Jan 31, 2011 - ... substance abuse problem. CtE. TRUE COPE ..... Professional Service Corporation Act N .S.A.'14A:17--11
PAULA T. DOW ATTORNEY GENERAL OF NEW JERSEY Division of Law Hughes Justice Complex 25 Market Street P.O. Box 093 Trenton, New Jersey 08625-0093
Attorney for New Jersey State Board of Medical Examiners
F
I L E D
JANUARY 31, 2011 By:
Kay R . Ehrenkrantz Deputy Attorney General Tel.
(609 )
NEW JERSEY STATE BOARD
OF MEDICAL EXAMINERS
292-1566
STATE OF NEW JERSEY DEPARTMENT OF LAW & PUBLIC SAFETY DIVISION OF CONSUMER AFFAIRS STATE BOARD OF MEDICAL EXAMINERS
IN THE MATTER OF THE LICENSE OF FRANK
Administrative Action CONSENT ORDER OF VOLUNTARY SURRENDER OF LICENSE
B. MAC-CIAVERNA, M . D .
LICENSE NO. M.A. 039711 TO PRACTICE MEDICINE AND SURGERY IN THE STATE OF NEW J ERSEY
This matter was opened to the State Board of Medical Examiners upon receipt of information M.D.
("Respondent") had recently been
filling numerous prescriptions and Ritalin, CDS Schedule II, Respondent represented himself minors who had been prescribed logs using a fictitious name.
that Frank E. Machiaverna, observed prescribing and
for amphetamines, namely Adderall in the names of fictious patients. at pharmacies as the parent of the medication, signing pharmacy On January 11, 2011, when
questioned by Enforcement Bureau Investigators, Respondent explained that he was suffering from a substance abuse problem.
�
. TRU E COPE CtE
According to information provided by Respondent to the Attorney General, Respondent has admitted an abuse problem for the past year and desires to seek medical treatment through the Professional Assistance Program (PAP). He seeks leave to voluntarily surrender his license to practice medicine and surgery in the State of New Jersey to be deemed a temporary suspension, in accordance with the terms of this Order. The Board finding the within disposition to be adequately protective of the public
health
-
.
safety .�.
r
IT IS , therefore
and and
wcttdZe,
, on this
.31ST day of ANf TARY
2011, ORDERED THAT:
1.
Respondent Frank E. Machiaverna, M.D. is hereby granted
leave and shall immediately surrender his license to practice medicine and surgery in the State of New Jersey for a minimum period of three months from the entry date of this Order. Such surrender shall be deemed the temporary suspension of his license.
2.
Respondent shall return his current biennial
registration to the New Jersey State-Board of Medical Examiners, P.O.B. 183, Trenton, New Jersey 08625-0183, within three days of the signing of this order.
3. Respondent shall comply with the attached directives for physicians whose surrender of licensure has been accepted by the Board, which are incorporated herein by reference.
4.
Within three days of the signing of the order,
Respondent shall meet and enter into an agreement with the PAP at his own cost, and provide to the PAP his prescription pads and his original CDS registration and all copies for all registered locations.
5.
Respondent shall immediately advise the DEA of this
Order.
6.
Prior
to
an y
an y
--01 star
-1011
of
his
license,
Respondent shall:
a.
Appear before the Board or a committee thereof to discuss his readiness to reenter the practice of medicine. At that time, Respondent shall be prepared to propose his plans for future practice in New Jersey.
b.
Provide the Board with evidence that he is capable of discharging the functions of a licensee in a manner consistent with the public's health, safety and welfare and that he is not then suffering from any impairment or limitation resulting from the use of C.D.S. which could affect his practice.
c.
Provide the Board with evidence that he is not a habitual user of C.D.S. that are not part of a treatment plan in violation of N.J.S.A . 45:9-16(b) and is not engaged in professional misconduct in violation of N.J.S.A. 45:1-21(e).
d.
Provide the PAP with a waiver permitting the release to the Board of all reports from each and every mental health professional (including but not limited to: psychologists, counselors, therapists, psychiatrists) who have participated in Respondent's care and/or treatment for the disability in this matter during the period
of time from his initial entry into treatment to his appearance before the Board. Any reports not provided by the PAP shall be provided by Respondent directly to the Board. e.
Provide the Board with a report from the Professional Assistance Program (PAP) detailing the nature and extent of his involvement with that entity, if any.
f.
