Flying Blind: When Your Professional License Comes Under Attack, Will You Even Know Why?

Under the Fifth Amendment to the U.S. Constitution, no person shall be “deprived of life, liberty, or property, without due process of law.” While the Fifth Amendment only applies to the federal government, the Fourteenth Amendment provides identical protections from unfair deprivation of those things by a state.

The Illinois Department of Financial and Professional Regulation (IDFPR) is a body of the state of Illinois. And your professional license is your property, likely one of your most valuable possessions insofar as your livelihood depends on it. This means that when the IDFPR initiates formal proceedings that could result in the denial, suspension, or revocation of your license, you are entitled to due process of law before they take such actions.

But due process in the context of administrative hearings like those before the IDFPR may not mean what you think it means. In fact, there is a good chance that you won’t receive the same due process protections that are your rights in a criminal prosecution or even in a civil lawsuit. This includes being fully informed of the allegations against you.

Due process involves many substantive and procedural aspects depending on the nature of the proceedings. One such element of due process is the right to know exactly why you are in the crosshairs of prosecutors, a plaintiff, or an administrative body. After all, you can’t properly mount a defense if you don’t know what you are defending yourself against.

In criminal cases, the Sixth Amendment gives defendants the right “to be informed of the nature and cause of the allegation” they face. The Federal Rules of Civil Procedure, as well as Illinois’ rules of civil procedure, contain similar requirements that a plaintiff’s complaint must provide sufficient detail to apprise the defendant of the claim for which they are being sued.  

When a complaint fails to contain enough information to either support a claim or afford the defendant an ability to respond, the defendant can move to dismiss the complaint on that basis.

Licensees facing formal IDFPR disciplinary action also have the right to be adequately advised of the allegations against them and can move to dismiss a complaint if the Department falls short in this regard.

The problem is that the standards that apply in administrative proceedings are much more forgiving to those making the accusations, allowing them to pursue catastrophic sanctions against licensees with minimal detail as to why they are doing so.

Under the Illinois Administrative Procedure Act (APA), agencies like the IDFPR only need to provide the following in their formal complaints regarding the claims against a licensee:

  • A statement of the legal authority and jurisdiction under which  the proceeding is to be held;
  • A reference to the particular sections of the substantive and procedural statutes and rules involved;
  • Except where a more detailed statement is required by law, a short and plain statement of the matters asserted;

Courts have held that the charges filed before an administrative agency like IDFPR “need not be drawn with the precision required of pleadings in judicial actions. They only must be drawn sufficiently so that the alleged wrongdoer is reasonably apprised of the case against him to intelligently prepare his defense.” Siddiqui v. Department of Professional Regulation.

“In determining whether the respondent has adequate notice, a court may consider the discovery and other materials available to the respondent.” Secrest v. Department of Corrections. But this just leads to another due process problem inherent in IDFPR proceedings.

Limited Discovery Rights

The process of investigating, obtaining evidence, and eliciting testimony relevant to a case – whether it be a civil, criminal, or administrative proceeding like IDFPR disciplinary hearings – is known as “discovery.” It’s how the parties find out the facts, whether they help or hurt their respective cases. It is a fundamental aspect of fairness, and if a party is not permitted to fully develop the evidence necessary to support their case or challenge the evidence obtained by the other side, it is an inherently unfair process.

In formal IDFPR disciplinary proceedings, the licensee’s ability to pursue the discovery necessary to defend themselves is extremely limited. In fact, the extent of allowable discovery is determined by the very people who are prosecuting the case. Once the Department provides names of witnesses, including the name of any individual whose complaint may be at the heart of the proceedings, a respondent cannot take their depositions unless the Department’s attorney agrees. If the Department nixes a deposition request, that means the respondent will not be able to confront that witness, learn what his testimony will be, or attack the veracity of his testimony until the actual hearing. That is manifestly unjust and leaves a respondent and their attorney fighting with one arm tied behind their back.

Similarly, if there are witnesses that the licensee wishes to subpoena for testimony, those subpoenas have to be authorized and approved by the Department. Again, the very people seeking to deprive someone of their professional license can also deprive them of their ability to defend themselves.

With the deck so stacked against licensees, it is crucial that you retain an experienced IDFPR defense attorney to protect your rights, your license, and your livelihood if you find yourself in the Department’s sights.

Louis Fine: Chicago Professional License Defense Attorney

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will get you back to your clients and your career.

Please give me a call at (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.

