How To Win During A Year Of Incomprehensible Loss: VOTE

While it may seem impossible to encapsulate into one word the multidimensional maelstrom of horrors and crises which is the year 2020, “loss” comes as close as anything. The loss of hundreds of thousands of lives and loved ones to a criminally mismanaged pandemic. The loss of countless more to gun violence, police misconduct, and systemic racism. The loss of millions of jobs, livelihoods, and economic security. The loss of certainty and the rhythms and rituals of ordinary life, from children playing with their friends and laughing in school hallways to attending a wedding or watching a ball game.

The Rule Of Law Is Under Attack – And On The Ballot

All of these losses are staggering and would have been incomprehensible at the start of this Godforsaken year. But there are even more insidious and ongoing losses that predate the pandemic. These aren’t losses caused by biology or random chance. Rather, these are losses purposefully engineered by those who see the foundational principles of America, as well as the concept of objective reality, as impediments to their own craven designs, their shameless corruption, and the advancement of their personal interests at the expense of everyone else’s.

As a lawyer – as an American – I see the rule of law as sacrosanct and one of the last remaining bulwarks standing between the survival of the Republic and authoritarianism. But the past four years have seen an unrelenting and unprecedented war on the rule of law by those charged with faithfully executing those laws and those who have aided and abetted them in these efforts.

If past is prologue, and if cornered rats are the most dangerous kind, I fear that the next few months will see an even more voracious attack on the rule of law. That war is occurring in plain sight, from the sabotage of the postal service, to the incitement of violence for political gain, to a firehose of lies and misinformation spewing from the highest office in the land.

Attacking the rule of law and purposefully and relentlessly undermining public trust in the institutions that uphold the law in order to facilitate rampant lawbreaking is an unforgivable civic sin. That those engaging in such misconduct laughably do so under the banner of “law and order” makes it even more enraging.

Voting Is How We Maintain The Rule Of Law

The rule of law is how we hold leaders and lawbreakers accountable. It is what levels the playing field, at least in theory. It is the way we as a society facilitate change and address inequality and other social and economic injustices. And the way we do that is through the power of our votes. That is why so much effort is focused on depriving individuals of their right to vote, encouraging bad actors to corrupt the system, and sowing doubt about the legitimacy of an outcome that may not go as those currently in power would like – in a fair fight.

Voting determines everything. On life and death matters, it determines whether or not you can get health insurance if you have a preexisting condition or if you’ll have the resources to be able to pay your rent or mortgage. Even on less existential issues, who we elect matters. As a professional license defense attorney, I’ve seen how changes in leadership and laws impact the lives and livelihoods of thousands of licensed professionals and those they serve.

So, as early voting is set to begin here in Illinois and across the country, it is imperative that all of us enlist in the fight to preserve the rule of law by ensuring that we are registered and know our options as to how to cast our ballots. Illinois residents can register to vote or check your registration status here. You can request a vote by mail application here. Given ongoing efforts to interfere with your right to vote, casting your ballot sooner rather than later should be a priority, more so than in prior elections.

Shakespeare wrote one of the most misinterpreted lines in history: “The first thing we do, let’s kill all the lawyers.” Rather than an attack on the legal profession, the quote from “Henry VI” was actually a strategic statement by someone out to destroy the rule of law. It was uttered by Dick the Butcher, who was a follower of the rebel Jack Cade and thought that if he disturbed law and order, he could become king.

We don’t do kings here. We are a democracy. We are a nation of laws – and voters.

Proposed Legislation Would Remove Telemedicine Licensing Barriers

Well-before the world had heard of COVID-19, the use of telemedicine was increasingly seen as a way to expand patient access to care and address a growing shortage of physicians, particularly in rural and underserved areas. As noted by the authors of an article in the American Journal of Managed Care, “The impact of restricting telemedicine falls hardest on poor patients, the uninsured, and those who rely on state Medicaid programs, many of whom lack access to reliable transportation and cannot travel across state lines to see specialists.”

But the pandemic and the lockdowns that followed in its wake dramatically changed the telehealth landscape for doctors, patients, and insurers. Now, legislation recently introduced in Congress seeks to address licensing barriers that have stood in the way of leveraging this technology to improve patient care.