Affirmatively establish his fitness, competence and capacity to re-enter the active
practi
ce
within New Jersey. g.
me dic
ine
and
surgery
Provide the Board with a full account of his conduct during the intervening period of time from his entry into treatment to his appearance pursuant to this Order.
7.
The parties hereby stipulate that entry of this Order
is without prejudice to further investigation and action by this Board or other law enforcement entities resulting from Respondent's conduct prior to entry into treatment.
NEW JERSEY STATE BOARD OF MEDICAL EXAMINERS
By: Paul T. Jordan, President
I have read and understood the within Order and agree to its terms. Consent is hereby given to the Board to enter this Order. i understand that this order has serious legal consequences and have decided to enter into this agreement with the Board without the advice of legal counsel, as is my right.
Frank E. Machiaverna, M.D.
Louis E. Baxter, Sr. MM.D., FASAM Medical Director, Professional Assistance Program
Jan, 21. 201111:25AM
Jan 21 11 10:30a
Frank&Lisa Maohiave
732.244.8813
Y aX %btrJJ4 LJWU
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T h e parties hereby stipulate that entry of this Order
6. is without
p rejudice to further investigation and action by this
Board or ot
t er law enforcement entities resulting from
Respondent'
conduct prior to entry into treatment.
NEVI JERSEY STATE BOARD OF MEDICAL EXAMINERS
By; Paul T. Jordan, M.D. President
I have read within OrdeF
and the andunderstood agree to its
coin �ent is hereby given to the Board 't p enter this Order. I understand .hat this Order has serious leg .1 consequences and have decided to nter into this terms,
ith the Board w
agreement w the advice
pf legal,
counsel,
ith out
as
is
my right.
Louie E. R a nter , Or., M.D ., FASAM Medical Di ctor, Professional Assistance Program
{
r.vr
p,. 12
11/18
Jan, 21,201111:25AM
Fax:6093415030
Jan 12 2011 15:uo,073502 P. 12/18
Order 6. is
he parti es Without
action b resulting
prejudice to further investigation and this Board or other from Respondent's conductaW en,torcement entities
hereby
stipulate
that
prior
treatment.
NEW JERSEY STATE BOARD OFMEDICAL EXAMINERS
ny
Paul T. Jordan, M.D. President I have 4 ad and understood the within Or er and agree to its terms. Consent is hereby given to the Board to enter this Orde I understand that this Ord r has serious legal consequenc s and have decided to enter into this agreement with the Board without the advice of legal counsel, as is my right.
Frank E, M chiaver na, M.D.
Louie
E.
Baxter, S
FASAm Medical Director, Assi a tance Program
Physicians'
entry
to
of
entry
this
into
Jan. 21. 201111:25AM
Jan 21 11 10:30a
Frank& Lisa Machiave ax - Mri vi 13u,)u
No. 3502 732-244.8813 Jar) 10 Lual iz-zu
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P. 14/18 p,14
DIllt CTIVES APPLICABLE TO ANYMEDICAL BOARD LICENSEE WH I IS DISC(PUNED OR WHOSE SURRENDER OF LiCENSURE HAS BEEN ACCEPTED, APPROVED BY THE BOARD ON MAY 10, 2000 Ali licensees the informatio will be mairi Board. Failu or oiling to Paragraphs : permanently are the subje or monitoring
1.
o are the subject of a disciplinary order of the Board are required to provide he information required on the addendum to these directives . T provided public document filed with the ined separately and will not be part of the to provide the information required may result in further disciplinary action cooperate with the Board, as required by N J A C 13: 45G-1 et Sea : through 4 below shall apply when a license Is suspended or revoked or rrendered, with or without prejudice. Paragraph 5 applies to licensees who of an order which, while permitting continued practice, contains a probation equirement.
