Disciplinary Actions And Civil Penalties

(1) Upon a finding by the Committee and Board that a certificate holder has violated any provision of T.C.A. §§ 63-6-1001, et seq., or the rules promulgated pursuant thereto, the Committee and Board may take any of the following actions separately or in any combination which is deemed appropriate to the offense; (a) Letter of Warning and Letter of Concern - This is a written action issued by the Board’s consultant for minor or near infractions. It is informal and advisory in nature and does not constitute a formal disciplinary action. However, if the Board takes this action at a contested case hearing through the issuance of a final order, it shall be considered an adverse action by the Board and reportable to the National Practitioner Databank and/or similar agency. (b) Reprimand - This is a written action issued for one time and less severe violations. It is a formal disciplinary action. (c) Probation - This is a formal disciplinary action which places a certificate holder on close scrutiny for a fixed period of time. This action may be combined with conditions that must be met before probation will be lifted and/or which restrict the individual’s activities during the probationary period. (d) Certificate Suspension - This is a formal disciplinary action that suspends the right to practice for a fixed period of time. It contemplates the re-entry into practice under the certificate previously issued. (e) Revocation for Cause - This is the most severe form of disciplinary action which removes an individual from the practice of the profession and terminates the certificate previously issued. The Committee and/or Board, in their discretion, may allow reinstatement of a revoked certificate upon conditions and after a period of time which they deem appropriate. No petition for reinstatement and no new application for certification from a person whose certificate was revoked for cause shall be considered prior to the expiration of at least six (6) months from the effective date of the revocation order. (f) Conditions - Any action deemed appropriate by the Committee and/or Board to be required of a disciplined certificate holder during any period of probation or suspension or as a prerequisite to the lifting of probation or suspension or the reinstatement of a revoked certificate. (g) Civil penalty - A monetary disciplinary action assessed by the Committee and Board pursuant to paragraph (5) of this rule. (2) Once ordered, probation, suspension, revocation, assessment of a civil penalty, or any other condition of any type of disciplinary action may not be lifted unless and until the certificate GENERAL RULES AND REGULATIONS GOVERNING CHAPTER 0880-12 THE PRACTICE OF ACUPUNCTURISTS holder petitions, pursuant to paragraph (3) of this rule, and appears before the Committee after the period of initial probation, suspension, revocation, or other conditioning has run and all conditions placed on the probation, suspension, revocation, have been met, and after any civil penalties assessed have been paid. (3) Order of Compliance - This procedure is a necessary adjunct to previously issued disciplinary orders and is available only when a petitioner has completely complied with the provisions of a previously issued disciplinary order, including an uncertified practice civil penalty order, and wishes or is required to obtain an order reflecting that compliance. (a) The Committee and Board will entertain petitions for an Order of Compliance as a supplement to a previously issued order upon strict compliance with the procedures set forth in subparagraph (b) in only the following three (3) circumstances: 1. When the petitioner can prove compliance with all the terms of the previously issued order and is seeking to have an order issued reflecting that compliance; or 2. When the petitioner can prove compliance with all the terms of the previously issued order and is seeking to have an order issued lifting a previously ordered suspension or probation; or 3. When the petitioner can prove compliance with all the terms of the previously issued order and is seeking to have an order issued reinstating a certificate previously revoked. (b) Procedures 1. The petitioner shall submit a Petition for Order of Compliance, as contained in subparagraph (c), to the Committee’s Administrative Office that shall contain all of the following: (i) A copy of the previously issued order; and (ii) A statement of which provision of subparagraph (a) the petitioner is relying upon as a basis for the requested order; and (iii) A copy of all documents that prove compliance with all the terms or conditions of the previously issued order. If proof of compliance requires testimony of an individual(s), including that of the petitioner, the petitioner must submit signed statements from every individual the petitioner intends to rely upon attesting, under oath, to the compliance. The Committee’s consultant and administrative staff, in their discretion, may require such signed statements to be notarized. No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, the petition. 2. The Committee authorizes its consultant and administrative staff to make an initial determination on the petition and take one of the following actions: (i) Certify compliance and have the matter scheduled for presentation to the Committee and Board as an uncontested matter; or (ii) Deny the petition, after consultation with legal staff, if compliance with all of the provisions of the previous order is not proven and notify the petitioner GENERAL RULES AND REGULATIONS GOVERNING CHAPTER 0880-12 THE PRACTICE OF ACUPUNCTURISTS of what provisions remain to be fulfilled and/or what proof of compliance was either not sufficient or not submitted. 