The number of virtual visits exploded as such appointments became seen more as a matter of health and safety rather than convenience. While it is estimated that only two percent of all patient appointments pre-pandemic were via telemedicine, a whopping 61 percent of visits have been conducted virtually since then. Even when, hopefully in the near future, COVID-19 recedes into memory, experts anticipate that telemedicine will remain an increasingly utilized option.

Scores of Separate Licenses Currently Needed For Telemedicine Across State Lines

But the inability of physicians to provide remote care to patients in other states where they are not licensed is holding back telemedicine’s potential and unnecessarily denying patients access to quality healthcare. This is particularly problematic in areas where the healthcare system is currently overwhelmed by COVID-19 cases.

The problem is that, as of November 2019, 49 state medical boards, plus the medical boards of the District of Columbia, Puerto Rico, and the Virgin Islands, require that physicians engaging in telemedicine have a license in the state in which the patient is located.

Equal Access To Care Act

However, a bill introduced in Congress in July – The Equal Access To Care Act (EACA) – seeks to remove this roadblock. If enacted, the act would allow licensed practitioners to provide services via telehealth in any state from any location for up to 180 days after the end of the current public health emergency period. On July 23, the federal government extended that period for another 90 days.

Specifically, the EACA provides that a physician, practitioner, or other healthcare provider who is licensed to provide health care services in their primary state, and who provides such health care services in interstate commerce through electronic information or telecommunication technologies to a patient in another state, does not need to obtain a comparable license from the state where the patient is located in order to provide such services.

It is expected that EACA will receive rare bipartisan support in both chambers. If it does pass, it raises the question of what happens to telehealth licensing requirements after the pandemic emergency ends. Given that almost all stakeholders have come around on the use of and payment for virtual visits, one would think that a permanent solution is more likely than not.

Expanded Medicare Coverage For Telemedicine Also On The Table

In addition to removing licensing burdens, Congress is also considering legislation to expand Medicare coverage for telehealth services. The Telehealth Modernization Act was introduced on July 30th. If it becomes law, the act would remove geographic and originating site restrictions from Medicare coverage of telehealth services, ensure that telehealth services at federally qualified health centers (FQHCs) and rural health clinics (RHCs) are covered by Medicare, and give the Health and Human Services Secretary the authority to permanently expand the types of telehealth services covered by Medicare, among other changes.

Louis R. Fine: Chicago Physician License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois physician’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Can You Lose Your Illinois Professional License For Making Racist Comments?

America’s current and long-overdue reckoning with systemic racism is manifesting itself in countless ways. From the millions marching in the streets to the pressure placed on corporations, executives, entertainers, and others to acknowledge and apologize for racist words and actions, it is clear that silence is no longer enough.

Similarly, those with far lower profiles are also being called out for their casual racism. Every week, seemingly, another so-called “Karen” becomes the unwitting star of a viral video in which they are seen flexing their privilege, entitlement, and prejudice by hurling insults at an African-American or other person of color. Birdwatching, sitting by the pool at a hotel where they are registered guests, doing some repairs on their own home – these are the transgressions for which they face the wrath of an angry white person making false claims of assault and calling 911 for absolutely no reason at all. As a matter of fact, after I started writing this post, yet another such video was burning up the internet

You Can Lose Your Job For Racism, But What About Your License?

But internet justice can be swift and unmerciful. Those whose repulsive conduct goes viral often find themselves out of a job, disowned and disavowed by employers who do not want their reputations tarnished by the racism of one of their employees. 

In the vast majority of states, private employers are well within their rights to fire an employee for being perceived as or for actually being a racist and/or Trump supporter, expressing other political or social views, or for pretty much any reason other than race, sex, religion, or membership in another legally protected other class.

But while you can lose your job for being a racist, can you also lose your professional license in Illinois for being one?

Is Racism “Unprofessional,” “Dishonorable,” and “Harmful”?

The Illinois Department of Financial and Professional Regulation (IDFPR) is a governmental body, which means that any adverse action based on the exercise of a professional’s free speech rights implicates the First Amendment. But the question of whether and how personal, off-the-clock, and non-criminal conduct can lead to professional license disciplinary action is still tricky.

