Attorney General- Laws

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


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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.

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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:

    • 11 practicing licensed physicians, including 1 Doctor of Osteopathy, appointed by the Governor with the advice of the Secretary of the Department of Health and Mental Hygiene (DHMH) and the advice and consent of the Senate;
    • 1 practicing licensed physician appointed at the Governor's discretion;
    • 1 physician representative of DHMH nominated by the Secretary;
    • 1 licensed physician assistant appointed at the Governor’s discretion;


2

    • 2 practicing licensed physicians with full-time faculty appointments to serve as representatives of academic medical institutions, in the State nominated by one of those institutions;
    • 5 consumer members, and
    • 1 public member knowledgeable in risk management or quality assurance matters
      • appointed from a list submitted by the Maryland Hospital Association.
      • In FY 13, four physicians and two consumer member appointments expired. The list of current Board Members and their term expiration dates appear in Exhibit 1 on page 32.

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