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Recent Blog Posts
Is Your Medical Practice Adhering to the No Surprises Act?
On January 1, 2022, the No Surprises Act (NSA) went into effect. This federal law gives doctors and other licensed health care professionals, medical facilities, hospitals, and insurers significant and often complex regulations that must be adhered to in order to avoid serious sanctions that could include hefty fines and loss of medical licenses.
What Does the NSA Cover?
Lawmakers passed the NSA as a way to protect patients from unexpected medical charges and force providers to be more transparent when it comes to what they are charging. National statistics show that at least 20 percent of patients have received shocking emergency medical care bills with unexpected charges at some point in their lives.
The law limits the amount of liability a patient has on deductibles, copays, and coinsurance they are responsible for if situations prevent them from obtaining services from providers in their health insurance network and they are forced to obtain medical treatment from out-of-network providers at in-network facilities.
Can I Lose My Professional License Because of Unpaid Taxes in Illinois?
Our Illinois professional license defense law firm has written many blog posts regarding the types of behaviors and activities that can result in the suspension of a professional license, including insurance fraud, substance abuse, and criminal convictions. But there are also other reasons why the state may take action against your professional license that you may not realize. One of those reasons is if you owe unpaid income taxes to the state of Illinois.
Actions by the Illinois Department of Revenue (IDOR)
Under Illinois law, the majority of residents – with some exceptions – are required to file a state income tax return. Businesses are also required to file state income tax returns, including medical offices and other healthcare facilities.
Your tax return will determine whether or not you owe taxes or if you are entitled to a refund. If you owe the state money but fail to pay when you send your tax return in, the IDOR will send you a bill for the amount you owe. That bill will also show the penalty and interest the state is charging you for not paying your taxes on time.
Is Marijuana Use Legal for Illinois Medical Professionals?
In January 2020, the recreational use of marijuana became legal in the state of Illinois. Under the law, anyone over the age of 21 is allowed to cumulatively possess 30 grams of cannabis flower, five grams of concentrate, and cannabis-infused products containing up to 500 milligrams of tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana.
But medical professionals are often held to a different standard when it comes to marijuana, even if it is legal. There may not be criminal consequences for using cannabis products, but you could be putting your medical license in jeopardy under certain circumstances.
Using Marijuana Products
If you are a doctor, nurse, or other medical license professional, you may be legally allowed to use marijuana products in Illinois under the following circumstances:
Have You Been Accused of Dental Insurance Fraud?
Our professional license defense law firm has written extensively about the serious consequences physicians face if they are accused of medical insurance fraud, including loss of medical license even criminal charges. However, dentists can also be accused with insurance fraud and face the same type of consequences. If you have been accused of dental insurance fraud, contact an Illinois professional license defense attorney right away.
Dental Insurance Fraud
Dental fraud is any intentional misrepresentation or deception of treatment needed in order to obtain unauthorized benefits. According to the National Health Care Anti-Fraud Association, more than $12 billion is lost to dental fraud every year.
One method of fraud that is becoming more common is the alterations of digital X-rays using software programs to create images that show bogus tooth decay, missing tooth structure, lesions, fractures, and more.
HHS OIG Announces Collection of Almost $2 Billion in Healthcare Fraud in 2021
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has issued the latest edition of the Health Care Fraud and Abuse Control Program (HCFAC) Annual Report. The report details the collection of just under $1.9 billion in healthcare fraud settlements and judgments in fiscal year 2021. Funds were returned to the Medicare Trust Funds and also to other federal agencies. Per the HCFAC, the federal government was able to recoup more than $5 billion in healthcare fraud.
Healthcare Fraud Charges
The U.S. Department of Justice (DOJ) initiated more than 800 new criminal healthcare fraud investigations last year. Of those investigations, federal prosecutors filed criminal charges against 741 defendants. More than 300 of those defendants have already been convicted of healthcare fraud-related offenses.