The laws and rules governing all professions in Illinois contain many specific bases for disciplinary action, almost all of which are based on acts and omissions directly related to their professional responsibilities. But some licensing acts and underlying rules contain vague and ambiguous language which could theoretically be used by IDFPR to institute disciplinary proceedings for private conduct.

For example, a nurse is subject to disciplinary action under Section 70-5(b)(7) of the Illinois Nurse Practice Act for “engaging in dishonorable, unethical or unprofessional conduct of a character likely to deceive, defraud or harm the public…”

Note that this section of the Act doesn’t discuss deceiving, defrauding, or harming a patient; it talks about “the public.” Is chanting racist slogans or baselessly calling 911 on an African-American “dishonorable” or “unprofessional” conduct likely to “harm” the public? The IDFPR (and most other folks) may see it that way, even if the First Amendment may ultimately thwart the Board if they try to discipline a licensee on that basis. But politics and free speech issues aside, other private conduct can put licensed professionals at risk for disciplinary action.

In Texas, for example, licensing boards have taken a very aggressive approach towards off-the-clock, legal, and harmless conduct which they believe implicates professional “fitness” or “judgment.” As one attorney in Texas described it, using such private behavior as the basis for discipline means that “anything you could do at any point could be considered unprofessional. They really do believe they have the ability to legislate morality.”

In Illinois, all kinds of personal behavior could arguably be scrutinized if a particular investigator or regulator at the IDFPR decides to look at things through that prism. Sexual conduct, controversial parenting techniques, a screaming tirade at a store clerk, internet searches – all legal, all having nothing to do with job performance – they may be fair game.

It would be serious overreach by the IDFPR if they were to take action based on such conduct, but as I have written before, the disciplinary process in Illinois can be manifestly unfair and stacked against you. Experienced and aggressive prosecutors have your license in their sights, and the hearing officer who will determine your fate is bringing their own biases to your case.

Everything we do in life has consequences. Those who are or act like racists should be prepared for the fallout from such repugnant beliefs and behavior. This can include the loss of their professional license. If decency, empathy, and a sense of shared humanity can’t change their views, perhaps the threat of losing their livelihood will.

Louis Fine: Chicago Professional License Defense Attorney

As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on professionals who suddenly find their future in disarray. I understand how and why the Department decides to pursue investigations, how it handles negotiations, and how to approach formal proceedings in a way that gives my clients the best possible chance of a positive and expeditious outcome.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. Together, we will get you back to your clients and your career.

What NOT To Do When Reopening Your Medical Practice in Illinois

We are now in Phase 3 of Gov. JB Pritzker’s five-phase Restore Illinois plan. For medical practices throughout the state, this means that many individuals who have delayed or deferred elective procedures, screenings, and other non-COVID-19 visits are now scheduling these visits. For physicians and staff at medical offices, returning to the routine care and treatment of patients will be anything but routine.

Healthcare providers across the country have been modifying their policies, practices, and procedures to comply with state and local requirements for the protection of both patients and staff. In Illinois, that means following safety guidance from the Illinois Department of Public Health. Additionally, the Centers for Disease Control & Prevention (CDC) has issued its “Framework for Healthcare Systems Providing Non-COVID-19 Clinical Care During the COVID-19 Pandemic” to help guide clinicians in their decision-making.

But on a more granular level, the modifications that practices must make to their clinical care and general operation can be quite extensive and require planning, thoughtfulness, and diligence in both formulation and execution. To help guide physicians in this regard. The American Medical Association (AMA) has compiled a reopening guide with actionable information, proposed best practices a checklist, and other resources to ensure that medical practices are ready to reopen.

Among the resources provided by the AMA is a list of mistakes that practices should avoid when reopening. Not only can such missteps put the health and safety of patients and staff at risk, but they can also draw the scrutiny of authorities who will not hesitate to intervene if a practice is not following required precautions.

