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Illinois Physician Licenses Impacted by Discipline in Other States

Illinois Professional License Defense LawyerCan a professional licensed in Illinois be subject to discipline only because the license holder was disciplined in another state?

Most likely no, but the Illinois Department of Financial and Professional Regulation won’t let that stop them. While the Medical Practice Act authorizes discipline of doctors based on sanctions imposed in another state, that discipline requires analysis beyond the fact that one was disciplined elsewhere. That is, the Illinois statute may authorize discipline based on out-of-state sanctions, but that does not mean that discipline is reasonable in every case.

In the case of Dr. Cadogan vs Division Of Professional Regulation of the Illinois Department of Financial and Professional Regulation (2013 IL App (1st) 122160-U), the court determined that the Illinois’ discipline was unreasonable based on the relationship between the out-of-state violation, the statutory intent, and the state's justification for punishing the license holder. The court determined that the statutory authorization to discipline a license holder does not, in and of itself, justify the imposition of punishment.

While the Illinois Medical Disciplinary Board and IDFPR are statutorily authorized to discipline doctors based on an adverse action taken by another state, the evidence or other mitigating circumstances presented at a disciplinary hearing must reasonably support the imposition of discipline. Discipline cannot be arbitrary or unreasonable and must be commensurate with any violations proved at a hearing.

Under section 22(A)(12) of the Medical Practice Act (225 ILCS 60/22(A)(12)):

(A) The Department may revoke, suspend, place on probation, reprimand, refuse to issue or renew, or take any other … action … with regard to the license …, including fines not to exceed $10,000 per violation, upon any of the following grounds:

(12)  Adverse action taken by another state or jurisdiction against a license or other authorization to practice as a medical doctor, doctor of osteopathy, doctor of osteopathic medicine or doctor of chiropractic, a certified copy of the record of the action taken by the other state or jurisdiction being prima facie evidence thereof. This includes any adverse action taken by a State or federal agency that prohibits a medical doctor, doctor of osteopathy, doctor of osteopathic medicine, or doctor of chiropractic from providing services to the agency's participants.

In the Cadogan case, the plaintiff was a physician with multiple state licensures who was issued a reprimand by regulators in Maryland.  After mandatory reporting of the out-of-state discipline, IDFPR started a sister state disciplinary action under section 22(A)(12) of the Medical Practice Act. The plaintiff received a reprimand and $1,000 fine based on recommendations from an administrative law judge.

After the plaintiff sought administrative review of the decision, the circuit court remanded the case, finding that the sanctions were arbitrary or capricious because the judge's recommended punishment was not supported by any reasoning. On remand, IDFPR issued another order affirming the punishment, because “the public needs to be informed of professional discipline.”

Upon a second review, the circuit court issued another order finding the punishment to be arbitrary or capricious because mitigating circumstances were not considered when imposing the sanctions. And the court said there was no support to say the Maryland violation warranted the imposed discipline – it determined public discipline was not necessary in Illinois because the plaintiff was already required to inform the Illinois public of the sister state action.

On remand again, IDFPR affirmed the reprimand but waived the fine. Upon a third review in circuit court, it reversed the discipline in total, reasoning that public discipline of the plaintiff was “arbitrary and unreasonable.” IDFPR appealed again!

The circuit court again agreed with the physician, and said the punishment was unreasonable and unrelated to the purpose of the Medical Practice Act. The reprimand was too harsh and did not serve the statute's purpose to protect the public health and welfare. The court held that discipline must not be solely predicated on statutory authority; rather, discipline must be supported by evidence and must be reasonable in light of the circumstances and state interests that form the basis of the discipline.

If you have sister-state discipline, Williams & Nickl is here to help you get through that process and back on the right track. Our firm focuses on professional license defense to ensure the Medical Board is acting with their rights, and you have a chance to move on from your past issue.p you get through that process and back on the right track. Our firm focuses on professional license defense to ensure the Medical Board is acting with their rights, and you have a chance to move on from your past issue.

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