Summary
A physician in New York State entered into a consent agreement following a federal felony conviction for healthcare fraud. The physician pled guilty in federal court to violating anti-kickback statutes, was sentenced to 30 months imprisonment with supervised release, and forfeited over $100,000. The disciplinary action resulted in immediate license suspension followed by a 36-month suspension and 36-month probation with extensive practice monitoring requirements upon return to practice.
Case Analysis
Effective Date: July 2, 2014
Type of Doctor: Medical Doctor (M.D.)
Disposition Type: Negotiated Consent (following federal criminal conviction)
How many total charges? 1
What specifications of charges were alleged? Criminal Conviction – Professional misconduct as defined in N.Y. Educ. Law § 6530(9)(a)(ii) by having been convicted of committing an act constituting a crime under federal law. Specifically, on February 14, 2013, in the United States District Court, District of New Jersey, the physician pled guilty to violating § 42 U.S.C. 1320a-7b(1)(A), a felony. The physician was sentenced on July 30, 2013, to thirty months imprisonment, two years supervised release, and forfeiture of $101,750.00.
How many patients were involved in each charge? Not specified – this was a federal criminal conviction case, likely involving healthcare fraud based on the federal statute cited.
Which charges was the licensee guilty of (either via hearing or negotiated consent)? The single charge of professional misconduct is based on a federal criminal conviction. The physician did not contest the specification in the Statement of Charges and agreed to the penalty in full satisfaction of the charges.
Which charges was the licensee not guilty of? None – there was only one charge, and it was not contested.
Outcome/Penalties (specific to this case):
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- License to practice medicine in New York State suspended for thirty-six months pursuant to N.Y. Pub. Health Law § 230-a(2)
- Thirty-six-month probation period following suspension pursuant to N.Y. Pub. Health Law § 230-a(9), subject to detailed terms in Exhibit “B”
- Compliance with requirements for closing medical practice (Exhibit “C”), including immediate cessation of practice, patient notifications, medical record transfers, and surrender of controlled substance privileges
- Extensive ongoing compliance and reporting requirements, including continuous registration compliance, profile information updates, and cooperation with OPMC investigations
- Upon return to practice after suspension: monitored practice requirements with board-certified physician oversight, quarterly reporting,and medical malpractice insurance requirements ($2 million per occurrence, $6 million per policy year)
- Practice monitor must conduct monthly unannounced visits and examine patient records, with authority to report deviations to OPMC within 24 hours
- Full cooperation with OPMC enforcement and periodic compliance verification throughout the entire disciplinary period