On January 1, 2022, the No Surprises Act (NSA) went into effect. This federal law gives doctors and other licensed health care professionals, medical facilities, hospitals, and insurers significant and often complex regulations that must be adhered to in order to avoid serious sanctions that could include hefty fines and loss of medical licenses.

What Does the NSA Cover?

Lawmakers passed the NSA as a way to protect patients from unexpected medical charges and force providers to be more transparent when it comes to what they are charging. National statistics show that at least 20 percent of patients have received shocking emergency medical care bills with unexpected charges at some point in their lives.

The law limits the amount of liability a patient has on deductibles, copays, and coinsurance they are responsible for if situations prevent them from obtaining services from providers in their health insurance network and they are forced to obtain medical treatment from out-of-network providers at in-network facilities. 

 Our Illinois professional license defense law firm has written many blog posts regarding the types of behaviors and activities that can result in the suspension of a professional license, including insurance fraud, substance abuse, and criminal convictions. But there are also other reasons why the state may take action against your professional license that you may not realize. One of those reasons is if you owe unpaid income taxes to the state of Illinois.

Actions by the Illinois Department of Revenue (IDOR)

Under Illinois law, the majority of residents – with some exceptions – are required to file a state income tax return. Businesses are also required to file state income tax returns, including medical offices and other healthcare facilities.

Your tax return will determine whether or not you owe taxes or if you are entitled to a refund. If you owe the state money but fail to pay when you send your tax return in, the IDOR will send you a bill for the amount you owe. That bill will also show the penalty and interest the state is charging you for not paying your taxes on time.  

In January 2020, the recreational use of marijuana became legal in the state of Illinois. Under the law, anyone over the age of 21 is allowed to cumulatively possess 30 grams of cannabis flower, five grams of concentrate, and cannabis-infused products containing up to 500 milligrams of tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana.

But medical professionals are often held to a different standard when it comes to marijuana, even if it is legal. There may not be criminal consequences for using cannabis products, but you could be putting your medical license in jeopardy under certain circumstances.

Using Marijuana Products

If you are a doctor, nurse, or other medical license professional, you may be legally allowed to use marijuana products in Illinois under the following circumstances:

Our professional license defense law firm has written extensively about the serious consequences physicians face if they are accused of medical insurance fraud, including loss of medical license even criminal charges. However, dentists can also be accused with insurance fraud and face the same type of consequences. If you have been accused of dental insurance fraud, contact an Illinois professional license defense attorney right away.

Dental Insurance Fraud

Dental fraud is any intentional misrepresentation or deception of treatment needed in order to obtain unauthorized benefits. According to the National Health Care Anti-Fraud Association, more than $12 billion is lost to dental fraud every year.

One method of fraud that is becoming more common is the alterations of digital X-rays using software programs to create images that show bogus tooth decay, missing tooth structure, lesions, fractures, and more.

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has issued the latest edition of the Health Care Fraud and Abuse Control Program (HCFAC) Annual Report. The report details the collection of just under $1.9 billion in healthcare fraud settlements and judgments in fiscal year 2021. Funds were returned to the Medicare Trust Funds and also to other federal agencies. Per the HCFAC, the federal government was able to recoup more than $5 billion in healthcare fraud.

Healthcare Fraud Charges

The U.S. Department of Justice (DOJ) initiated more than 800 new criminal healthcare fraud investigations last year. Of those investigations, federal prosecutors filed criminal charges against 741 defendants. More than 300 of those defendants have already been convicted of healthcare fraud-related offenses.

According to the report, the COVID-19 pandemic contributed to an increase in the number of healthcare fraud cases that involved unnecessary lab testing, unnecessary services, and fraudulently obtaining pandemic healthcare relief funds.