ANNUAL REPORT TO LEGISLATIVE POLICY COMMITTEE
FISCAL YEAR 2013
CH. 662(6)/HB 1325, 1994
Intake Unit
Complaints come to the Board’s attention from a wide variety of sources which include patient and consumer complaints, hospital and health care facility adverse actions, other federal, state, and local agencies, such as the Drug Enforcement Administration, the State Division of Drug Control, media, other Board referrals and federal, state and local law enforcement authorities.
During the intake process, a complaint is reviewed and analyzed, relevant records are subpoenaed and the respondent (i.e. licensee who is the subject of the complaint) is requested to respond to the complaint. In most standard of quality care cases a medical consultant will review all the materials obtained. Thereafter, the investigation is presented to the Investigative Review Panel (IRP). Most complaints are closed at this stage because no violation of the Maryland Medical Practice Act occurred. Cases not closed will proceed to a full investigation.
The Intake Unit (Intake) performs preliminary investigations on all complaints in which the Board has jurisdiction. Intake received and processed 988 complaints during FY 13. To accomplish this task, Intake staff reviews and analyzes each complaint to determine the Board’s jurisdiction with respect to allegations. Intake presented 622 cases for review by the Investigative Review Panel (IRP). Intake generated 115 advisory letters, prepared 13 Orders in reciprocal
Phillip E. F. Roman, M.D., MPH Cardiothoracic Anesthesiology
Bryan M. Steinberg, M.D. Cardio-Thoracic Surgery
Jeffrey T. Swett, M.D., Internal Medicine
Theresa Lewis, Consumer Member
Keith Amberman, CCP
Shelley Dulik-Brown, BS,CCP
Tim Moretz, CCP
15
cases (i.e. cases where Maryland takes action because another state took action against the licensee) and processed 12 cases involving deficiencies of continuing medical education credits (first-time offenders receive an administrative fine for missing CME/CEU hours).
Investigations Unit
The Investigations Unit (Investigations) is responsible for conducting full investigations into allegations filed against physicians and AH providers that may involve violations of the Maryland Medical Practice Act (Act). Complaints are received from a wide variety of sources, including but not limited to, patients, family members, hospitals, physicians, other healthcare providers, hospitals, pharmacies, pharmacists, other state agencies, law enforcement and the media. The Board also reviews and investigates anonymous complaints.
The complaints received at the Board cover a wide range of allegations, including but not limited to, boundary violations, sexual improprieties, substance abuse, standard of care and standard of documentation violations, illegal and illegitimate prescriptions, professional, physical or mental incompetency, misrepresentations in the medical record and in applications and practicing without a medical license. Investigations is responsible for fully developing the cases through objective investigative fact finding directed towards proving or disproving each alleged violation of the Act.
Based on information gathered during an investigation, the Board may determine that there is a risk of imminent danger to the public health, safety and welfare posed by the licensee. The Board may vote to Summarily Suspend the practitioner’s license. A Summary Suspension suspends the practitioner’s license before the evidentiary hearing is held at OAH. Following the Board’s vote for a summary suspension, the case is transmitted to the OAG.
Upon receipt of the Summary Suspension documents from the OAG, Compliance handles service on the Respondent and prepares for the corresponding pre or post-deprivation hearings in the matter. These pre or post deprivation hearings are not full evidentiary hearings; no witnesses are permitted. The issue is whether or not the respondent is an imminent danger to the public. If the respondent is dissatisfied with the result, he or she can also request an evidentiary hearing at the OAH. Once the pre or post-deprivation hearing at the Board is completed, a summary suspension case follows the usual track of issuing a formal charging document, offering a settlement conference, and if not settled, a full evidentiary hearing at the OAH. In FY 13, the Board issued 17 Summary Suspension Orders and held 16 hearings before the full Board on those orders.
In standard of care case(s), analysts also handle the supplemental response process required by HB 114/SB 291 (Chapters 534 and 533, Acts of 2010) whereby, in any peer review case initiated after July 1, 2010, the Board provides the licensee under review with an opportunity to review the completed peer review report and provide a supplemental response to the Board before the Board decides whether to issue charges.
Compliance is also responsible for cases after completion of the Board’s investigation and oversees cases from the time of issuance of charges until the case has a final disposition.
16
Compliance also processes all Charging documents, Final Orders, Disposition Agreements, Letters of Surrender, Suspensions, Orders for Summary Suspension and Revocations.
