Fall 2015
Volume 4, Issue 4

“STINGY DOC?”

Physician Publicly Reprimanded and Fined for Failure to Cooperate With Board Investigation, Maintain Proper Records and Refusal to Issue Refund to a Patient  A physician failed to respond to three (3) successive letters from the State Board of Medical Examiners over the course of a year that requested patient records and a narrative response concerning allegations raised by a former patient. The patient alleged payments made by her and her insurance company resulted in an overpayment of $400.00 to the physician, which the doctor failed to refund despite numerous requests from the patient, her health advocate and the doctor’s own billing service. Although the doctor claimed that the correspondence was never received as the letters were sent to a “wrong address” and not her office address, the Board determined that the address where the letters were sent was the doctor’s home. In reviewing the records, the Board noted that multiple consultation reports were only consultation reports in name, as the substance of each note was tantamount to progress notes. Upon reviewing the medical records, the Board noted multiple inconsistencies and deficiencies. The Board also found the billing records troubling, noting that the patient’s office visit bills were increased without any explanation and an “Itemized Payments” list only showed patient payments and not the insurance payments that were received. Concerning the overpayment of $400.00, the physician admitted receiving the three notices from her billing company to issue a refund to the patient but stated to the Board that she felt entitled to back-charge a higher fee. The physician also testified that she felt entitled to keep the overpayment. The Board reprimanded the physician for her conduct, ordered her to cease and desist from her billing practices, required her to change her office’s electronic medical record system, ordered her to refund the $400.00 overpayment to the patient, ordered CME courses and assessed a penalty of $2,000.00 for the deficiencies in conduct.
 


IN OTHER NEWS...


Physician Suspended for Overprescribing of Opioids and Failure to Refer to Psychiatric Care A family practitioner recently entered into a Consent Order with the Board after appearing before a Medical Review Practitioner Panel (“Panel”). The Panel was convened to review the facts and circumstances surrounding the death of a former patient who overdosed on opioids prescribed by the family practitioner. The Panel found that he provided grossly negligent care to the patient in prescribing excessive amount of opioids in the four months prior to the patient’s death. The Panel further found that the physician failed to consider the combination effects of the drugs prescribed to the patient and failed to consider or investigate whether the patient was abusing the prescribed drugs. Additionally, the Panel found that the physician failed to make referrals to a psychiatrist, knowing that the patient had made several suicide attempts and was continuously diagnosed with depression and anxiety. The physician was also found to have repeatedly violated the Board’s regulations on recordkeeping by failing to adequately document and monitor prescriptions written for the patient and by failing to document the results of examinations performed on the patient. During a follow-up Preliminary Evaluation Committee (“PEC”) hearing, the physician was also found by the PEC to have failed to take regular urine screens and failed to refer those patients that developed an addiction to opioids to a pain management specialist. The PEC also found that the physician failed to adequately document and monitor prescriptions written to his patients. Based on the foregoing, the Board suspended the physician for three (3) years, with the first 364 days to be served as a period of active suspension. The remaining two (2) years and one (1) day are to be served as a period of probation with a ban on all CDS prescribing. The physician was also required to return his NJ CDS license, ordered to immediately advise the DEA of the Consent Order and assessed a civil penalty of $20,000.00.

Physician Publicly Reprimanded after Hospital Privileges were Revoked for Sexual Harassment  A physician was recently called before the Medical Practitioner Review Panel (“Panel”) after it received an Adverse Action Report from the physician’s employer. The physician’s privileges at the hospital were revoked following complaints of sexual harassment. Various female staff members had alleged that the physician made inappropriate comments with sexual innuendo, touched them without invitation and made inappropriate comments. Although the physician denied many of the allegations and alleged the comments attributed to him were snippets of conversations being taken out of context, the Board found sufficient evidence to reprimand the physician. The Board further ordered the physician to immediately cease and desist from using inappropriate and/or sexually charged language and conduct in professional settings or with professional co-workers. The physician was also required to pay a civil penalty in the amount of $10,000.00, ordered to successfully complete both professional boundaries and ethics courses and required to continue to enroll and follow all recommendations from the Physician Assistance Program (“PAP”) for no less than one (1) year.

Physician Disciplined for Selling Art Work And Herbal Supplements to Patient; Practicing Without Malpractice Insurance A psychiatrist was recently disciplined after the Board received a complaint that the psychiatrist had engaged in improper behavior by selling at least six (6) personal paintings and books of artwork, and non-therapeutic herbal supplements to his eighty-nine (89) year old patient. The physician appeared before the Preliminary Evaluation Committee (“PEC”), which found that the psychiatrist did not secure the level of medical malpractice insurance coverage required by statute and was deficient in continuing medical education (“CME”) credits for the last reporting period. The Board ordered the psychiatrist to cease and desist from engaging in private practice in New Jersey until he procured the level of medical malpractice insurance coverage required by law. The physician was further ordered to cease and desist from the preparation and sale of natural herbal medications. The Board further ordered a full refund to the patient for all monies paid to him for his paintings and books of artwork, which totaled $13,500.00. The physician was also assessed penalties in the amount of $8,000.00 for misrepresenting completion of CME requirements and for failure to procure the statutorily-required level of malpractice insurance.

 


THE PHYSICIAN ADVOCACY PROGRAM®
Far too few physicians are aware of the overwhelming weight that would befall them if targeted by the SBME. For SBME Protection go toThePAP.com.