New Rules for Reporting Abuse, Neglect, or Exploitation of Adults

On September 29, 2018, the Ohio Department of Job and Family Services (JFS) issued a new version of Rule 5101.63 that expands the list of individuals required to report suspected elder abuse. Now, any individuals licensed under Chapter 4731, those licensed to practice medicine and surgery, or Chapter 4723, registered nurses and licensed practical nurses, who have reasonable cause to believe that an adult is being abused, neglected or exploited shall immediately report such belief to their county JFS department, or they may face criminal charges.

The report can be oral, but the department may request a more formal, written report. Anyone who makes a report of abuse is immune from civil or criminal liability, unless they act in bad faith or with malicious purpose. ORC 5101.63(E) provides that an employer may not discharge, reduce benefits/work privileges, or take any other detrimental action against an employee for making a report of abuse.

You can download the related guides through JFS Forms Central (http://www.odjfs.state.oh.us/forms/) using these form numbers: JFS 08097 – Understanding Elder Abuse: A Guide for Medical Professionals and JFS 08098 – Understanding Elder Abuse: A Guide for Ohioans. ODJFS will develop training materials about identifying and reporting elder abuse.

The county JFS departments will be available to receive reports of abuse 24/7. If you have any questions about this new rule change, please contact the Collis Law Group at (614) 486-3909.

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The Differences Between Suspension, Permanent Revocation and Non-Permanent Revocation of a Medical License by the State Medical Board of Ohio

The State Medical Board of Ohio (“Medical Board”) is authorized to take disciplinary action against a licensee based on a violation of Ohio Revised Code Section 4731.22(B). Discipline can include, but is not limited to, suspension, permanent revocation and non-permanent revocation of a medical license.

A suspension results in the loss of the license to practice medicine for either an indefinite or a specified period of time.  The licensee may apply for reinstatement of the medical license following completion of all terms and conditions required by the Medical Board for reinstatement of the license.

A non-permanent revocation results in the loss of the license to practice medicine.  The licensee may re-apply for licensure.

A permanent revocation results in the loss of the license to practice medicine.  The licensee is forever barred from being licensed to practice medicine.

The Medical Board’s Disciplinary Guidelines provide maximum and minimum penalties for certain offenses: http://med.ohio.gov/Portals/0/Disciplinary%20Guidelines%20rev.%2006-13-2018.pdf?ver=2018-06-13-143928-823.  However, the Medical Board is not bound by the Disciplinary Guidelines and may impose any sanction authorized by law including, but not limited to, permanent revocation.

Although a licensee whose license to practice medicine has been non-permanently revoked may re-apply for licensure, a non-permanent revocation is viewed as a higher level of discipline than a suspension.  The Medical Board typically imposes non-permanent (and permanent) revocation for the most serious violations of its laws or rules.

The Medical Board meets the second Wednesday of each month and reviews all disciplinary matters in an open forum.  The Medical Board’s monthly Agenda can be found at the Medical Board’s website at: http://med.ohio.gov/The-Board/Board-Meetings-Minutes.

If you have any questions about this post or the State Medical Board of Ohio in general, please feel free to contact one of the attorneys at Collis Law Group LLC at (614) 486-3909 or email me at Beth@collislaw.com.

 

Attorney Beth Collis quoted in Medscape article on Medical Board investigations

Attorney Beth Collis, of Collis Law Group LLC, was quoted in a Medscape article titled “The Dangers of a Medical Board Investigation: How to Protect Yourself”. In the article Ms. Collis addresses the 9,000 complaints that the State Medical Board of Ohio receives each year. “Many are minor or frivolous, such as allegations that the doctor or his staff was rude to the patient or family, billing questions, being forced to wait too long for an appointment, etc. The Board generally doesn’t take action in these cases and may not even inform the doctor of them.”

Ms. Collis also addresses how it is necessary for physicians to respond to Board investigations or inquiries. Ms. Collis warns physicians against ignoring inquiries from the Board, or from talking to the Board without counsel. “No complaint is too minor. Too many physicians think they don’t need a lawyer and can just talk the Board investigators into dropping the complaint. Doctors may sincerely want to help but they don’t understand the rules and pitfalls. They are often too chatty and explain things that weren’t even asked.” Legal counsel is recommended for any physician in connection with any Medical Board investigation or disciplinary action.

