Telemedicine and Physician Licensing: How the 19th Century is Holding Back the 21st

teleAdvancements in technology almost always outpace efforts by legislators and regulators to address the new realities, issues, and concerns that arise from such innovations. Laws that made sense even a short ten years ago can quickly become anachronistic, if not counterproductive.

Such is the dilemma facing physicians and healthcare providers who see telemedicine as a key way to address a growing physician shortage, especially in rural and other underserved areas. That shortage is expected to grow to 120,000 doctors by 2030, according to a 2018 report by the Association of American Medical Colleges.

51 Different Licenses

The problem is that while the internet knows no borders, medical licenses do. Increasingly, 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.

Physicians must be licensed in each state where their current and future patients are located, so a doctor wanting to counsel patients through telemedicine would need to obtain and stay compliant with licensing requirements in up to 51 jurisdictions governed by 51 different medical boards imposing 51 different standards, conditions, and rules.

The current state-based medical licensing regime traces its roots back to the 19th Century, and the system is clearly showing its age. While effective and robust licensing is still essential in ensuring quality of care, the lack of license reciprocity and portability between states is now more of a hindrance to providing such care than a help.

That is why already active efforts to change medical licensing to facilitate telemedicine continue to gain steam. The most successful of these efforts to date has been the Federation of State Medical Licensing Board’s (FSMB) work establishing the Interstate Medical Licensure Compact. Physicians in good standing can freely practice in any of the states participating in the compact so long as they possess a “full and unrestricted” license in their state of principal license (SPL). To date, only 24 states, including Illinois, have joined the compact.

A Uniform, Nationwide System

This still leaves too many doctors and too many patients locked out of telemedicine. As noted by the authors of a recent 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.”

That is why the FSMB and other telemedicine advocates have advanced several proposals to enhance license portability and reduce regulatory barriers to telemedicine. They all are based around a mutual recognition scheme whereby states honor each other’s medical licenses based on models that have been successfully used in Europe and Australia and by the Veterans Health Administration, US military, and US Public Health Service.

Adoption of a nationwide licensing scheme would be facilitated by establishing consistent standards for using and regulating telemedicine services, the sharing of malpractice, medical error, and license cancellation or suspension information between states, and other federal and state-level reforms.

Any efforts that would streamline the physician licensing process while at the same time increasing access to healthcare for those who need it most should be encouraged.

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.

Illinois Adult Use Cannabis Dispensary Applications Are Ready. Are You?

pot appIf you want to obtain a license to own and operate an Illinois adult use cannabis dispensary, your time has come. On October 1st, the Illinois Department of Financial and Professional Regulation (IDFPR), which is charged with implementing and administrating multiple aspects of the state’s adult use marijuana program under the Cannabis Regulation and Tax Act (the “Act”), made available the application form for new Conditional Adult Use Dispensing Organization Licenses.

These licenses, applications for which must be hand-delivered to the Department’s Chicago offices no later noon on January 2, 2020, are “conditional” in that they do not allow the licensee to purchase or sell marijuana until they have found a suitable location (which they must do within 180 days), passed an inspection by IDFPR, and paid the registration fee. All available conditional licenses will be issued no later than May 1, 2020.

Once these requirements are met, the Department will award the licensee an Adult Use Dispensing Organization License, which authorizes the holder to legally obtain and sell cannabis pursuant to the Act.

In a previous post, I discussed application fees, the number of licenses that the Department will issue, the criteria that the Department will use in choosing licensees, and general ownership requirements. Now that applications are available for preparation and completion, let’s discuss what is involved in the application itself.

In short, a lot.

Hundreds of Pages of Supporting Documentation Required

The application form itself is all of one page long, but the supporting documentation that must be gathered, prepared, and submitted is voluminous and comprehensive. This isn’t just a matter of making copies of existing records; applicants must develop detailed plans covering several aspects of dispensary operation. IDFPR will not consider any application that lacks the required exhibits.

