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  • NY State Department of Health in The Matter of Jeffrey Leathersich, RPA

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    The Lima, Livingston County, physician assistant will surrender his license after a conviction related to narcotics.

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    NY State Department of Health in the Matter of Jeffrey Leathersich, RPA

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    The Lima, Livingston County, physician assistant will surrender his license after a conviction related to narcotics.

    Copyright:

    © All Rights Reserved
    Als PDF herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    282 Ansichten10 Seiten

    NY State Department of Health in The Matter of Jeffrey Leathersich, RPA

    Hochgeladen von

    patti singer
    The Lima, Livingston County, physician assistant will surrender his license after a conviction related to narcotics.

    Copyright:

    © All Rights Reserved
    Als PDF herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    von 10
    NEWYORK) Department Seeitiwr OF Health ANDREW M. CUOMO HOWARD A. ZUCKER,M.D,J.D. SALLY DRESLIN, MS. RN. Governor Commissioner Execatve Depuly Commissioner anuary 4, 2017 (CERTIFIED MAIL-RETURN RECEIPT REQUESTED i Leathersich. PA Dear Mr, Leaterscn Re: License No, 005125 Enclosed i 2 copy of the New York State Board fr Professional Medical Conduct (BPMC) Order No. 17-003. This order and any penalty provided therein goes ino effect January 11.2017, ‘You are roquired to deliver your license and registration within § days ofthe effective date ‘of the surrender provision to: co Physician Mentoring Unit, NYS DOH - OPMC, Riverview Center ‘Suite 985, 10 Broadway, Albany, NY 12204-2719, your leonse is framed, please remove it from the frame and only end the parchment paper ‘onwhich your name is printed, Our office fe unable to store framed licenses, tye documents) are lst, misplaced or destroyed, you ae required to submit to this ofce an sfidavi wo tat eft. Please complete and sign (he aftgavt efore @ ovary PUDIE and Taunt the Office of Professional Medical Conduct Please drectany questions fo: NYS DOH - PMC, Riverview Center, Sule 355, 150 Broadway, ‘Avany, NY. 122042719, telephone # (6) 402-0848. Sincerely, Robert A. catalan, MO. Executive Secretary Board for Professional Medical Conduct ce: Dennis Gruttadar, Ese Brown, Grttads, Gaujean, Prato Hale House 19 Prince Steet Rocher, New York 14607 Enclosure Erp Sa Pac, Coming Toner, Albany, NY 1227 ras oe NEW YORK STATE DEPARTMENT OF HEALTH STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT BPMC No, 17-003 INTHE MATTER ‘SURRENDER oF JEFFREY LEATHERSICH, PA, ane) Upon the application of (Respondent) Jeffrey Leathersich, P.A lo surrender his nse 185 a physicion assistant in the State of New York, which is made a par ofthis Surtender Order ORDERED, that the Surrender, ands lees, ore adopled and its futher (ORDERED, that Respondents name be stricken fom the roster of physician asitans inthe State of Now Yor; ts further ‘ORDERED, thal his Order shall be effective upon esvence by the Board ether + by mating of copy ofthis Surender Order, ether by fret ass mal to Respandent atte address inthe attached Surrender of License eppcelion Corby ceed mala Respondents storey, OR + upon facsimile tansmision lo Respondent or Respondents attomey, Whichever is rat, ‘SO ORDERED. DATE: 1031 ‘ARTHURS, HENGERER, MD. Chair ‘Sale Board for Professional Medical Conduct P NEW YORK STATE. DEPARTMENT OF HEALTH STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT INTHE MATTER oF JEFFREY LEATHERSICH, P.A. SURRENDER OF Ucense AND, ORDER Jeffrey Leathersich, P.A., represents that all ofthe following statements are tue: ‘That on or about June 8, 1995, ! was licensed to practice as a physician assistant in the State of New York, and issued License No. 005125 by the New York State Education Department, My curent adress (i | understand that the New York State Board for Professional Medical Conduct (Board) has charged me with one or more specifications of professional misconduct, as set forth in a Statement of Charges, marked as Exhibit", which is attached to and part of this Surrender of License. {Lam applying to the State Board for Professional Medical Conduct for