A new non-disciplinary ”Remedial Plan” option enacted by the Texas Legislature last session may allow some Texas physicians to resolve charges of professional misconduct pending before the Texas Medical Board without the National Practitioner Data Bank report that normally results when a physician is formally disciplined by the Texas Medical Board.
Previously, Texas law only allowed the Texas Medical Board to resolve complaints against a physician through either:
- Dismissal; or
- Imposing public discipline.
A public discipline order typically results in a report to the National Practitioner Data Bank in addition to any sanctions and public reporting of the disciplinary action.
Under reforms enacted in Senate Bill 227/House Bill 680 last session, however, the Texas Medical Board now also may resolve some complaints by offering a “Remedial Plan” rather than imposing formal discipline. The primary advantage to a physician of having a complaint resolved by a Remedial Plan rather than formal disciplinary actions is that the Remedial Plan will not result in a misconduct and discipline report to the National Practitioner Data Bank because of the “non-disciplinary” nature of the Remedial Plan remedy.
Under the Remedial Plan option, the physician typically will be required to agree to certain remedial actions dictated by the Texas Medical Board in a public document that will appear on a physician’s public profile. The written Remedial Plan generally will state that the physician is subject to a “non-disciplinary” action for a specified violation. While the basis of the charge leading to the Remedial Plan and agreed to corrective action generally will be included in the posted Remedial Plan, a physician generally will not be required to admit guilt. Since the physician will avoid disciplinary action, resolution by the Remedial Plan avoids the obligation for a report of disciplinary action to the National Practitioner Data Bank. In addition to avoiding a report to the National Practitioner Data Bank, resolution of a complaint by a Remedial Plan also allows a physician to avoid having his name listed in the Board’s newsletter or in the Board’s press releases like would result in the case of a disciplinary action.
Remedial Plans are not available for all charges. Rather, Remedial Plans generally are an option only for a limited number of situations in which the Texas Medical Board decides to offer the option for resolution of a complaint through a Remedial Plan based on its decision that fulfillment of the specified conditions sufficiently corrects the concerns raised by the charge that it is appropriate to forgo formal disciplinary action. Most typically, this could happen when the Texas Medical Board is addressing administrative violations after receiving a complaint or in other instances where the Texas Medical Board decides the nature and circumstances of a charged violation can be adequately addressed through the Remedial Plan without formal discipline. When offered, Remedial Plan resolution is a take it or leave it propositions. The Texas Medical Board decides the required terms of the Remedial Plan and these terms are non-negotiable. Also physicians offered the option of resolution under a Remedial Plan generally must accept the offered Remedial Plan terms by a specific deadline.
While a physician generally cannot insist upon the option for resolution through a Remedial Plan or dictate the terms of a Remedial Plan, a physician facing charges before the Texas Medical Board often can can improve his odds for avoiding discipline by the Texas Medical Board or qualifying for resolution of charges under a Remedial Plan by acting quickly with the assistance of experienced legal counsel to gather and present to the Texas Medical Board factual evidence and documentation that negate or mitigate charges of misconduct as well as signaling his interest and willingness to take action to mitigate the risks reflected by the charges and improve performance whether or not the action resulting in the charge in fact resulted in misconduct.
For Help With Compliance, Investigations Or Other Needs
If you need help dealing with licensing, peer review, or other quality assurance, compliance or other health care related risk management, compliance, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer, may be able to help. Vice President of the North Texas Health Care Compliance Professionals Association, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer has more than 24 years experience advising health industry clients about these and other matters. Ms. Stamer has extensive experience advising and assisting health care providers and other health industry clients to establish and administer and other compliance and risk management policies, to health care industry investigation, enforcement and other compliance, public policy, regulatory, staffing, and other quality and performance concerns, and to address other operations and risk management concerns. A popular lecturer and widely published author on health industry concerns, Ms. Stamer continuously advises health industry clients about compliance and internal controls, workforce and medical staff performance, quality, governance, reimbursement, and other risk management and operational matters. Ms. Stamer also publishes and speaks extensively on health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns/ She also regularly designs and presents risk management, compliance and other training for health care providers, professional associations and others including highly popular programs on “Sex Drugs & Rock ‘N Role: Managing Personal Misconduct in Health Care,” “Managing Physician Performance” and others.. Her publications and insights appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications. You can get more information about her health industry experience here. If you need assistance with these or other compliance concerns, wish to inquire about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here.