In addition to the fee and Principal Officer application form, applicants must submit a:

  • Table of Organization, Ownership and Control and Business Operating Agreements
  • Dispensing Organization Agent Training and Education Plan
  • Purchaser Education Plan
  • Business Plan
  • Recalls, Quarantine, and Destruction Plan
  • Security Plan
  • Inventory Monitoring and Recordkeeping Plan
  • Proposed Floor Plan
  • Operating Plan
  • Plan for Community Engagement
  • Diversity Plan
  • Anonymized Document or Resume for Each Proposed Principal Officer (demonstrating education, knowledge, or experience in the cannabis industry)
  • Financial Information
  • Evidence of Status as a Social Equity Applicant, if applying as a Social Equity Applicant
  • Labor and Employment Practices Plan (optional)
  • Environmental Plan (optional)
  • Evidence of Status as an Illinois Owner (optional)
  • Evidence of Status as a Veteran (optional)

For each of the foregoing exhibits, IDFPR has established detailed and specific requirements as to what applicants need to include. Given how much is involved in preparing a dispensary application, January 2, 2020 doesn’t seem that far away. Aspiring Illinois cannabis entrepreneurs need to fire up their efforts immediately, if they haven’t already done so.

Need Help With Your Illinois Adult Use Cannabis Dispensary Application? Call Me Today.

If you are considering entering the legal cannabis industry in Illinois and have questions about the IDFPR application process and criteria, 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.

Minor Licensing Violations Could Cost Physicians Medicare Billing Privileges Under Proposed Rule

For phmedicareysicians and other eligible health care professionals, Medicare enrollment and billing privileges are invaluable and lucrative assets that can form a substantial portion of their revenues, allow them to treat more patients, and expand their career opportunities. Losing those privileges can be a catastrophic blow to a practice.

But a new rule proposed by the Centers for Medicare & Medicare Services (CMS) would dramatically expand CMS’ authority to deny or revoke Medicare privileges, allowing it to substitute its judgment for that of state licensing boards and impose such catastrophic sanctions even for infractions a state board deems relatively minor.

On August 14, 2019, CMS issued what it called a “major proposed rule” addressing a wide range of changes to the Medicaid physician fee schedule and other aspects of participation in the program. If it becomes final, all 808 pages of the proposed rule would represent the most substantial modification to program enrollment and eligibility since the establishment of the regulations in 2006.

CMS Can Impose Harsher Sanctions Than State Boards

In the proposed rule, CMS notes that, at the moment, it cannot make Medicare eligibility and renewal decisions based solely on state board disciplinary actions:

“We currently lack the legal basis to take administrative action against a physician or other eligible professional for a matter related to patient harm based solely on… an administrative action (excluding a state medical license suspension or revocation) imposed by a state oversight board,” such as the Illinois Department of Financial and Professional Regulation (IDFPR).

The new rule would grant CMS such authority and “would permit us to revoke or deny, as applicable, a physician’s or other eligible professional’s… enrollment if he or she has been subject to prior action from a state oversight board… with underlying facts reflecting improper physician or other eligible professional conduct that led to patient harm.”

84 Fed. Reg. at 40723.

As a practical matter, the rule gives CMS the power to review a state board’s conclusions and sanctions and then make its own determination as to whether the physician’s or other professional’s conduct warrants exclusion from Medicare.

This can lead to a situation in which IDFPR deems an infraction to be relatively minor and perhaps deserving of a “slap on the wrist” while CMS could decide to impose a “death sentence” in terms of Medicare eligibility, a conflict CMS readily acknowledges:

“We recognize that situations could arise where a state oversight board has chosen to impose a relatively minor sanction on a physician or other eligible professional for conduct that we deem more serious. We note, however, that we, rather than state boards, is ultimately responsible for the administration of the Medicare program and the protection of its beneficiaries. State oversight of licensed physicians or practitioners is, in short, a function entirely different from federal oversight of Medicare. We accordingly believe that we should have the discretion to review such cases to determine whether, in the agency’s view, the physician’s or other eligible professional’s conduct warrants revocation or denial.”

Id.

Making matters worse for sanctioned physicians, a decision by CMS to revoke Medicare privileges results in an automatic cross-termination of participation in Medicaid and other federal payer programs.