Some “don’t’s” physicians should avoid when reopening, per the AMA, include:

  • Don’t jump the gun. Stay in line with the latest requirements and limitations issued by the governor, IDPH, and local authorities. These change frequently with events, so it is imperative that you keep continuously abreast of what is and isn’t permitted in terms of patient care and office safety.
  • Don’t assume your supply chain will return to normal. Assess your practice’s current inventory and future needs for personal protective equipment and order enough to have on hand when reopening.
  • Don’t allow non-patient visitors. Clearly post on your website and practice door your revised visitor policy. Reroute vendors, salespeople, educators, and service providers (other than caregivers) to phone or videoconference communication.
  • Don’t presume that your obligations as an employer are the same. In addition to new safety precautions and procedures for you and your staff, the pandemic has changed the rights of employees and the obligations of employers in several respects. From paid sick leave and family medical leave to ADA issues and more, practices should consult with experienced counsel to ensure that they avoid any exposure related to their employment practices.

Louis Fine: Chicago Professional License Defense Attorney

This is an unprecedented and challenging time for everyone, including and perhaps especially, for medical professionals. During this crisis, I remain committed to being a resource, counselor, and advocate for all Illinois licensees as they navigate the rapidly changing legal, regulatory, and practical landscape.

If you have questions or concerns about your professional license or COVID-19, please contact me immediately. Call (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Pritzker Indicates That IDFPR Will Take Action Against Professional Licensees Who Jump The Gun On Reopening

After over two months on personal and professional lockdown, we all want things to return to some semblance of “normal” at the earliest opportunity, while also remaining cognizant of the continuing public health risks posed by COVID-19. Business owners and service providers, including those who hold professional licenses, are desperate to get back to work and bring in income after sitting idle for what seems like forever.

But we are currently only in phase two of Gov. JB Pritzker’s administration five-phase “Restore Illinois” plan. This means that, depending on the course of the virus in the coming weeks, most businesses will continue to remain shuttered or extremely limited in operations for weeks to come, at minimum.

That’s not good enough for many professionals and business owners, especially in less hard-hit areas Downstate. From bars to salons to retail stores, many folks are defying public health orders and are opening their doors despite the prohibitions against doing so. But if you hold a professional license and start serving customers, clients, or patients in violation of the state’s current rules, you could be putting your professional license at risk.

In recent days, Pritzker has made it clear that he will turn up the heat on those businesses that open prematurely. This includes professional licensees.  At his May 14th daily COVID-19 briefing, Pritzker sternly issued the following warning:

“For the small minority of businesses that choose to ignore the medical doctors and the data and to ignore your legal obligations for the residents of your communities, there will be consequences. Businesses that ignore the executive orders, that ignore the law, will be held accountable by our department of Professional Regulation. There are enforcement mechanisms here that we will be using against them.”

“Practicing Beyond the Scope Permitted By Law”

The Illinois Department of Financial and Professional Regulation (IDFPR) has not as of yet issued any statements relating to the governor’s comments or provided any detail as to what actions they plan on taking, if any, against licensees who provide services to the public in violation of applicable laws and orders. However, it seems clear that they have the power to sanction licensees for such transgressions, including suspending their licenses.

All Illinois professional licensing acts enumerate scores of reasons a licensee can face disciplinary action, as do the administrative rules that apply to each act. Violating applicable laws or orders, or putting the health and safety of the public at risk, generally can constitute bases for sanctions against a licensee.

For example, the administrative rules that govern barbers, hairstylists, nail salons, and other cosmetologists provide that IDFPR “may suspend or revoke a license, refuse to issue or renew a license, or take other disciplinary action based upon its findings of dishonorable, unethical or unprofessional conduct… which is interpreted to include, but is not limited to, the following acts or practices:

  • Engaging in conduct likely to deceive, defraud or harm the public, or demonstrating a willful disregard for the health, welfare or safety of a client or student.  Actual injury need not be established;
  • Practicing or offering to practice beyond the scope permitted by law, or accepting and performing professional responsibilities that the licensee knows or has reason to know that he/she is not competent to perform;

Again, it remains unclear how aggressively IDFPR will pursue licensees who violate COVID-19 restrictions before they are lifted. Hopefully, it will be a moot point soon enough. But until then, licensees should be aware that they may be putting their business or career at long-term risk for short-term gain.