Cognitive Decline Among Older Physicians Leading to Increased Screening

For every accomplished physician who dreams of retiring early, there is one who can’t imagine giving up the work that brings them so much personal and professional satisfaction and financial security. Every year, 20,000 American doctors turn 65, but only half of them retire by then. Thousands of physicians continue to practice well past their 70th, even 80th, birthdays. It is estimated that one in every eight practicing doctors in the U.S. is over 65, overseeing 50-70 million office visits and 11 million to 20 million hospitalizations each year.

One In Eight Doctors Over 70 Found to Have Significant Cognitive Deficits

With so many patients receiving care from physicians 65 and up, many hospitals and healthcare systems are also increasing their scrutiny of the cognitive abilities and faculties of these senior clinicians. Major institutions such as Scripps Health Care, Intermountain Healthcare, Stanford Hospitals and Clinics, and Penn Medicine have implemented mandatory cognitive screens for older practitioners.

At Yale New Haven Hospital, for example, all applicants 70 or older who seek reappointment to the medical staff are required to have an objective evaluation of cognitive function as part of the two-year reappointment process. What a recent round of that testing revealed was that one in eight doctors who participated in the screening had cognitive deficits that were likely to impair their ability to practice medicine independently.

Testing or No Testing, Cognitive Issues Raise Professional Licensing Concerns

The wisdom and efficacy of such testing programs is subject to debate, with many arguing that age-based screening is empirically unjustified or inherently discriminatory. Whether subject to required testing or not, however, all older physicians who continue to treat patients later in life will at some point face difficult questions about their abilities and the prudence of continuing to practice.

Confronting issues of cognitive decline, if not impairment, is no easy task, personally and professionally. But recognizing any such concerns is also an ethical imperative. Continuing to practice while suffering from cognitive impairment significant enough to raise concerns about patient safety can subject a physician of any age to disciplinary action and the loss of their license.

The Illinois Medical Practice Act (the “Act”), for example, makes it a basis for suspension or revocation of a license for a physician to practice if they have a:
• Mental illness or disability which results in the inability to practice under this Act with reasonable judgment, skill or safety.
• Physical illness, including, but not limited to, deterioration through the aging process… which results in a physician’s inability to practice under this Act with reasonable judgment, skill, and safety.

The Act also imposes reporting requirements on certain health care executives regarding “impaired” physicians, defined as those who lack the ability “to practice medicine with reasonable skill and safety due to physical or mental disabilities as evidenced by a written determination or written consent based on clinical evidence including deterioration through the aging process or loss of motor skill… of sufficient degree to diminish a person’s ability to deliver competent patient care.”

Doctors, for all their talents, are as vulnerable as anyone else to the inevitable effects of time and aging. While debate may continue as to the best way to identify and remediate instances of age-related cognitive or physical impairment, doctors who practice well into their golden years need to combine their clinical judgment with self-awareness when evaluating the wisdom of continuing to treat patients. Failing to do so puts both patients and professional licenses at risk.

Louis R. Fine: Chicago Physician License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois physician’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Task Force Recommends More Breaks, Shorter Shifts, and Fewer Responsibilities for Illinois Pharmacists

Pharmacists are highly trained and knowledgeable professionals. They handle and dispense powerful drugs to vulnerable patients who rely on them for guidance and for their careful filling and dispensing of prescriptions.

But pharmacists are also human. Their jobs come with business pressures, policies, and priorities that may impede their ability to fulfill their duties as they should. These pressures can have tragic consequences when pharmacists feel like they can’t spend the time needed to properly advise patients about their prescription. Overwhelmed and overworked pharmacists may also make any number of critical errors between the time they receive a prescription from a patient or their physician and the time they dispense the prescribed medication.

These problems manifested themselves in a 2016 Chicago Tribune investigation which found that pharmacists at 52% of 255 Chicagoland pharmacies failed to adequately warn customers about drug interactions that could result in adverse health consequences or death.

As a result of this shocking report, the state of Illinois formed a task force to examine and make recommendations on “how to further advance the practice of pharmacy in a manner that recognizes the needs of the healthcare system, patients, pharmacies, pharmacists, and pharmacy technicians.” 

On October 11, 2019, the Illinois Collaborative Pharmaceutical Task Force released its final Report and Recommendations.

An Assembly-Line Process

The report found that pharmacists felt overwhelmed by an assembly-line process at busy pharmacies where they are expected to fill hundreds of prescriptions in a single shift. In turn, pharmacists routinely skipped breaks and meals and became easily distracted due to competing priorities and too many responsibilities relating to the management and operation of pharmacy practices.

