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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
Continue Reading Crimes of Moral Turpitude and Your Illinois Medical License

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
Continue Reading Preparing for a DEA Pharmacy Audit

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
Continue Reading What Every Medical Professional Should Know About the NPDB

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
Continue Reading Defending Your Illinois Medical License Against Allegations of Drug Addiction

It takes strong dedication to be a hospital nurse. The majority work long shifts, with hours that go into the double digits, dealing with lack of sleep and heavy workloads, all while trying to provide patients with the best care possible. The hospital work culture can – and often does – leads to errors that can ultimately put a nurse’s license at risk.
Hospital Work Culture
Several years ago, the Vickie Milazzo Institute in Houston conducted a survey of nurses throughout the country. The results found that most of them were overworked and stressed, as well as feeling underutilized and
Continue Reading Do Hospital Work Environments Create a High Risk for Nursing Errors?

In many criminal cases, the person who has been charged will often enter into a plea agreement with the prosecutor’s office instead of going to trial and letting a jury decide their guilt or innocence. If it appears that the prosecutor has enough evidence to convict them, a defendant agrees to a plea bargain in order to receive a lesser sentence than what they would receive if convicted.
For most people, agreeing to a plea bargain will conclude the legal process for them. However, for a person who holds a professional license, agreeing to a plea bargain in a
Continue Reading How a Plea Bargain Can Affect Your Illinois Professional License

It takes years of education, training, and dedication to become a successful psychologist in Illinois. Not only is there grinding coursework to get your degree, but there are also stringent requirements to obtain your license to practice in the state. Unfortunately, all it takes is one accusation of wrongdoing and a dedicated psychologist can find his or her career in jeopardy.
All licensure issues are handled by the Illinois Clinical Psychologists Licensing and Disciplinary Board, which falls under the Illinois Department of Financial and Professional Regulation (IDFPR). If you have been contacted by the board that you are under
Continue Reading Allegations That Can Place Your Psychology License at Risk

In every state in the country, there are certain professionals who are required to hold a professional license that is issued through the state. In this state, the Illinois Department of Financial and Professional Regulation (IDFPR) is the state agency that has regulation over all the different professional boards that issue these licenses and are in charge of oversight. Some of these boards include the Illinois Medical Board, Illinois Board of Nursing, Illinois Board of Pharmacy, the Illinois Dental Board, and Illinois Board of Clinical Psychologists/Social Workers.
When there is an issue with a professional license holder, the board that
Continue Reading Issues That Can Result in Suspension of Your Illinois Professional License

The healthcare industry faces an ever-growing mountain of rules and regulations issued by the federal government that must be followed. Failure to adhere can result in fines, sanctions, and even a suspension or revocation of an individual’s professional license or the facility’s operating license. As new requirements issued for hospices as a result of the Consolidated Appropriations Act of 2021 go into effect in the fiscal year 2022, it is critical to understand what those requirements are.

Why the Change?
These new rules were created as a result of the findings of reports filed over the past several years that
Continue Reading New Federal Rules for Hospice Providers

In the past 20 years or so, there has been a concerted effort by the federal government to crack down on the number of fraudulent claims that are submitted to Medicare by medical providers. One of the ways that the government prevents fraudulent claims is through prepayment audits. If your practice has been notified that you are the subject of a prepayment audit, you should contact an Illinois professional license defense attorney for legal assistance.
Zone Program Integrity Contactors
Prepaid audits fall under the bailiwick of the Centers for Medicare and Medicaid Services. The agency often employs Zone Program
Continue Reading Have You Been Notified Your Medical Practice Is Under a ZPIC Audit?

In 1996, the federal government passed the Health Insurance Portability and Accountability Act (HIPAA). The law was created to establish national standards to protect sensitive patient health information from being disclosed to any other party unless the patient consents. In order to implement the requirements of the standards, the HIPAA Privacy Rule was established. Entities that are subject to the Privacy Rule include healthcare providers, health plans, and healthcare clearinghouses. Violations of HIPAA can result in hefty civil fines and even criminal charges.

Examples of HIPAA Violations
There are a number of actions that could result in a violation allegation.
Continue Reading Defending Against HIPAA Violations in Illinois

According to data collected by John Hopkins patient safety professionals, medical errors are responsible for more than a quarter of a million deaths each year in this country. This major study used data collected over an eight-year period and put a spotlight on the dangers medical errors pose to patients. One of the most important factors in preventing these errors is the proper documentation by the nursing staff of the care provided to patients. Accusations of improper documentation by nurses can lead to disciplinary action or even suspension of your nursing license. The following are some of the more
Continue Reading Are You an Illinois Nurse Accused of Committing a Medical Error?

In order to protect patients who are covered under federal health programs, such as Medicaid and Medicare, the federal government has put in place certain laws that medical providers are required to adhere to. The Department of Health & Human Services Office of Inspector General (OIG), the Centers for Medicare & Medicaid Services (CMS), and several other federal agencies are in charge of making sure these laws are followed, and to investigate and prosecute those who do not. We have discussed two of them – the Physician Self-Referral Law (Stark Law)  and the Federal Anti-Kickback Statute (AKS) – in prior
Continue Reading Violations of the False Claims Act

There are several federal laws that have been put in place in order to protect patients by ensuring that there are no financial incentives or other conflicts of interest regarding referrals by healthcare providers. In our last post, we discussed the seriousness any accusations of violating the Physician Self-Referral Law (Stark Law) can have on a physician’s career. In this post, we will address the Federal Anti-Kickback Statute.

Federal Anti-Kickback Statute
Unlike the Stark Law, in which any violations are met with civil penalties, the Anti-Kickback Statute (AKS) is a criminal law, meaning that if a provider is
Continue Reading Violations of the Federal Anti-kickback Statute

There are many federal and state laws that physicians are required to abide by, including laws that address fraud and abuse. According to the Office of Inspector General, U.S. Department of Health and Human Services (OIG), the most serious of these laws include the Physician Self-Referral Law (Stark Law), the Anti-Kickback Statute (AKS), and the False Claims Act (FCA). Violations of these laws can result in severer penalties, including exclusion from federal health care programs, civil fines, loss of medical license, and even criminal penalties. In our next few posts, we will discuss each of these laws and how they
Continue Reading  Violations of the Stark Law

In the healthcare industry, pharmacy benefit managers (PBMs) serve a pivotal role. In fact, a pharmacy would be unable to operate without having a contract with a PBM. The PBM serves as an intermediary between the pharmacy and the insurance company, negotiating rates and processing the majority of all prescriptions.
Under these contracts, the PBM also has the right to conduct an audit of the pharmacy to make sure that all terms of the contract and proper guidelines are being met. Any discrepancies found during the audit could result in not only the pharmacy being required to pay back funds
Continue Reading PBM Audits for Black-Market Diabetic Test Strips