As a result of the investigation of the original complaint the Board, after a review of the investigatory information at the end of any stage of the process, may determine to close an investigation or to continue the investigation and ultimately take some form of action against a practitioner’s license. In FY 13, Compliance received and resolved the following
Complaints, as illustrated in the table below along with data for FY 10, FY 11 and FY 12:
Performance Measures
New Complaints Received
Complaints Pending from Previous Fiscal Years
Total Complaints
Complaints Resolved without Formal Disciplinary Action
Complaints Resolved with Nonpublic Advisory Letter
Complaints Resolved with Formal Action
Total Complaints Resolved
Participants Under Monitoring in Probation
FY 10
994
702
1,696
628
227
102
957
110
FY 11
988
739
1,727
589
167
180
936
120
FY 12
1,202
870
2,072
1,272
261
197
1,747
140
FY13
988
254
1242
633
238
342
1213
211
EXHIBIT 1
ROSTER OF MEMBERS OF THE BOARD OF PHYSICIANS (2013)
NAME
Andrea Mathias, M.D., MPH Board Chair
Laura E. Henderson, M.D. Board Vice Chair
Alexis J. Carras, M.D.
Gary J. Della’Zanna, D.O.
Suresh C. Gupta, M.D.
Suresh K. Gupta, M.D.
Avril M. Houston, M.D.
Jonathan A. Lerner, PA-C
John R. Lilly, M.D.
Celeste M. Lombardi, M.D.
Ahmed Nawaz, M.D.
Hilary T. O’Herlihy, M.D.
Robert P. Rocca, M.D.
Beryl J. Rosenstein, M.D.
Devinder Singh, M.D.
Laurie S. Y. Tyau, M.D.
Brenda G. Baker
Carmen M. Contee
Deborah R. Harrison
SPECIALTY/CATEGORY
Physician Family Medicine, DHMH Representative
Physician Internal Medicine/Pediatrics
Physician Anesthesiology
Surgical Hospitalist/Program Director
Physician Internal Medicine
Physician Internal Medicine/Geriatrics
Physician Pediatrics
Physician Assistant
Physician Family Medicine
Physician Anesthesiology
Physician Internal Medicine
Physician Cardiology
Physician Psychiatrist
Physician Pediatrics
Physician Full-time Faculty Appointment
Physician Obstetrics/Gynecology
Consumer member
Consumer member
Consumer member
TERM ENDS
2016
2015
2017
2017
2015
2014
2016
2013
2014
2016
2016
2014
2017
2015
2015
2013
2016
2016
2015
BOARD COMPOSITION
Chapter 401 (House Bill 1096) “State Board of Physicians and Allied Health Advisory Committees – Sunset Extension and Program Evaluation” passed during the 2013 session of the Maryland General Assembly increased Board membership from 21 to 22 members by adding a second licensed physician with a full-time faculty appointment to serve as a representative of an academic medical institution in the State. Members are appointed by the Governor, based on specific criteria set forth in § 14-202 of the Health Occupations Article. The 22 member Board includes:
2
The number of physicians and AH practitioners who were reprimanded or
placed on probation, or who had their licenses suspended or revoked during FY 13.
FY13 DISCIPLINARY ACTIONS
PHYSICIAN ASSISTANTS
8
3
1
2
14
$500
$500
ALLIED HEALTH
Disciplinary Definitions
LOSS OF LICENSE:
Summary Suspension, Revocation, Suspension, Letter of Surrender & Denials
RESTRICTION OF LICENSE: Reprimand with Probation or Conditions, Probation, Conditions
OTHER PREJUDICIAL ACTION: Reprimand & Cease & Desist
OTHER PREJUDICIAL ACTION: CMEs
OTHER PREJUDICIAL ACTION: Practicing without a license
NON-PREJUDICIAL ACTION:
Summary Suspension Lifted, License Granted, Termination & Non-Public Orders
TOTAL DISCIPLINARY ACTIONS
FINES (Disciplinary)
ADMINISTRATIVE FINES (CMEs)
FINES (Unlicensed Practice of Medicine)
TOTAL FINES
PHYSICIANS
90
77
22
11
9
71
280
$177,000
$31,100
$71,000
$279,100
18
5
4
9
12
48
$4,700
$4,500
$9,200
TOTALS
116
85
22
15
19
85
342
$177,000
$35,800
$76,000
$288,800
E.
The number of unresolved allegations pending before the Board.
A total of 747 allegations remain unresolved and are pending before the Board as of June 30, 2013.
TABLE B
ALLEGATIONS BROUGHT AGAINST PHYSICIANS UNDER EACH OF THE DISCIPLINARY GROUNDS ENUMERATED UNDER HO §14-404-
COMPLAINTS RESOLVED DURING FY 13
Grounds
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Description
Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or licensee or for another.
Fraudulently or deceptively uses a license.
Is guilty of immoral or unprofessional conduct in the practice of medicine.
Is professionally, physically, or mentally incompetent.
Solicits or advertises in violation of HO§14-503.