The public comment period for the proposed rule closes on September 27, 2019. If the rule is enacted, it becomes that much more critical for physicians facing IDFPR investigations or disciplinary proceedings – even for a “minor” infraction – to retain experienced professional license defense counsel.

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.

HIPAA and IDFPR: Violations of Patient Privacy Can Threaten Your Professional License

hipaaThe Jussie Smollett saga earlier this year made headlines here in Chicago and throughout the country. It was a juicy tale of a supposed hate crime against an actor, that turned out to be a hoax, that led to criminal charges against Smollett, that were later dropped by State’s Attorney Kimberly Foxx, who then found herself under scrutiny for that decision. But Smollett and Foxx weren’t the only ones in this tale whose conduct raised eyebrows or put them in legal or ethical jeopardy.

Fifty employees, including several nurses, at Northwestern Memorial Hospital lost their jobs and faced disciplinary action because they violated the patient privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA). This included one nurse who did nothing more than search for Smollett’s name in the hospital’s system.

Breaching HIPAA Obligations Is Easy. Dealing With the Fallout Is Not.

If you are a physician or registered nurse, or if you work in healthcare in any capacity, you are no doubt generally aware of HIPAA and the duties it creates to ensure the confidentiality of protected health information (PHI). That fired nurse no doubt knew about HIPAA’s privacy and security rules as well. But her case demonstrates how quickly and inadvertently you can breach your professional obligations as to patient privacy and put your career – and professional license – in peril.

After HIPAA became law in 1996, the U.S. Department of Health and Human Services (HHS) issued a set of national standards governing the use, maintenance, and disclosure of patients’ protected health information. Commonly known as the Privacy Rule, the Standards for Privacy of Individually Identifiable Health Information limit how and to whom PHI can be disclosed.

Additionally, medical professionals and organizations must comply with detailed rules involving the physical and electronic security of PHI (the Security Rule, or Security Standards for the Protection of Electronic Protected Health Information) as well as the Breach Notification Rule which addresses what doctors and healthcare providers need to do in the event of a data breach.

As complex as HIPAA rules can be, violating them couldn’t be easier. It doesn’t require malicious intent (though that makes matters worse) or the knowledge that an act or omission violates HIPAA. In fact, most HIPAA infractions are inadvertent and more a factor of “loose lips sink ships” than anything else. But that doesn’t insulate a doctor or nurse from civil penalties or professional license consequences.

Common HIPAA Privacy Rule Violations

The following are common examples of how medical professionals can and do unknowingly violate HIPAA’s Privacy Rule:

  • Leaving patient files and information in plain view, such as at a nurse’s station or reception desk, so that anyone in proximity may be able to see that information.
  • Social media posts, pictures, or videos that may directly or indirectly reveal information about a patient or their condition, even in “closed” groups. A 2015 ProPublica review uncovered 22 cases of HIPAA-violating photo and video sharing in just the previous three years, with 35 instances of inappropriate image and video sharing found in total. There have been plenty more widely-publicized incidents since then.
  • Sending PHI over messaging apps without patient authorization.
  • Accessing the PHI of patients you are not required to treat
  • Gossiping about specific patients and disclosing their health information to family, friends & colleagues
  • Improper disposal of PHI, such as discarding it in regular trash.

Possible Consequences of a HIPAA Privacy Violation

The Office for Civil Rights (OCR) at DHS is responsible for enforcing HIPAA’s privacy requirements and can impose civil fines and criminal penalties, including possible jail time, for violations. The penalties and/or fines administered by OCR are based on the severity of each HIPAA violation and the knowledge and intent involved. Only willful violations will raise the specter of criminal prosecution, but civil penalties can rise to the level of tens of thousands of dollars.

Additionally, under Illinois’ Medical Patient Rights Act, any physician or healthcare provider who discloses a patient’s PHI without their express consent or as otherwise provided by law is guilty of a petty offense and will be fined $1,000.

If a physician or nurse violates HIPAA in a willful or egregious way, or is negligent in their handling of patient information, the Illinois Department of Financial and Professional Regulation (IDFPR) may take an interest and see such conduct as the basis for disciplinary action.

