BEFORE THE MINNESOTA COPY OF ORIGINAL BOARD OF MEDICAL PRACTICE COMPLAINT REVIEW COMMITTEE

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< " TRUE AND EXACT BEFORE THE MINNESOTA COPY OF ORIGINAL BOARD OF MEDICAL PRACTICE COMPLAINT REVIEW COMMITTEE In the Matter ofthe Medical License of Thomas A Niebeling, M,D, Birth Date: 417/1960 License Number: 34,051 AGREEMENT FOR CORRECTIVE ACTION This agreement is entered into by and bet\veen Thomas A. },Jiebeling, I\'1.D. ("Respondent"), and the Complaint Review Committee of the Minnesota Board of Medical Practice ("Committee") pursuant to the authority of Minn, Stat. 214.103, subd,6(a) (2010). Respondent has been advised by Board representatives that Respondent may choose to be represented by legal counsel in this matter. Respondent has chosen to be represented by Rebecca Egge Moos, Bassford Remelt!, 33 South Sixth Street, Suite 3800, Minneapolis, Minnesota 55402, telephone (612) 333-3000. The Board was represented by Kermit N. Fruechte, Assistant Attorney General, 1400 Bremer Tower, 445 Minnesota Street, St. Paul, Minnesota 55101, (651) 296-7575. Respondent and the Committee hereby agree as follows: FACTS 1. Thi~. Agreement is based upon the foho\ving facts: a. Respondent was licensed by the Board to practice medicine and surgery in the State of Minnesota on September 15, 1990. Respondent is board-certified in family medicine. b. In October 2009, the Board received a complaint alleging that Respondent inappropriately prescribed controlled substances and failed to recognize drug-seeking behaviors in his patients. The Board initiated an investigation by the Attorney General's Office, including

an audit of Respondent's practice, which revealed concerns regarding Respondent's patient care, documentation, and his prescribing practices and procedures. 2. On May 11, 2011, Respondent met with the Complaint Review Committee to discuss the infonnation set forth in paragraph 1 above. Based on thediscussion, the Committee views Respondent's conduct as inappropriate under Minn. Stat. 147.091, subd. 1(0), and (s) (2010), and Respondent agrees that the conduct cited above constitutes a reasonable basis in law and fact to justify corrective action under these statutes. CORRECTIVE ACTION 3. Respondent agrees to address the concerns referred to in paragraph I by taking the following corrective action: a. Respondent shall successfully complete the following coursework, approved in advance by the Complaint Review Committee or its designee, within one year of the date of this Agreement: 1) Chemical dependency awareness. 2) Chronic pain management. 3) Medical records management. 4). Assertiveness training. Successful completiollshall be determined by the Board or its designee. b. Respondent shall read the "Model Policy for the Use of Controlled Substances for the Treatment of Pain," adopted as policy by the House of Delegates of the Federation of State Medical Boards of the United States, Inc. (FSMB"j, May 2004. Respondent shall also read Responsible Opioid Prescribing, A Physician's Guide," by Scott M. Fishman, M.D., published by Waterford Life Sciences, Washington D.C., 2007. 2

c. Following successful completion of the above-reference coursework and following his reading of the FSMB guidelines and the Responsible Opioid Prescribing book referenced above, and within one year of the date of this Agreement, Respondent shall write and submit a paper, for review and approval by the Complaint Review Committee or its designee, discussing what he has learned from the required coursework, what he has learned from his reading of the FSMB guidelines and the Responsible Opioid Prescribing book, what he has learned from using the Minnesota Prescription Monitoring Program (PMP), and how he has implemented the combined knowledge into his practice. As an attachment to this paper, Respondent shall also provide copies of medical records for three patients that demonstrates how he has implemented this knowledge into his practice, including documentation that he has checked the PMP for each patient prescription or refill. d. Respondent shall submit, within one year of the date of this Agreement, a copy of his pain management contract for review by the Complaint Review Committee or its designee. 4. This Agreement shall become effective upon execution by the Committee and shall remain in effect until Respondent successfully completes the terms of the agreement. Successful completion shall be determined by the Committee. 5. Upon Respondent's satisfactory completion of the Agreement for COiTective Action, the Committee agrees to issue a letter of satisfaction to Respondent and dismiss the complaint(s) referred to in paragraph 1. Respondent agrees that the Committee shall determine satisfactory completion. Respondent understands and further agrees that if, after dismissal, the Committee receives additional complaints similar to the information in paragraph 1, the Committee may reopen the dismissed complaint(s). 3

,,.,"... 6. If Respondent fails to complete the corrective action satisfactorily or if the Committee receives additional complaints similar to the allegations described in paragraph 1, the Committee may, in its discretion, reopen the investigation and proceed according to Minn. Stat. chs. 147, 214, and 14. Failure to complete corrective action satisfactorily constitutes failure to cooperate under Minnesota Statutes section 147.l31. In any subsequent proceeding, the Committee may use as proof of the allegations of paragraphs 1 and 2 Respondent's agreements herein. 7. Respondent understands that this agreement does not constitute disciplinary action. Respondent further understands and acknowledges that this agreement and any letter of satisfaction are classified as public data. 8. Respondent hereby acknowledges having read and understood this agreement and having voluntarily entered into it. This agreement contains the entire agreement between the Committee and Respondent, there being no other agreement of any kind, verbal or otherwise, which varies the terms of this agreement. Dated: iil)'6 /Jb \{ Dated: ~ IN /1 t ----~------------ Respondent FOR THE COMMITTEE AG: #2827252-vl 4

AFFIDAVIT OF SERVICE BY U.S. MAIL Re: In the Matter of the Medical License of Thomas A. Niebeling, M.D. License No. 34,051 STATE OF MINNESOTA ) ) ss. COUNTY OF RAMSEY ) KATHLEEN DAVIS, being first duly sworn, deposes and says: That at the City ofst. Paul, County of Ramsey and State of Minnesota, on September 12, 20 II, slhe caused to be served the Agreement For Corrective Action, by depositing the same in the United States mail at said city and state, true and correct copy(ies) thereof, properly enveloped with prepaid first class postage, and addressed to: Rebecca Egge Moos, Esq. Bassford Remele 33 South Sixth Street, Suite 3800 Minneapolis, MN 55402 Subscribed and sworn to before me on September 12, 20 II. &J.~D. ~ NOTARY PUBLIC DEIBOF~AH A. BASTYR NOTARY PUBLIC - MINNESOTA MY COMMISSION ;expires..ipn. 31 2015 AG: #2881847-vl