensions

Any professional licenses issued by the Department that have renewal dates between March 1st, 2020 through and including July 31st, 2020 are granted an automatic extension to renew to September 30th, 2020.

Continuing Education Obligations

All current licensees whose license renewal deadlines fall between March 1st, 2020 and July 31st, 2020 shall have up to, and including, September 30th, 2020 to complete their continuing education coursework.

The Department is also allowing licensees to complete their continuing education coursework remotely without requiring live attendance. The variance allows for interactive webinars and online distance education courses in addition to currently permitted methods.

Louis Fine: Chicago Professional License Defense Attorney

This is an unprecedented and challenging time for everyone, including licensed professionals. During this crisis, I remain committed to being a resource, counselor, and advocate for all Illinois licensees as they navigate the rapidly changing legal, regulatory, and practical landscape.

If you have questions or concerns about your professional license or how these variances and other COVID-19 changes affect you, please contact me immediately. Call (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.