Louis Fine: Chicago Professional License Defense Attorney

This is an unprecedented and challenging time for everyone, including licensed professionals. During this crisis, I remain committed to being a resource, counselor, and advocate for all Illinois licensees as they navigate the rapidly changing legal, regulatory, and practical landscape.

If you have questions or concerns about your professional license or COVID-19, please contact me immediately. Call (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Flying Blind: When Your Professional License Comes Under Attack, Will You Even Know Why?

Under the Fifth Amendment to the U.S. Constitution, no person shall be “deprived of life, liberty, or property, without due process of law.” While the Fifth Amendment only applies to the federal government, the Fourteenth Amendment provides identical protections from unfair deprivation of those things by a state.

The Illinois Department of Financial and Professional Regulation (IDFPR) is a body of the state of Illinois. And your professional license is your property, likely one of your most valuable possessions insofar as your livelihood depends on it. This means that when the IDFPR initiates formal proceedings that could result in the denial, suspension, or revocation of your license, you are entitled to due process of law before they take such actions.

But due process in the context of administrative hearings like those before the IDFPR may not mean what you think it means. In fact, there is a good chance that you won’t receive the same due process protections that are your rights in a criminal prosecution or even in a civil lawsuit. This includes being fully informed of the allegations against you.

Due process involves many substantive and procedural aspects depending on the nature of the proceedings. One such element of due process is the right to know exactly why you are in the crosshairs of prosecutors, a plaintiff, or an administrative body. After all, you can’t properly mount a defense if you don’t know what you are defending yourself against.

In criminal cases, the Sixth Amendment gives defendants the right “to be informed of the nature and cause of the allegation” they face. The Federal Rules of Civil Procedure, as well as Illinois’ rules of civil procedure, contain similar requirements that a plaintiff’s complaint must provide sufficient detail to apprise the defendant of the claim for which they are being sued.  

When a complaint fails to contain enough information to either support a claim or afford the defendant an ability to respond, the defendant can move to dismiss the complaint on that basis.

Licensees facing formal IDFPR disciplinary action also have the right to be adequately advised of the allegations against them and can move to dismiss a complaint if the Department falls short in this regard.

The problem is that the standards that apply in administrative proceedings are much more forgiving to those making the accusations, allowing them to pursue catastrophic sanctions against licensees with minimal detail as to why they are doing so.

Under the Illinois Administrative Procedure Act (APA), agencies like the IDFPR only need to provide the following in their formal complaints regarding the claims against a licensee:

  • A statement of the legal authority and jurisdiction under which  the proceeding is to be held;
  • A reference to the particular sections of the substantive and procedural statutes and rules involved;
  • Except where a more detailed statement is required by law, a short and plain statement of the matters asserted;

Courts have held that the charges filed before an administrative agency like IDFPR “need not be drawn with the precision required of pleadings in judicial actions. They only must be drawn sufficiently so that the alleged wrongdoer is reasonably apprised of the case against him to intelligently prepare his defense.” Siddiqui v. Department of Professional Regulation.

“In determining whether the respondent has adequate notice, a court may consider the discovery and other materials available to the respondent.” Secrest v. Department of Corrections. But this just leads to another due process problem inherent in IDFPR proceedings.

Limited Discovery Rights

The process of investigating, obtaining evidence, and eliciting testimony relevant to a case – whether it be a civil, criminal, or administrative proceeding like IDFPR disciplinary hearings – is known as “discovery.” It’s how the parties find out the facts, whether they help or hurt their respective cases. It is a fundamental aspect of fairness, and if a party is not permitted to fully develop the evidence necessary to support their case or challenge the evidence obtained by the other side, it is an inherently unfair process.

In formal IDFPR disciplinary proceedings, the licensee’s ability to pursue the discovery necessary to defend themselves is extremely limited. In fact, the extent of allowable discovery is determined by the very people who are prosecuting the case. Once the Department provides names of witnesses, including the name of any individual whose complaint may be at the heart of the proceedings, a respondent cannot take their depositions unless the Department’s attorney agrees. If the Department nixes a deposition request, that means the respondent will not be able to confront that witness, learn what his testimony will be, or attack the veracity of his testimony until the actual hearing. That is manifestly unjust and leaves a respondent and their attorney fighting with one arm tied behind their back.

