State medical board chair Dr. Brian Hyatt resigns, faces Medicaid fraud allegations

Ashley Savage

Arkansas Democrat Gazette

Originally published 3 MAR 23

Dr. Brian Hyatt stepped down as chairman of the Arkansas State Medical Board Thursday in a special meeting following "credible allegations of fraud," noted in a letter from the state's office of Medicaid inspector general.

Members of the board met remotely Thursday with only one item on the agenda: "Discussion of Arkansas State Board's leadership."

The motion to approve Hyatt's request to step down as chairman and out of an executive role on the board was approved unanimously.

Board members also decided that Dr. Rhys Branman will take over as the interim chairman until an election to fill the seat is held in April.

According to the board Thursday, the vacant seats for vice chair and chair of the board will be voted on separate ballots in the April elections.

The Medicaid letter states "red flags" were discovered in Hyatt's use of Medicaid claims and process of billing for medical services. In Arkansas, Medicaid fraud resulting in an overpayment over $2,500 is a felony.

"Dr. Hyatt is a clear outlier, and his claims are so high they skew the averages on certain codes for the entire Medicaid program in Arkansas," the affidavit states.

"The suspension is temporary and there's a right to appeal. I see only allegations and I don't see any actual charges and I haven't dealt with this a lot," said Branman.

Hyatt has 30 days to appeal his suspension from the Medicaid program.

Other information from the letter shows that Hyatt is alleged to have billed more Medicaid patients at the 99233 code than any other doctor billed for all of their Medicaid patients between January of 2019 and June 30, 2022.

The info is here.

Abuse case reveals therapist’s dark past, raises ethical concerns

Associated Press

Originally posted 11 JUN 22

Here is an excerpt:

Dushame held a valid driver’s license despite five previous drunken driving convictions, and it was his third fatal crash — though the others didn’t involve alcohol. The Boston Globe called him “the most notorious drunk driver in New England history.”

But over time, he dedicated himself to helping people recovering from addiction, earning a master’s degree in counseling psychology and leading treatment programs from behind bars.

Two years later, he legally changed his name to Peter Stone. He was released from prison in 2002 and eventually set up shop as a licensed drug and alcohol counselor.

Last July, he was charged with five counts of aggravated felonious sexual assault under a law that criminalizes any sexual contact between patients and their therapists or health care providers. Such behavior also is prohibited by the American Psychological Association’s ethical code of conduct.

In a recent interview, the 61-year-old woman said she developed romantic feelings for Stone about six months after he began treating her for anxiety, depression and alcohol abuse in June 2013. Though he told her a relationship would be unethical, he initiated sexual contact in February 2016, she said.

“‘That crossed the line,’” the woman remembers him saying after he pulled up his pants. “‘When am I seeing you again?’”

While about half the states have no restrictions on name changes after felony convictions, 15 have bans or temporary waiting periods for those convicted of certain crimes, according to the ACLU in Illinois, which has one of the most restrictive laws.

Stone appropriately disclosed his criminal record on licensing applications and other documents, according to a review of records obtained by the AP. Disclosure to clients isn’t mandatory, said Gary Goodnough, who teaches counseling ethics at Plymouth State University. But he believes clients have a right to know about some convictions, including vehicular homicide.

The info is here.

Social Workers’ Perceptions of Their Peers’ Unprofessional Behavior

Gricus, M., & Wysiekierski, L. (2021).

Journal of Social Work. 

https://doi.org/10.1177/14680173211012576

Abstract

Summary

This article explores social workers’ perceptions of their colleagues’ professional mistakes, and the influences of those opinions. Vignettes in a factorial survey helped to determine whether certain variables related to the social worker or the situation influenced the perception of others’ professional errors and ethical violations. The changed variables included personal characteristics of the offending social worker such as perceived race, gender, and sexual orientation of the social worker, and characteristics of the situation, such as the length of time involved in unprofessional behavior.

Findings

Licensed social workers in six U.S. states (n = 5596) read vignettes based on real cases brought before licensing boards (n = 22,127) and assigned levels of seriousness and importance to discipline. The vignettes rated most highly involved perceived harm to a client or other vulnerable individual. Those on the lower end of seriousness and importance to discipline were those violations against the profession of social work. Analysis of changed variables indicated respondents’ ratings were influenced by several situational factors, but not by personal characteristics of the social worker involved in the vignette.

Applications

Our findings provide some insight into the decision-making factors important to social workers. The results may be helpful to licensing boards considering the contextual factors of unprofessional behavior and whether to discipline certain actions.

