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Former PA Sentenced After Posing as Licensed Practitioner for 2nd Time

23 Apr, 2023 F.J. Thomas

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Sarasota, FL (WorkersCompensation.com) – Employers are required to perform not only an extensive federal background check but verify medical licenses when employing clinical staff. Additionally, healthcare employers are required to do a review of the HHS-OIG Exclusions list on a routine basis to check for matches of all their employees, not just clinical employees. The OIG Exclusions list is a federal register of both individuals and entities that are excluded from participating in federally funded healthcare programs due to a federal conviction of healthcare fraud, patient abuse or neglect, and illegal distribution of controlled substances.

Employers who fail to verify license and OIG Exclusion status can face substantial penalties. In fact, employers may be fined $10,000 for each excluded individual they employ, and garner a penalty of $10,000 for each item or service provided during the term of the individual’s employment. Additionally, healthcare organizations that employ these individuals can be denied reinstatement into federal healthcare programs, which impacts revenue.

If healthcare employers are under such requirements to verify the credibility of the clinical providers they have working for them, one would think that it would be hard to obtain employment if you did not meet the requirements. However, two recent criminal cases involving a nurse and a former physician assistant demonstrate that even strict requirements are not fool proof.

In a case spanning three states, travel nurse Jacqueline Brewster was arrested late last year on charges of alleged drug tampering and diversion. Prior to her arrest, Brewster’s privileges had been suspended in Tennessee after a formal complaint was filed. Due to the state not taking immediate emergency action, Brewster was able to obtain employment a few months later as a travel nurse in West Virginia and Kentucky where court documents indicate she continued tampering with medications, and potentially exposed patients to Hepatitis and HIV.

In yet another recent case announced earlier this week, a former physician assistant has been sentenced for healthcare fraud and posing as a licensed practitioner in the state of Georgia. Theresa Picking had worked as a physician assistant in Mississippi, but lost her license in 2014 and served prison time for a 2015 fraud and narcotics case.

Due to her criminal background, Pickering was not eligible to reinstate her license as a physician assistant, however in 2019, Pickering moved and obtained employment as a licensed physician’s assistant at a family medical practice in Norcross, Georgia. As part of her employment, Pickering practiced medicine in the scope of what is normal for a licensed physician assistant, including treating patients, diagnosing illnesses, ordering lab tests and diagnostic tests, and prescribing certain medications. However, Pickering also issued prescriptions for controlled substances under the name of a contracted physician without the physician’s permission.

Due to her posing as a licensed physician assistant, paired with her employer failing to verify her licensure status, the practice billed out at $147,000 in fraudulent claims. Pickering was sentenced to two years, nine months in prison with three years of supervised release afterwards. Additionally, Pickering is required to pay out $48,742.30 in restitution.

Some state medical boards have eased the restrictions on interstate licensed providers in an effort to address staffing shortages. The Nurse Compact Act is a multi-state agreement that allows licensed nurses to practice in any state, however tracking nurses that fall under the act can be extremely tricky as indicated by the Brewster case. As travel arrangements and legislation grows, the verification of licensure and background will be a tougher task for employers.


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    About The Author

    • F.J. Thomas

      F.J. Thomas has worked in healthcare business for more than fifteen years in Tennessee. Her experience as a contract appeals analyst has given her an intimate grasp of the inner workings of both the provider and insurance world. Knowing first hand that the industry is constantly changing, she strives to find resources and information you can use.

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