 In the report, the task force made the following recommendations:

  • Increasing whistleblower protections for pharmacists and pharmacy technicians who report violations of the Pharmacy Practice Act (the “Act”);
  • Adding new grounds for discipline of licensed pharmacists under the Act, including:
    • Failing to provide “adequate time for a pharmacist to complete professional duties and responsibilities”;
    • Failing to provide “sufficient personnel to prevent fatigue, distraction or other conditions that interfere with a pharmacist’s ability to practice with competency and safety or creates an environment that jeopardizes patient care”;
    • Failing to provide “appropriate opportunities for uninterrupted rest periods and meal breaks”;
  • Adding a new section to the Act entitled “Pharmacy Work Conditions,” which states that:
    • Employers “shall keep and maintain a complete and accurate record of the daily break periods of its pharmacists”;
    • Employers “shall not require a pharmacist, student pharmacist, or pharmacy technician to work longer than twelve (12) continuous hours per day, inclusive of the breaks”;
    • A pharmacist working longer than six continuous hours per day shall be allowed to take a 30-minute uninterrupted meal break and one 15-minute break, as well as one additional break if working 12 hours per day.
    • No pharmacist shall work longer than five hours per day without the opportunity to take an uninterrupted meal break.

A bill currently pending in the Illinois legislature would incorporate the task force’s recommendations into the Pharmacy Practice Act. The bill also includes new provisions for disciplinary action, including written warnings or fines against the pharmacy, pharmacist, and pharmacist-in-charge that would be posted online and could not be expunged, as well as possible license revocation for repeat violations. The bill is expected to become law during the current legislative session.

Louis R. Fine: Chicago Pharmacist License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of pharmacists and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois pharmacist’s license and get you back to your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Telemedicine and Physician Licensing: How the 19th Century is Holding Back the 21st

teleAdvancements in technology almost always outpace efforts by legislators and regulators to address the new realities, issues, and concerns that arise from such innovations. Laws that made sense even a short ten years ago can quickly become anachronistic, if not counterproductive.

Such is the dilemma facing physicians and healthcare providers who see telemedicine as a key way to address a growing physician shortage, especially in rural and other underserved areas. That shortage is expected to grow to 120,000 doctors by 2030, according to a 2018 report by the Association of American Medical Colleges.

51 Different Licenses

The problem is that while the internet knows no borders, medical licenses do. Increasingly, the inability of physicians to provide remote care to patients in other states where they are not licensed is holding back telemedicine’s potential and unnecessarily denying patients access to quality healthcare.

Physicians must be licensed in each state where their current and future patients are located, so a doctor wanting to counsel patients through telemedicine would need to obtain and stay compliant with licensing requirements in up to 51 jurisdictions governed by 51 different medical boards imposing 51 different standards, conditions, and rules.

The current state-based medical licensing regime traces its roots back to the 19th Century, and the system is clearly showing its age. While effective and robust licensing is still essential in ensuring quality of care, the lack of license reciprocity and portability between states is now more of a hindrance to providing such care than a help.

That is why already active efforts to change medical licensing to facilitate telemedicine continue to gain steam. The most successful of these efforts to date has been the Federation of State Medical Licensing Board’s (FSMB) work establishing the Interstate Medical Licensure Compact. Physicians in good standing can freely practice in any of the states participating in the compact so long as they possess a “full and unrestricted” license in their state of principal license (SPL). To date, only 24 states, including Illinois, have joined the compact.

A Uniform, Nationwide System

This still leaves too many doctors and too many patients locked out of telemedicine. As noted by the authors of a recent article in the American Journal of Managed Care, “The impact of restricting telemedicine falls hardest on poor patients, the uninsured, and those who rely on state Medicaid programs, many of whom lack access to reliable transportation and cannot travel across state lines to see specialists.”

That is why the FSMB and other telemedicine advocates have advanced several proposals to enhance license portability and reduce regulatory barriers to telemedicine. They all are based around a mutual recognition scheme whereby states honor each other’s medical licenses based on models that have been successfully used in Europe and Australia and by the Veterans Health Administration, US military, and US Public Health Service.

Adoption of a nationwide licensing scheme would be facilitated by establishing consistent standards for using and regulating telemedicine services, the sharing of malpractice, medical error, and license cancellation or suspension information between states, and other federal and state-level reforms.

Any efforts that would streamline the physician licensing process while at the same time increasing access to healthcare for those who need it most should be encouraged.

