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Appeal panel modifies sanctions in unprofessional conduct case

October 28, 2020

Lessons Learned: licensees must understand their responsibilities in operating their pharmacies, including honesty and integrity in dealings with third-party insurers.

On April 17, 2019, ACP published a Lessons Learned article about a Hearing Tribunal’s written decisions on the merit and orders regarding the conduct of a pharmacist who was a pharmacy’s owner, proprietor, and licensee during the period of the alleged misconduct.

Since publishing of that article, the pharmacist appealed the Hearing Tribunal’s decisions to a panel of Council of ACP.

The appeal was heard on January 28, 2020, and on April 24, 2020, the appeal panel issued its written decision on the merits of the appeal. The appeal panel affirmed four of the five findings of unprofessional conduct made by the Hearing Tribunal. The appeal panel overturned the Hearing Tribunal’s fifth finding, that the pharmacist failed or refused to cooperate with the complaint investigation.

However, the appeal panel affirmed the importance of, and requirement for, registrants to provide ACP with accurate and current contact information, as is required in the Pharmacists and Pharmacy Technicians Professional Regulation. In its April 24, 2020, decision on the merits of the appeal, the appeal panel stated the following:

It is true that the Hearing Tribunal’s findings against [the pharmacist] are serious, but the lack of actual notice of the hearing resulted from her own failure to provide the College with accurate, current contact information. Had she met her own statutory, regulatory obligations then she would have received notice of the hearing. There was no breach of natural justice or procedural fairness and no miscarriage of justice.

On July 6, 2020, the appeal panel and the parties reconvened and submissions on sanctions were heard.

In its September 14, 2020, decision on sanctions, the appeal panel modified the previous sanctions of the Hearing Tribunal. The appeal panel ordered the following:

  • In lieu of cancellation, a suspension of the pharmacist’s practice permit for 36 months, from April 4, 2019, to April 3, 2022, after which the pharmacist’s practice permit shall be subject to all of the following conditions:
    • The pharmacist must practice under direct supervision for one year, with the supervising pharmacist to provide a report to the ACP complaints director confirming satisfactory completion of the supervised practice.
    • The pharmacist shall successfully complete ACP’s Ethics and Jurisprudence Exam and Center for Personalized Education for Physician’s (CPEP) Probe Course, at her own expense, prior to being reissued a pharmacy practice permit with ACP.
    • If the pharmacist does not successfully complete ACP’s Ethics and Jurisprudence Exam and CPEP Probe course within one year of the completion of the 36-month suspension, her registration with ACP shall be cancelled.
  • Fines totalling $40,000 [a reduction from the previously order $50,000 in fines].
  • The pharmacist must not be an owner, proprietor, or licensee of a pharmacy for a period of 10 years.
  • Payment of $26,000 towards the costs of the investigation and hearing.
  • Payment of $50,000 towards the costs of the appeal.

Rationale for the appeal panel’s decisions, is reflected in its following statements from the September 14, 2020 decision on sanctions (see pages 14 - 19):

[The pharmacist’s] proven unprofessional conduct was extremely serious. The Appeal Panel agrees with the Hearing Tribunal’s conclusion that [the pharmacist] received substantial monetary benefits from submitting claims to ABC that she was not entitled to make. She also created false dispensing records and a risk of patient harm, in addition to other findings of unprofessional conduct for dispensing drugs without authorization and failing to create or retain original prescriptions.

… … …

Honesty and integrity are essential for healthcare professionals such as pharmacists and pharmacy technicians. If the public cannot trust regulated members of the College to act with honesty and integrity, then the highly regulated system by which the public obtains access to necessary drugs and other pharmacy services would fail. The College cannot allow this.

… … …

The public depends on the College to address the problem of regulated members abusing the drug benefits system for their own financial gain, which places patients at risk in the process.

… … …

We must make it clear not just to [the pharmacist], but to the whole pharmacy profession that what we see happening can happen no longer.

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