From the article:

The availability heuristic proposes that people make judgments based only on the information available at the time (Croskerry, 2002; Shah & Oppenheimer, 2008). The representativeness heuristic allows people to judge whether an example belongs to a given category (Bowes et al., 2020). In clinical settings, this heuristic can play out in diagnosing similar, but not identical, clinical presentations with the same diagnosis. The representativeness heuristic can also cause people to make judgments based on race and gender stereotypes (Bowes et al., 2020). Bisking et al. (2003) (as cited in Salvador, 2019) found that when individuals are involved in enacting sanctions on someone perceived to have engaged in misconduct, their decisions are influenced by characteristics of the offender such as gender. The anchoring and adjustment heuristic, also known as focalism or priming, reveals that people form judgments largely based on the first piece of information they receive and weigh it against all other information (Bowes et al., 2020). Focalism can help to explain why misinformation can be difficult to disprove.

The research is here.

Spreading False Vax Info Might Cost You Your Medical License

Ryan Basen

Medpagetoday.com

Originally posted 3 Aug 21

Physicians who intentionally spread misinformation or disinformation about the COVID-19 vaccines could be disciplined by state medical boards and may have their licenses suspended or taken away, said the Federation of State Medical Boards (FSMB).

Due "to a dramatic increase in the dissemination of COVID-19 vaccine misinformation and disinformation by physicians and other health care professionals on social media platforms, online and in the media," the FSMB, a national nonprofit representing medical boards that license and discipline allopathic and osteopathic physicians, issued the following statement:

Physicians who willfully generate and spread COVID-19 vaccine misinformation or disinformation are risking disciplinary action by state medical boards, including the suspension or revocation of their medical license. Due to their specialized knowledge and training, licensed physicians possess a high degree of public trust and therefore have a powerful platform in society, whether they recognize it or not. They also have an ethical and professional responsibility to practice medicine in the best interests of their patients and must share information that is factual, scientifically grounded and consensus driven for the betterment of public health. Spreading inaccurate COVID-19 vaccine information contradicts that responsibility, threatens to further erode public trust in the medical profession and puts all patients at risk.

The FSMB is aiming to remind physicians that words matter, that they have a platform, and that misinformation and disinformation -- especially within the context of the pandemic -- can cause harm, said president and CEO Humayun Chaudhry, DO. "I hope that physicians and other licensees get the message," he added.

The info is here.

New Texas rule lets social workers turn away clients who are LGBTQ or have a disability

Edgar Walters

Texas Tribune

Originally posted 14 Oct 2020

Texas social workers are criticizing a state regulatory board’s decision this week to remove protections for LGBTQ clients and clients with disabilities who seek social work services.

The Texas State Board of Social Work Examiners voted unanimously Monday to change a section of its code of conduct that establishes when a social worker may refuse to serve someone. The code will no longer prohibit social workers from turning away clients on the basis of disability, sexual orientation or gender identity.

Gov. Greg Abbott’s office recommended the change, board members said, because the code’s nondiscrimination protections went beyond protections laid out in the state law that governs how and when the state may discipline social workers.

“It’s not surprising that a board would align its rules with statutes passed by the Legislature,” said Abbott spokesperson Renae Eze. A state law passed last year gave the governor’s office more control over rules governing state-licensed professions.

The nondiscrimination policy change drew immediate criticism from a professional association. Will Francis, executive director of the Texas chapter of the National Association of Social Workers, called it “incredibly disheartening.”

He also criticized board members for removing the nondiscrimination protections without input from the social workers they license and oversee.

The info is here.

Note: All psychotherapy services are founded on the principle of beneficence: the desire to help others and do right by them.  This decision from the Texas State Board of Social Work Examiners is terrifyingly unethical.  The unanimous decision demonstrates the highest levels of incompetence and bigotry.

Pa. prison psychologist loses license after 3 ‘preventable and foreseeable’ suicides

Samantha Melamed
inquirer.com
Originally posted 4 Dec 19

Nearly a decade after a 1½-year stretch during which three prisoners at State Correctional Institution Cresson died by suicide and 17 others attempted it, the Pennsylvania Board of Psychology has revoked the license of the psychologist then in charge at the now-shuttered prison in Cambria County and imposed $17,233 in investigation costs.

An order filed Tuesday said the suicides were foreseeable and preventable and castigated the psychologist, James Harrington, for abdicating his ethical responsibility to intervene when mentally ill prisoners were kept in inhumane conditions — including solitary confinement — and were prevented from leaving their cells for treatment.

Harrington still holds an administrative position with the Department of Corrections, with an annual salary of $107,052.

The info is here.