3. If the petition is presented to the Committee and Board the petitioner may not submit any additional documentation or testimony other than that contained in the petition as originally submitted. 4. If the Committee and Board finds that the petitioner has complied with all the terms of the previous order an Order of Compliance shall be issued. 5. If the petition is denied either initially by staff or after presentation to the Committee or Board and the petitioner believes compliance with the order has been sufficiently proven the petitioner may, as authorized by law, file a petition for a declaratory order pursuant to the provisions of T.C.A. § 4-5-223 and Rule 1200-10-01-.11. (c) Form Petition Petition for Order of Compliance Board of Medical Examiners Advisory Committee for Acupuncture Petitioner’s Name: Petitioner’s Mailing Address: Petitioner’s E-Mail Address: Telephone Number: Attorney for Petitioner: Attorney’s Mailing Address: Attorney’s E-Mail Address: Telephone Number: The petitioner respectfully represents, as substantiated by the attached documentation, that all provisions of the attached disciplinary order have been complied with and I am respectfully requesting: (circle one) 1. An order issued reflecting that compliance; or 2. An order issued reflecting that compliance and lifting a previously ordered suspension or probation; or 3. An order issued reflecting that compliance and reinstating a certificate previously revoked. Note - You must enclose all documents necessary to prove your request including a copy of the original order. If any of the proof you are relying upon to show compliance is the testimony of any individual, including yourself, you must enclose signed statements from every individual you intend to rely upon attesting, under oath, to the compliance. The Committee’s consultant and administrative staff, in their discretion, may require such signed statements to be notarized. No documentation or testimony GENERAL RULES AND REGULATIONS GOVERNING CHAPTER 0880-12 THE PRACTICE OF ACUPUNCTURISTS other than that submitted will be considered in making an initial determination on, or a final order in response to, this petition. Respectfully submitted this the day of , 20 . __________________________________ Petitioner’s Signature (4) Order Modifications - This procedure is not intended to allow anyone under a previously issued disciplinary order, including an uncertified practice civil penalty order, to modify any findings of fact, conclusions of law, or the reasons for the decision contained in the order. It is also not intended to allow a petition for a lesser disciplinary action, or civil penalty other than the one(s) previously ordered. All such provisions of Committee and Board orders were subject to reconsideration and appeal under the provisions of the Uniform Administrative Procedures Act (T.C.A. §§ 4-5-301, et seq.). This procedure is not available as a substitute for reconsideration and/or appeal and is only available after all reconsideration and appeal rights have been either exhausted or not timely pursued. It is also not available for those who have accepted and been issued a reprimand. (a) The Committee and Board will entertain petitions for modification of the disciplinary portion of previously issued orders upon strict compliance with the procedures set forth in subparagraph (b) only when the petitioner can prove that compliance with any one or more of the conditions or terms of the discipline previously ordered is impossible. For purposes of this rule the term “impossible” does not mean that compliance is inconvenient or impractical for personal, financial, scheduling or other reasons. (b) Procedures 1. The petitioner shall submit a written and signed Petition for Order Modification on the form contained in subparagraph (c) to the Committee’s Administrative Office that shall contain all of the following: (i) A copy of the previously issued order; and (ii) A statement of why the petitioner believes it is impossible to comply with the order as issued; and (iii) A copy of all documents that proves that compliance is impossible. If proof of impossibility of compliance requires testimony of an individual(s), including that of the petitioner, the petitioner must submit signed and notarized statements from every individual the petitioner intends to rely upon attesting, under oath, to the reasons why compliance is impossible. No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, the petition. 2. The Committee authorizes its consultant and administrative staff to make an initial determination on the petition and take one of the following actions: (i) Certify impossibility of compliance and forward the petition to the Office of General Counsel for presentation to the Committee and Board as an uncontested matter; or (ii) Deny the petition, after consultation with legal staff, if impossibility of compliance with the provisions of the previous order is not proven and GENERAL RULES AND REGULATIONS GOVERNING CHAPTER 0880-12 THE PRACTICE OF ACUPUNCTURISTS notify the petitioner of what proof of impossibility of compliance was either not sufficient or not submitted. 