U.S. Supreme Court Overturns Doctors’ Convictions on Controlled Substance Act Violations
One of the most serious charges that a physician can be accused of is violating the Controlled Substances Act. Under the Act, doctors are authorized to dispense controlled substances covered under the law by prescription to patients but only under if that medication is provided for a “legitimate medical purpose.” Violations of this law can result not only in a doctor losing their medical license but they could also face a prison sentence if found guilty.
Last month, the U.S. Supreme Court overturned the convictions of two doctors who were convicted in two different cases of unlawful drug distribution. In a unanimous decision, the justices sent both cases back to the lower courts in each case’s respective state.
Accusations of Unauthorized Prescriptions
In the first case, a doctor who ran a clinic in Alabama was accused of issuing almost 300,000 prescriptions for controlled substances in a four-year period. Prosecutors said the clinic was the country’s leading source of fentanyl drug prescriptions.
Crimes of Moral Turpitude and Your Illinois Medical License
Our law firm has written a number of blog posts regarding the consequences that can occur with a physician’s medical license should they find themselves facing criminal charges. This is why any type of criminal accusation – even if it is a first offense – should trigger a phone call to a skilled Illinois medical license defense attorney since there is little doubt that the criminal charges will lead to some kind of action by the Illinois Medical Board.
Self-Reporting
Although your first instinct may be to try to keep the news of your arrest as quiet as possible, Illinois physicians have a responsibility to self-report certain types of arrests and/or convictions to the medical board. Medical facilities also have an obligation to report any information they learn about a physician affiliated with their organization who is facing certain charges or has been convicted. So, if the doctor fails to self-report, there is a high risk the hospital or medical facility they work for could, compounding an already potential dire situation with the medical board.
Preparing for a DEA Pharmacy Audit
The Drug Enforcement Administration (DEA), which was established in 1973, is the federal agency that is responsible for the enforcement of laws and regulations related to narcotics and controlled substances. Pharmacies and other businesses that administer, dispense, or supply controlled substances are required to register with the DEA.
Periodically – and at random – the DEA will conduct an inspection of a pharmacy in order to ensure the pharmacy is compliant and following required regulations under the Controlled Substances Act (CSA). These inspections – referred to as audits – typically take place every three years or so. However, there are situations where the DEA may decide to conduct an audit, such as receiving information of potential irregularities.
If you have been notified that your pharmacy is under a DEA audit, the following steps can help you prepare.
What Every Medical Professional Should Know About the NPDB
In 1986, Congress passed the Title IV of Public Law 99-660, the Health Care Quality Improvement Act. Included in the law was the establishment of the National Practitioner Data Bank (NPDB), which serves as a federal repository of health care providers in the U.S. The law requires reporting of any hospital, licensure, or professional society actions against doctors, dentists, and other healthcare professionals. It is important for any healthcare professional to be aware of the NPDB and what may be required of them.
What Type of Information Is Reported to the NPDB?
Under the law, the following information is required to by reported to the NPDB by specific health care entities:
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Any medical malpractice payments made on a healthcare professional’s behalf, including out-of-court settlements
Defending Your Illinois Medical License Against Allegations of Drug Addiction
Last year, Hulu produced the limited series, “Dopesick.” The show revealed how the opioid epidemic that has gripped the U.S. started and how it has affected people. One of the characters in the show, Dr. Samuel Finnix, is a doctor in a small town who is persuaded by an OxyContin salesperson to prescribe the drug to his patients. Not only do many of his patients become addicted to the drug, but the doctor also develops an addiction. Sadly – although the character is a fictional one – he is based on many true-life stories that have found themselves in the same place the character does.
Addiction in Medical Professionals
According to national statistics, more than 100,000 medical professionals – including physicians, nurses, therapists, technicians, and other health professionals – are struggling with abuse or addiction to Oxycodone, Fentanyl, or other narcotics. One in 10 doctors will abuse or become addicted to drugs or alcohol during their career, while 20 percent of nurses struggle with some form of addiction.
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