Medical board declines to act against fertility doctor who inseminated woman with his own sperm

Dr. McMorries

Marie Saavedra and Mark Smith
wfaa.com
Originally posted Oct 28, 2019

The Texas Medical Board has declined to act against a fertility doctor who inseminated a woman with his own sperm rather than from a donor the mother selected.

Though Texas lawmakers have now made such an act illegal, the Texas Medical Board found the actions did not “fall below the acceptable standard of care,” and declined further review, according to a response to a complaint obtained by WFAA.

In a follow-up email, a spokesperson told WFAA the board was hamstrung because it can't review complaints for instances that happened seven years or more past the medical treatment. 

The complaint was filed on behalf of 32-year-old Eve Wiley, of Dallas, who only recently learned her biological father wasn't the sperm donor selected by her mother. Instead, Wiley discovered her biological father was her mother’s fertility doctor in Nacogdoches.

Now 65, Wiley's mother, Margo Williams, had sought help from Dr. Kim McMorries because her husband was infertile.

The info is here.

Ohio medical board knew late doctor was sexually assaulting his male patients, but did not remove his license, report says

Richard Strauss

Laura Ly
CNN.com
Originally posted August 30, 2019

Dr. Richard Strauss is believed to have sexually abused at least 177 students at Ohio State University when he worked there between 1978 and 1998. A new investigation has found that the State Medical Board of Ohio knew about the abuse by the late doctor but did nothing.

A new investigation by a working group established by Ohio Gov. Mike DeWine found that the state medical board investigated allegations of sexual misconduct against Strauss in 1996.

The board found credible evidence of sexual misconduct by Strauss and revealed that Strauss had been "performing inappropriate genital exams on male students for years," but no one with knowledge of the case worked to remove his medical license or notify law enforcement, DeWine announced at a press conference Friday.

The investigation revealed that an attorney with the medical board did intend to proceed with a case against Strauss, but for some reason never followed through. That attorney, as well as others involved with the 1996 investigation, are now deceased and cannot be questioned about their conduct, DeWine said.

"We'll likely never know exactly why the case was ultimately ignored by the medical board," DeWine said Friday.

The allegations against Strauss — who died by suicide in 2005 — emerged last year after former Ohio State athletes came forward to claim the doctor had sexually abused them under the guise of a medical examination.

The info is here.

Therapist accused of sending client photos of herself in lingerie can’t get her state license back: Pa. court

Matt Miller
www.pennlive.com
Originally posted July 17, 2019

A therapist who was accused of sending a patient photos of herself in lingerie can’t have her state counseling license back, a Commonwealth Court panel ruled Wednesday.

That is so even though Sheri Colston denied sending those photos or having any inappropriate interactions with the male client, the court found in an opinion by Judge Robert Simpson.

The court ruling upholds an indefinite suspension of Colston’s license imposed by the State Board of Social Workers, Marriage and Family Therapists and Professional Counselors. That board also ordered Colston to pay $7,409 to cover the cost of investigating her case.

The info is here.

Time to End Physician Sexual Abuse of Patients: Calling the U.S. Medical Community to Action

AbuDagga, A., Carome, M. & Wolfe, S.M.
J GEN INTERN MED (2019).
https://doi.org/10.1007/s11606-019-05014-6

Abstract

Despite the strict prohibition against all forms of sexual relations between physicians and their patients, some physicians cross this bright line and abuse their patients sexually. The true extent of sexual abuse of patients by physicians in the U.S. health care system is unknown. An analysis of National Practitioner Data Bank reports of adverse disciplinary actions taken by state medical boards, peer-review sanctions by institutions, and malpractice payments shows that a very small number of physicians have faced “reportable” consequences for this unethical behavior. However, physician self-reported data suggest that the problem occurs at a higher rate. We discuss the factors that can explain why such sexual abuse of patients is a persistent problem in the U.S. health care system. We implore the medical community to begin a candid discussion of this problem and call for an explicit zero-tolerance standard against sexual abuse of patients by physicians. This standard must be coupled with regulatory, institutional, and cultural changes to realize its promise. We propose initial recommendations toward that end.

Somers Point therapist charged with hiring hitman to 'permanently disfigure' victim

Lauren Carroll
The Press of Atlantic City
Originally posted November 6, 2018

A Somers Point therapist told an undercover FBI agent posing as a hitman she wanted her Massachusetts colleague’s “face bashed-in” and arm broken, according to a criminal complaint filed with the U.S Attorney’s Office.

Diane Sylvia, 58, has been charged with solicitation to commit a crime of violence and appeared in Camden federal court Monday.