For example, the Illinois Medical Practice Act provides that the Department may revoke, suspend, place on probation, reprimand, refuse to issue or renew, or take any other disciplinary or non-disciplinary action against a physician for “willfully or negligently violating the confidentiality between physician and patient except as required by law.”

To avoid all of these potential consequences, physicians and nurses must remain vigilant and ever mindful of their patients’ privacy and their obligations under HIPAA.

Louis Fine: Chicago Professional License Defense Attorney

If you have questions or concerns about your duties under HIPAA or find yourself facing an IDFPR investigation or complaint about patient privacy, please contact me immediately. 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 can 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.

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Illinois Recreational Marijuana Licensing: A High-Level Overview

dopeIllinois is expected to be one of the largest retail marijuana markets in the country, and plenty of budding pot entrepreneurs will want to get in on the action and meet consumer demand by opening adult use dispensaries. And if you’re going to legally sell weed to the masses, you’ll have to pass muster with the Illinois Department of Financial and Professional Regulation (IDFPR).

Under the Cannabis Regulation and Tax Act (the “Act”) signed into law earlier this year, IDFPR is charged with implementing and administrating multiple aspects of the state’s adult use marijuana program, including the licensing and oversight of dispensing organizations. Needless to say, IDFPR won’t be passing around dispensary licenses without ensuring that applicants meet the Act’s multitude of requirements and limitations on dispensary ownership and operations.

On a very high level, here is what you need to know before firing up your efforts to apply for a license to open a recreational marijuana dispensary in the Land of Lincoln:

When to Apply

Applications for Conditional Adult Use Dispensing Organization Licenses will be available no later than October 1, 2019, and will be due no later than January 1, 2020. These licenses are “conditional” in that they do not allow the licensee to purchase or sell marijuana until they have found a suitable location (which they must do within 180 days), passed an inspection by IDFPR, and paid the registration fee.

Once these requirements are met, the Department will award the licensee an Adult Use Dispensing Organization License, which authorizes the holder to legally obtain and sell cannabis pursuant to the Act.

Costs of Application and License

The costs involved in applying for and maintaining an adult use license depends on whether or not the applicant is a “Social Equity Applicant.” In an effort to promote and ensure socio-economic diversity and opportunity in the Illinois cannabis industry, the Act provides for reduced fees and other accommodations for applicants from economically disadvantaged areas in the state.

The application fee is $5,000 for Non-Social Equity applicants and $2,500 for Social Equity Applicants. The fee for maintaining a two-year license is $60,000 for Non-Social Equity licensees and $30,000 for Social Equity licensees.

Number of Available Licenses

IDFPR may grant up to 75 adult-use dispensary licenses by May 1, 2020, and up to 110 licenses by December 21, 2021. But the law imposes limitations on the number of licenses IDFPR may issue for each of the 17 Bureau of Labor Statistics (BLS) Regions in Illinois based on that region’s percentage of the state population. The number of available licenses per BLS region is:

  • Bloomington: 1
  • Cape Girardeau: 1
  • Carbondale-Marion 1
  • Champaign-Urbana: 1
  • Chicago-Naperville-Elgin: 47
  • Danville: 1
  • Davenport-Moline-Rock Island: 1
  • Decatur: 1
  • Kankakee: 1
  • Peoria: 3
  • Rockford: 2
  • Louis: 4
  • Springfield: 1
  • Northwest Illinois Nonmetropolitan Area: 3
  • West Central Illinois Nonmetropolitan Area: 3
  • East Central Illinois Nonmetropolitan Area: 2
  • South Illinois Nonmetropolitan Area: 2

Criteria for Choosing Winning Applicants

There will be a heck of a lot more than 75 applicants for these 75 licenses, so IDFPR will use a point system based on numerous factors to determine who will receive licenses. Those who score highest on the following 250-point scale will be the most likely to be opening dispensary doors next year:

