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.

In Illinois, there are a number of occupations that require obtaining a professional license. Each type of license is issued by a particular board and that board has oversight over license holders. All of these boards fall under the umbrella of the Illinois Department of Financial and Professional Regulation (IDFPR).

There are a number of issues that could threaten that professional license’s standing in the state, including accusations of negligence, malpractice, substance abuse issues, insurance fraud, and more. Although each board has its own set of rules and regulations, the one issue that can result in the suspension of a professional license no matter what type of occupation is failure to pay court-ordered child support.

Illinois Child Support Laws

The family court system in Illinois takes the duties of both parents when it comes to the care of children very seriously. Under the law, every parent – whether the child lives with them or not – has a legal responsibility to provide for the needs of that child. A parent who has been ordered to pay child support but fails to abide by the court’s order faces serious penalties for that failure.

There are a number of different categories of professional licenses that fall under the jurisdiction of the Illinois Department of Financial and Professional Regulation (IDFPR). Many of these professions have their own boards, including physicians, nurses, pharmacists, social workers, real estate agents, dentists, psychologists, and more. Any individual who is required to apply for a professional license in order to work in their profession is also required to adhere to all the rules and regulations the IDFPR has put in place.

When an allegation or complaint is made against a professional license holder, the IDFPR will initiate an investigation to determine if the complaint is a legitimate one and, if it is, if action should be taken against the individual’s license. That action can include probation, suspension, or even complete revocation. Given the potential consequences of an investigation, anyone who has been informed they are under investigation should contact a professional license defense attorney immediately.

The following are some of the reasons why you should contact Williams & Nickl, LLC if you have been notified by the IDFPR that you are under investigation.

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.

 Being accused of a criminal act can be stressful enough. When you hold a medical license, not only do you have to defend yourself against the charges, but you will likely need to defend your medical license with the Illinois Department of Financial and Professional Regulation (IDFPR). If you are arrested, your first reaction may be to keep this news as quiet as possible, however, under the rules of the Illinois Medical Board, you are required to notify the board if you are facing certain criminal charges.

Felony Defenses

Under the rules of the IDFPR, a doctor is required to self-report if they have been arrested for any felony offense. One of the most common crimes that medical professionals are arrested for is healthcare fraud. These charges are usually brought forth by federal prosecutors since they usually involve fraud against Medicare or Medicaid. These allegations are very serious – not only does the accused face prison time and hefty fines if they are convicted, but their professional future is also in jeopardy since it also could mean loss of medical license or at the very least, loss of provider status.

Examples of the most recent cases of healthcare fraud arrests include:

The state of Illinois has stringent requirements for any resident wishing to own a gun. The state has certain requirements a person must meet to obtain a Firearm Owner Identification (FOID) card. There are also certain factors that may result in a person being denied a FOID or having a current card revoked. If this has happened to you, do not delay in contacting an Illinois FOID attorney, especially if you currently own guns.

High Number of FOID Revocations Not Accounted For

According to recent testimony from members of the Cook County Sheriff’s Police Department to Illinois lawmakers, approximately 20,000 Cook County residents are holding revoked FOID cards. The testimony occurred at a hearing about how the state can curb violence and gun crimes.

The testimony revealed that approximately 33,000 Cook County residents have had their FOID cards revoked. Reasons for the revocations include domestic violence charges, felony convictions, or serious mental health issues. Of that number, almost 20,000 of those residents have not turned in their cards to law enforcement.

On January 1, 2020, the Cannabis Regulation and Tax Act went into effect, providing for the controlled legalization of cannabis use for adults in Illinois. Not only did the law make the recreational use of cannabis legal for adults, but it also established regulations for cannabis dispensing organizations. The licensing and oversight for these businesses fall under the bailiwick of the Illinois Department of Financial and Professional Regulation (IDFRP). If you have been granted a cannabis dispensing license and have questions or run into any legal issues, a Chicago business license lawyer can help.

State Issues Licenses

So far, the IDFR has issued a total of 182 conditional adult use dispensing organization licenses out of the 185 licenses that are available. There were a total of 177 licenses issued in July and another five issued so far this month. The IDFR does anticipate issuing the remaining three licenses within the next few weeks as soon as additional documents are received from the businesses chosen.

Under the law, when a business has been awarded a conditional license, it has 180 days to choose a physical storefront location and obtain an adult use dispensing organization license. If the conditional license holder is unable to find a physical location within those 180 days, they may request an extension of an additional 180 days.

Licensed nursing professionals are dedicated to helping people when they are sick and helping them stay healthy. One of the tools of their job is accessing a patient’s medical record to look up and record important and relevant information about the patient.

But those medical records are highly confidential. They are so confidential that the federal government passed the Health Insurance Portability and Accountability Act (HIPAA) to ensure that patients’ privacy is protected. Violating HIPAA could result in serious consequences and could even put your nursing license in jeopardy.

Privacy Violations

Because the majority of medical providers use electronic medical records (EMR), it is a lot easier for any violations to be discovered by the facility's IT department. Viewing a patient’s record without permission can lead to serious disciplinary action, depending on the circumstances of the violation. Penalties can range from a warning by an employer all the way to criminal charges.