permission to surrender my license as a physician assistant in the State of New York on the grounds that | pleed no contest o the specification in full satisfaction ofthe charges against me, |1ask the Board to accept my Surrender of License, and | agree to be bound by all of the terms set forth in attached Exhibit ‘understand tha, ifthe Board does not accept my Surrender of License, none of its terms shall bind me or constitute an admission of any of the acts of misconduct alleged; this aoplication shall not be used against me in any way and shall be kept in strict contsence; and the Boar's denial shall be without rue tthe pending decenay breceecing ad the Boar's fal determination pursuant tothe Puke Hel Lav saree tha, the Board accepts my Surender of License, the Chalo the Board shal issue a Surender Oder in accordance wih is ems agree thl his Order shall take eet upon ts issuance bythe Boa her by maling of copy fhe Surender Or ty ist lass mao mea the address inthis Surender of License, oro my attorey by ceed malo pon face ransision tome ory atlomey, whichever is rt The Surender Order, this agreement andl atached exhib ha be pubic locus, wit only paint ents or other confidential information, any, redacted As ble documents, they maybe posted on the Departments website(s), PMC shall repos acton othe National Practoner Osta Bank, the Federation of tate Medical Soars, and ay ther ents thatthe Detar of PMC shall deem appropri. lask he Boon o accep his Surender of Liss, which submit my nn re ‘wi andnot under dures, compulsion or rear. consderaon of the value tome of the Boots accepance of his Surender of License, lowing me eso this mater \wthout ine various risks and burden of hearing onthe mers, kningly waive my "ght to contest he Surender Order or wich apply, whether administratively oul, and age tobe bound by the Surender Order, |understand and agree that he attorney fr the Deparment he Dretor ef he Office of Preessionl Medial Conduct nd the Chao the Sale Bost or Profesional Mericl Conduct ach retain complet discretion ster el ino he prpased ‘@greement and Order, based upon my application, or to decine to do so. | further 3 ‘understand and agree that no prior or separate writen or oral communication can Imit that discretion vate {24/1/20 STHERSICH, PA. 13 4 ‘The undersigned agree to Respondent's atiched Gurrender of License and Order {and tolls proposed penally, terms and conditions. are: 21 afer DERINIS GRUTTADARO, a. Brown, Grutiadaro, Gaujean, Prato Altoméys for Respondent pare: (a/al//é TIMOTHY BH Associa’ Counce Bureau of Professional Medical Conduct hie Drecior Office of Professional Medical Conduct NEW YORK STATE, DEPARTMENT OF HEALTH EXHIBIT A ‘STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT INTHE MATTER STATEMENT OF OF ROES JEFFREY LEATHERSICH, P.A. ee Jettrey Leathers ,P.A, the Respondent, was authorized to provide medical services in New York State on or about June 8, 1995, by the issuance of a physician assistant license, license number 005125, by the New York State Education Department FACTUAL ALLEGATIONS ‘A. On October 28, 2016, Respondent was convicted of two counts of having violated Tile 21 USC§641(9)(1), he Controlled Substances Act, felon, in connection wth his having dispensed controled substances outside ofthe scope of his professional practice ‘The conviction was recorded in the United States District Court forthe Western Distt of New York. Respondent was sentenced to three years’ probation with six months of ome detention, 100 hours of community and a $2000.00 fine, among other penalties, ‘SPECIFICATION OF CHARGES. CONVICTION OF A FEDERAL CRIME Respondent is charged wih commiting professional misconduct as defined in Educ. Law § 6530(2)(a)(i) by reason of his having been found guilty of eommitting an act constituting @ crime undsr federal law, and more specicaly, violating Tile 21 of United Slates Code § 841(a)(1), as alleged in the facts of the following: 1. Ths facts 28 alleged in paragraph A. he, 21,2016 pare Recent 3°16 ‘Albany, "2 Yor IMISHAEL A, FISE? Deputy Counsel ‘Sureeu of Professional Mecical Conduct EXHIBIT “B" Requirements for Closing a Medical Practice Fol vocation, Surrender, Limialion oF ofa Medical License 1. Licensee shall immediately cease and desist from providing medical services as 8 physician assistant in New York State, or under Licensee's New York license, in accordance with the terms ofthe Order In addition, Licensee shal refrain {rom providing an opinion as to professional practice ors application and fom representing thal Licensee is ellgble to practice medicine. The directives and Conditions ofthis and all subsequent paragraphs of Exhibit B shall be interpreted ‘o apply oa physician assistant. 