Docu ent Return and Agency Notification
hall promptly forward to the Board office at Post Office Box 183 , 140 East The licensee Front Street , nd floor, Trenton, New Jersey 08625-0183 , the original license , current . - in addition, if the biennial regis ration and, if applicable, the original COS registration licensee hold a Drug Enforcement Agency (DEA) registration , he or she shall promptly advise the D A of the licenseee action . (With respect to suspensions of a finite term, at the conclusip of the term , the licensee may contact the Board office for the return of the documents 0r viously surrendered to the Hoard . In addition, at the conclusion of the term, the license ® hould contact the DEA to advise of the resumption of practice and to his/her DEA registration-) ascertain the mpact of that change upon
2,
Practi a Cessation
The licensee hall cease and desist from engaging in the practkce of medicine in this State_ This prohibl1i not only bars a licensee from rendering professional services, but also from providing e{1'ropinion as to professional practice 'or its application, or representing hirn/herself ; being eligible to practice . (Although the licensee need not affirmatively of the revocation , suspension or surrender , the lioensec muster advise patien s or others truthfully disjc l se his /her licensure status in response to inquiry .) The disciplined licensee
is alsoprohib ed from occupying, sharing orusingoffice space in which another licenses provides hea care services . The disciplined licensee may contract for, accept payment from anothe licensee for or rent at fair market value office premises and /or equipment, In no case ' y the disciplined licensee authorize , allow or condone the use of his/her provider nuts er by any health care practice or any other licensee or health care provider. (in situations here the licensee has been suspended for less than one year , the licensee may accept ayment from another professional who Is using hislher office during the period that th licensee is suspended , for the payment of salariesfor office staff employed at the time b the Board action.)
. 2011 11:26AM Jan. 21 Jan 21 11 10:31 a
Frank 8, Lisa Machiave r dx . uUljJU.L Dwu
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A licensee iv ose license has been revoked, suspended for one (1) year or or permanently surrendered must remove signs and take affirmative action more to stop advertlsem6 rs by which his/her elig ibility to practice is represented The licensee must also We Ste s to remove his/her name from professional listings , telephone directories, .
professional
tationery , or billings- If the licensee's name
Is utilized in a group practice
title, It shag deleted - Prescription pads bearing the licensee 's name shall be destroyedA destructs report form obtained from the Office of Dru g Controlall(973 -504 -6559) must be filed. tf noother licensee Is providing services at the location, Medications must be removed ant resumed t o the manufacturer, if possible, destroyed or safeguarded- (In situations wh re a license has been suspended for less than one year , prescription pads and medicati ms need not be d t es royed but must be secured in a locked place for
safekeeping.
e Income Prohibitions/Divestiture of Equity Interest Cor p or a tions and Limited Liability Companies
i n Professional
A licensee "D not charge, receive or share in any fee for professional servicesrendered by him /herse, f or others while barred from engaging in the professional practice. The licensee may �e compe nsate d for the reasonable value of services lawfully rendered and disbursemeb incurred on a patient's behalf prior to the effective date of the Board action,
A licensee w Is a shareholder in a professional service cor 4 pora tion organized to engage in the profs lonal practice, whose license is revoked , surrendered or suspended for a -W term of one X year or more s ha lt be deemed to be disqualified from the practice within the meaning of i Professional Service Corporation Act N .S.A.'14A:17--11). A disqualified licensee staa divest him/herself of all financial interest In the professio corporation; rsuant to N.J.S.A. 14A:17-13(c)_ A licensee who is a memb na l serv ice er of a limited liability comp ny organized pursuant to NA SA 42:144 shall divest hi lhersetf m financial irate , following the the et, Such divestiture shall occur within 90 days entryofofall the Order renders g the licensee disqualified to participate In the aplicabl e form of ownership, Upon divestiit re, a licensee shall forward to the Board a copyp of document a tion to the Secrq ry of State , Commercial Reporting Division , demonstrating that theforwarded interest has been to *+inated If the licensee is the sole shareholder in a professional service . corporation corporation must be dissolved within 90 days of the licensee's dlsquelifceij 4.
Med)
If, as a resultf the Board 's action , a practice is dosed or transferred to another location, the licensee all ensure th t d ri a u ng the three(3) month period followin of the discipl any order, a message will be delivered to patients calli g the e ffec tive date e former office ng thinform premises, a,ising where records may be obtained . The message should patients of the na e and tele phone numbers of the licensee (or his/her attorney ) assuming custody of fh records . The same Information shall also be disseminated by means of a notlt a to be ublished at least once per month for three (3) months i a newspaper of general cirou lion in thegeographic vicinity in which the practice wasn conducted At the end of the: ree month period , the licensee shall file with the Board the name and . telephone nu bey of 'Ehe contact person who will have access to medical records of former patients.. A change in that individual or his /her telephone number shall be promptly reported tol Board. When a patient or his/her representative re of his/her quests a copy medical rec rd or asks that record be forwarded to another health care provider, the
4
Jan 21Jan. 21 2011 11, 26A% L -11 r\
isa Machiave rax.bUJZA15UJU
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licensee shAlt1promptly provide the record without charge to the patient.