Medical practitioners in Illinois owe their patients a duty of care to provide them with reasonable medical care according to their education and skill. Part of this duty of care is the responsibility to protect patients from harm. Although an essential part of being a doctor is constantly weighing the risks and rewards of particular treatments, evaluating important factors becomes difficult or impossible when a doctor is working under the influence of drugs or alcohol. 

Studies show that the vast majority of doctors who have faced medical license disciplinary action for providing treatment while intoxicated did not cause harm that was threatening to the patient’s life. Nor did they cause their supporting staff to report feeling distressed about the situation. However, clear cases of patient misdiagnoses, poor treatment, and other mistakes do occur because of physician intoxication and licensing disciplinary boards take this behavior seriously. If you are being accused of practicing under the influence, it is important to retain legal help right away. 

What is the IDFPR Disciplinary Process Look Like? 

The disciplinary process can look a little different depending on the circumstances of your case, but the general procedure is typically the same and involves the following steps: 

In response to growing levels of burnout and psychological distress in the pharmacy industry, the National Association of Board of Pharmacy (NABP) in coordination with the American Pharmacists Association (APhA) has developed an online self-assessment tool. The tool, which is designed to be taken by pharmacists, pharmacy students, and pharmacy technicians, consists of nine questions and can be completed in less than one minute. The respondents retain anonymity but, based on their responses, are given resources that can help improve their well-being. They can also compare their results to peers and national averages. One benefit of the tool could be to reduce errors and behaviors that can put a pharmacist’s license at risk.

Additional Stresses on the Pharmacy Industry

The pharmacy profession already suffered from high rates of burnout before the COVID-19 pandemic hit over two years ago. High workloads, stressful working conditions, and technological challenges all contributed to feelings of distress among pharmacy industry workers, with over 60% showing signs of burnout. The pandemic added additional safety protocols, staffing shortages, drug shortages, and supply chain issues, plus the controversial nature of COVID treatments and the small but vocal public distrust of the healthcare field in general.

The tool, which is known as the Pharmacist Well-Being Index (WBI), was created by the Mayo Clinic. Based on the responses to simple yes/no questions, it measures multiple dimensions of distress and well-being. Instead of having to infer or guess what industry professionals need, the creators and individual state boards of pharmacy hope the results of the survey tool can be used to design and implement effective interventions in the pharmacy industry. Research shows that only 14.5% of pharmacy professionals knew where resources to help burnout could be found. Illinois is among the states that had already begun to look at working conditions in the pharmacy industry and could be helped by this tool.

When entering the field of clinical psychology, you work hard to earn the trust of your patients. So any perceived breach of that trust, especially around the disclosure of confidential information, is taken very seriously. Violations can put psychologists at risk of disciplinary action toward their license. If you are facing a case before the Clinical Psychologists Licensing and Disciplinary Board, you need to contact an experienced license defense attorney.

Threats to a Psychologist License in Illinois

Clinical psychologists, like all other licensed professionals in the medical field, are expected to have a high standard of conduct to earn and keep their license. There are a wide variety of potential issues that may jeopardize a psychologist’s license and instigate action by the disciplinary board. These can include:

• Unprofessional or unethical conduct

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As a doctor, you take your duty to care for your patients with the utmost seriousness. So, if you are accused of misdiagnosing or failing to diagnose a patient, you may have many questions. You may also be concerned about how the allegations may affect your medical license. If you feel your license may be threatened, it is important to be proactive and contact an experienced license defense attorney who can begin discussing your options with you. We are often able to help our clients resolve these types of matters without any public discipline to their license.

Commonly Missed or Delayed Diagnoses

Misdiagnosis, along with surgical errors, medication errors, and failure to obtain informed consent, can be considered gross negligence if it can be proved that a doctor caused injury to a patient by acting recklessly or carelessly while diagnosing or treating the patient. In the case of a misdiagnosis, this may occur if the patient’s symptoms, medical history, or test results are not properly analyzed or considered.

According to the Journal of the American Medical Association (JAMA), the most commonly missed conditions for primary care doctors are pneumonia, decompensated congestive heart failure, acute renal failure, cancer in any form, and urinary tract infections. In a broader survey of physicians also conducted by JAMA, including general internists, specialists, and emergency physicians, commonly missed or delayed diagnoses included pulmonary embolism, drug reactions or overdose, lung cancer, colorectal cancer, acute coronary syndrome, breast cancer, and stroke.

For those looking to enter the fields of private alarm contractor, private detective, or private security contractor, the Illinois Department of Financial and Professional Regulation (IDFPR) offers licensing exams twice a year in September and March. To assist those who are preparing to take a licensing exam, Williams & Nickl, LLC is again offering study-review sessions. We have helped hundreds of past participants successfully achieve their licenses.

The next scheduled date for all of the examinations is Wednesday, September 07, 2022, with an application deadline of July 22, 2022. However, the testing company strongly recommends submitting your application in sooner.

