NEW YORK Department ?l?il?rfi?mw of Health ANDREW M. CUOMO HOWARD A. ZUCKER. MD. JD. SALLY DRESLIN, M.S.. R.N. Governor Commissioner Executive Deputy Commissioner December 1. 2015 MAIL-RETURN RECEIPT REQUESTED Alfred L. Ramirez. MD. PO. Box 482'. 7'5 Run Road. Suite 125 Middletown. NY 10941 Re; License No. 100036 Dear Dr Ramirez: Enclosed IS a copy of the New York State Board for Professional Medical Conduct Order No. 15-286. This order and any penalty provided therein goes into effect December 8. 2015. If the penalty imposed by this Order is a surrender, revocation or suspension, you are required to deliver your license and registration within five days of receipt of this Order to: clo Physician Monitoring Unit, NYS DOH - OPMC. Riverview Center. Suite 355. 150 Broadway. Albany, NY 12204-2719. If your license is framed. please remove it from the frame and only send the parchment paper on which your name is printed. Our of?ce is unable to store framed licenses. If the documentis) are lost, misplaced or destroyed, you are reqwred to submit to this office an affidavit to that effect. Please complete and sign the affidavit before a notary public and return it to the Office of Professional Medical Conduct. Please direct any questions to: NYS DOH - OPMC. Riverview Center. Suite 355. 150 Broadway. Albany, NY 12204-2719. telephoneft (518)402-0855. Sincerely. Katherine A. Hawkins. MD. JD. Executive Secretary Board for Professional Medical Conduct cc: Thomas M. Gallo. Esq. Kern Augustine Conroy Schoppmann. PG. 865 Merrick Avenue. Suite 200 South Westbury. NY 11590 Enclosure Emp:re Slate Plaza. Corning Tower. Albany, NY 1223? No. 15-285 NEW YORK STATE DEPARTMENT OF HEALTH STA BOARD FOR PROFESSIONAL MEDICAL CONDUCT i IN THE MATTER SURRENDER OF ALFRED RAMIREZ, Mp. ORDER Upon the application ofAlfred Ramirez, MD. to surrender his or her license as a physician in the State of New York, which is made a part of this Surrender Order. it is ORDERED, that the Surrender, and its terms. are adopted and it is further OQDERED, that Respondent?s name be stricken from the roster of physicians in the State of New York; it is further ORDERED, that this Order shall be effective upon issuance by the Board, either by mailing of a copy of this Surrender Order, either by ?rst class mail to Res Jondent at the address in the attached Surrender of License application or by certified rnail to Respondent's attorney, OR upon facsimiie transmission to Respondent or Respondent's attorney, Whichever is first. 30 C-RDERED DATE- 11t30i?2015 ARTHUR S. HENGERER. D. Chair State Board for Professional Medical Conduct 1 NEW YORK STATE DEPARTMENT OF HEALTH STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT IN THE MATTER 0F HEENSE ALFRED RAMIREZ. M-D- ORDER Alfred Ramirez, M.D., represents that all of the following statements are true: That on or about September 20, 1967, was licensed to practice as a physician in the State of New York, and issued License No. 100036 by the New York State Education Department. {"61 . 54-1351}; rid?ail; dirt/K Eric-'5 ,x 5215? - My current address is m?rdv?i 79"?2?4?7, I understand that the New York State Board for Professional Medical Conduct (Board) has charged me with one or more speci?cations 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. I am applying to the State Board for Professional Medical Conduct for permission to surrender my license as a physician in the State of New York on the grounds that i agree not to contest the allegations in full satisfaction of the charges against me. I ask the Board to accept my Surrender of License. and I agree to be bound by all of the terms set forth in attached Exhibit I understand that. if the 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 application shall not be used against me in any way and shall be kept in strict 2 confidence; and the Board's denial shall be without prejudice to the pending disciplinary proceeding and the Board's final determination pursuant to the Public Health Law. i agree that. if the Board accepts my Surrender of License. the Chair of the Board shall issue a Surrender Order in accordance with its terms. I agree that this Order shall take effect upon its issuance by the Board, either by mailing of a copy of the Surrender Order by ?rst class mail to me at the address in this Surrender of License, or to my attorney by certi?ed mail. or upon facsimile transmission to me or my attorney, whichever is ?rst. The Surrender Order, this agreement, and all attached exhibits shall be public documents, with only patient identities, if any, redacted. As public documents, they may be posted on the Department's website(s). OPMC shall report this action to the National Practitioner Data Bank. the Federation of State Medical Boards. and any other entities that the Director of OPMC shall deem appropriate. I ask the Board to accept this Surrender of License. which I submit of my own free will and not under duress, compulsion or restraint. In consideration of the value to me of the Board's acceptance of this Surrender of License. allowing me to resolve this matter without the various risks and burdens ofa hearing on the merits, knowingly waive my right to contest the Surrender Order for which I apply, whether administratively or judicially, and