Physician Board Investigation And Discipline Proceedings In Minnesota
Physician Board Investigation And Discipline Proceedings In Minnesota
Good doctors can be accused of making big mistakes. Physicians licensed in Minnesota often times receive complaints that are filed with the Minnesota Board of Medical Practice (“Board”) alleging some form of misconduct. The types of misconduct can vary from substance use, sexual relations with patient(s), practice that falls below the accepted standards, inadequate record keeping, abusive or fraudulent billing practices including violations of the federal Medicare and Minnesota Medicaid or Medical Assistance laws, practicing without a valid license, incompetent practice, a criminal conviction(s), failing to meet the continuing education requirements, and defrauding the public, etcetera. While this list is not exhaustive, many complaints filed with the Board will fall into one of the aforementioned categories.
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What Happens After The Minnesota Board Of Medical Practice Receives A Complaint?
Board's staff first will gather information from a variety of sources, starting with the information contained in the complaint. The staff will gather and review medical records, collect data and may interview those involved. If it is appropriate, the staff will also obtain a response from the accused physician. After the board has gathered a sufficient amount of information, the Board's Complaint Review Committee will review the facts and decide whether to take action against the physician involved.
The Board is able to learn whether accused physician has violated Minnesota’s Medical Practice Act, after reviewing all information obtained. If the review shows that the physician has violated the law, the Board may take action, as described below.
What Is The Minnesota Board Of Medical Practice?
The Board of Medical Practice consists of 16 residents of the state of Minnesota appointed by the governor. Eleven board members must be licensed to practice medicine under this chapter. At least one board member must hold a degree of doctor of medicine, and at least one board member must hold a degree of doctor of osteopathic medicine. Five board members must be public members as defined by section 214.02. The governor shall make appointments to the board which reflect the geography of the state. In making these appointments, the governor shall ensure that no more than one public member resides in each United States congressional district, and that at least one member who is not a public member resides in each United States congressional district. The board members holding the degree of doctor of medicine or doctor of osteopathic medicine must, as a whole, reflect the broad mix of expertise of physicians practicing in Minnesota. A member may be reappointed but shall not serve more than eight years consecutively. Membership terms, compensation of members, removal of members, the filling of membership vacancies, and fiscal year and reporting requirements are as provided in sections 214.07 to 214.09. The provision of staff, administrative services and office space; the review and processing of complaints; the setting of board fees; and other provisions relating to board operations are as provided in chapter 214.
Minn. Stat. § 147.01, Subd. 1.
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What Is The Purpose Of The Minnesota Board Of Medical Practice?
The primary responsibility and obligation of the Board of Medical Practice is to protect the public.
In the interest of public health, safety, and welfare, and to protect the public from the unprofessional, improper, incompetent, and unlawful practice of medicine, it is necessary to provide laws and regulations to govern the granting and subsequent use of the license to practice medicine.
Minn. Stat. § 147.001, Subd. 2.
What Are Grounds For Disciplinary Action By The Minnesota Board Of Medical Practice?
While the Board receives some complaints that do not lead to action against the accused physician, many complaints lead to disciplinary actions. However, the Board cannot take action against a physician accused of misconduct unless there is sufficient evidence to show that the physician violated Minnesota's Medical Practice Act. The Board must review each complaint thoroughly before it takes any action.
What Actions Can The Minnesota Board of Medical Practice Take?
The Board can take a variety of actions: It can limit, suspend or revoke a physician's license to practice medicine in Minnesota. It can order a physician to pay civil penalties and to pay all court and investigative costs incurred during the complaint review process. It can order physicians to take more training, to stop treating some illnesses or to stop performing certain procedures. It can order physicians to enroll in appropriate treatment programs. It can issue a written reprimand.
Call (651) 468-2108 to receive a free and confidential consultation from the attorneys at RAM Law PLLC.
What Actions Are Grounds for Discipline?
The Minnesota Board of Medical Practice may refuse to grant a license, may refuse to grant registration to perform interstate telehealth services, or may impose disciplinary action as described in section 147.141 against any physician. The following conduct is prohibited and is grounds for disciplinary action:
(a) Failure to demonstrate the qualifications or satisfy the requirements for a license contained in this chapter or rules of the board. The burden of proof shall be upon the applicant to demonstrate such qualifications or satisfaction of such requirements.
(b) Obtaining a license by fraud or cheating, or attempting to subvert the licensing examination process. Conduct which subverts or attempts to subvert the licensing examination process includes, but is not limited to: (1) conduct which violates the security of the examination materials, such as removing examination materials from the examination room or having unauthorized possession of any portion of a future, current, or previously administered licensing examination; (2) conduct which violates the standard of test administration, such as communicating with another examinee during administration of the examination, copying another examinee's answers, permitting another examinee to copy one's answers, or possessing unauthorized materials; or (3) impersonating an examinee or permitting an impersonator to take the examination on one's own behalf.