Read the article, written by Mark Crane, by clicking on the following link: https://www.medscape.com/viewarticle/899247_2

As always, if you have any questions about this blog or the State Medical Board of Ohio, please feel free to contact one of the attorneys at Collis Law Group LLC at (614) 486-3909 or email me at Beth@collislaw.com.

Ohio Medical Board Proposes Confidential Monitoring Program for Licensees With Mental or Physical Illness Other Than a Substance Use Disorder

The State Medical Board of Ohio (“Board”) has proposed rules for a new confidential monitoring program, which, if approved, is anticipated to be implemented later this year and the rules for which would be contained in OAC 4731-28, Mental or Physical Impairment.

The proposed program would be non-disciplinary and voluntary. The licensee’s participation in the proposed program would be governed by a written contract (called a participation agreement) between the licensee and the Board. The Board’s intent of the proposed program is to enable licensees, who would otherwise be subject to formal discipline, to avoid formal discipline for issues related to mental or physical illness.

Eligibility criteria for the proposed program includes, but is not limited to:

1) The Board may conduct any investigation necessary to evaluate the totality of circumstances, including requiring a physical or mental examination;

2) The individual must provide continuing authorization for the disclosure and release of information between the Board, the individual, and any other persons or entities involved in the evaluation, treatment or monitoring of the individual;

3) The individual must be willing to begin treatment or demonstrate that they have been significantly compliant with their established treatment plan;

4) Any individual that has been issued a Notice of Opportunity for Hearing that is pending is not eligible; and

5) There is no information indicating that allowing the individual to participate in the proposed program will create a substantial risk of potential harm to patients.

As proposed, OAC 4731-28-04 authorizes the Board to disqualify a participant from the proposed program for any alleged violation of their participation agreement, as determined by the sole discretion of the Secretary and Supervising Member, and shall constitute grounds for the Board to take a public disciplinary action against the licensee.
Finally, as proposed, OAC 4731-28-05 outlines the conditions that the participant must complete to have the participation agreement terminated.

The full draft of the proposed rules may be found at the Board’s website at: http://med.ohio.gov/Laws-Rules/Newly-Adopted-and-Proposed-Rules/Confidential-Monitoring-Program.

As always, if you have any questions about this blog or the State Medical Board of Ohio, please feel free to contact one of the attorneys at Collis Law Group LLC at (614) 486-3909 or email me at Beth@collislaw.com.

OHIO PHYSICIANS: DO YOU KNOW THE REPORTING REQUIREMENTS?

Did you know that in Ohio, if you give aid to a sick or injured person, the failure to report to law enforcement any gunshot or stab wound that you have treated or observed, or any serious physical harm to a person that you know or have reasonable cause to believe resulted from an offense of violence, could result in a misdemeanor criminal charge and conviction?

Ohio Revised Code 2921.22(B) provides:
“Except for conditions that are within the scope of division (E) of this section, no person giving aid to a sick or injured person shall negligently fail to report to law enforcement authorities any gunshot or stab wound treated or observed by the person, or any serious physical harm to persons that the person knows or has reasonable cause to believe resulted from an offense of violence.”

Many are unaware of this reporting requirement.  However, ignorance of the law is no defense.

Unless you have completed a residency program in emergency medicine, trauma, or surgery, you might have never heard of this reporting law.  We are not aware that medical schools in Ohio routinely address this reporting law.

Often, patients who have been involved in or have been a victim of a crime, or an incident involving a gunshot or stab wound or serious physical harm, are unwilling or unable to truthfully explain to their medical professional how the injury occurred.  In certain instances, it may be difficult to determine if an injury is the result of a crime of violence.  Physicians should be aware that a patient who has been involved in a crime might try to tell the physician that they were “accidently” injured (for example, while hunting or by mistake).

If you have reasonable cause to believe that a gunshot or stab wound or serious physical harm resulted from an offense of violence, the failure report to law enforcement could result in criminal charges and conviction for misdemeanor, Failure to Report a Crime, and the conviction could result in a disciplinary action against your Ohio medical license (R.C. 4731.22(B)(11)).

As always, if you have any questions about this post or the State Medical Board of Ohio, please feel free to contact one of the attorneys at the Collis Law Group LLC, or contact me at beth@collislaw.com or 614-486-3909.