I agree to be bound by the Surrender Order. I understand and agree that the attorney for the Department. the Director of the Of?ce of Professional Medical Conduct and the Chair of the State Board for Professional Medical Conduct each retain complete discretion either to enter into the proposed agreement and Order, based upon my application, or to decline to do so. I further 3 understand and agree that no prior or separate written or oral communication can limit that discretion. .f ,ar/ oArEj?x?zT in 9 7?9?3 ALFRED RAMIREZ. MD. RESPONDENT 4 The undersigned agree to Respondent?s attached Surrender of License and Order and to its proposed penaity. terms and conditions. .A I. onre: 5 H. ?uh THOMAS GALLO. ESQ. Attorney for Respondent DATES: Ac LesLiE Eiseuee?Re Associate Counsii Bureau of Profes ional Medicai Conduct DH: ti: KEITH W. Director Office of Professional Medical Conduct ?Exhibit NEW YORK STATE DEPARTMENT OF HEALTH STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT IN THE MATTER STATEMENT OF 0F CHARGES ALFRED L. RAMIREZ, NLD. Alfred L. Ramirez, M.D., the Respondent, was authorized to practice medicine in New York State on or about September 20. 1967, by the issuance of license number 100036 by the New York State Education Department. FACTUAL A. Respondent treated Patient A from in or about April 11. 2013 and thereafter. Respondent?s care and treatment deviated from minimally accepted standards of care in that he: 1. Failed to appropriately evaluate the patient prior to and during treatment. 2. Inappropriater prescribed narcotics and sedatives andfor did so in an inappropriate manner. 3. Failed to check the New York State Prescription Monitoring Program Registry pursuant to Public Health Law ?3343-a(2) and 4. Failed to appropriately monitor the patient. 5. Failed to maintain a medical record that accurately reflects the care and treatment of the patient. 8. Respondent treated Patient from in or about April 15, 2013 and thereafter. Respondent?s care and treated deviated from minimally accepted standards of care in that he: 1. Failed to appropriately evaluate the patient prior to and during treatment. 2. Inappropriater prescribed narcotics and sedatives and/or did so in an inappropriate manner. 3. Failed to check the New York State Prescription Monitoring Program Registry pursuant to Public Health Law ?3343-a(2) and Failed to appropriately monitor the patient. Failed to maintain a medical record that accurately reflects the care and treatment of the patient. (3. Respondent treated Patient from in or about December 10. 2012 and thereafter. Respondent?s care and treated deviated from minimally accepted standards of care in that he: 1. Failed to appropriately evaluate the patient prior to and during treatment. 2. Inappropriater prescribed narcotics and sedatives andfor did so in an inappropriate manner. 3. Failed to check the New York State Prescription Monitoring Program Registry pursuant to Public Health Law ?3343va(2) and 4. Failed to appropriater monitor the patient. Failed to maintain a medical record that accurately reflects the care and treatment of the patient. D. Respondent treated Patient from in or about October 22. 2012 and thereafter. Respondent's care and treated deviated from minimally accepted standards of care in thathe: 1. Failed to appropriately evaluate the patient prior to and during treatment. 2. Inappropriater prescribed narcotics and sedatives and/or did so in an inappropriate manner. 3. Failed to check the New York State Prescription Monitoring Program Registry pursuant to Public Health Law ?3343-a(2) and 4. Failed to apprOpriately monitor the patient. 2 5. Failed to maintain a medical record that accurately reflects the care and treatment of the patient. E. Respondent treated Patient from in or about January 7. 2012 and thereafter. Respondent's care and treated deviated from minimally accepted standards of care in that he: 1. 2. Failed to appropriately evaluate the patient prior to and during treatment. Inappropriater prescribed narcotics and sedatives andfor did so in an inappropriate manner. Failed to check the New York State Prescription Monitoring Program Registry pursuant to Public Health Law ?3343?a(2) and Failed to appropriately monitor the patient. Failed to maintain a medical record that accurately reflects the care and treatment of the patient. F. Respondent treated Patient from in or about May 23. 2013 and thereafter. Respondent?s care and treated deviated from minimally accepted standards of care in that he: 1. 2. Failed to appropriately evaluate the patient prior to and during treatment. InapprOpriately prescribed narcotics and sedatives andfor did so in an inappropriate manner. Failed to check the New York State Prescription Monitoring Program Registry pursuant to Public Health Law ?3343-a(2) and 0 Failed to appropriately monitor the patient. Failed to maintain a medical record that accurately reflects the care and treatment of the patient. G. Respondent treated Patient from in or about December 10, 2012 and thereafter. Respondent?s care and treated deviated from minimally accepted standards of care in that he: Failed to appropriately evaluate the patient prior to and during treatment. Inappropriater prescribed narcotics and sedatives and/or did so in an inappropriate manner. Failed to check the New York State Prescription Monitoring Program Registry pursuant to Public Health Law ?3343-a(2) and 0 1). Failed to appropriately monitor the patient. Failed to maintain a medical record that accurately reflects the care and treatment of the patient. H. Respondent treated Patient from in or about April 1, 2013 and thereafter. Respondent's care and treated deviated from minimally accepted standards of care in that he: 1. 