5.
Probe on/Monitoring Conditions
With respedtEo any licensee who is the subject of any
Order imposing a probation or , in whole or In part , which is conditioned p on compliance with a probation or monitoring requirement , the licensee shall fully coops ',e with the Board and its designated representatives, including the Enforcement3ureau of the Division of Consumer Affairs, in ongoing monitoring of the licensee's sta is and practice . Such monitoring shall be at the expense of the disciplined practitioner-.'
monitoring totulrement or a stay of an active suspension
of the
may include, but is not limited to, ins section (a) . Monitoring of practice conditions
profeetsi
CU premisesand equipment, and Inspectionand copying of patient records (confidentia)l of patient identity shall be protected by the Board) to verify compliance with the Board Q
(b)
er and accepted standards
of practice.
onitoring of status conditions for
red practitioner may Include, but an Impa ireleases is not timiteld to , practitioner cooperation In providing permitting unrestricted access to rec ords and other information to the exteni permitted by law from -any treatment facility, other t eating practitioner , support group or other iridividuallfaciiity involved in the education , atment , monitoring or oversight of the practitioner , or maintained by a rehabilrlatior�rograrn for impaired practitioners, if bodily substance monitoring has been ordered , thei ctitioner shall fully cooperate by responding to a demand for breath , blood, and providing the designated sample. One or other sample in a timely manner
a
Jan 21Jan. , , ,,
21.201111:27A ,4 , , a?l Lisa Machiave rdx.ouy')yea, v
N
Pursuant to ;J available for pu Inquirer will be evidentiary h hearings and i t public inaPe ctlo
732.244.8813No, 3502 JdFI
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C TING P O BO E K RGARDINt3 hmr-Inj _iNARY ACTIONS
_
16 - 41
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P. 17/18 Y•
52148.3 (3), all orders of the New Jersey State Board of Medical Examiners are is inspection . Should any inquiry be made concerning the status of a licensee, the formed of the existence of the order and a copy will be provided If requested. All ings, proceedings on motions or other applications which are conducted as public record, including the transcript and documents marked in evidence , are available for , upon request.
PMuari tto 45 CIFR SubdueA 60.8, the board Is obligated to report to the National Practitioners Data Bank any aetidn or professional
(1) (2) (3)
acing to a physician which is based on reasons relating to professional competence duct
ch revokes or sus pends(or otherwise restrict s) a license, ich censures, reprimands or places an probati on, nder which a license Is surrendered.
Pursuant to 46 FR Section 61.7. the Board k , obli g ate d t osuch report to t he Healthcare Integrity and Protection (Hl� Data Bank , any formal or of ficial actions licenseand this ength of any such suspension), rep rimand, censure as or any suspension of aof or revocation probation or other loss
or the iig license It to apply for, or renew a Dense of th
e provider, supplier, or practitioner, whether by operation of t3 voluntary surrender, nort-renewability ,
or otherws i e, or any other negative action or finding by such ederai or Slate agency that-is publicly,available Information.
Pursuant to N ' 46:9-19.13, if the Board refuses to issue, suspends, revokes or otherwise places conditions on a cerise or permit , it Is obligated to notify each licensed health care facility and health me fften)m h 4r izailon with which a licensee Is affiliated and every other board licensee in this state with whom he: she is directly associatedin privatemedicalpractice, In l wth an agreement with the Federation of State Medical Boards of the United States, a I taccordance of or disci � o ry orders are provided to that organization on a monthly basis. Within the rnor4 ( following entry of an order, a summary of the order will for the petit on the public agenda i lly Board meeting and Is forwarded to those members ofappear the public requesting a copy. in addition, the s me summary wilt appear in the minute s of that Board meeting , which are also made available to (hp'srequesting a copy.
Within the m'n following miry of an order, a summ of the order mnll Dis plinary A4ti n Listing which is made available to those mem bers of he publ ic regesti g a co ci
PY tht y
On a periodiq sis the board disseminates to its licensees a newsletter which includes a brief description of pi of the orders entered by the Board. From time to If , the Press Office of the Division of Consumer Affairs may issue releases including the summarie$ f the content of public orders. Nothing herein s Intended in any way to limit the Board, the Division or the Attorney General from disclosing any, p blic document
t ,03
, ,.