Similarly, if there are witnesses that the licensee wishes to subpoena for testimony, those subpoenas have to be authorized and approved by the Department. Again, the very people seeking to deprive someone of their professional license can also deprive them of their ability to defend themselves.

With the deck so stacked against licensees, it is crucial that you retain an experienced IDFPR defense attorney to protect your rights, your license, and your livelihood if you find yourself in the Department’s sights.

Louis Fine: Chicago Professional License Defense Attorney

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will get you back to your clients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Pritzker Executive Order Gives Hospitals and Healthcare Workers Immunity From Civil Liability During COVID-19 Crisis

With Illinois hospitals and healthcare workers overwhelmed on the front lines of the COVID-19 pandemic, and with freshly minted doctors and retired healthcare professionals being called into the fight, Gov. JB Pritzker signed an Executive Order providing them with immunity from civil liability for “rendering assistance” during the crisis.

Executive Order 2020-19, issued on April 1, 2020, directs “all Health Care Facilities, Health Care Professionals, and Health Care Volunteers, as defined in Section 1 of the order, to render assistance in support of the State’s response to” the COVID-19 disaster proclamation. It provides that all such facilities, professionals, and volunteers:

“shall be immune from civil liability for any injury or death alleged to have been caused by any act or omission… which injury or death occurred at a time when [the hospital, professional, or volunteer] was engaged in the course of rendering assistance to the State by providing health care services in response to the COVID-19 outbreak, unless it is established that such injury or death was caused by gross negligence or willful misconduct”

As defined in the order, “health care facilities” include “any government-operated site providing health care services established for the purpose of responding to the COVID-19 outbreak,” such as the field hospital recently established at McCormick Place. The order also covers hospitals, skilled and intermediate care nursing facilities, skilled and intermediate facilities under the ID/DD Community Care Act, skilled mental health rehabilitation facilities, kidney disease treatment centers, emergency medical service providers, outpatient surgery centers, and institutions that provide major medical diagnostic equipment, among others.

Health care professionals for purposes of the order include “all licensed or certified health care or emergency medical services workers” providing services at a health care facility in response to the COVID-19 outbreak or “are working under the direction of the Illinois Emergency Management Agency or the Department of Public Health in response to the Gubernatorial Disaster Proclamations.”

Health care volunteers are defined as volunteers or unlicensed medical or nursing students who are working under IEMA or DPH in response to the governor’s disaster proclamation.

The order cites several statutory bases for the grant of immunity, including the Illinois Emergency Management Agency Act, the Good Samaritan Act, and the Emergency Medical Services Systems Act.

The immunity provided through the governor’s order is just one of several steps that Illinois has taken to make it easier for desperately needed physicians and health care workers to participate in the COVID-19 battle, including expedited healthcare license reinstatement and streamlined out-of-state licensing.

Louis Fine: Chicago Professional License Defense Attorney

This is an unprecedented and challenging time for everyone, including licensed professionals. During this crisis, I remain committed to being a resource, counselor, and advocate for all Illinois licensees as they navigate the rapidly changing legal, regulatory, and practical landscape.

If you have questions or concerns about your professional license or how these variances and other COVID-19 changes affect you, please contact me immediately. Call (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

URGENT COVID-19 Professional Licensing Update

Pritzker Paves Way for Expedited Healthcare License Reinstatement

IDFPR Issues Emergency Variances and Extensions

With the vast majority of Illinois residents working from home – or not working at all – because of the COVID-19 pandemic, the Illinois Department of Financial and Professional Regulation (IDFPR) has announced several variances and extensions that impact all 1.3 million Illinoisans with professional licenses. It is likely that these first five variances, issued on March 18th, 2020, will not be the last.

Healthcare Workers: Expedited Reinstatement and Streamlined Out-of-State Licensing

In fact, at his Saturday, March 21st daily coronavirus press conference, Gov. JB Pritzker issued a plea to retired healthcare workers to join the fight against the virus, indicating that the state would expedite licensing and waive fees for any healthcare professionals seeking reinstatement. “Applications will be processed on an expedited basis, and we’ll be coordinating with hospitals and health care sites throughout the state to deploy these re-enlisted medical professionals to the frontlines,” Pritzker said.