Louis R. Fine: Chicago Physician License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois physician’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Minor Licensing Violations Could Cost Physicians Medicare Billing Privileges Under Proposed Rule

For phmedicareysicians and other eligible health care professionals, Medicare enrollment and billing privileges are invaluable and lucrative assets that can form a substantial portion of their revenues, allow them to treat more patients, and expand their career opportunities. Losing those privileges can be a catastrophic blow to a practice.

But a new rule proposed by the Centers for Medicare & Medicare Services (CMS) would dramatically expand CMS’ authority to deny or revoke Medicare privileges, allowing it to substitute its judgment for that of state licensing boards and impose such catastrophic sanctions even for infractions a state board deems relatively minor.

On August 14, 2019, CMS issued what it called a “major proposed rule” addressing a wide range of changes to the Medicaid physician fee schedule and other aspects of participation in the program. If it becomes final, all 808 pages of the proposed rule would represent the most substantial modification to program enrollment and eligibility since the establishment of the regulations in 2006.

CMS Can Impose Harsher Sanctions Than State Boards

In the proposed rule, CMS notes that, at the moment, it cannot make Medicare eligibility and renewal decisions based solely on state board disciplinary actions:

“We currently lack the legal basis to take administrative action against a physician or other eligible professional for a matter related to patient harm based solely on… an administrative action (excluding a state medical license suspension or revocation) imposed by a state oversight board,” such as the Illinois Department of Financial and Professional Regulation (IDFPR).

The new rule would grant CMS such authority and “would permit us to revoke or deny, as applicable, a physician’s or other eligible professional’s… enrollment if he or she has been subject to prior action from a state oversight board… with underlying facts reflecting improper physician or other eligible professional conduct that led to patient harm.”

84 Fed. Reg. at 40723.

As a practical matter, the rule gives CMS the power to review a state board’s conclusions and sanctions and then make its own determination as to whether the physician’s or other professional’s conduct warrants exclusion from Medicare.

This can lead to a situation in which IDFPR deems an infraction to be relatively minor and perhaps deserving of a “slap on the wrist” while CMS could decide to impose a “death sentence” in terms of Medicare eligibility, a conflict CMS readily acknowledges:

“We recognize that situations could arise where a state oversight board has chosen to impose a relatively minor sanction on a physician or other eligible professional for conduct that we deem more serious. We note, however, that we, rather than state boards, is ultimately responsible for the administration of the Medicare program and the protection of its beneficiaries. State oversight of licensed physicians or practitioners is, in short, a function entirely different from federal oversight of Medicare. We accordingly believe that we should have the discretion to review such cases to determine whether, in the agency’s view, the physician’s or other eligible professional’s conduct warrants revocation or denial.”

Id.

Making matters worse for sanctioned physicians, a decision by CMS to revoke Medicare privileges results in an automatic cross-termination of participation in Medicaid and other federal payer programs.

The public comment period for the proposed rule closes on September 27, 2019. If the rule is enacted, it becomes that much more critical for physicians facing IDFPR investigations or disciplinary proceedings – even for a “minor” infraction – to retain experienced professional license defense counsel.

Louis R. Fine: Chicago Physician License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois physician’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

HIPAA and IDFPR: Violations of Patient Privacy Can Threaten Your Professional License

hipaaThe Jussie Smollett saga earlier this year made headlines here in Chicago and throughout the country. It was a juicy tale of a supposed hate crime against an actor, that turned out to be a hoax, that led to criminal charges against Smollett, that were later dropped by State’s Attorney Kimberly Foxx, who then found herself under scrutiny for that decision. But Smollett and Foxx weren’t the only ones in this tale whose conduct raised eyebrows or put them in legal or ethical jeopardy.

Fifty employees, including several nurses, at Northwestern Memorial Hospital lost their jobs and faced disciplinary action because they violated the patient privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA). This included one nurse who did nothing more than search for Smollett’s name in the hospital’s system.

Breaching HIPAA Obligations Is Easy. Dealing With the Fallout Is Not.

If you are a physician or registered nurse, or if you work in healthcare in any capacity, you are no doubt generally aware of HIPAA and the duties it creates to ensure the confidentiality of protected health information (PHI). That fired nurse no doubt knew about HIPAA’s privacy and security rules as well. But her case demonstrates how quickly and inadvertently you can breach your professional obligations as to patient privacy and put your career – and professional license – in peril.

After HIPAA became law in 1996, the U.S. Department of Health and Human Services (HHS) issued a set of national standards governing the use, maintenance, and disclosure of patients’ protected health information. Commonly known as the Privacy Rule, the Standards for Privacy of Individually Identifiable Health Information limit how and to whom PHI can be disclosed.

