Little Health Law Blog
For various reasons, licensed medical providers may choose to voluntarily surrender their state medical license. Earlier this year, our healthcare and business law firm blogged about the repercussions of voluntarily surrendering a state medical license on the physician’s Medicare enrollment. Our firm recently had success in challenging a Medicare MAC’s decision to revoke a client’s Medicare enrollment based on a voluntary surrender of a medical license, resulting in the rescission of the revocation decision. Another usually unexpected repercussion may also be ineligibility for Board examination or loss of Board Certification status. Losing board certification or being found ineligible for board certification is a serious matter with potentially far-reaching adverse consequences. This post outlines the American Board of Internal Medicine’s (“ABIM”) eligibility rules and steps to challenge such a decision. If you have questions regarding this blog post or wish to discuss an adverse decision by the ABIM or strategize ways to overcome an adverse decision, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.
Board Eligibility / Certification Rules
A policy of the American Board of Internal Medicine is: “A physician with a restricted, suspended, revoked or surrendered license in any jurisdiction is not eligible to be certified or admitted to a certification examination.” see ABIM General Policies, Licensure. This is the entire statement; the result of ineligibility does not change depending on the reason for the surrender or whether the physician holds a license elsewhere. According to ABIM personnel, this policy “is firm.” As such, the decision to voluntarily surrender a medical license, regardless of the reason, makes a physician ineligible to take the board examination.
For physicians who are board certified with ABIM, the analysis is slightly different. According to the policies:
“ABIM will suspend or revoke the Board Certification of any diplomate who has a license that is . . . surrendered . . . (whether voluntarily or otherwise) so as to prohibit the practice of clinical medicine in one or more jurisdictions, and no valid license in any other jurisdiction. A diplomate who has a license that is . . . surrendered . . . (whether voluntarily or otherwise) so as to prohibit the practice of clinical medicine in one or more jurisdictions, but who continues to hold a valid license in another jurisdiction—or a diplomate whose license in any jurisdiction has been restricted—may be subject to disciplinary sanctions, including the suspension or revocation of the physician’s Board Certification.”
The policy for Board Certified physicians allows ABIM more flexibility in how it responds to a physician’s voluntary surrender of a license. Furthermore, if a physician who voluntarily surrenders a license holds a license in another state, the ABIM has the option of using disciplinary sanctions in lieu of suspension or revocation of the Board Certification.
Exception Request / Appeal
The difficulty for a physician with an adverse eligibility determination is that there is no official appeal process like there is for a physician who already holds Board Certification. That, however, does not mean that there is not a method for requesting the ABIM to reconsider its decision or allow an exception. There is no deadline for requesting reconsideration on an eligibility decision and it requires submitting correspondence to the ABIM outlining the request and supporting reasons. Because there is no formal process for requesting an eligibility determination, it is useful to establish a connection with ABIM personnel.
For physicians with Board certification, the process begins by ABIM providing notice of recommended disciplinary sanctions issued by the ABIM Credentials and Certification Committee (“CCC”). The notice must “advise the physician that while a recommended sanction is not final and does not affect a physician’s Board Certification status, a physician who is subject to a recommended sanction is not eligible to participate in the Certification process. If a physician declines to appeal a recommended sanction, the recommended sanction determined by the CCC shall become the final decision of ABIM.” see ABIM Policies, Disciplinary Sanctions and Appeals. The deadline for submitting an appeal is “30 days of the date of the notice of the CCC’s determination.” The physician may request a hearing at which to make her or his arguments.
If you have questions regarding this blog post or wish to discuss an adverse decision by the ABIM or strategize ways to overcome an adverse decision, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.
*Disclaimer: Thoughts shared here do not constitute legal advice.