  • Suitability of Employee Training Plan (15 points)
  • Security and Record-Keeping (65 points)
  • Business Plan, Financials, Operating Plan, and Floor Plan (65 points)
  • Knowledge and Experience in Cannabis or Related Fields (30 points)
  • Status as a Social Equity Applicant (50 points)
  • Labor and Employment Practices (5 points)
  • Environmental Plan (5 points)
  • Illinois Owner (5 points)
  • Status as a Veteran (5 points)
  • Diversity Plan (5 points)

Ownership Requirements

Not every aspiring dispensary owner will be eligible to receive a license. In addition to being 21 or older, “principal officers” of the business (pretty much anyone with any ownership stake or management authority) must not have been “convicted of an offense that would impair the person’s ability to engage in the practice of owning a dispensary.” IDFPR will use several criteria when evaluating the impact of a principal officer’s previous conviction on their application.

These are just some of the issues involved in applying for and obtaining an adult use cannabis dispensary license in Illinois. While IDFPR may be the body granting licenses, applicants will also have to deal with local governments which will have a big say in whether and where a dispensary can set up shop.

If you are considering entering the legal cannabis industry in Illinois and have questions about the IDFPR application process and criteria, 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.

Universal Professional License Reciprocity: New Arizona Law May Be the Start of Something Big

recip 2Qualifying for, obtaining, and maintaining a professional license can be a time-consuming, often frustrating, and burdensome endeavor – even if everything goes as smoothly as possible. Going through the process once is tough enough; the thought of going through it again simply because you want to move and practice your profession in a new state can be enough to make you stay put and lose out on lucrative opportunities.

That is the dilemma faced by contractors, dentists, cosmetologists, and scores of other professionals who must meet a whole new set of licensing requirements -such as education and testing – when they want to work in another state. While some states do have “reciprocity” for a very narrow group of professions and will grant a license based on an out-of-state license, not one state had universal license recognition – until now.

Arizona Passes Nation’s First Universal License Recognition Law

Recently, Arizona became the first state in the nation to pass a law allowing almost all professionals who have valid occupational licenses in other states to obtain a license to work in Arizona without having to meet the state’s education and testing requirements.

Under the new law, Arizona’s licensing boards will recognize out-of-state occupational licenses for people who have been licensed in their profession for at least one year, are in good standing in all states where they are licensed, pay applicable Arizona fees, and meet all residency and background check requirements. Licensed professionals will not be required to duplicate training and other requirements that often needlessly delay or prevent them from starting to work in their new home.

Limited Reciprocity in Illinois

While Arizona is the first state to bring reciprocity and license recognition to broad swaths of professions and occupations, Illinois and several other states do offer reciprocity for specific licenses. The most prominent of these is for real estate brokers. Individuals who hold an active broker’s license in any of the following states can obtain an Illinois license without having to meet the education and testing obligations that other applicants do:

  • Colorado
  • Connecticut
  • Florida
  • Georgia
  • Indiana
  • Iowa
  • Nebraska
  • Wisconsin

Individuals in a handful of other professions who hold a valid license in another state, including architects and registered nurses, can obtain an Illinois license under a process called “licensure by endorsement” if the licensure process in that other state was substantially equivalent to the process in Illinois at the time of licensure.

Will Other States Follow Suit?

Arizona’s bold move is a boon for any professional wanting to pick up and move to the Grand Canyon State. But what about the rest of the country? To date, no other state has advanced a bill along the lines of Arizona’s. But there is increasing business and political pressure to reduce licensing burdens generally so that qualified professionals can work without being deterred by costs, bureaucracy, and other hurdles. Universal license recognition certainly fits into that philosophy. I expect that other states will take a cautious approach initially, waiting to see how Arizona’s law works in practice before jumping on the universal licensing bandwagon. Nevertheless, this law is a great start.

Louis Fine: Chicago Professional License Defense Attorney

If you have questions or concerns about your professional license, or you learn that you are the subject of an IDFPR investigation or complain, please contact me immediately. 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 can 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.

JB + IDFPR = More Aggressive Licensing Enforcement?

JBIf it wasn’t already apparent, the recent conclusion of the spring legislative session in Springfield makes it abundantly clear that we’re not in the land of Bruce Rauner anymore. Legalized recreational pot and sports betting, constitutional amendments, tax overhauls, and additional protections for abortion rights – all of these are just the most high-profile changes about to be signed into law by Gov. J. B. Pritzker.

