When an Illinois physician faces discipline in another state, can that action put their Illinois medical license at risk too? Most likely no, but the Illinois Department of Financial and Professional Regulation (IDFPR) won’t let that stop it from trying.
This is known as sister state discipline. One state uses an adverse licensing action that another state has taken as grounds for imposing its own discipline.
While the Medical Practice Act authorizes this practice, that authority does not make discipline automatic or reasonable in every case.
[Related: Does an Illinois Physician Have To Submit to Questioning by an IDFPR Investigator?]
What the Medical Practice Act Says About Out-of-State Discipline
Section 22(A)(12) of the Medical Practice Act (225 ILCS 60/22) provides the statutory basis for IDFPR sister state disciplinary actions. The relevant language reads as follows:
- (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.
While the Illinois Medical Board and the IDFPR are authorized to act under this statute, that authorization is not a blank check.
Evidence and 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 the hearing.
[Related: When Personal Beliefs Interfere With State Policies in License Regulations]
Cadogan v. IDFPR: When Illinois Discipline Goes Too Far
Dr. Cadogan tested the limits of the IDFPR’s sister state authority in Cadogan v. Division of Professional Regulation of the Illinois Department of Financial and Professional Regulation, 2013 IL App (1st) 122160-U.
The court determined that Illinois’ discipline was unreasonable given the relationship between the out-of-state violation, the statutory intent and the state’s justification for punishing the license holder. Statutory authorization alone does not justify the imposition of punishment.
How the Case Unfolded
The plaintiff was a physician holding multiple state licenses who received a reprimand from Maryland regulators. After mandatory reporting of the out-of-state discipline, the IDFPR initiated a sister state action under Section 22(A)(12). The plaintiff received a reprimand and $1,000 fine based on an administrative law judge’s recommendations.
The plaintiff sought administrative review. The circuit court remanded the case, finding the sanctions arbitrary and capricious because the recommended punishment lacked any supporting reasoning.
On remand, the IDFPR affirmed the punishment, citing the public’s need “to be informed of professional discipline.”
The circuit court again found the punishment arbitrary and capricious, this time because mitigating circumstances were not considered. The court further found no basis for the Maryland violation to warrant Illinois discipline, noting the physician was already required to inform the Illinois public of the sister state action.
On second remand, the IDFPR affirmed the reprimand but waived the fine. The circuit court reversed the discipline in full, finding public discipline “arbitrary and unreasonable.” The IDFPR appealed again.
The appellate court agreed with the physician. The reprimand was too harsh and did not serve the Medical Practice Act’s stated purpose of protecting public health and welfare. The court held on two key fronts:
- That discipline must not rest solely on statutory authority.
- That evidence must support discipline, and discipline must be reasonable in light of the circumstances and state interests that form the basis for the action.
[Related: Medical Malpractice Lawsuits and Your Illinois Medical License]
Contact Williams & Nickl If You Are Facing Sister State Discipline in Illinois
The IDFPR will pursue sister state discipline aggressively, even when the underlying out-of-state action was minor or already resolved. Cadogan shows you can beat it, but that takes experienced representation and a precise defense strategy.
At Williams & Nickl, we’re here to help you get through the process and back on the right track. We’re just as determined as the IDFPR.
Call us at 312-335-9470 or contact us online to schedule a free, confidential 1-hour consultation.
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