Our prep classes will take place on the following dates:

For those who are looking to enter the field of dentistry and become a dental hygienist, you must first go through the required training and meet a variety of other requirements to obtain a dental hygienist license. The understandable fear of any potential licensee is to have their application denied by the Illinois Department of Financial and Professional Regulation (IDFPR). If you have a past criminal conviction, you may receive a Deficiency Checklist from IDFPR asking you to provide information on the conviction as part of the application review process. If you have received a Deficiency Checklist, you need to contact the lawyers at Williams & Nickl, LLC.

License Application Obstacles for Dental Hygienists

If you have received a Deficiency Checklist from IDFPR, you may not know how to respond or even whether your conviction is disqualifying. This notice does not mean your application has been denied, but not responding does put your application in jeopardy. Among the reasons that you may receive the notice is that you have been found guilty of a felony, a misdemeanor in which the essential element is dishonesty, or a crime that is directly related to the practice of dental hygiene. Being convicted of any crime on this list will not automatically bar you from obtaining your license, but the conviction should have been disclosed on your initial application. Some of the convictions that IDFPR will not consider when evaluating your license application are convictions related to cannabis possession or sale, traffic offenses except for DUI or reckless homicide, trespassing, or vandalism.

Our firm can help provide you with guidance on the appropriate next steps. If necessary, we can draft a letter of response to IDFPR that answers their questions and makes the case for why your license should be approved. By waiting too long or attempting to respond on your own, you are putting all of your hard work at risk.

People across the state rely on real estate brokers, more commonly known as agents, every day when they are buying or selling a house, condo, townhouse, or other property. They trust that agents will act ethically and keep high standards of professionalism. These ethics and standards are enforced by the Real Estate Administration and Disciplinary Board, which regulates licenses for those in the real estate industry, including real estate agents, managing brokers, and leasing agents.

Professional and Personal Infractions Can Cause Licensing Issues

There are a wide variety of reasons that a complaint may be filed against a real estate agent. Some involve professional infractions, while others reflect the personal behavior of the individual. The actions related to an agent’s professional business that could cause disciplinary action include:

• Accounting or recordkeeping irregularities, including not keeping records available for review

  ...

The state of Illinois has enacted several pieces of legislation designed to address the growing opioid crisis. The bills were signed last week by Governor Pritzker, and three bills, in particular, are of interest to pharmacists and other medical professionals who handle opioids on a daily basis.

Opioid Legislation to Prevent Overdoses and Expand Resources

Senate Bill 2535 requires pharmacists and medical professionals who write prescriptions for opioids to inform the patients of the drugs’ addictive nature. They also must give the patient the option to receive a drug that may be used to reverse opioid overdoses, also known as an opioid antagonist. This bill takes effect on January 1, 2023.

House Bill 4556, which is effective immediately, allows pharmacists and other medical professionals to distribute testing strips for fentanyl. These strips and other testing supplies can often be classified under the law as drug paraphernalia. This will allow health care facilities, including hospitals and pharmacies, to store these important supplies without the fear of being prosecuted. The strips can quickly determine the presence of fentanyl in a substance and prevent accidental overdoses.

With the trust that doctors and pharmacies are given to prescribing controlled substances, they also have a responsibility to ensure that the substances are being used for legitimate medical purposes. Physicians and pharmacists may fall under investigation for drug diversion if they are suspected of facilitating prescription drugs to be obtained, shared, or transferred inappropriately. This can be for their own personal use, the use of their patients, or by outside individuals. These investigations can lead to discipline to their medical license as well as criminal charges. Any medical provider who has been accused of drug diversion should contact an experienced medical license defense attorney to discuss their options.

Potential Causes of Drug Diversion Suspicion

Given the risk of drug abuse from prescription drugs, drug diversion cases are taken seriously by the Illinois Department of Financial and Professional Regulation (IDFPR) and the federal Drug Enforcement Agency (DEA). There are a variety of different circumstances that can cause a physician or pharmacist to be investigated for drug diversion. These can include:

• Selling narcotics or opioids to individuals for non-therapeutic uses, also known as operating a pill mill

  ...

In the latest budget for the state of Illinois, licensing fees are waived for frontline health care workers for the state fiscal year 2023, which runs from July 1, 2022 through June 30, 2023. This includes licensing fees for nurses, pharmacists, pharmacy technicians, physicians and surgeons, physician assistants, and social workers. The waiver covers initial applications for licensing as well as renewals.  

Appreciation for Frontline Healthcare Workers

In an effort to show appreciation for the frontline workers still battling the COVID-19 pandemic after two long years and in recognition of the financial burden many have faced, Governor J.B. Pritzker proposed that license fees will be waived for nearly 470,000 frontline healthcare workers. The budget was approved in February and takes effect on July 1.  

If you hold more than one license through the Illinois Department of Financial and Professional Regulation (IDFPR), you will be granted a waiver for each application. There are certain variances to license renewal schedules that have been granted to ensure all possible workers will be able to benefit. Refer to the IDFPR website for more details. Nurses who qualify include registered nurses, APRNs, full practice APNs, APRN controlled substance nurses, and full practice APN controlled substance nurses.