Additionally, medical professionals and organizations must comply with detailed rules involving the physical and electronic security of PHI (the Security Rule, or Security Standards for the Protection of Electronic Protected Health Information) as well as the Breach Notification Rule which addresses what doctors and healthcare providers need to do in the event of a data breach.

As complex as HIPAA rules can be, violating them couldn’t be easier. It doesn’t require malicious intent (though that makes matters worse) or the knowledge that an act or omission violates HIPAA. In fact, most HIPAA infractions are inadvertent and more a factor of “loose lips sink ships” than anything else. But that doesn’t insulate a doctor or nurse from civil penalties or professional license consequences.

Common HIPAA Privacy Rule Violations

The following are common examples of how medical professionals can and do unknowingly violate HIPAA’s Privacy Rule:

  • Leaving patient files and information in plain view, such as at a nurse’s station or reception desk, so that anyone in proximity may be able to see that information.
  • Social media posts, pictures, or videos that may directly or indirectly reveal information about a patient or their condition, even in “closed” groups. A 2015 ProPublica review uncovered 22 cases of HIPAA-violating photo and video sharing in just the previous three years, with 35 instances of inappropriate image and video sharing found in total. There have been plenty more widely-publicized incidents since then.
  • Sending PHI over messaging apps without patient authorization.
  • Accessing the PHI of patients you are not required to treat
  • Gossiping about specific patients and disclosing their health information to family, friends & colleagues
  • Improper disposal of PHI, such as discarding it in regular trash.

Possible Consequences of a HIPAA Privacy Violation

The Office for Civil Rights (OCR) at DHS is responsible for enforcing HIPAA’s privacy requirements and can impose civil fines and criminal penalties, including possible jail time, for violations. The penalties and/or fines administered by OCR are based on the severity of each HIPAA violation and the knowledge and intent involved. Only willful violations will raise the specter of criminal prosecution, but civil penalties can rise to the level of tens of thousands of dollars.

Additionally, under Illinois’ Medical Patient Rights Act, any physician or healthcare provider who discloses a patient’s PHI without their express consent or as otherwise provided by law is guilty of a petty offense and will be fined $1,000.

If a physician or nurse violates HIPAA in a willful or egregious way, or is negligent in their handling of patient information, the Illinois Department of Financial and Professional Regulation (IDFPR) may take an interest and see such conduct as the basis for disciplinary action.

For example, the Illinois Medical Practice Act provides that the Department may revoke, suspend, place on probation, reprimand, refuse to issue or renew, or take any other disciplinary or non-disciplinary action against a physician for “willfully or negligently violating the confidentiality between physician and patient except as required by law.”

To avoid all of these potential consequences, physicians and nurses must remain vigilant and ever mindful of their patients’ privacy and their obligations under HIPAA.

Louis Fine: Chicago Professional License Defense Attorney

If you have questions or concerns about your duties under HIPAA or find yourself facing an IDFPR investigation or complaint about patient privacy, please contact me immediately. As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on professionals who suddenly find their future in disarray. I can work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will get you back to your clients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

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Universal Professional License Reciprocity: New Arizona Law May Be the Start of Something Big

recip 2Qualifying for, obtaining, and maintaining a professional license can be a time-consuming, often frustrating, and burdensome endeavor – even if everything goes as smoothly as possible. Going through the process once is tough enough; the thought of going through it again simply because you want to move and practice your profession in a new state can be enough to make you stay put and lose out on lucrative opportunities.

That is the dilemma faced by contractors, dentists, cosmetologists, and scores of other professionals who must meet a whole new set of licensing requirements -such as education and testing – when they want to work in another state. While some states do have “reciprocity” for a very narrow group of professions and will grant a license based on an out-of-state license, not one state had universal license recognition – until now.

Arizona Passes Nation’s First Universal License Recognition Law

Recently, Arizona became the first state in the nation to pass a law allowing almost all professionals who have valid occupational licenses in other states to obtain a license to work in Arizona without having to meet the state’s education and testing requirements.

Under the new law, Arizona’s licensing boards will recognize out-of-state occupational licenses for people who have been licensed in their profession for at least one year, are in good standing in all states where they are licensed, pay applicable Arizona fees, and meet all residency and background check requirements. Licensed professionals will not be required to duplicate training and other requirements that often needlessly delay or prevent them from starting to work in their new home.

