CHRISTOPHER s. PORRINO ATTORNEY GENERAL OF NEW JERSEY Division of Law Su?Floor 124 Halsey Street APR 3 20f] P.O. Box 45029 Newark, New Jersey 07101 1 NEW JERSEY STATE 3 By: Alina Wells Deputy Attorney General Tel. No. (973) 648?2779 Attorney 029512006 STATE OF NEW JERSEY DEPARTMENT OF LAW PUBLIC SAFETY DIVISION OF CONSUMER AFFAIRS STATE BOARD OF MEDICAL EXAMINERS IN THE MATTER OF ROBIN J. KOVAL Administrative Action CHARGED WITH ENGAGING IN THE UNLICENSED PRACTICE OF MEDICINE AND SURGERY IN THE STATE OF NEW JERSEY CONSENT ORDER THIS MATTER was opened to the New Jersey State Board of Medical Examiners (?Board?) upon receipt of information that Robin Koval (?Respondent?) offered. to engage :hi or engaged. in the practice of medicine in the State of New Jersey by providing injections of Botox to individuals at her home in Franklin Lakes, New Jersey. Respondent was previously licensed in the State of New Jersey as a Physician Assistant, but her license expired in 2003 and has not been renewed. Respondent admits that she is not licensed by the State of New Jersey and 'that she has administered. Botox ?to individuals in this state. Respondent's holding herself out as being able to practice, offering to practice and. practicing' medicine in New Jersey without a 'valid COPY medical license constitutes a violation of N.J.S.A. N.J.S.A. 45:9?6 and N.J.S.A. 45:9?22. The Board finding the within disposition adequately protective of the public health, safety and other good cause shown, IT IS ON THIS 3% DAY or BEEN 2017, HEREBY ORDERED AND AGREED: 1. Respondent shall immediately cease and desist from engaging in the practice of' medicine and surgery' in. New Jersey. Respondent shall immediately cease and desist from engaging in or offering to engage in the practice of medicine and surgery within the State of New Jersey, including but not limited to administering Botox to individuals in her Franklin Lakes, New Jersey home. 2. Respondent is assessed civil. penalties in the amount of $10,000 pursuant to ZN.J.S.A. 45:1?22. Payment of 'the civil. penalty shall be stayed provided that Respondent complies with the terms of the within Consent Order. Failure to comply with the terms of this Consent Order will automatically activate the stayed civil penalty, which will then be due and owing. Upon becoming due and owing, payment of the civil penalty shall be submitted by certified bank check, wire transfer, credit card, or money order made payable to the ?State of New Jersey" and sent to William Roeder, Executive Director, Board of Medical Examiners, 140 East Front Street, P.O. Box 183, Trenton, New Jersey 08625. Any other form of payment will be rejected and will be returned 1x) the party making payment. If payment i1; not received within five days of it becoming due and owing, a Certificate of Debt shall be filed pursuant to N.J.S.A. 45:1_24 to protect the judgment. 3. The parties hereby stipulate that entry of this Order is with prejudice as to any actions by this Board arising from the violations and facts expressly referenced in this Order. This Consent Order is without prejudice to further action, investigation and prosecution by this Board, the Attorney General, the Drug Control Unit, the Director of the Division of Consumer Affairs or other law enforcement entities resulting from any other conduct not addressed by the terms of this Order. Nothing in this Consent Order shall prevent Respondent from reapplying for a Physician?s Assistant license in the State of New Jersey. The Board shall retain jurisdiction to enforce the terms of this Order. Upon receipt of any reliable information indicating that Respondent has violated any term of this Order, the Board reserves the right to bring further disciplinary action. NEW STAT BO MEDIC A. p,o.I0.p,n1 . By: - George CI. D.P.M., 13.0. President I have read the above order and I understand and agree to abide by its terms. Consent is hereby given to the Board of Medical Exam' ers to enter this Order. ?obin J. Ko al 8 13/131 Date (20% form ?g Bfian legs/ig, Esq. Atto for Robin Koval Date: 21/ DIRECTIVES APPLICABLE TO ANY MEDICAL BOARD LICENSEE WHO IS DISCIPLINED OR WHOSE SURRENDER OF LICENSURE OR CESSATION OF PRACTICE HAS BEEN ORDERED OR AGREED UPON APPROVED BY THE BOARD ON AUGUST 12, 2015 All licensees who are the subject of a disciplinary order or surrender or cessation order (herein after, ?Order?) of the Board shall provide the information required on the addendwn to these directives. Failure to provide the information required may result in further disciplinary action for failing to cooperate with the Board, as required by N.J.A.C. 13:45C?l e_t Paragraphs 1 through 4 below shall apply when a licensee is suspended, revoked, has surrendered his or her license, or entered into an agreement to cease practice, with or without prejudice, whether on an interim or final basis. Paragraph 5 applies to licensees who are the subject of an order which, while permitting continued practice, contains probationary terms or monitoring requirement. 