What remains less clear is the impact that the Pritzker administration and unified Democratic control of state government will have on professional licensing and the activities and priorities of the Illinois Department of Financial and Professional Regulation (IDFPR). Pritzker has appointed a new IDFPR Secretary and Director of Real Estate, but these leadership decisions don’t provide much insight into how if at all the department will change. However, two recent initiatives and investigations may foretell a more aggressive approach to licensing enforcement and disciplinary action.

Bogus Stem Cell Therapies

Touted as a revolutionary advancement in the treatment of a range of maladies including bone and muscle injuries and pain relief, various iterations of stem cell therapy are being offered by doctors and clinics throughout Illinois. But, according to IDFPR, these treatments – which can cost thousands of dollars each – are unproven and ineffective at best, and a bogus scam at worst.

As reported by CBS Chicago, Dr. Brian Zachariah, IDFPR’s medical coordinator, is taking a decidedly more skeptical approach to stem cell therapy than the department did under the previous administration. “People are being misled, oversold, overcharged on therapies that they are desperate to get,” he is quoted as saying. Dr. Zachariah indicated that the department would ramp up its investigation of patient complaints and increase disciplinary efforts. “We can and will discipline them ranging from a reprimand through fines, suspensions all the way to revoking their license,” he said.

Contractors Preying on Vulnerable Storm Victims

This spring has seen horrific weather throughout the state with torrential rains, tornadoes, and powerful storms wreaking havoc on homes and businesses. When that happens, unscrupulous “storm chasers” often descend on communities looking to exploit those who desperately need repairs because of storm-related damage.

While general contractors, oddly, are not required to be licensed by IDFPR, roofing contractors must have a license. Same goes for insurance adjusters. IDFPR, along with As reported in AdvantageNews, Attorney General Kwame Raoul have indicated that they will aggressively go after unlicensed roofers as well as licensed ones who attempt to scam victims in the wake of extreme weather.

These efforts relating to stem cell therapy and contracting scams may not seem particularly noteworthy; after all, shielding patients and consumers from fraud, misrepresentations, or incompetence is one of the foundational justifications for professional licensing regimes. But it would not be surprising to see Gov. Pritzker’s IDFPR continue with a robust consumer protection approach that will keep a keen eye on any actions by licensed professionals that could be seen as taking advantage of the state’s most vulnerable citizens.

Louis Fine: Chicago Professional License Defense Attorney

If you have questions or concerns about your professional license, or you learn that you are the subject of an IDFPR investigation or complain, please contact me immediately. 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 can 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.

What Is Included in “Gross Income” For Calculating Spousal Maintenance in Illinois?

gross“How much do you make?” While that may not be an appropriate or welcome question in casual conversation, it is the fundamental inquiry used to calculate the amount of spousal maintenance obligations awarded in an Illinois divorce. But for many divorcing couples, especially for those with high-net-worth, significant investments, or multiple sources of wealth, determining the actual amount of “income” which will be the foundation of these calculations involves a lot more than looking at pay stubs. Whether you are seeking a maintenance award or want to keep any such payments to a minimum, it is important to understand what constitutes “income” under Illinois Marriage and Dissolution of Marriage Act (the “Act”)

New Spousal Maintenance Guidelines  

In response to the 2017 federal tax overhaul that eliminated the tax deduction for spousal maintenance payments, Illinois lawmakers in 2018 changed the guidelines for determining how monthly payments are calculated.

As of 2018, these guidelines now apply to couples with a combined “gross income” of less than $500,000. For divorces finalized in 2019 or later, the award should be 33.3% of the payor’s net (not gross) income, minus 25% of the recipient’s net (not gross) income. The amount calculated as maintenance, however, when added to the gross income of the payee, may not result in the payee receiving an amount that is more than 40% of the combined net income of the parties.

Since net income is derived from gross income, defining the spouses’ “gross income” is the key to figuring out maintenance awards, both under the guidelines and for couples over the $500,000 threshold.

