DANS (Disciplinary Action Notification System) Pat Janda Director, Credentials and Meetings American Board of Psychiatry and Neurology

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DANS (Disciplinary Action Notification System) Pat Janda Director, Credentials and Meetings American Board of Psychiatry and Neurology

Outline of Presentation 1. Current ABPN Licensure Language 2. DANS Procedures 3. Reinstatement 4. Retired Physicians 5. Alerts Investigated 6. Certificates Invalidated 7. No Action Taken 8. Behavior Leading to ABPN Action

1. Current ABPN License Language Subject to the exceptions noted below, throughout the certification and maintenance of certification processes, and in order to maintain a valid certificate and ABPN Diplomate status, physicians must, at all times, hold an active, full, and unrestricted allopathic and/or osteopathic license to practice medicine in at least one state, commonwealth, territory, or possession of the United States or province of Canada. If licenses are or have been held in more than one jurisdiction, all licenses held by the physician must be full and unrestricted to meet this requirement. An active, full, and unrestricted medical license must be maintained even if a physician is out of the country for extended periods of time.

Current ABPN License Language An unrestricted medical license is a license to practice medicine that has been issued by an appropriate and authorized licensing board and contains no restrictions, conditions, or contingencies on the physician s privilege to practice professionally and does not have any added requirements to remain full and active.

Current ABPN License Language Restrictions include but are not limited to any revocation, suspension, limitation or prohibition against attaining any Drug Enforcement Administration license and/or any licensing board action that results in a revocation, cancellation, suspension, condition, obligation, requirement, probation, forfeiture, surrender, failure to renew, prohibition against applying or renewing, lapse, inactive status or contingency imposed upon a license or in any way relevant to the physician's privilege to practice professionally regardless of whether the restriction was imposed by an adjudicated order, agreed order, non-contested order, consent order, agreement, stipulation, settlement, or plea agreement. In addition, restrictions include any incarceration as a result of any criminal charges, indictments and/or convictions.

Current ABPN License Language A diplomate who is in possession of a restricted medical license pursuant to these policies, whether the Board knows of the restriction or not, no longer meets the Board's licensure requirements and shall, without any action necessary by the Board or any right to a hearing, automatically lose his or her diplomate status in all specialties and subspecialties for which the individual has received a certificate from the Board, and all such certificates shall be invalid. A physician in possession of any restricted medical license, even if the physician also possesses an unrestricted license, will not be scheduled for examination, be issued a certificate, or be allowed to represent himself or herself as an ABPN-certified physician. It is the obligation of the candidate/diplomate to inform the Board immediately upon any change in licensure status.

Current ABPN License Language Exceptions: Restriction of a physician s medical license does not include voluntary participation in an impaired physicians' program or other appropriate, monitored alcohol or chemical substance abuse recovery program if the physician has NOT been reported to either the National Practitioner Data Bank or the Data Bank of FSMB. Restriction of a physician s medical license does not include medical licenses that, when issued, are limited to a geographic area within a jurisdiction (e.g., practice limited to under-served areas) as long as such licenses are not in any way limited due to, because of, or by virtue of a disciplinary, legal, or administrative action against the license holder. At its sole discretion, the Board may review instances of licensure restrictions to determine whether such restrictions constitute a violation of the Board s licensure requirements.

2. DANS PROCEDURES DANS Administrator reviews DANS e-mail alerts to see if she should proceed with investigation DANS Administrator contacts the state medical board DANS Administrator reviews the documentation from the state licensing board Manager and Director, Credentials reviews recommendations of DANS Administrator If there are no restrictions, or if the physician is not an ABPN candidate/diplomate no action is taken If it is unclear if ABPN is okay to move forward with invalidating, the file is sent to the attorney for review.

DANS PROCEDURES If the physician has a license restriction: DANS Administrator sends letter to physician stating that it appears that the physician no longer meets the ABPN license requirement and therefore, physician: cannot sit for ABPN exam or ABPN certificate(s) are no longer valid. The physician is given 30 days to respond to the letter. This gives the physician the opportunity to provide any updated documentation or request clarification regarding the ABPN s policy on license restrictions.

DANS PROCEDURES After 30 days, DANS Administrator sends second letter to physician stating: Physician no longer meets Board requirements, Diplomate status is no longer in effect for all specialties/subspecialties, Physician should discontinue referring to himself as a diplomate of the ABPN, Physician must return all ABPN certificates, and ABPN will remove diplomate s name from ABMS website as an ABPN certified diplomate. ABPN reports to ABMS and to AAN names of physicians who have been invalidated.

3. Reinstatement In order for physician to be re-instated: All licenses must be full and unrestricted. Physician must: Pay $350.00 re-instatement fee Complete one unit of MOC activities, including 90 CME s 24 CME s from SA 1 PIP Pass the MOC exam

Reinstatement Once the physician has passed the MOC exam, a new certificate is issued. The certificate issued is time-limited, even if the physician previously held a life-time certificate.

4. Retired Physicians ABPN has established a Certified-Retired status for Diplomates who have surrendered their license for nondisciplinary and/or non-ethical related reasons. Certified-Retired status does not apply to Diplomates who have voluntarily or involuntarily suspended their practice with the intention of returning to practice.

5. Alerts Investigated Year P N ChiN P/N Total 2007 98 18 5 0 121 2008 123 29 5 0 157 2009 270 40 8 2 320 2010 261 43 6 1 311 2011 183 43 3 1 230 2012 147 30 5 1 183 2013 98 27 6 1 132 2014 468 106 24 2 600 2015 1173 204 19 0 1396 14

6. Certificates Invalidated Year P N ChiN P/N Total 2007 16 2 1 0 19 2008 24 2 0 0 26 2009 54 12 2 0 68 2010 99 16 3 0 118 2011 22 5 0 0 27 2012 13 2 2 0 17 2013 21 6 1 0 28 2014 88 69 6 0 163 2015 350 38 4 0 392 15

7. No Action Taken Year P N ChiN P/N Total 2007 39 9 3 0 51 2008 64 22 4 0 90 2009 97 13 3 2 115 2010 127 20 3 1 151 2011 64 17 2 1 84 2012 38 14 0 0 53 2013 28 11 1 1 41 2014 149 23 10 1 183 2015 538 98 12 0 648 16

Reasons for No Action Taken Minor State Board administrative matters License is now clear. Certificate has already been invalidated. Diplomate is retired. Diplomate is deceased. 17

8. Behavior leading to ABPN Action Behavior leading to restricted license Failure to comply with CME Failure to maintain medical records Chemical dependency Boundary Issues Inappropriate prescribing Surrendered license to avoid adverse action Non payment of income taxes Unprofessional conduct-improper management of medical records Convicted of a crime ABPN Action Invalidate (if reprimanded and license has conditions) Invalidate Invalidate (unless has been on probation for 5 yrs. and met probation) Invalidate Invalidate Invalidate Invalidate Invalidate Invalidate 18