STATE OF FLORIDA DEPARTMENT OF HEALTH

Transcription

1 DEPARTMENT OF HEALTH, Petitioner, STATE OF FLORIDA DEPARTMENT OF HEALTH v. CASE NO.: ISHRAT SONAR, M.D., Respondent. ADMINISTRATIVE COMPLAINT Petitioner Department of Health files this before the Board of Medicine against Respondent Ishrat Sohail, M.D., and in support thereof alleges: 1. Petitioner is the state agency charged with regulating the practice of medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed medical doctor within the state of Florida, having been issued license number ME Respondent's address of record is 2702 North Orange Avenue, Suite B, Orlando, Florida DOH v. Ishrat Sohail, M.D. 1

2 4. At all times material to this Complaint, Respondent participated in the Vaccines for Children (VFC)1 program. 5. In or about 2016, the Department of Health (DOH) conducted an inspection of Respondent's office to ensure Respondent's compliance with the rules and regulations of the VFC program. 6. During this inspection, Respondent was found to have administered two vials of VFC vaccines to non-medicaid patients. The cost of these two vaccine administrations were then billed to those patient's private insurance company. 7. On one or more occasions, on or between 2016 and January 17, 2018, Respondent used vaccines provided to her at no cost by the VFC program to vaccinate one or more patients with private insurance. 8. Respondent then billed the patient's private insurance company for the cost of administering the vaccines. 1 Vaccines for Children (VFC), is a program funded through the Center for Medicaid and Medicare Services intended to provide free vaccines for Medicaid recipients and uninsured children to help prevent the spread of life-threatening diseases. In Florida, the program is administered by the Florida Department of Health, Division of Disease Control and Health Protection, Bureau of Communicable Diseases, Immunization Section (DOH). The program allows participating doctors to order free vaccines to be used for qualifying patients (Medicaid recipients or uninsured children). Each vaccine has a unique lot number, and participating doctors are required to record the vaccines administered to each patient. Doctors must complete annual training and detailed record keeping training before participating in the program. The VFC program requires doctors to reimburse the program for any vaccines administered to privately insured patients. DOH v. Ishrat Sohail, M.D. 2

3 9. Respondent never reimbursed the VFC program for the improperly used VFC vaccines. 10. On one or more occasions, on or between 2016 and January 17, 2018, Respondent administered partial doses of single-dose vaccines to more than one patient. 11. Respondent inaccurately recorded the administration of a full, proper dose of the vaccine in each patient's medical records. 12. On or about January 24, 2018, DOH conducted an inspection of Respondent's office. 13. During the inspection, Respondent removed partially used vaccines from the office refrigerator and placed them in her pocket. 14. The DOH inspector observed five partially used, single-dose vaccine vials in the office refrigerator. 15. Single-dose vaccine vials should not have any vaccine remaining after administration and should be discarded after administration. There is no medical reason to save a used vial of a single-dose vaccine nor for a vial to have any vaccine left inside after administration. DOH v. Ishrat Sohail, M.D.

4 16. On February 16, 2018, the Medicaid Fraud Control Unit (MFCU)2, DOH investigators, and the Orlando Police Department executed a search warrant at Respondent's office. 17. During the search, MFCU located several empty vaccine vial boxes in Respondent's desk. 18. Respondent kept the empty vial boxes in her desk because she had not yet used those lot numbers for billing purposes and intended to use the lot numbers of these empty vials to engage in fraud. 19. MFCU investigators located three partially administered singledose vials of vaccines, containing various amounts of liquid inside, from within the office refrigerator. 20. On February 21, 2018, the MFCU met with DOH Inspector Robert Colon to review Vaccine Utilization Reports and Vaccine Usage Worksheets obtained during the January 2018 inspection of Respondent's office. 21. On one or more occasions, on or between October 1, 2017, through January 23, 2018, Respondent administered 63 vaccines to 43 2 The Medicaid Fraud Control Unit (MFCU) exists to investigate Medicaid fraud in the State of Florida. The MFCU is under the authority and supervision of the Office of the Attorney General of the State of Florida. The MFCU is authorized to investigate violations of section , Florida Statutes, Medicaid provider fraud, and any criminal violations discovered during those investigations. DOH v. Ishrat Sohail, M.D. 4