“Gross Income” Defined

Section 504 of the Act, which covers spousal maintenance, defines “gross income” as “all income from all sources,” and refers to the definition of gross income used in Section 505 of the Act regarding child support. Under that section, “gross income” means “the total of all income from all sources, except for:

  • Public assistance benefits
  • Benefits and income received by the parent for other children in the household.

Outside of those exceptions, almost every dollar, every appreciation in value, every dividend paid and every capital gain is included in gross income. The Illinois Supreme Court has ruled that the definition of “income” under the Act mirrors that found in Webster’s Dictionary:

“As the word itself suggests, ‘income’ is simply ‘something that comes in as an increment or addition * * *: a gain or recurrent benefit that is usu[ually] measured in money * * *: the value of goods and services received by an individual in a given period of time.’”

In re Marriage of Rodgers, 213 Ill. 2d 129 (2004)

Over the years, Illinois courts have made decisions about the specific forms of income to be included in gross income for purposes of spousal maintenance calculations. These include:

  • Monetary gifts
  • “Loans” in name only, such as those from a family member, a corporation, or a business the payor spouse has an ownership interest in when there is little or no expectation that the loan will be repaid or any evidence to support the claim that it is a loan rather than a gift -such as documentation, requests for repayment, or reporting the money as a loan on tax returns.
  • Salaries, bonuses, and commissions
  • Pension proceeds
  • Workers’ compensation benefits
  • Interest and appreciation of an IRA
  • Liquidation of an IRA
  • Distribution of stock sold pursuant to an employment bonus-based option

Spousal Maintenance Questions? Call Chicago Divorce Attorney Louis Fine Today

An experienced divorce attorney, working in concert with accounting and tax professionals, can ensure that the amounts used to calculate maintenance obligations include every appropriate income stream and exclude those carved out by the law so that any maintenance award is fair and equitable.

If you have questions or concerns regarding gross income or spousal maintenance generally, please give me a call at (312) 236-2433 or fill out my online form to arrange for a consultation.

Spring Ahead With These Important Professional Licensing Updates and Developments

updateHappy Springtime. In the spirit of the season, we’ve put together a potpourri of recent stories, issues, and developments in the world of Illinois professional licensing. As a Chicago professional license defense law firm, we stay abreast of all matters involving the Illinois Department of Financial and Professional Regulation (IDFPR) and that impact licensed professionals throughout the state.

Here is the latest news on the Illinois professional licensing front:

Citizenship Not Required For Professional Licenses Under New Bill

A bill recently introduced in the Illinois Senate would allow otherwise qualified applicants for professional licenses to obtain a license regardless of their citizenship or immigration status.

Senate Bill 1166, which passed the full Senate on March 21 and is now pending in the Illinois House of Representatives, provides that, except as otherwise provided by law, no department shall deny an occupational or professional license based solely on the applicant’s citizenship status or immigration status.

The bill’s author, Assistant Majority Leader Iris Martinez (D-Chicago), explained said that she drafted the legislation because, “If anyone in our state wants to contribute by working hard and paying taxes, they should not be denied because of where they were born.”

Extended IDFPR Delays Risks Exodus of Physician Assistants From Illinois

There is always a bit of a wait time between the date IDFPR receives a professional license application and the date it issues one. But every day that passes during that time is a day that the applicant can’t make a living and earn a paycheck working in their chosen profession.

For physician assistants (PAs), who are in one of the fastest-growing and most in-demand professions in the country, the problem with IDFPR delays is particularly acute. PAs are having to sit on their hands for months before they can begin to do their jobs helping patients.

The current processing time for Illinois Physician Assistant applications is 8 to 10 weeks, according to IDFPR, though some applicants report having to wait well-over three months before receiving their license. By way of contrast, the average wait time in neighboring Wisconsin is all of eight days.

The Illinois Academy of Physician Assistants (IAPA) places the blame on understaffing at IDFPR and its lack of “sufficient funding to tackle the backlog of applications.”

A report earlier this year by NBC 5 Chicago indicated that the difference in wait times is making a difference in where newly-minted PAs are choosing to practice, potentially leaving a shortage of PAs in Illinois at the same time their services are increasingly being utilized by more patients.