2. Within 5 days ofthe Order's effective date, Licensee shall deer Licensee's original icense to practice medicine in New York Slate and current biennial ‘egisiration to the Office of Professional Medical Conduct (OPMC) al Riveriew Center, 150 Broadway, Suite 355, Albany, New York 12204-2718, 3. Within 15 days of the Order’ effective date, Licensee shall notify all patients of the cessation or limitation of Licensee's medical practice, and shall refer all patients to another licensed pracicing physician for continued care, 23 ‘appropriate, Licensee shall notify, in wring, each health care plan with which the Licensee contracts or is employed, and each hospital where Licensee has Privileges, that Licensee has ceased medical practice. Within 48 days ofthe Order's effective date, Licensee shall provide OPMC with writen documentation ‘that al patients end hospitals have been ntfied ofthe cessation of Licensee's ‘medical practice. 4. Licensee shall make arrangements forthe transfer and maintenance ofall Patient medical records. Within 30 days ofthe Orders etfective date, Licensee shall notify OPMC of these arrangements, including the name, address, and {elephone number of an appropriate and acceptable contact person who she have access to these records. Orginal records shall be retained for atleast § years aller the last date of service rendered to a paliont or, ia the case of a ‘minor, fora least 6 years after the last date of service or 3 years after the sient reaches the age of majriy, whichever time peried is longer. Records | Sra be maiame ina safe ano sects pace ats veasonscl soeassicts —] former palienis. The arrangements shall intude provisions to ensure thatthe information in the record is kept confidential and is available only to authorized Persons. When a palient ora palient’s representative requests a copy af the Patients medical record, or requests that the original medical record be sent lo ‘another health care provider, a copy of the record shall be promptly providec or forwarded at a reasonable cos! tothe patient (not io exceed 75 cenis pat page.) Radiographic, sonographic and similat materials shall be provided al cost A 4ualified person shall not be denied access lo patient information solely because of an inability to pay. 5. {nthe event that Licensee holds & Drug Enforcement Administration (DEA) ceriicate for New York Stale, Licensoe shal, within 15 days ofthe Order's effective date, advise the DEA, in wring, ofthe censure action and shall surrender Licensee's DEA controled substance privleges for New Yark State to the DEA. Licensee shall promplly surender any unused DEA #222 U.S. Official (Order Forms Schedules 1 and 2 or New York Stale lo the DEA. Allsubmissions to the DEA shall be addressed lo Diversion Program Manager, New York Fill Diision, U.S. Drug Enforcement Administration, 99 Tenth Avenue, New York, Ny 10041. Within 15 days ofthe Orders efiective date, Licensee shall return any unused New York State oficial prescription forms lo the Bureau of Narcotic Enforcement ‘ofthe New York Stale Department of Health. Ifno olher lcensee is providing services at Licensee's practice location, Licensee shal property depose of al ‘medications. Win 15 days ofthe Order's effective date, Licensee shall remove from the pubile domain any representa that Leeneae Ie lige 1o practice medicine, Including all related slns, adverisements, professional istinas (whether in {elephione directories, hismel or othenuse), professional stationery or bling. LUcensee shal nol shave, occupy, or use office space In which enother licensee provides healthcare services. LUcensee shal not chaige, receive or share any fee or distribution of dividends for professional services rendered by Licensee or others while Licensee Is barred ffom engaging inthe practice of medline. Licensee may be ‘compensated forthe reasonable value of services twfully rendered, and

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