2. Failed to appropriately evaluate the patient prior to and during treatment. inappropriately prescribed narcotics and sedatives andfor did so in an inappropriate manner. Failed to check the New York State Prescription Monitoring Program Registry pursuant to Public Health Law ?3343?a(2) and Failed to appropriately monitor the patient. Failed to maintain a medical record that accurately reflects the care and treatment of the patient. Respondent treated Patient I from in or about September 23. 2012 and thereafter. Respondent's care and treated deviated from minimally accepted standards of care in that he: 1. 2. Failed to appropriately evaluate the patient prior to and during treatment. Inappropriater prescribed narcotics and sedatives and/or did so in an inappropriate manner. Failed to check the New York State Prescription Monitoring Program Registry pursuant to Public Health Law ?3343-a(2) and 0 Failed to appropriately monitor the patient. 4 5. Failed to maintain a medical record that accurately reflects the care and treatment of the patient. SPECIFICATION OF CHARGES FIFIST SPECIFICATION NEGLIGENCE ON MORE THAN ONE OCCASION Respondent is charged with committing professional misconduct as defined in NY. Educ. Law 6530(3) by practicing the profession of medicine with negligence on more than one occasion as alleged in the facts of: 1. Paragraph A and its subparagraphs and/or Paragraph and its subparagraphs andfor Paragraph and its subparagraphs andlor Paragraph and its subparagraphs and/or Paragraph and its subparagraphs andlor Paragraph and its subparagraphs andfor Paragraph (3 and its subparagraphs andfor Paragraph and its subparagraphs andfor Paragraph and its subparagraphs. SECOND SPECIFICATION INCOMPETENCE ON ONE OCCASION Respondent is charged with committing professional misconduct as defined in N.Y. Educ. Law 6530(5) by practicing the profession of medicine with incompetence on more than one occasion as alleged in the facts of: 2. Paragraph A and its subparagraphs andi'or Paragraph and its subparagraphs and/or Paragraph and its subparagraphs andlor Paragraph and its subparagraphs andr'or Paragraph and its subparagraphs andfor Paragraph and its subparagraphs and/or Paragraph and its subparagraphs andlor Paragraph and its subparagraphs andfor Paragraph 1 and its subparagraphs. THIFID THROUGH ELEVENTH SPECIFICATIONS GROSS NEGLIGENCE Respondent is charged with committing professional misconduct as defined in NY. Educ. Law 6530(4) by practicing the profession of medicine with gross negligence on a particular occasion as alleged in the facts of the following: 3. Paragraph A and its subparagraphs. 4. Paragraph and its subparagraphs. 5. Paragraph and its subparagraphs. 6. Paragraph and its subparagraphs. 7. Paragraph and its subparagraphs. 8. Paragraph and its subparagraphs. 9. Paragraph (3 and its subparagraphs. 10. Paragraph and its subparagraphs. 11. Paragraph i and its Subparagraphs. SPECIFICATION GROSS INCOMPETENCE Respondent is charged with committing professional misconduct as defined in N.Y. Educ. Law 6530(6) by practicing the profession of medicine with gross incompetence as alleged in the facts of the following: 12. Paragraph A and its subparagraphs andfor Paragraph and its subparagraphs and/or Paragraph and its subparagraphs andfor Paragraph and its subparagraphs and/or Paragraph and its subparagraphs andlor Paragraph and its subparagraphs andfor Paragraph and its subparagraphs andlor Paragraph and its subparagraphs and/or Paragraph i and its subparagraphs. THIRTEENTH THROUGH MENTYFIFIST SPECIFICATIONS FAILURE TO MAINTAIN RECORDS Respondent is charged with committing professional misconduct as defined in N.Y. Educ. Law 6530(32) by failing to maintain a record for each patient which accurately reflects the evaluation and treatment of the patient. as alleged in the facts of: 13. Paragraph A and A5. 14. Paragraph 8 and BS. 15. Paragraph and CS. 16. Paragraph and D5. Paragraph and E5. 18. Paragraph and F5. 19. Paragraph and G5. 20. Paragraph and H5. 21. Paragraph 1 and I5. THROUGH THIRTIETH WILFUL FAILURE To come}: Fiespondent is charged with committing professional misconduct as defined in N.Y. Educ. Law 6530( 16) by willfully or grossly negligent failure to comply with substantial provisions of federal, state. or local laws. rules, or regulations governing the practice of medicine. as alleged in the facts of: 22. Paragraph A and A3. 23. Paragraph and BS. 24. Paragraph and CS. 25. Paragraph and 03. 26. Paragraph and E3. 27. Paragraph and F3. 28. Paragraph (3 and G3. 29. Paragraph and H3. 