3. If the petition is presented to the Committee and Board the petitioner may not submit any additional documentation or testimony other than that contained in the petition as originally submitted. 4. If the petition is granted a new order shall be issued reflecting the modifications authorized by the Committee and Board that it deemed appropriate and necessary in relation to the violations found in the previous order. 5. If the petition is denied either initially by staff or after presentation to the Committee or Board and the petitioner believes impossibility of compliance with the order has been sufficiently proven the petitioner may, as authorized by law, file a petition for a declaratory order pursuant to the provisions of T.C.A. § 4-5- 223 and Rule 1200-10-01-.11. (c) Form Petition Petition for Order Modification Board of Medical Examiners Advisory Committee for Acupuncture Petitioner’s Name: Petitioner’s Mailing Address: Petitioner’s E-Mail Address: Telephone Number: Attorney for Petitioner: Attorney’s Mailing Address: Attorney’s E-Mail Address: Telephone Number: The petitioner respectfully represents that for the following reasons, as substantiated by the attached documentation, the identified provisions of the attached disciplinary order are impossible for me to comply with: Note - You must enclose all documents necessary to prove your request including a copy of the original order. If any of the proof you are relying upon to show impossibility is the testimony of any individual, including yourself, you must enclose signed and notarized statements from every individual you intend to rely upon attesting, under oath, to the reasons why compliance is impossible. No documentation or testimony GENERAL RULES AND REGULATIONS GOVERNING CHAPTER 0880-12 THE PRACTICE OF ACUPUNCTURISTS other than that submitted will be considered in making an initial determination on, or a final order in response to, this petition. Respectfully submitted this the day of , 20 . __________________________________ Petitioner’s Signature (5) Civil Penalties (a) Purpose - The purpose of this rule is to set out a schedule designating the minimum and maximum civil penalties which may be assessed pursuant to T.C.A. § 63-1-134. (b) Schedule of Civil Penalties 1. A “Type A” Civil Penalty may be imposed whenever the Committee and Board find a person who is required to be licensed, certified, permitted, or authorized by the Committee and Board, guilty of a willful and knowing violation of T.C.A. §§ 63-6-1001, et seq., or regulations promulgated pursuant thereto, to such an extent that there is, or is likely to be, an imminent, substantial threat to the health, safety and welfare of an individual patient or the public. For purposes of this section, willfully and knowingly practicing as an acupuncturist or as an ADS without a permit, license, certificate, or other authorization from the Committee and Board is one of the violations for which a “Type A” Civil Penalty is assessable. 2. A “Type B” Civil Penalty may be imposed whenever the Committee and Board find the person required to be licensed, certified, permitted, or authorized by the Committee and Board is guilty of a violation of T.C.A. §§ 63-6-1001, et seq., or regulations promulgated pursuant thereto in such manner as to impact directly on the care of patients or the public. 3. A “Type C” Civil Penalty may be imposed whenever the Committee and Board find the person required to be licensed, certified, permitted, or authorized by the Committee and Board is guilty of a violation of T.C.A. §§ 63-6-1001, et seq., or regulations promulgated pursuant thereto, which is neither directly detrimental to the patients or public, nor directly impacts their care, but has only an indirect relationship to patient care or the public. (c) Amount of Civil Penalties. 1. “Type A” Civil Penalties shall be assessed in the amount of not less than $500 nor more than $1000. 2. “Type B” Civil Penalties may be assessed in the amount of not less than $100 and not more than $500. 3. “Type C” Civil Penalties may be assessed in the amount of not less than $50 and not more than $100. (d) Procedures for Assessing Civil Penalties. 1. The Division of Health Related Boards may initiate a civil penalty assessment by filing a Memorandum of Assessment of Civil Penalty. The Division shall state in the memorandum the facts and law upon which it relies in alleging a violation, the GENERAL RULES AND REGULATIONS GOVERNING CHAPTER 0880-12 THE PRACTICE OF ACUPUNCTURISTS proposed amount of the civil penalty and the basis for such penalty. The Division may incorporate the Memorandum of Assessment of Civil Penalty with a Notice of Charges which may be issued attendant thereto. 2. Civil penalties may also be initiated and assessed by the Committee and Board during consideration of any Notice of Charges. In addition, the Committee and Board may, upon good cause shown, assess a type and amount of civil penalty which was not recommended by the Division. 3. In assessing the civil penalties pursuant to these rules the Committee and Board may consider the following factors: (i) Whether the amount imposed will be substantial economic deterrent to the violator; (ii) The circumstances leading to the violation; (iii) The severity of the violation and the risk of harm to the public; (iv) The economic benefits gained by the violator as a result of non- compliance; and (v) The interest of the public. 4. All proceedings for the assessment of civil penalties shall be governed by the contested case provisions of Title 4, Chapter 5, T.C.A.