There are many issues that physicians face today that can result in some form of punitive action taken against their medical license. In some cases, it can even result in the loss of that license. One issue that has become particularly prevalent is allegations of overprescribing medications, especially for older patients.

Overprescribing Can Be a Real Problem

There is no denying that prescription drugs have become a problem for many people in the United States who struggle with drug addiction or other drug-related issues. According to national data, the number of Americans who are taking five or more medications has doubled over a 10-year period to approximately 15 percent. Prescription drugs can present a problem to seniors especially. Almost 45 percent of adults 65 years or older are taking five or more medications. This spike has led to a significant rise in the number of adverse drug events that happen each year, leading to increased scrutiny of the prescribing doctors. 

Why Are Doctors Accused of Overprescribing?

The vast majority of doctors work hard to take good care of their patients. Sometimes, confounding factors can cause a doctor to accidentally or inadvertently overprescribe drugs, or to prescribe drugs that cause patients an adverse reaction without realizing the danger. Doctors may be accused of overprescribing medications to seniors for many reasons, including:

When one hears the word “audit,” it often triggers a negative reaction. After all, no one wants their financial life picked apart by the IRS. Being notified that your practice is going through a Medicaid audit can bring about the same type of reaction. Even if you feel there should be no issues with your practice, if the government finds any errors, it can lead to very expensive consequences and even have an impact on your medical license.

Notification of a Medicaid Audit

Approximately 25 percent of Illinois residents are covered under the state’s Medicaid program for their medical benefits. The Department of Healthcare and Family Services, Office of the Inspector General, Bureau of Medicaid Integrity is the state agency that oversees Medicaid audits. The goal of these audits is to prevent abuse, fraud, misconduct, and waste of the state’s Medicaid program. If any evidence of wrongdoing is found, those held responsible could face payment suspensions and even criminal charges, depending on the allegations.

When a practice has been selected for an audit, the physician will be notified by the OIG in writing that an audit is being conducted. Along with that written notification will usually be either a request for samples or a list of patients in the practice, along with a detailed questionnaire for each patient. During the audit process, there will typically be even more requests for information.

There is no denying we have become a video-based society. What started out as “selfie” photos on Facebook about a decade ago has mushroomed into videos and reels on Instagram, TikTok, Snapchat, and multiple other social media platforms, to say nothing of ubiquitous security footage.

Not all of those videos are made with our knowledge. In fact, one major study found that the average person is caught on camera almost 240 times a week. And if you travel a lot or work at certain jobs, that number can reach up to a thousand times a week – with your likeness captured on traffic cameras, surveillance cameras, and even doorbell cameras.

All this video also means there is a higher chance that when a doctor has had a complaint filed against them with the Illinois Medical Board, the evidence of allegations may also include video.

Under Illinois law, all physicians, chiropractors, nurses, dentists, pharmacists, psychologists, and other healthcare professionals are required to obtain a professional license through the Illinois Department of Financial and Professional Regulation (IDFPR). A person who practices medicine without a valid professional license is committing a crime under Illinois law and a conviction could result in potential jail time.

Practicing Without a License

When an individual gives medical advice or medical treatment, but that individual does not hold a current valid medical license, Illinois law says they are guilty of the unauthorized practice of medicine. This includes engaging in any of the following activities:

• Diagnosing conditions
• Issuing prescriptions for medications
• Performing surgery
• Advertising or attempting to advertise the practice

If a patient suffered any type of harm because of the unauthorized practice, the individual could also face additional criminal charges.

It takes great dedication and commitment to be an Illinois social worker. After all, one of the main duties of the profession is helping people navigate through difficult life situations. Many times, it is the most vulnerable that a social worker is helping, such as children and the elderly.

The majority of social workers are never named in any ethical complaints or arrested on charges of wrongdoing in the course of their job. Some say that the cost of liability and malpractice insurance for social workers is proof of the low rate of incidences – the premiums much lower than they are for malpractice insurance for other healthcare professionals.

Unfortunately, despite the low numbers, there are situations where a social worker may be notified by the Illinois Social Work Examining and Disciplinary Board that they are under investigation due to an allegation made by a third party. If this happens to you, make sure you contact an Illinois professional license defense attorney immediately.