STATE OF FLORIDA BOARD OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY DEPARTMENT OF HEALTH, PETITIONER, V. CASE NO. 2010-02056 CLARA ZAMBRANO-CANIZARES, S.L.P., RESPONDENT. ADMINISTRATIVE COMPLAINT COMES NOW Petitioner Department of Health and files this Administrative Complaint before the Board of Speech-Language Pathology and Audiology against Respondent, Clara Zambrano-Canizares, S.L.P., and in support thereof alleges: 1. Petitioner is the state agency charged with regulating the practice of speech-language pathology and audiology pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 468, Part I, Florida Statutes. 2. At all times material to this Administrative Complaint, Respondent was a licensed speech-language pathologist in the state of
Florida, having been issued license number SA249. 3. Respondent's address of record is 3436 Northwest 17th Street, Miami, Florida 33125. 4. Additional addresses for Respondent are 7310 Southwest 169th Street, Miami, FL 33157, and 101 Southwest 36th Court, Apartment 308, Miami, Florida 33135. 5. At all times material to this Complaint, Respondent was the owner and director of On-Site Therapy & Educational Training, Inc. ("On- Site), a clinic offering speech therapy services. 6. At all times material to this Complaint, On-Site was a Florida corporation and Respondent was the registered agent listed for the corporation. 7. Pursuant to rule 64B20-4.004(3) Florida Administrative Code, a Speech-Language Pathologist Assistant ("SLPA") must be under the direct supervision of a Speech-Language Pathologist ("SLP") when performing duties involving direct client contact. 8. Between January 2006 and December 2010, Respondent delegated responsibilities to an SLPA by allowing the SLPA to provide therapy services to patients without direct supervision of an SLP as DOH Case No. 2010-02056 2
required by the Florida Administrative Code. 9. Moreover, in about or around January 2006 until December 2010, Respondent forged SLPs' signatures, without their knowledge or permission, on evaluations and progress notes in patient records. 10. Respondent submitted upcoded claimsl, which included fraudulent misrepresentations, as the Medicaid Program was billed for services rendered by an SLPA at the SLP rate. 11. Respondent signed Weekly Therapy Notes for SLPAs under her supervision even though she neither treated the patient nor directly supervised the therapy provided by the SLPAs. 12. In 2010, the Medicaid Fraud Control Unit conducted an investigation of Respondent and On-Site's billing and therapy practices. Respondent was subsequently charged with 1) Grand Theft, First Degree; 2) Medicaid Fraud/Filing a False Claim; and 3) Organized Fraud of $50,000 or more. 13. On or about January 16, 2014, Respondent, on behalf of On- Site entered a plea of guilty to Grand Theft Over $20,000, but less than $100,000 against Respondent's corporation, On-Site, in the Circuit Court of 1 Upcoded claims or upcoding are terms that means to assign an inaccurate billing code to a medical procedure or treatment to increase reimbursement. DOH Case No. 2010-02056 3
the Eleventh Judicial Circuit, in and for Miami-Dade County, Florida, in Case Number F10-11718A-B. COUNT I 14. Petitioner re-alleges and incorporates paragraphs one (1) through eleven (11) as if fully set forth herein. 15. Section 468.1295(1)(y), Florida Statutes (2005-2010), provides that delegating or contracting for the performance of professional responsibilities by a person when the licensee delegating or contracting for performance of such responsibilities knows, or has reason to know, such person is not qualified by training, experience, and authorization to perform them, constitutes grounds for discipline. 16. Rule 64B20-4.004(3), Florida Administrative Code states, in relevant part, that: Assistants must be under the direct supervision of a licensee who has met all the requirements of Section 468.1185, Florida Statutes direct supervision requires the physical presence of the licensee in the same facility when the assistant is carrying out assigned responsibilities, in order for the licensee to be available for consultation and direction. [...] In the event that a supervising licensee is not on the premises, the assistant may only perform duties not involving direct client contact. 17. Respondent improperly delegated her professional responsibilities when she allowed SLPAs to perform speech therapy DOH Case No. 2010-02056 4
services on a patient without direct supervision when she knew or had reason to know that they were not qualified or authorized to do so. 18. Based on the foregoing, Respondent violated Section 468.1295(1)(y) through a violation of Rule 64B20-4.004(3), Florida Administrative Code, by allowing an SLPA to perform speech therapy on a patient without direct supervision, as required and defined by the laws and rules governing speech-language pathology. COUNT H 19. Petitioner re-alleges paragraphs one (1) through eleven (11) as if fully set forth herein. 20. Section 456.072(1)(m), Florida Statutes (2005-2010), provides making deceptive, untrue, or fraudulent representations in or related to the practice of a profession or employing a trick or scheme in or related to the practice of a profession. 21. Respondent made fraudulent representations by a. forging SLPs' signatures; and, b. billing the Medicaid Program for services rendered by an SLPA at the rate of an SLP. 22. Based on the foregoing, Respondent violated Section DOH v. tiara Zambranos-Canizares, S.L.P. DOH Case No. 2010-02056 5
456.072(1)(m), Florida Statutes (2005 2010) by forging SLPs' signatures and submitting upcoded claims to the Medicaid Program. COUNT III 23. Petitioner re-alleges paragraphs one (1) through five (5) and twelve (12) through thirteen (13) as if fully set forth herein. 24. Section 468.1295(1)(c), Florida Statutes (2013), provides being convicted or found guilty of, or entering a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction which directly relates to the practice of speech-language pathology, constitutes grounds for discipline. 25. Respondent entered a plea of guilty to Grand Theft Over $20,000, but less than $100,000 against Respondent's corporation, On- Site. 26. Based on the foregoing, Respondent violated Section 468.1295(1)(c), Florida Statutes (2013). WHEREFORE Petitioner requests that the Board of Speech-Language Pathology and Audiology 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, DOH Case No. 2010-02056 6
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 ~~day of WY Oa 2018, FILED DEPARTMENT OF HEALTH DEPUT/ CLERK Angel Sanders CLERK 1)81t Z 2018 Celeste Philip, M.D., M.P.H. Surgeon G- 1 & Secretary sok I If...,..._ Ro.e G., iso'n Assistant General Counsel Florida Bar #105920 Florida Department of Health Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 (850) 558-9842 (850) 245-4684 (fax) PCP: tacka- c- k*n- )". t PCP Members: kcr;s kit.h 1&.1.1ki 0.. rvi I Se.r-g; G tkt-fr- r" 0 DOH Case No. 2010-02056 7
NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, 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 Administrative Complaint, pursuant to Rule 28-106.111(2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule 28-106.111(4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in the Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Mediation under Section 120.573, Florida Statutes, is not available to resolve this Administrative Complaint. 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 456.072(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 Case No. 2010-02056 8