30. Paragraph and l3. DATEzoqgtober if .2015 New York, New York Flay Nemerson Deputy Counsel Bureau of Professional Medical Conduct EXHIBIT Reouirementgior Closinqa Medical Practice Followino a Revocation. S_urrenderLLimitation or Susoension of a Medical License Licensee shall immediately cease and desist from engaging in the practice of medicine in New York State. or under Licensee's New York license. in accordance with the terms of the Order. In addition. Licensee shall refrain from providing an opinion as to professional practice or its application and from representing that Licensee is eligible to practice medicine. Within 5 days of the Order's effective date. Licensee shall deliver Licensee's original license to practice medicine in New York State and current biennial registration to the Office of Professional Medical Conduct (OPMC) at Riverview Center. 150 Broadway. Suite 355. Albany. New York 12204?2719. Within 15 days of the Order's 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 practicing physician for continued care. as appropriate. Licensee shall notify. in writing. 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 45 days of the Order's effective date. Licensee shall provide OPMC with Written documentation that all patients and hospitals have been notified of the cessation of Licensee's medical practice. Licensee shall make arrangements for the transfer and maintenance of all patient medical records. Within 30 days of the Order's effective date. Licensee shalt notify OPMC of these arrangements. including the name. address. and telephone number of an appropriate and acceptable contact person who shall have access to these records. Original records shall be retained for at least 6 years after the last date of service rendered to a patient or. in the case of a minor. for at least 6 years after the last date of service or 3 years after the patient reaches the age of majority. whichever time period is longer. Records shall be maintained in a safe and secure place that is reasonably accessible to former patients. The arrangements shall include provisions to ensure that the information in the record is kept con?dential and is available only to authorized persons. When a patient or a patient's representative requests a copy of the patient's medical record. or requests that the original medical record be sent to another health care provider. a copy of the record shall be provided or forwarded at a reasonable cost to the patient (not to exceed 75 cents per page.) Radiographic. sonographic and similar materials shall be provided at cost. A quali?ed person shall not be denied access to patient information solely because of an inability to pay. In the event that Licensee holds a Drug Enforcement Administration (DEA) certificate for New York State. Licensee shall. within 15 days of the Order?s effective date. advise the DEA. in writing, of the licensure action and shall surrender Licensee's DEA controlled substance privileges for New York State to the DEA. Licensee shall surrender any unused DEA #222 U.S. Official Order Forms Schedules 1 and 2 for New York State to the DEA. All submissions to the DEA shall be addressed to Diversion Program Manager, New York Field Division. U.S. Drug Enforcement Administration, 99 Tenth Avenue, New York. NY 10011. Within 15 days of the Order's effective date, Licensee shall return any unused New York State official prescription forms to the Bureau of Narcotic Enforcement of the New York State Department of Health. If no other licensee is providing services at Licensee's practice location. Licensee shall properly dispose of all medications. Within 15 days of the Order's effective date. Licensee shall remove from the public domain any representation that Licensee is eligible to practice medicine. including all related signs. advertisements. professional listings (whether in telephone directories, internet or othemrise). professional stationery or billings. Licensee shall not share. occupy. or use of?ce space in which another licensee provides health care services. Licensee shall not charge. receive or share any fee or distribution of dividends for professional services rendered by Licensee or others while Licensee is barred from engaging in the practice of medicine. Licensee may be compensated for the reasonable value of services lawfully rendered, and disbursements incurred on a patient's behalf. prior to the Order's effective date. If Licensee is a shareholder in any professional service corporation organized to engage in the practice of medicine. Licensee shall divest all financial interest in the professional services corporation. in accordance with New York Business Corporation Law. Such divestiture shall occur within 90 days. if Licensee is the sole shareholder in a professional services corporation. the corporation must be dissolved or sold within 90 days of the Order?s effective date. Failure to comply with the above directives may result in a civil penalty or criminal penalties as may be authorized by governing law. Under N.Y. Educ. Law 6512. it is a Class Felony. punishable by imprisonment for up to 4 years. to practice the profession of medicine when a professional license has been suspended, revoked or annulled. Such punishment is in addition to the penalties for professional misconduct set forth in NY. Pub. Health Law 230-a, which include fines of up to 510.000 for each speci?cation of charges of which the Licensee is found guilty. and may include revocation of a suspended license.