(c) Conviction, during the previous five years, of a felony reasonably related to the practice of medicine or osteopathic medicine. Conviction as used in this subdivision shall include a conviction of an offense which if committed in this state would be deemed a felony without regard to its designation elsewhere, or a criminal proceeding where a finding or verdict of guilt is made or returned but the adjudication of guilt is either withheld or not entered thereon.
(d) Revocation, suspension, restriction, limitation, or other disciplinary action against the person's medical license in another state or jurisdiction, failure to report to the board that charges regarding the person's license have been brought in another state or jurisdiction, or having been refused a license by any other state or jurisdiction.
(e) Advertising which is false or misleading, which violates any rule of the board, or which claims without substantiation the positive cure of any disease, or professional superiority to or greater skill than that possessed by another physician.
(f) Violating a rule promulgated by the board or an order of the board, a state, or federal law which relates to the practice of medicine, or in part regulates the practice of medicine including without limitation sections 604.201, 609.344, and 609.345, or a state or federal narcotics or controlled substance law.
(g) Engaging in any unethical or improper conduct, including but not limited to:
(1) conduct likely to deceive or defraud the public;
(2) conduct likely to harm the public;
(3) conduct that demonstrates a willful or careless disregard for the health, welfare, or safety of a patient;
(4) medical practice that is professionally incompetent; and
(5) conduct that may create unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of actual injury need not be established.
(h) Failure to provide proper supervision, including but not limited to supervision of a:
(1) licensed or unlicensed health care provider; and
(2) physician under any agreement with the board.
(i) Aiding or abetting an unlicensed person in the practice of medicine, except that it is not a violation of this paragraph for a physician to employ, supervise, or delegate functions to a qualified person who may or may not be required to obtain a license or registration to provide health services if that person is practicing within the scope of that person's license or registration or delegated authority.
(j) Adjudication by a court of competent jurisdiction, within or outside this state, as:
(1) mentally incompetent;
(2) mentally ill;
(3) developmentally disabled;
(4) a chemically dependent person;
(5) a person dangerous to the public;
(6) a sexually dangerous person; or
(7) a person who has a sexual psychopathic personality.
Such adjudication shall automatically suspend a license for the duration of the adjudication unless the board orders otherwise.
(k) Conduct that departs from or fails to conform to the minimal standards of acceptable and prevailing medical practice in which case proof of actual injury need not be established.
(l) Inability to practice medicine with reasonable skill and safety to patients by reason of the following, including but not limited to:
(1) illness;
(2) intoxication;
(3) use of drugs, narcotics, chemicals, or any other type of substance;
(4) mental condition;
(5) physical condition;
(6) diminished cognitive ability;
(7) loss of motor skills; or
(8) deterioration through the aging process.
(m) Revealing a privileged communication from or relating to a patient except when otherwise required or permitted by law.
(n) Failure by a doctor of osteopathic medicine to identify the school of healing in the professional use of the doctor's name by one of the following terms: osteopathic physician and surgeon, doctor of osteopathic medicine, or D.O.
(o) Improper management of medical records, including failure to maintain adequate medical records, to comply with a patient's request made pursuant to sections 144.291 to 144.298 or to furnish a medical record or report required by law.
(p) Fee splitting, including without limitation:
(1) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, or remuneration, directly or indirectly, primarily for the referral of patients or the prescription of drugs or devices;
(2) dividing fees with another physician or a professional corporation, unless the division is in proportion to the services provided and the responsibility assumed by each professional and the physician has disclosed the terms of the division;
(3) referring a patient to any health care provider as defined in sections 144.291 to 144.298 in which the referring physician has a "financial or economic interest," as defined in section 144.6521, subdivision 3, unless the physician has disclosed the physician's financial or economic interest in accordance with section 144.6521; and
(4) dispensing for profit any drug or device, unless the physician has disclosed the physician's own profit interest.
The physician must make the disclosures required in this clause in advance and in writing to the patient and must include in the disclosure a statement that the patient is free to choose a different health care provider. This clause does not apply to the distribution of revenues from a partnership, group practice, nonprofit corporation, or professional corporation to its partners, shareholders, members, or employees if the revenues consist only of fees for services performed by the physician or under a physician's direct supervision, or to the division or distribution of prepaid or capitated health care premiums, or fee-for-service withhold amounts paid under contracts established under other state law.
(q) Engaging in abusive or fraudulent billing practices, including violations of the federal Medicare and Medicaid laws or state medical assistance laws.
(r) Becoming addicted or habituated to a drug or intoxicant.
(s) Inappropriate prescribing of or failure to properly prescribe a drug or device, including prescribing a drug or device for other than medically accepted therapeutic or experimental or investigative purposes authorized by a state or federal agency.