Today, March 23rd, IDFPR announced several actions to implement this directive. Specifically:

  • Physicians whose licenses are expired or inactive for less than three years can temporarily restore their license, for no fee or continuing education requirement, to work under the direction of Illinois Emergency Management Agency (“IEMA”) and the Illinois Department of Public Health (“IDPH”) or in a long-term care facility, hospital, or federally qualified health center (“FQHC”). Application for physician reinstatement can be found here.
  • Physician Assistants whose licenses are inactive or in non-renewed status for less than three years can also temporarily restore their license, for no fee or continuing education requirement, to work under the direction of IEMA and IDPH or in a long-term care facility, hospital, or FQHC. Applications for reinstatement can be found here.
  • Licensed practical nurses, registered professional nurses, advanced practice registered nurses, and respiratory care therapists whose licenses are inactive or in nonrenewed status for less than five years can also temporarily restore their license, for no fee or continuing education requirement, to work under the direction of IEMA and IDPH or in a long-term care facility, hospital, or FQHC. Applications for reinstatement can be found here.
  • Out-of-State physicians, nurses, physician assistants, pharmacists, and respiratory care therapists may practice in Illinois if they are licensed in another state and are in good standing. These licensees must be operating under the authority of IEMA/IDPH or at a long-term care facility, hospital or FQHC, and must meet the standards of care mandated by the respective health care acts. They must provide contact information and dates of arrival and departure on forms provided by IDFPR. This temporary practice approval expires on September 30, 2020. Applications for an Out-of-State Temporary Practice Permit can be found here.

In addition to these healthcare-focused changes, other COVID-19 variances issued by IDFPR include:

Upcoming License Renewal Extensions

Any professional licenses issued by the Department that have renewal dates between March 1st, 2020 through and including July 31st, 2020 are granted an automatic extension to renew to September 30th, 2020.

Continuing Education Obligations

All current licensees whose license renewal deadlines fall between March 1st, 2020 and July 31st, 2020 shall have up to, and including, September 30th, 2020 to complete their continuing education coursework.

The Department is also allowing licensees to complete their continuing education coursework remotely without requiring live attendance. The variance allows for interactive webinars and online distance education courses in addition to currently permitted methods.

Louis Fine: Chicago Professional License Defense Attorney

This is an unprecedented and challenging time for everyone, including licensed professionals. During this crisis, I remain committed to being a resource, counselor, and advocate for all Illinois licensees as they navigate the rapidly changing legal, regulatory, and practical landscape.

If you have questions or concerns about your professional license or how these variances and other COVID-19 changes affect you, please contact me immediately. Call (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Cognitive Decline Among Older Physicians Leading to Increased Screening

For every accomplished physician who dreams of retiring early, there is one who can’t imagine giving up the work that brings them so much personal and professional satisfaction and financial security. Every year, 20,000 American doctors turn 65, but only half of them retire by then. Thousands of physicians continue to practice well past their 70th, even 80th, birthdays. It is estimated that one in every eight practicing doctors in the U.S. is over 65, overseeing 50-70 million office visits and 11 million to 20 million hospitalizations each year.

One In Eight Doctors Over 70 Found to Have Significant Cognitive Deficits

With so many patients receiving care from physicians 65 and up, many hospitals and healthcare systems are also increasing their scrutiny of the cognitive abilities and faculties of these senior clinicians. Major institutions such as Scripps Health Care, Intermountain Healthcare, Stanford Hospitals and Clinics, and Penn Medicine have implemented mandatory cognitive screens for older practitioners.

At Yale New Haven Hospital, for example, all applicants 70 or older who seek reappointment to the medical staff are required to have an objective evaluation of cognitive function as part of the two-year reappointment process. What a recent round of that testing revealed was that one in eight doctors who participated in the screening had cognitive deficits that were likely to impair their ability to practice medicine independently.