According to the criminal complaint filed Friday, a person contacted the FBI to report a murder-for-hire scheme on Sept. 24.

The informant is a former member of an organization criminal gang and was in therapy with Sylvia, a licensed clinical social worker. Sylvia allegedly asked the informant to help kill a North Attleboro, Massachusetts, man, the complaint said.

Sylvia’s lawyer Michael Paulhus of Toms River could not be reached for comment. Sylvia could not be reached for comment.

According to the court documents, Sylvia targeted the man after he threatened to report her to a licensing board. She wanted the man assaulted to “make (her) feel better,” according to court documents.

The info is here.

Illegal VA policy allows hiring since 2002 of medical workers with revoked licenses

Donovan Slack
USA Today
Originally published December 21, 2017

The Department of Veterans Affairs has allowed its hospitals across the country to hire health care providers with revoked medical licenses for at least 15 years in violation of federal law, a USA TODAY investigation found.

The VA issued national guidelines in 2002 giving local hospitals discretion to hire clinicians after “prior consideration of all relevant facts surrounding” any revocations and as long as they still had a license in one state.

But a federal law passed in 1999 bars the VA from employing any health care worker whose license has been yanked by any state.

Hospital officials at the VA in Iowa City relied on the illegal guidance earlier this year to hire neurosurgeon John Henry Schneider, who had revealed in his application that he had numerous malpractice claims and settlements and Wyoming had revoked his license after a patient death. He still had a license in Montana.

The article is here.

Two licensing boards, for psychologists and counselors, at impasse with governor over sexual orientation language

Nancy Hicks
Lincoln Journal Star  
Originally posted March 11, 2017

Two state licensing boards that oversee psychologists and mental health counselors have been at odds with two Nebraska governors and the Nebraska Catholic Conference for almost a decade over sexual orientation and gender identity language in their rules.

The two licensing boards -- the Board of Psychology and the Board of Mental Health Practice -- have been unable to update their rules because they have refused to compromise on these issues.

And it looks like that impasse will continue, after the administration of Gov. Pete Ricketss recently rejected both sets of rules and provided its own draft of acceptable language.

That proposed language -- which strips out antidiscrimination protection based on sexual orientation and gender identity -- “is completely unacceptable and egregious,” said Dr. Anne Talbot, president of the Nebraska Psychological Association, which represents psychologists across the state.

Her group will oppose the administration's proposed changes when the issue is before the state licensing board May 31.

The article is here.

Risk Management and You: 9 Most Frequent Violations for Psychologists

Ken Pope and Melba Vasquez
Ethics in Psychotherapy and Counseling: Practical Guide (5th edition)
(2016)

For U.S. and Canadian psychologists, the 9 most frequent causes among the 5,582 disciplinary actions over the years were (in descending order of frequency):

1. unprofessional conduct, 
2. sexual misconduct, 
3. negligence, 
4. nonsexual dual relationships, 
5. conviction of a crime, 
6. failure to maintain adequate or accurate records, 
7. failure to comply with continuing education or competency requirements, 
8. inadequate or improper supervision or delegation, and 
9. substandard or inadequate care. 

The book can be purchased here.

Cross-Sectional Analysis of the 1039 U.S. Physicians Reported to the National Practitioner Data Bank for Sexual Misconduct, 2003-2013

Azza AbuDagga , Sidney M. Wolfe , Michael Carome , Robert E. Oshel
PLoS ONE 11(2): e0147800.

Background

Little information exists on U.S. physicians who have been disciplined with licensure or restriction-of-clinical-privileges actions or have had malpractice payments because of sexual misconduct. Our objectives were to: (1) determine the number of these physicians and compare their age groups’ distribution with that of the general U.S. physician population; (2) compare the type of disciplinary actions taken against these physicians with actions taken against physicians disciplined for other offenses; (3) compare the characteristics and type of injury among victims of these physicians with those of victims in reports for physicians with other offenses in malpractice-payment reports; and (4) determine the percentages of physicians with clinical-privileges or malpractice-payment reports due to sexual misconduct who were not disciplined by medical boards.

The article is here.

Complaints about doctors rarely lead to formal discipline

By Holly Moore
CBC News 
Originally posted January 29, 2016

Nearly 8,000 Canadians filed a complaint about a physician last year, but on average only about 54 doctors were formally disciplined in each of the past 15 years. Of those complaints, just over half were determined to require no further action.

Historical data examined by CBC News found cases of 817 physicians that resulted in formal discipline, which is the only part of the disciplinary process for colleges of physicians and surgeons that is consistently made public across Canada.