Limited Reciprocity in Illinois

While Arizona is the first state to bring reciprocity and license recognition to broad swaths of professions and occupations, Illinois and several other states do offer reciprocity for specific licenses. The most prominent of these is for real estate brokers. Individuals who hold an active broker’s license in any of the following states can obtain an Illinois license without having to meet the education and testing obligations that other applicants do:

  • Colorado
  • Connecticut
  • Florida
  • Georgia
  • Indiana
  • Iowa
  • Nebraska
  • Wisconsin

Individuals in a handful of other professions who hold a valid license in another state, including architects and registered nurses, can obtain an Illinois license under a process called “licensure by endorsement” if the licensure process in that other state was substantially equivalent to the process in Illinois at the time of licensure.

Will Other States Follow Suit?

Arizona’s bold move is a boon for any professional wanting to pick up and move to the Grand Canyon State. But what about the rest of the country? To date, no other state has advanced a bill along the lines of Arizona’s. But there is increasing business and political pressure to reduce licensing burdens generally so that qualified professionals can work without being deterred by costs, bureaucracy, and other hurdles. Universal license recognition certainly fits into that philosophy. I expect that other states will take a cautious approach initially, waiting to see how Arizona’s law works in practice before jumping on the universal licensing bandwagon. Nevertheless, this law is a great start.

Louis Fine: Chicago Professional License Defense Attorney

If you have questions or concerns about your professional license, or you learn that you are the subject of an IDFPR investigation or complain, please contact me immediately. As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on professionals who suddenly find their future in disarray. I can work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will get you back to your clients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

JB + IDFPR = More Aggressive Licensing Enforcement?

JBIf it wasn’t already apparent, the recent conclusion of the spring legislative session in Springfield makes it abundantly clear that we’re not in the land of Bruce Rauner anymore. Legalized recreational pot and sports betting, constitutional amendments, tax overhauls, and additional protections for abortion rights – all of these are just the most high-profile changes about to be signed into law by Gov. J. B. Pritzker.

What remains less clear is the impact that the Pritzker administration and unified Democratic control of state government will have on professional licensing and the activities and priorities of the Illinois Department of Financial and Professional Regulation (IDFPR). Pritzker has appointed a new IDFPR Secretary and Director of Real Estate, but these leadership decisions don’t provide much insight into how if at all the department will change. However, two recent initiatives and investigations may foretell a more aggressive approach to licensing enforcement and disciplinary action.

Bogus Stem Cell Therapies

Touted as a revolutionary advancement in the treatment of a range of maladies including bone and muscle injuries and pain relief, various iterations of stem cell therapy are being offered by doctors and clinics throughout Illinois. But, according to IDFPR, these treatments – which can cost thousands of dollars each – are unproven and ineffective at best, and a bogus scam at worst.

As reported by CBS Chicago, Dr. Brian Zachariah, IDFPR’s medical coordinator, is taking a decidedly more skeptical approach to stem cell therapy than the department did under the previous administration. “People are being misled, oversold, overcharged on therapies that they are desperate to get,” he is quoted as saying. Dr. Zachariah indicated that the department would ramp up its investigation of patient complaints and increase disciplinary efforts. “We can and will discipline them ranging from a reprimand through fines, suspensions all the way to revoking their license,” he said.

Contractors Preying on Vulnerable Storm Victims

This spring has seen horrific weather throughout the state with torrential rains, tornadoes, and powerful storms wreaking havoc on homes and businesses. When that happens, unscrupulous “storm chasers” often descend on communities looking to exploit those who desperately need repairs because of storm-related damage.

While general contractors, oddly, are not required to be licensed by IDFPR, roofing contractors must have a license. Same goes for insurance adjusters. IDFPR, along with As reported in AdvantageNews, Attorney General Kwame Raoul have indicated that they will aggressively go after unlicensed roofers as well as licensed ones who attempt to scam victims in the wake of extreme weather.

These efforts relating to stem cell therapy and contracting scams may not seem particularly noteworthy; after all, shielding patients and consumers from fraud, misrepresentations, or incompetence is one of the foundational justifications for professional licensing regimes. But it would not be surprising to see Gov. Pritzker’s IDFPR continue with a robust consumer protection approach that will keep a keen eye on any actions by licensed professionals that could be seen as taking advantage of the state’s most vulnerable citizens.

Louis Fine: Chicago Professional License Defense Attorney

If you have questions or concerns about your professional license, or you learn that you are the subject of an IDFPR investigation or complain, please contact me immediately. As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on professionals who suddenly find their future in disarray. I can work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will get you back to your clients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.