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Licensed healthcare fraud and criminal conduct may result in license revocation



Kevin A. Imhof ("Imhof") appealed the decision of the Board of Medical Licenses and Discipline (hereinafter referred to as "the Board") and found that he was engaging in unprofessional conduct. A final order from the board (hereinafter referred to as "the order") found that Imhof, a health care licensed nurse, engaged in conduct that constituted an offense that was essentially related to the practice of medicine; engaged in dishonesty, unethical or other conduct that may mislead, deceive or harm the public; and deliberately failed to report certain behavior in a timely manner. I Kevin Imhof v. Delaware Board Of Medical Licensure And Discipline, CA No. K21A-06-004 NEP, Superior Court of Delaware (January 26, 2022), a Delaware appellate court resolved some of the issues raised by the Delaware appeal.

FACT HISTORY

In 2019, Imhof filled out a questionnaire and underwent a pre-employment polygraph test as part of his application for a position with the Delaware State Police. On the questionnaire and during the test, Imhof made some acknowledgments, including the following:

  1. he had access to his ex-wife's accounts on social media, emails and text messages without her permission during the second half of 2018;
  2. he had driven to his ex-wife's residence and had seen through a window outside while she and another person engaged in sexual activity;
  3. he had invaded his ex-wife's house and committed indecent acts inside; and
  4. he had committed vandalism by keying his ex-wife's car and then his own – to conceal his actions – and had subsequently filed a fraudulent insurance claim related to such damages.

As a result, Delaware The state police made a criminal referral. In September 2019, Imhof pleaded guilty to the crimes Criminal Mischief, Violation of Privacy and Trespass with Intent to Peer or Peep. The remaining charges were dropped. Imhof did not inform the board of the allegations of crime or his convictions until he applied to renew his license in May 2020.

The hearing officer, after reviewing all submissions and testimonies, issued a written recommendation to the board and recommended discipline. The Hearing Officer concluded that Imhof had violated the three statutory provisions and that the Board, by pleading guilty to two offenses, had determined that it was "essentially related to medicine", Imhof had violated 24 Del. C. § 1731 (b) (2); that Imhof had engaged in "dishonest, unethical or other conduct that may mislead, deceive or harm the public" in violation of 24 Part. C. § 1731 (b) (3); and that Imhof's report of his criminal conduct "was grossly early" in that he had waited nine months after the arrest to report the matter to the board and thus violated 24 Del. C. § 1731 (b) (14).

The hearing officer's recommended discipline included revocation of Imhof's paramedic license.

DISCUSSION

The Hearing Officer's recommendation n

Administrative authorities appear less formal than courts. The rules of evidence therefore do not apply strictly to administrative interrogations. The board will hear all evidence that may shed light on the controversy. Only when hearsay is incompetent will the board's reliance on such testimony be considered an abuse of discretion. However, the board should apply the rules of evidence as far as is practically possible.

With regard to the question of evidence, Imhof's behavior reported to the polygraph driver sometimes exceeded the limits of relevance to the procedure. Therefore, in so far as this evidence was erroneously acknowledged, the acknowledgment constituted a harmless error. the practice of medicine. The board has the authority and obligation to point out crimes that it deems to be significantly related to the practice of medicine. In addition, the court has previously found that the board followed the correct procedures for adopting Regulation 15.

Imhof's primary argument regarding the "case decision" is that his conduct was not significantly related to the practice of medicine. Two of Imhof's alleged offenses, breach of privacy and intrusion with intent to peer or peep, are listed among the offenses that have to do essentially with the practice of medicine found in rule 15. There is thus no dispute that Imhof pleaded guilty to two of the listed

The Board, in accordance with its powers and obligations, "shall" and committed certain offenses essentially related to the practice of medicine and went through the appropriate administrative procedures to do so by adopting Regulation 15. There was significant evidence both through Imhof's own confessions in his questionnaire and polygraph, and through his confessions of culprits, to establish that the crimes were committed. Consequently, according to the authorization in Regulation 15, the offenses are considered to be "substantially related to the practice of medicine."

or unethical conduct that may mislead, deceive or harm the public "… shall include but not be limited to… [a] new… act that tends to discredit the profession."

The Court of Appeal concluded that there was significant evidence to support the Board's conclusion that Imhof had violated the Charter by committing acts that were likely to "harm the public". and "discredit" the profession.

Without turning the board to the requirement of self-declaration, the court referred the case back to the board for further examination of whether an intentional failure to report had been established and to consider whether the imposed discipline should be changed in the light of possible further considerations.

The court upheld the Board's conclusion that Imhof engaged in conduct that constituted an offense that was essentially related to the practice of medicine in violation of the law and that he engaged in dishonest, unethical or other conduct that may mislead , deceive or harm the public. However, further investigation is required from the board as to whether Imhof has intentionally failed to report certain behavior and whether, as a result of that investigation, the imposed discipline should be changed. "t" sent the case back to the board to determine whether the failure to prove that Imhof intentionally failed to report his crimes to the board and whether it had any effect on the sentence. The criminal behavior should have been sufficient so I expect the board will reconsider and then withdraw the license.


© 2022 – Barry Zalma

Barry Zalma, Esq., CFE, now limits his internship to the position of insurance consultant specializing in insurance coverage, handling insurance claims, bad faith and insurance fraud almost equally for insurance policyholder.

He practiced law in California for more than 44 years as an attorney for insurance coverage and claims management and more than 54 years in the insurance industry.

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You can find the interesting podcast "Zalma On Insurance" at https://anchor.fm/barry-zalma; you can follow Zalma on Twitter at; you should watch Barry Zalma's videos at https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg/featured; or videos at https://rumble.com/zalma. Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claimslibrary/ The last two issues of ZIFL can be found at https://zalma.com/zalmas-insurance- fraud- letter-2 /


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