"That number's not anywhere near what's actually happening. Those are the ones you could get to," said Ann Van Regan, a volunteer responder with TELL (Therapy Exploitation Link Line), a network of survivors of sex abuse by physicians and psychotherapists. "They say they're taking it seriously, but their actions show that they are not."

The article is here.

When the Therapist Is a Quack

By Olga Khazan
The Atlantic
Originally published June 4, 2015

Here is an excerpt:

Some conversion therapy practitioners are bona-fide psychologists or counselors. But many operate on the fringes, pitching themselves either as religious mentors or, in Downing’s case, as mere “coaches.” In some ways, the rise of therapeutic-sounding titles like “life coach”—with its patina of personal growth and near absence of accountability—has allowed conversion therapy to flourish.

“To my knowledge there is no regulation of the [life coach] title, nor are they licensed by any state,” said Jack Drescher, a psychiatrist and psychoanalyst who helped write the American Psychological Association’s reports on conversion therapies. “As far as I know, life coaches can say and do pretty much whatever they want.” In most states, he added, even the title of "therapist" is not regulated: Anyone who wants to hang a shingle, can.

The entire article is here.

Psychologist in "Kids for Cash" Scandal Surrenders License

By Roger DuPuis
The Times Leader
Originally published November 12, 2014

The psychologist brother-in-law of disgraced former Luzerne County judge Michael T. Conahan has given up his license for “gross incompetence, negligence or misconduct” carrying out his past work evaluating juveniles in the county court system, state officials said Wednesday.

The Pennsylvania Board of Psychology said Frank James Vita, of Dorrance Township, “grossly deviated from ethical and professional standards” after reviewing 76 of the cases he had handled.

Vita once was linked to the county’s “Kids for Cash” judicial scandal in a civil suit that alleged he conspired with Conahan and fellow former judge Mark Ciavarella to perform evaluations that led to juveniles being incarcerated in facilities in which the judges had a financial interest.

The entire article is here.

When Do Doctors Have the Right to Speak?

Room for Debate

The New York Times

Updated August 22, 2014

Here are two great questions to debate in any ethics class, from the New York Times.

Two federal appellate court decisions, one allowing Florida to prevent doctors from discussing gun safety with patients, the other letting California ban “gay-conversion” therapy, raise questions about health professionals’ First Amendment rights.

Do occupational-licensing laws trump the First Amendment? What limits, if any, does the First Amendment impose on government’s ability to restrict advice?

The responses are here.

Here is one response:

As a physician, it is important to remember the guiding principle of medicine: "first, do no harm." Barring physicians from discussing whether or not lethal weapons exist in the home is wrong. It is well understood that the simple presence of a firearm in the home is associated with a greater risk of bodily harm - either to oneself or any children in the home. Asking about weapons is a usual (standard and accepted) practice as part of the screening assessment for depression; since those with easy access to a firearm and who have suicidal thoughts are significantly more likely to harm themselves. Here, the physician's role is simple: protect human life. Contrast this to the ban on "gay-conversion," therapy, which has been scientifically proven to have more harm than benefit to the individual. In both cases, the tenet being upheld here is to "first, do no harm." It is tragically ironic that those who are often supporting both of these causes are one usually crying to "get the government out of my healthcare," yet they seem perfectly willing to impede the practice of good medicine when it is politically expedient. I can only hope that those supporting the "opposite" views from those expressed here will have a caring physician him/herself that will ignore these political debates in order to provide care that is in the best interest of the patient.

Prominent Hilton Head psychologist’s license revoked; Sex with patient alleged

By Alice Stice
The State (South Carolina News Site)
Originally published May 31, 2013

A prominent Hilton Head Island psychologist has had his license permanently revoked for having a sexual relationship with a patient that included intimate encounters in his office, according to an order from the S.C. Board of Examiners in Psychology.

Dr. Howard Rankin, a psychologist, neuropsychologist and author who has been featured in the national media, admitted the relationship to an investigator from the S.C. Department of Labor, Licensing & Regulation and is barred from practice after an April disciplinary hearing before the board, records show.

Rankin has been featured as an expert on addiction, weight loss and other fields in The Wall Street Journal and Los Angeles Times, and has appeared as a guest on CNN and ABC’s “The View” and “20/20.”

He declined to comment for this article.

According to the board’s order, a female patient diagnosed with borderline personality disorder and post-traumatic stress disorder began seeing Rankin for therapy in 2005. The patient, referred to only by her initials in the order, had attempted suicide on several occasions and had been hospitalized for psychiatric treatment more than once, the order says.

The entire story is here.