Just Tell Me What You Want Me To Do: Conditions For License Reinstatement After Disciplinary Action

Do the right thing. Follow the rules. Straighten up and fly right. Do what you’re told. If the Illinois Department of Financial and Professional Regulation (IDFPR) has suspended your professional license or put you on probation, following or satisfying the probationary terms and conditions imposed by the department is a necessary prerequisite to reinstatement and resumption of your career. But it can be hard to comply with probationary terms if you don’t know what they are.

Unfortunately, the orders and consent decrees that impose sanctions and establish conditions for reinstatement are often so vague and ambiguous that it can be difficult, if not impossible, to know what you need to do to get your license back. And that ambiguity can lead to frustration, disappointment, and more months or years of sitting on the sidelines when the IDFPR denies your petition for restoration.

What Does Probation Mean For A Professional Licensee?

If the IDFPR determines that disciplinary action is warranted against a licensee, they have a range of sanctions they can impose, metaphorically ranging in severity from a slap on the wrist to a death sentence. The department can impose these sanctions in an order after a disciplinary hearing, or they can be part of a consent decree entered into between the licensee and IDFPR.

Probation is one of those sanctions. If the IDFPR places you on probation, you will be able to continue working or practicing subject to specific conditions and limitations established by the Department. As with probation in the criminal justice system, a violation of any of the imposed terms will create additional problems potentially involving further discipline. The probation term could be for a set period which will automatically expire providing the licensee complies with all conditions, or it could be for an indefinite time, requiring that the licensee petition the board to terminate the probation. 

But probationary terms can also be part of a license suspension. In that case, the licensee cannot obtain reinstatement of their license until they meet the conditions set forth in the order or consent decree.

Sometimes, probationary terms can be quite specific and usually relate to the nature of the acts or omissions that led to disciplinary action. Common probationary terms can include:

  • Undergoing physical or psychological exams
  • Seeing a therapist or undergoing psychotherapy
  • Completing a substance abuse program and attending ongoing counseling or support groups
  • Avoiding all criminal arrests/convictions during the probationary period
  • Complying fully with the applicable laws governing the licensed profession
  • Notifying an employer or employers about the probation
  • Fulfilling continuing education courses related to your violation

What If There Are No Specific Terms Contained In The Order Or Consent Decree?

When the terms and conditions for reinstatement are clear and specific, complying with them simply requires doing the work and staying out of trouble. But many license suspensions fail to delineate precisely what steps a licensee must take or complete to get their license back.

A licensee can spend their suspension or probationary term doing everything right – addressing the issues that got them in trouble, working on improving themselves personally and professionally, sobering up and undergoing therapy, etc. – and still not get their license reinstated. The power to give a licensee their career and livelihood back is entirely in the hands of the hearing officer who evaluates the petition for reinstatement.

That unfettered discretion can and does lead to unjust results. As noted, it can be hard to follow the rules if you don’t know what they are. Therefore, if a licensee is considering a consent decree to agree to probation or a license suspension, it is critical that the terms of probation be set forth as specifically as possible. This is yet another reason that licensees should never represent themselves before the IDFPR or enter into a consent decree without first consulting with an experienced Chicago professional license defense attorney.

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.

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.

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.

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.

Task Force Recommends More Breaks, Shorter Shifts, and Fewer Responsibilities for Illinois Pharmacists

 

Pharmacists are highly trained and knowledgeable professionals. They handle and dispense powerful drugs to vulnerable patients who rely on them for guidance and for their careful filling and dispensing of prescriptions.

But pharmacists are also human. Their jobs come with business pressures, policies, and priorities that may impede their ability to fulfill their duties as they should. These pressures can have tragic consequences when pharmacists feel like they can’t spend the time needed to properly advise patients about their prescription. Overwhelmed and overworked pharmacists may also make any number of critical errors between the time they receive a prescription from a patient or their physician and the time they dispense the prescribed medication.

These problems manifested themselves in a 2016 Chicago Tribune investigation which found that pharmacists at 52% of 255 Chicagoland pharmacies failed to adequately warn customers about drug interactions that could result in adverse health consequences or death.

As a result of this shocking report, the state of Illinois formed a task force to examine and make recommendations on “how to further advance the practice of pharmacy in a manner that recognizes the needs of the healthcare system, patients, pharmacies, pharmacists, and pharmacy technicians.” 

On October 11, 2019, the Illinois Collaborative Pharmaceutical Task Force released its final Report and Recommendations.

An Assembly-Line Process

The report found that pharmacists felt overwhelmed by an assembly-line process at busy pharmacies where they are expected to fill hundreds of prescriptions in a single shift. In turn, pharmacists routinely skipped breaks and meals and became easily distracted due to competing priorities and too many responsibilities relating to the management and operation of pharmacy practices.

 In the report, the task force made the following recommendations:

  • Increasing whistleblower protections for pharmacists and pharmacy technicians who report violations of the Pharmacy Practice Act (the “Act”);
  • Adding new grounds for discipline of licensed pharmacists under the Act, including:
    • Failing to provide “adequate time for a pharmacist to complete professional duties and responsibilities”;
    • Failing to provide “sufficient personnel to prevent fatigue, distraction or other conditions that interfere with a pharmacist’s ability to practice with competency and safety or creates an environment that jeopardizes patient care”;
    • Failing to provide “appropriate opportunities for uninterrupted rest periods and meal breaks”;
  • Adding a new section to the Act entitled “Pharmacy Work Conditions,” which states that:
    • Employers “shall keep and maintain a complete and accurate record of the daily break periods of its pharmacists”;
    • Employers “shall not require a pharmacist, student pharmacist, or pharmacy technician to work longer than twelve (12) continuous hours per day, inclusive of the breaks”;
    • A pharmacist working longer than six continuous hours per day shall be allowed to take a 30-minute uninterrupted meal break and one 15-minute break, as well as one additional break if working 12 hours per day.
    • No pharmacist shall work longer than five hours per day without the opportunity to take an uninterrupted meal break.

A bill currently pending in the Illinois legislature would incorporate the task force’s recommendations into the Pharmacy Practice Act. The bill also includes new provisions for disciplinary action, including written warnings or fines against the pharmacy, pharmacist, and pharmacist-in-charge that would be posted online and could not be expunged, as well as possible license revocation for repeat violations. The bill is expected to become law during the current legislative session.

Louis R. Fine: Chicago Pharmacist License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of pharmacists 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 pharmacist’s license and get you back to 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?

If 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 physicians 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

The 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

Illinois 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

Qualifying 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.