Hairstylists Now Need Domestic Violence Training

Hairstylists often become unofficial therapists and sounding boards for their clients. Now, they will officially need training so that they can spot signs of domestic violence or sexual assault and help those clients who are experiencing such trauma.

Under an Illinois law passed in 2016, all 84,000 beauty professionals in the state have until this September to complete the in-person or online classes. Cosmetologists, cosmetology teachers, estheticians, esthetic teachers, hair braiders, hair braiding teachers, nail technicians, and nail technology teachers will not be able to renew their professional licenses unless they do so.

The classes are one-hour and only one session is required, There are 20 approved sponsors across the state providing the needed training, including several locations in Chicago. IDFPR has a full list of all available class locations.

Louis Fine: Chicago Professional License Defense Attorney

If you have questions or concerns about your professional license, or you learn that you are the subject of an IDFPR investigation or complain, please contact me immediately. 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 can 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.

“It Ain’t Over `Til It’s Over”: Appeals of IDFPR Disciplinary Decisions

You, yourappeal professional license, your reputation, and your career have been put through the wringer. You fought the good fight before the Illinois Department of Financial and Professional Regulation (IDFPR), but after a formal disciplinary hearing, the Department concluded that you should be sanctioned for your alleged acts or omissions. Perhaps the Director decided to suspend or revoke your license or imposed other penalties which could impact your ability to earn a living. Your worries about your future and righteous indignation at the unfairness of the decision may lead to you to ask whether there is anything you can do to change this outcome.

What Can Be Appealed?

IDFPR, like many Illinois administrative agencies, uses Administrative Law Judges (ALJs) to make decisions that affect the legal rights, duties or privileges of individuals over whom they have jurisdiction. Once a formal disciplinary proceeding concludes, the ALJ presents his or her findings, conclusions, and recommendations to the Director of Professional Regulation. Based on these findings, the Director will make the final decision as to sanctions.

You have the right to appeal – or more accurately, seek “administrative review” of – the Director’s final order in the circuit court of the county in which you reside.

You can, however, lose any right to seek relief from the decision unless you file your petition for administrative review within 35 days after the decision was mailed to you. This deadline is strict and unwavering, and a judge will dismiss your appeal if you miss it.

Administrative Review is Not a “Do-Over”

As with appeals of decisions made by a trial court, many people are under the mistaken impression that an appeal of an administrative decision is essentially a second bite at the apple; a “do-over.” They may think that they’ll have the opportunity to reargue their case and present their evidence and testimony in front of a judge who they hope will make the “right” decision this time.

This is simply not the case. “It is not a court’s function on administrative review to reweigh evidence or to make an independent determination of the facts.” Cook County Republican Party v. Illinois State Board of Elections,  232 Ill. 2d 231, 244 (2009). In fact, Illinois’ Administrative Review Law specifically says that: “No new or additional evidence in support of or in opposition to any finding, order, determination or decision of the administrative agency shall be heard by the court.”

Instead, the court will presume that the findings and conclusions of the ALJ as to questions of fact are true and correct.

Questions of Law

The circuit court will only review a decision to determine whether the correct rules, procedures, and law were applied during the course of the proceeding and when the ALJ made his or her determination. These are “questions of law,” and the reviewing court will only reverse the Department’s decision if it was “clearly erroneous” or the ALJ “abused their discretion” regarding the conduct of the hearing and the introduction of evidence, and that abuse caused “demonstrable prejudice to the party.”

Simply put, you won’t be able to challenge an ALJ’s decision to believe the testimony one witness and not believe another, but you could challenge the ALJ’s decision to allow such testimony at all if it should have been deemed inadmissible under the applicable rules of evidence.

If You Were Sanctioned by IDFPR, Speak With an Experienced Chicago Professional License Defense Attorney Immediately

As noted, whether you have a viable basis for administrative review of an IDFPR decision imposing sanctions against you will depend on the facts and circumstances of your case. But you have an extremely limited time to decide whether to pursue an appeal, so it is critical to contact an experienced professional license defense lawyer as soon as possible after you receive a final decision.

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.