(t) Engaging in conduct with a patient which is sexual or may reasonably be interpreted by the patient as sexual, or in any verbal behavior which is seductive or sexually demeaning to a patient.
(u) Failure to make reports as required by section 147.111 or to cooperate with an investigation of the board as required by section 147.131.
(v) Knowingly providing false or misleading information that is directly related to the care of that patient unless done for an accepted therapeutic purpose such as the administration of a placebo.
(w) Aiding suicide or aiding attempted suicide in violation of section 609.215 as established by any of the following:
(1) a copy of the record of criminal conviction or plea of guilty for a felony in violation of section 609.215, subdivision 1 or 2;
(2) a copy of the record of a judgment of contempt of court for violating an injunction issued under section 609.215, subdivision 4;
(3) a copy of the record of a judgment assessing damages under section 609.215, subdivision 5; or
(4) a finding by the board that the person violated section 609.215, subdivision 1 or 2. The board shall investigate any complaint of a violation of section 609.215, subdivision 1 or 2.
(x) Practice of a board-regulated profession under lapsed or nonrenewed credentials.
(y) Failure to repay a state or federally secured student loan in accordance with the provisions of the loan.
(z) Providing interstate telehealth services other than according to section 147.032.
Minn. Stat. § 147.091.
Furthermore, discipline from the Minnesota Board of Medical Practice can result in revocation, suspension, restriction, limitation, or other disciplinary action against the physician’s medical license in another state or jurisdiction; and engaged in unethical or improper conduct.
Moreover, discipline from the Minnesota Board of Medical Practice can result from unethical or improper conduct; engaged in conduct that departs from or fails to conform to the minimal standards of acceptable and prevailing medical practice; and inappropriate prescribing of or failure to properly prescribe a drug or device, including prescribing a drug or device for other than medically accepted therapeutic or experimental or investigative purposes authorized by a state or federal agency.
Additionally, discipline from the Minnesota Board of Medical Practice can result from improper management of medical records, including failure to maintain adequate medical records.
It is important to understand the limits of relationships with patients. Physicians that engaged in unethical or improper conduct; and engaged in conduct with a patient which is sexual or may reasonably be interpreted by the patient as sexual, or in any verbal behavior which is seductive or sexually demeaning to a patient will result in discipline.
Health care and Medicaid fraud charges are very serious allegations often levied against individuals that have never been charged with a crime, who inadvertently fail to comply with sophisticated laws, rules, and regulations created by the many state and federal agencies that regulate the medical field in Minnesota.
Honest mistakes may lead to unfair criminal charges of health care or Medicaid fraud in Minnesota. These charges often stem from innocent, good faith misunderstandings since the regulations and processes involved with public health care programs are complex. Furthermore, many individuals receive inadequate training to properly bill for medical services. At RAM Law PLLC, we understand that good people make honest mistakes.
The Medicaid Program
The Medicaid program provides medical care and services to low-income Minnesotans (recipients) who meet certain income and other eligibility requirements. DHS, located in St. Paul, Minnesota, administers the Medicaid program.
Health Care Fraud Investigation
Doctors, RNs, LPNs, PCAs, and other medical professionals often become the subject of health care fraud investigations due to poor or inadequate record keeping. These investigations are often initiated by the Minnesota Department of Human Services (DHS), by the Medicaid Fraud Control Unit (MCFU) of the Minnesota Attorney General’s Office, or by the Department of Human Services Surveillance Integrity Review Section (SIRS). These departments often allege the submission of false or inflated timesheets for medical services that were not provided. Furthermore, these agencies have been known to trick providers into confessing to committing crimes that were not actually committed. DHS, MCFU, and SIRS often refer their investigations to prosecutors that charge individuals with Theft by False Representation of Public Funds (theft of public funds), Minn. Stat. 609.52, and Aiding and Abetting Theft by False Representation of Public Funds, Minn. Stat. 609.52. Said agencies often allege over billing or billing for medical services that were not performed.
Board Discipline Defense Attorneys
The attorneys at RAM Law PLLC have experience representing licensed medical professional in Board investigations and discipline proceedings, as well as defending licensed medical professionals against criminal charges such as Medicaid Fraud. If you have been contacted by the Medicaid Fraud Control Unit (MCFU) of the Minnesota Attorney General’s Office or the Department of Human Services Surveillance Integrity Review Section (SIRS), do not speak with them without a lawyer present. You have a 5th Amendment right to remain silent. Anything you say can and will be used against you.
Call (651) 468-2108 to receive a free and confidential consultation from the attorneys at RAM Law PLLC if you have any questions or if you are under investigation. Contacting a lawyer before speaking with any investigators can change the outcome of their investigation.