Beyond Exclusions – Is Your Current Screening Program Finding These Actions?


License Restriction


Probation and License Restriction:

The physician did not contest the charge of engaging in conduct which evidences moral unfitness. License suspension for three years, stayed with probation for thirty-six months. Effective one hundred and twenty days after the effective date of this order, the physician has a permanent license restriction whereby he may only examine and/or treat female patients in the presence of a chaperone.

Discipline and License Restriction:

The physician’s license is limited precluding her from being a director or shareholder of a professional service corporation or physician business entity unless she is the sole physician provider of patient care. The physician is also prohibited from receiving funds from a third party for professional service not related to her direct provision of patient care. The physician must also sever professional relationships with Care Medical, Inc., Ambulatory Surgical Center, Inc., and Family Health Center, Inc. and pay a $5,500 fine.

Misconduct, Probation and License Restriction:

The physician did not contest the charges of permitting, aiding or abetting the unlicensed practice of medicine and failing to comply with state law. License suspension for three years, stayed with probation commencing upon the active practice of medicine in Massachusetts for five years and the completion of a psychiatric evaluation. The physician will complete his term of probation on December 9, 2015. The physician also has a permanent license restriction precluding him from treating female patients who are seventeen years old or younger.

Misconduct and Probation:

The physician did not contest the charge of having been convicted in First District Court of attempted disseminating indecent material to minors. Censure and reprimand with probation for two years, $3,000 fine and continuing medical education regarding medical ethics, coding and billing.

Misconduct Description:

The provider is dually licensed in New York, license number 161XXX, and Georgia, license number 023XXX, in the field of Psychiatry. On or about November 25, 2004, the State of Georgia, Composite State Board of Medical Examiners, indefinitely suspended the providers physician license. The Georgia Board required him to enter into a treatment facility, obtain professional advocacy, and publicly reprimanded him, based on chemical dependency and substance abuse in the recent past.

This disciplinary action resulting from the Georgia Board constitutes professional misconduct under New York State laws as well. The provider violated New York State Law when he was found guilty of improper professional practice of professional misconduct by a duly authorized professional disciplinary agency of another state (Georgia) and by having his license to practice medicine suspended in another state as well.

These actions are NOT exclusions.

However, if your internal or outsourced exclusions program is not finding these or similar results during your monthly screening of employee, physician or vendor lists, your organization may be at risk for fines/penalties associated with “continuing conditions” related to license-based actions. Audit prerequisites for your organization include maintaining documentation and proof of monitoring for probationary conditions, continuing education requirements, and supervision of license-restricted disciplinary actions.

At OIGCN, we find actions like these each month during screening programs for our clients using our proprietary software and trained investigators. In addition, we offer single-name sanction searches that can identify exclusions and misconduct actions before individuals/vendors are hired or contracted by you.