1. Document Return and Agency Notification The licensee shall forward to the Board office at Post Office Box 183, 140 East Front Street, 2nd floor, Trenton, New Jersey 08625?0183, the original license, current biennial registration and, if applicable, the original CDS registration. In addition, if the licensee holds a Drug Enforcement Agency (DEA) registration, he or she shall advise the DEA of the licensure action. (With respect to suspensions of a finite term, at the conclusion of the term, the licensee may contact the Board office for the return of the documents previously surrendered to the Board. Prior to the resumption of any' prescribing of 'controlled dangerous substances, the licensee shall petition the? Director of Consumer Affairs for a return of the CDS registration if the basis for discipline involved CDS misconduct. In addition, at the conclusion of the term, the licensee should contact the DEA to advise of the resumption of practice and to ascertain the impact of that change upon his/her DEA registration.) 2. Practice Cessation The licensee shall cease and desist from engaging in the practice of :medicine in this State. This jprohibition. not only' bars a licensee from rendering jprofessional services, but also from providing an opinion as to professional practice or its application, or representing him/herself as being eligible to practice. (Although the licensee need not affirmatively advise patients or others of the revocation, suspension, surrender or cessation, the licensee must truthfully disclose his/her licensure status in response to inquiry.) The licensee subject to the order is also prohibited from occupying, sharing or using office space in which another licensee provides health care services. The licensee subject to the order may contract for, accept payment from another licensee for rent at fair market value for office premises and/or equipment. In no case may the licensee subject to the order authorize, allow or condone the use of his/her provider number by any health care practice or any other licensee or health care provider. In situations where the licensee has been subject to the order for less than one year, the licensee may accept payment from another professional who is using his/her office during the period that the licensee is (suspended), subject to the order for the payment of salaries for office staff employed at the time of the Board action. A licensee whose license has been revoked, suspended or subject to a surrender or cessation order for one (1) year or more must immediately take steps to remove signs and take affirmative action to stop advertisements by which his/her eligibility to practice is represented. The licensee must also take steps to remove his/her name from professional listings, telephone directories, professional stationery, or billings. If the licensee's name is utilized in a group practice title, it shall be deleted. Prescription pads bearing the licensee's name shall be destroyed. A destruction report form obtained from the Office of Drug Control (973?504?6558) must be filed. If no other licensee is providing services at the location, all medications must be removed and returned to the manufacturer, if possible, destroyed or safeguarded. (In situations where a license has been suspended for less than one year, prescription pads and medications need not be destroyed but must be secured in a locked place for safekeeping.) 3. Practice Income Prohibitions/Divestiture of Equity Interest in Professional Service Corporations and Limited Liability Companies A licensee subject to the order shall not charge, receive or share in any fee for professional services rendered by him/herself or others while barred from engaging in the professional practice.1 The licensee :may' be compensated for the reasonable value of services lawfully rendered and disbursements incurred on a patient's behalf prior to the effective date of the Board order. 1This bar on the receipt of any fee for professional services is not applicable to cease and desist orders where there are no findings that would be a basis for Board action, such as those entered adjourning a hearing. A licensee who is a shareholder in a professional service corporation organized to engage in the professional practice, whose license is revoked, surrendered or suspended or who is ordered to cease practice for a term of one (1) year or more shall be deemed to be disqualified from the practice within the meaning of the Professional Service Corporation..Act. (N.J.S.A. 14Agl7-ll). A disqualified licensee shall divest him/herself of all financial interest in. the ;professional service corporation. pursuant to N.J.S.A. A disqualified licensee who is a member of a limited liability company organized pursuant to N.J.S.A. 42:1?44, shall also divest him/herself of all financial interest. Such divestiture of the licensee's interest in the limited liability company or professional service corporation shall occur within 90 days following the entry of the order rendering the licensee disqualified to participate in the applicable form of ownership. Upon divestiture, a licensee shall forward to the Board a copy of documentation forwarded to the Division of Revenue and Enterprise Services demonstrating that the interest has been terminated. If the licensee is the sole shareholder in a professional service corporation or sole member of the limited liability company, the corporation must be dissolved within 90 days of the licensee?s disqualification unless it is lawfully transferred to another licensee and documentation of the valuation process and consideration paid is also provided to the Board. 