About Solutions Law Press
Solutions Law Press™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press resources including:
- Hospitals Can Expect CMS To Add Hospital Incident Reporting To Surveys In Response To OIG Report
- North Texas Medical Supply Company Owner Indicted For Health Care Fraud Now Also Charged With Immigration Fraud
- DOL Proposes Tighter Overtime, Minimum Wage Rules For Home Care Workers, Continues Scrutiny Of Health Care Employers
- DFW Hospital Council Foundation Among 26 Organizations Selected To Lead Quality Effort
- Former Houston Texas Physician Gets 70 Month Prison Sentence For Fraud Conviction
- Euless Healthcare Corporation Owner, Associates Face Conspiracy And Health Care Fraud Charges For Alleged Submission Of $700,000+ In Fraudulent Health Care Claims
- Former Manager 9th Employee Sentenced For Involvement In Maxim Medicare False Claims Action
- Medical Identity Theft/Fraud Convictions Highlight Need For Health Care Providers To Safeguard Health Information, Guard Against Fraud Schemes
- Detroit-Area Foot Doctor Pleads Guilty to Medicare Fraud Scheme
- Merck To Pay $950 Million To Settle Vioxx® Off-Label Marketing Charges
- Texas Medical Board Suspends Child Psychiatrist For Sexual Misconduct
- Joint Commission Equal Visitation Rules & Guidance Supplement New Medicare Equal Visitation Requirements
- OCR Audit Program Kickoff Further Heats HIPAA Privacy Risks
- Houston Doctor Gets 135 Month Health Care Fraud Sentence
- Bill Extending Funding For Certain Veteran Medical and Other Projects Heads To President
- OCR Settlements Show Health Care & Disabled Housing Providers Face Growing Disability Discrimination Risks
- Physician’s Suspension Shows Complying With Medical Board Orders Critical
- Bill Extending Funding For Certain Veteran Medical and Other Projects Heads To President
- UCLA Health Systems Payment of $865,500 To Settle HIPAA Charges Shows Rising HIPAA Risk
- Indictment of 91 Shows Growing Health Care Fraud
- Unions Get New Tool As NLRB Changes Bargaing Units Certification Rules For Non-Acute Health Care Facilities
- HHS Imposes 1st HIPAA Privacy Civil Penalty of $4.3 million
- States Get More Info On Affordable Care Act Medicaid Eligibility Maintenance Of Effort; Payers & Providers Must Monitor
- ONC Giving Small Critical Access And Rural Hospitals Added Electronic Health Records Funds
- Health Care Employer’s NLRB Settlement Shows Care Necessary When Using Social Networking & Other Policies Restricting Employee Communications
- Medicare Proposes To Require Providers To Notify Patients Of Quality Of Care Complaint Rights
- OIG Launch of Health Care Fraud “Most Wanted” List Sign of Enforcement Risks
- Rhode Island DHS Must Provide Translation, Other Services For Limited English, Other Language Impaired Persons
- Texas Doctor, Pharmacy Suspension Reminder of Pain Management Prescribing Risks
- Supreme Court Ruling Medical Resident Stipend Are Wages Highlights Advisability of Compliance Review
- CMS Physician Compare Tool Gives Patients New Info On Physicians & Other Providers
- Minimum Wage, Overtime Risks Highlighted By Labor Department Strike Force Targeting Residential Care & Group Homes
- Health Care Fraud Enforcement Packs New Heat
- President Signs Long-Sought Red Flag Rule Exemption Into Law
- Quality, Recordkeeping & Unprofessional Conduct Lead Reasons For Medical Board Discipline of Physicians
- DEA Cautions Practitioners Must Restrict Delegation of Controlled Substance Prescribing Functions, Urges Adoption of Written Policies & Agreements
- EEOC Attacks Medical Leave Denials As Prohibited Disability Discrimination
If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here. For important information concerning this communication click here.
THE FOLLOWING DISCLAIMER IS INCLUDED TO COMPLY WITH AND IN RESPONSE TO U.S. TREASURY DEPARTMENT CIRCULAR 230 REGULATIONS. ANY STATEMENTS CONTAINED HEREIN ARE NOT INTENDED OR WRITTEN BY THE WRITER TO BE USED, AND NOTHING CONTAINED HEREIN CAN BE USED BY YOU OR ANY OTHER PERSON, FOR THE PURPOSE OF (1) AVOIDING PENALTIES THAT MAY BE IMPOSED UNDER FEDERAL TAX LAW, OR (2) PROMOTING, MARKETING OR RECOMMENDING TO ANOTHER PARTY ANY TAX-RELATED TRANSACTION OR MATTER ADDRESSED HEREIN.
©2011 Cynthia Marcotte Stamer, P.C. Non-exclusive license to republish granted to Solutions Law Press. All other rights reserved.