Medical Marijuana Control Program Update

On September 8, 2016, Ohio House Bill 523 legalized medical marijuana in Ohio. The Medical Marijuana Control Program will allow patients, with certain medical conditions and upon the recommendation of an Ohio-licensed physician, to purchase and use medical marijuana. The Ohio Medical Marijuana Control Program takes effect on September 8, 2018.

Physicians may recommend, but not prescribe, medical marijuana to patients who suffer from certain medical conditions. A physician in Ohio who wants to recommend medical marijuana for a patient must first apply for a Certificate to Recommend through the State Medical Board of Ohio. Applications are available on the Medical Board’s website at http://www.med.ohio.gov.

Ohio physicians applying for the Certificate to Recommend medical marijuana must hold an active and unrestricted Ohio Medical license. Prior to applying for the Certificate, a physician must complete “two hours of continuing medical education” related to diagnosing and treating patients with medical marijuana among other requirements. (See O.A.C. Section 4731-32-02 for more details, and a complete list of Application requirements.)

Prior to recommending medical marijuana for a patient, O.A.C. 4731-32-03 requires that a physician must perform tasks including but not limited to:

• Establish and maintain a bona fide physician-patient relationship;
• Create and maintain a medical record;
• Examine the patient;
• Inquire about the patient’s medical history and any current medications; and
• Include in the patient’s record a diagnosis of the patient’s condition.

There are certain qualifying medical conditions for recommending medical marijuana including but not limited to Parkinson’s disease, ulcerative colitis, fibromyalgia, and cancer. (See R.C. 3796.01(A)(6) for full list of medical conditions).

Qualifying patients must first register with the Ohio Board of Pharmacy. Prior to recommending medical marijuana, a physician must determine from the medical marijuana patient registry whether the patient has an active registration for medical marijuana. O.A.C. 4731-32-03. Only patients who are registered with the Ohio Board of Pharmacy may receive a recommendation for medical marijuana.

Physicians may recommend medical marijuana to minors with the consent of the minor’s parent or legal representative. O.A.C. 4731-32-03(C)(5).

You can find the Ohio Medical Board rules regarding the Medical Marijuana Control Program at: http://codes.ohio.gov/oac/4731-32.

As always, if you have any questions about this blog or the State Medical Board of Ohio, please feel free to contact one of the attorneys at Collis Law Group LLC at (614) 486-3909 or email me at Beth@collislaw.com.

Medical Practice Closure Considerations

We receive questions concerning the steps that are required or necessary in connection with the closure of a medical practice.  Typically, a physician who has devoted their entire life to the day-to-day practice of medicine is faced with numerous legal, accounting, and administrative tasks, some of which extend beyond the actual shut-down of the practice.  Planning, organization, communication, and administration are key elements to avoid issues after the closure.

Practice closure matters include but are not limited to:

Staff Notification: Staff of the practice should be notified of the closure.  A physician may have to prepare to hire temporary staff if employees leave prior to closing date.

Patient Notification: The State Medical Board of Ohio (“Ohio Medical Board”) has laws and rules pertaining to the notice that a physician is required to give patients.  These laws and rules include, but are not limited to, when notice must be given, the information that is required to be included in the notice, and how notice must be given.

Government/Payor/Agency Notifications: Notice concerning the closure of the practice must be coordinated and given to entities including, but not limited to, the DEA, Medicare, Medicaid, private insurance payors, hospitals, professional associations, and the Ohio Medical Board.  Each entity may have different requirements.

Professional Liability Insurance: If necessary, extended reporting professional liability insurance (so called, “tail coverage”) should be obtained, which provides coverage against claims reported after the liability policy expires.

Medical Records: The storage or transfer of paper and electronic medical records in compliance with Federal and State law including, but not limited to, HIPAA must be completed.  An address or PO Box to receive, and procedure to respond to, medical records requests after the closure of the medical practice must be established and followed.

Service and Supply Providers: Notice concerning the closure of the practice to providers including, but not limited to, providers of ancillary services, medical supplies, and other services and supplies should be coordinated and given.  Accounts with such providers should be closed.

Business Entity Issues: Termination of any Lease Agreement(s), termination of utilities services, collection of accounts receivables, sale of medical and office equipment, dissolving the medical practice legal entity with the Ohio Secretary of State, and filing of final Federal, State, and local tax returns must be coordinated and completed.

If you have any questions about this blog or the State Medical Board of Ohio, please feel free to contact one of the attorneys at Collis Law Group LLC at (614) 486-3909 or email me at Todd@collislaw.com.