5 different patients with private insurance with vaccines that the VFC program had provided to Respondent at no cost. COUNT ONE 22. Petitioner re-alleges and incorporates paragraphs one through twenty-one as if fully set forth herein. 23. Section (1)(h), Florida Statutes ( ), subjects a licensee to discipline for making or filing a report which the licensee knows to be false, intentionally or negligently failing to file a report or record required by state or federal law, willfully impeding or obstructing such filing or inducing another person to do so. Such reports or records shall include only those which are signed in the capacity as a licensed physician. 24. Respondent violated section (1)(h), Florida Statutes ( ) in one or more of the following ways: a. Intentionally failing to file a report or record required by state or federal law to reimburse the VFC program for vaccines administered to private-pay patients; b. Intentionally filing false and fraudulent Medicaid and insurance claims. 25. Based on the foregoing, Respondent violated Section (1)(h), Florida Statutes ( ). DOH v. Ishrat Sohail, M.D. 5

6 COUNT TWO 26. Petitioner re-alleges and incorporates paragraphs one through twenty-one as if fully set forth herein. 27. Section (1)(p), Florida Statutes ( ), subjects a licensee to discipline for performing professional services which have not been duly authorized by the patient or client, or his or her legal representative, except as provided in s , s , or s Respondent administered less than full doses of vaccines to patients without their knowledge and informed consent to receiving less than the full dose. 29. Based on the foregoing, Respondent violated (1)(p), Florida Statutes ( ). COUNT THREE 30. Petitioner re-alleges and incorporates paragraphs one through twenty-one as if fully set forth herein. 31. Section (1)(k), Florida Statutes ( ), subjects a licensee to discipline for making deceptive, untrue, or fraudulent representations in or related to the practice of medicine or employing a trick or scheme in the practice of medicine. DOH v. Ishrat Sohail, M.D. 6

7 32. Respondent violated Section (1)(k), Florida Statutes ( ), in one or more of the following ways: a. Improperly administered VFC program vaccines to privately insured patients without reimbursing the VFC program and with the intent to receive payment from private insurance companies for vaccines that she was provided for free from the VFC; and b. Administered improper partial doses of vaccines to Medicaid and VFC eligible patients and privately insured patients who presented to her to be properly immunized. 33. Based on the foregoing, Respondent violated section (1)(k), Florida Statutes ( ). COUNT FOUR 34. Petitioner re-alleges and incorporates paragraphs one through twenty-one as if fully set forth herein. 35. Section (1)(g), Florida Statutes ( ), subjects a licensee to discipline for failing to perform any statutory or legal obligation placed upon a licensed physician. 36. Respondent failed to comply with one or more of the following statutory or legal obligations governing her participation in the VFC program: a. VFC Program Provider Agreement dated March 7, 2016; DOH v. Ishrat Sohail, M.D. 7

8 b. VFC Program Provider Agreement dated January 6, 2017; c. VFC Program Provider Agreement dated November 15, 2017; d. VFC Program Provider Agreement dated December 12, 2017; e. Section (2)(a)3, Florida Statutes ( ); f. Section (2)(b)1a, Florida Statutes ( ); g. 42 U.S.C. 1396s. 37. Based on the foregoing, Respondent violated section (1)(g), Florida Statutes ( ). COUNT FIVE 38. Petitioner re-alleges and incorporates paragraphs one through twenty-one as if fully set forth herein. 39. Section (1)(r), Florida Statutes ( ), subjects a licensee to discipline for improperly interfering with an investigation or inspection authorized by statute, or with any disciplinary proceeding. 40. Respondent, during the January 24, 2018 DOH inspection, removed partially used vaccine vials from the refrigerator and placed them in her pocket to conceal them from the inspector. 41. Based on the foregoing, Respondent violated section (1)(r), Florida Statutes ( ). DOH v. Ishrat Sohail, M.D. 8

9 WHEREFORE, Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. SIGNED this 9th day of March, Celeste Philip, MD, MPH Surgeon General and Secretary FILED DEPARTMENT OF HEALTH DEPUTY CLERK CLERK Angel Sanders DATE MAR /14,er Keith Humphrey Assistant General Counsel Florida Bar No Florida Department of Health Prosecution Services Unit 4052 Bald Cypress Way-Bin C-65 Tallahassee, Florida (P) (850) (F) (850) Keith.Humphrey@flhealth.gov PCP Date: March 9, 2018 PCP Members: Avila, Rosenberg, Mullins DOH v. Ishrat Sohail, M.D.

10 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section and , Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. A request or petition for an administrative hearing must be in writing and must be received by the Department within 21 days from the day Respondent received the, pursuant to Rule (2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule (4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in the must conform to Rule (5), Florida Administrative Code. Mediation under Section , Florida Statutes, is not available to resolve this. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section (4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed. DOH v. Ishrat Sohail, M.D. 10