Testing or No Testing, Cognitive Issues Raise Professional Licensing Concerns

The wisdom and efficacy of such testing programs is subject to debate, with many arguing that age-based screening is empirically unjustified or inherently discriminatory. Whether subject to required testing or not, however, all older physicians who continue to treat patients later in life will at some point face difficult questions about their abilities and the prudence of continuing to practice.

Confronting issues of cognitive decline, if not impairment, is no easy task, personally and professionally. But recognizing any such concerns is also an ethical imperative. Continuing to practice while suffering from cognitive impairment significant enough to raise concerns about patient safety can subject a physician of any age to disciplinary action and the loss of their license.

The Illinois Medical Practice Act (the “Act”), for example, makes it a basis for suspension or revocation of a license for a physician to practice if they have a:
• Mental illness or disability which results in the inability to practice under this Act with reasonable judgment, skill or safety.
• Physical illness, including, but not limited to, deterioration through the aging process… which results in a physician’s inability to practice under this Act with reasonable judgment, skill, and safety.

The Act also imposes reporting requirements on certain health care executives regarding “impaired” physicians, defined as those who lack the ability “to practice medicine with reasonable skill and safety due to physical or mental disabilities as evidenced by a written determination or written consent based on clinical evidence including deterioration through the aging process or loss of motor skill… of sufficient degree to diminish a person’s ability to deliver competent patient care.”

Doctors, for all their talents, are as vulnerable as anyone else to the inevitable effects of time and aging. While debate may continue as to the best way to identify and remediate instances of age-related cognitive or physical impairment, doctors who practice well into their golden years need to combine their clinical judgment with self-awareness when evaluating the wisdom of continuing to treat patients. Failing to do so puts both patients and professional licenses at risk.

Louis R. Fine: Chicago Physician License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois physician’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

New CPA Licensure Model Looks to “Future-Proof” the Profession

The Internal Revenue Code contains three times as many pages as it did in 1980. There are four times more accounting standards and five times more auditing standards than there were the year Ronald Reagan was elected president, according to the American Institute of Certified Public Accountants (AICPA). During that same 40-year span, technology has fundamentally changed not only the accounting profession but every business and industry that it serves. Nevertheless, CPA licensure standards and requirements have barely changed since the time when fax machines were the epitome of cutting-edge technology.

That appears poised to change. Working with the National Association of State Boards of Accountancy (NASBA), the AICPA has proposed a dramatic reconceiving of what new members of the profession need to know, understand, and demonstrate competence in.

Part of the groups’ CPA Evolution initiative, the proposed standards come after they received over 2,000 comments throughout the latter half of 2019 in response to their release of five guiding principles to inform the creation of a new licensure model last summer. Those comments overwhelmingly supported a rethinking of CPA licensure, including the need for a regime that put a larger emphasis on technology skills and knowledge and required new CPAs to demonstrate strong core competencies in the basics of the profession.

Core + Disciplines

The proposed standards are based on a “core + disciplines” licensure model. The core consists of deep and strong training and testing in accounting, auditing, tax, and technology that all candidates would be required to complete. Each CPA candidate would then select a specific discipline in which they demonstrate even deeper skills and knowledge. Those disciplines include:

  • Tax compliance and planning
  • Business reporting and analysis
  • Information systems and controls

Regardless of which discipline a candidate chooses, the new model will result in full CPA licensure, with the same rights and privileges as any other CPA.

The NASBA and the AICPA believe that the new licensure standards will “future-proof” CPAs as the profession and the technology that it utilizes continue to evolve. The groups expect to finalize the new model this summer, followed by a sustained multi-year effort to implement the new licensure standard across the country. If the proposed core + disciplines model is ultimately adopted, it likely will result in changes to the Uniform Accountancy Act and Model Rules, implementation of new professional education requirements, and the creation of a new Uniform CPA Examination.

We will keep abreast of the progress of this initiative and provide updates as events warrant.

Louis Fine: Chicago CPA License Defense Attorney

As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on accountants and other professionals who suddenly find their future in disarray. I understand how and why the Department decides to pursue investigations, how it handles negotiations, and how to approach formal proceedings in a way that gives my clients the best possible chance of a positive and expeditious outcome.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. Together, we will get you back to your clients and your career.