Abandons a patient.
Habitually is intoxicated.
Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in Section 5-101 of the Criminal Law Article.
Provides professional services while under the influence of alcohol; or while using any narcotic or controlled dangerous substance, as defined in Section 5-101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication.
Promotes the sale of drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain.
Willfully makes or files a false report or record in the practice of medicine.
Fails to file or record any medical report as required under law, willfully impedes or obstructs the filing or recording of the report, or induces another to file or record the report.
On proper request, and in accordance with the provisions of Title 4, Subtitle 3 of the Health General Article fails to provide details of a patient's medical record to another physician or hospital.
Solicits professional patronage through an agent or other person or profits from the acts of a person who is represented as an agent of the physician.
Pays or agrees to pay any sum to any person for bringing or referring a patient or accepts or agrees to accept any sum from any person for bringing or referring a patient.
Agrees with a clinical or bioanalytical laboratory to make payments to the laboratory for a test or test series for a patient unless the licensed physician discloses on the bill to the patient or third-party payor: the name of the laboratory; the amount paid to the laboratory for the test or test series; and the amount of procurement or processing charge of the licensed physician, if any, for each specimen taken.
Makes a willful misrepresentation in treatment.
Practices medicine with an unauthorized person or aids an unauthorized person in the practice of medicine.
Grossly over utilizes health care services.
Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine.
Allegations
0
1
317
27
1
9
4
9
5
2
23
1
52
0
0
0
1
15
13
1
Days
0
20
357
439
67
188
161
648
445
573
659
78
100
0
0
0
1214
464
558
81
26
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
Is disciplined by a licensing or disciplinary authority or convicted or disciplined by a court of any state or country or disciplined by any branch of the United States uniformed services or the Veterans Administration for an act that would be grounds for disciplinary action under this section.
Fails to meet appropriate standards as determined by appropriate peer review for the delivery of quality medical and surgical care performed in an outpatient surgical facility, office, hospital, or any other location in this State.
Willfully submits false statements to collect fees for which services are not provided.
Was subject to investigation or disciplinary action by a licensing or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under this section and the licensee: (i) surrendered the license...; or (ii) allowed the license ...to expire or lapse.
Knowingly fails to report suspected child abuse in violation of §5-704 of the Family Law Article.
Fails to educate a patient being treated for breast cancer of alternative methods of treatment as required by §20-113 of the Health-General Article.
Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes.
Fails to comply with the provisions of HO§12-102 (Physician Dispensing).
Refuses, withholds from, denies or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive.
Except as to an association that has remained in continuous existence since July 1, 1963: (i) Associates with a pharmacist as a partner or co-owner of a pharmacy for the purpose of operating a pharmacy, (ii) Employs a pharmacist for the purpose of operating a pharmacy, or (iii) Contracts with a pharmacist for the purpose of operating a pharmacy.
Except in an emergency life-threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control's guidelines on universal precautions.
Fails to display the notice required under HO§14-415.
Fails to cooperate with a lawful investigation conducted by the Board.
Is convicted of insurance fraud as defined in §27-801 of the Insurance Article.
Is in breach of a service obligation resulting from the applicant’s or licensee’s receipt of State or federal funding for the licensee’s medical education.
Willfully makes a false representation when seeking or making application for licensure or any other application related to the practice of medicine.
By corrupt means, threats, or force, intimidates or influences, or attempts to intimidate or influence, for the purpose of causing any person to withhold or change testimony in hearings or proceedings before the Board or those otherwise delegated to the Office of Administrative Hearings.
By corrupt means, threats, or force, hinders, prevents, or otherwise delays any person from making information available to the Board in furtherance of any investigation of the Board.
26
254
22
2
0
0
45
1
1
0
0
0
0
0
0
30
0
0
169
417
725
61
0
0
455
61
63
0
0
0
0
0
0
275
0
0
27
39
40
41
404(b)
Intentionally misrepresents credentials for the purpose of testifying or rendering an expert opinion in hearings or proceedings before the Board or those otherwise delegated to the Office of Administrative Hearings.
Fails to keep adequate medical records as determined by appropriate peer review.
Performs a cosmetic surgical procedure in an office or a facility that is not accredited by the American Association for Accreditation of Ambulatory Surgical Facilities, the Accreditation Association for Ambulatory Health Care; or the Joint Commission on the Accreditation of Health Care Organizations or certified to participate in the Medicare program, as enacted by Title XVIII of the Social Security Act.
Crimes of moral turpitude
0
24
0
7
893
0
382
0
425
TOTAL RESOLVED ALLEGATIONS AGAINST PHYSICIANS
Link Here- http://www.mbp.state.md.us/forms/annual_report2013.pdf