4. Medical Records If, as a result of the Board's action, a practice is closed or transferred to another location, the licensee shall ensure that (during the three (3) period) immediately following the effective date of the disciplinary" order, a :message *will be delivered to patients calling the former office premises, advising where records may be obtained. The message should inform patients of the names and telephone numbers of the licensee (or his/her attorney) assuming custody of the records. The same information shall also be disseminated by means of a notice to be published at least once per month for three (3) months in a newspaper of general circulation in the geographic vicinity in which the practice was conducted. If the licensee has a website, a notice shall be posted on the website as well. At the end of the three month period, the licensee shall file with the Board the name and telephone number of the contact person who will have access to medical records of former patients. Any change in that individual or his/her telephone number shall be reported to the Board. When a patient or his/her representative requests a copy of his/her medical record or asks that record be forwarded to another health care provider, the licensee shall provide the record without charge to the patient. 5. Probation/Monitoring Conditions With respect to any licensee who is the subject of any order imposing a.pmcbatian or monitoring requirement or a stay of an active suspension, in whole or in part, which is conditioned upon compliance with a probation or monitoring requirement, the licensee shall fully cooperate with the Board and its designated representatives, including the Enforcement Bureau of the Division of Consumer Affairs, in ongoing monitoring of the licensee's status and practice. Such monitoring shall be at the expense of the disciplined practitioner. Monitoring of practice conditions may include, but is not limited to, inspection of the professional premises and equipment, and Inspection and copying of patient records (confidentiality of patient identity? shall be jprotected. by the Board) to 'verify compliance with the Board Order and accepted standards of practice. Monitoring of status conditions for an impaired practitioner may include, but is not limitedto, practitioner cooperation in providing releases permitting unrestricted access to records and other information to the extent permitted by law from any treatment facility, other treating practitioner, support group or other individual/facility involved in the education, treatment, monitoring or oversight of the practitioner, or maintained by a rehabilitation program for impaired practitioners. If bodily substance monitoring has been ordered, the practitioner shall fully cooperate by responding to a demand for breath, blood, urine or other sample ill a timely manner and providing the designated sample. 6. Payment of Civil and Criminal Penalties and Costs. With respect to any licensee who is the subject of any order imposing a civil penalty and/or costs, the licensee shall satisfy the payment obligations within the time period ordered by the Board or be subject to collection efforts or the filing of a certificate of debt. The Board shall not consider any application for reinstatement nor shall any appearance before a committee of the Board seeking reinstatement be scheduled until such time as the Board ordered payments are satisfied in full. (The Board at its discretion may grant installment payments for not more than a 24 months period.) As to the satisfaction of criminal penalties and civil forfeitures, the Board will consider a reinstatement application so long as the licensee is current in his or her payment plans. NOTICE OF REPORTING PRACTICES OF BOARD REGARDING DISCIPLINARY ORDERS ACTIONS All Orders filed.by the New Jersey State Board of Medical Examiners are ?government records? as defined under the Open Public Records Act and are available for public inspection, copying or examination. See N.J.S.A. et seq., N.J.S.A. Should any inquiry be made to the Board concerning the status of a licensee who has been the subject of a Board Order, the inquirer will be informed of the existence of the Order and a copy will be provided on request. Unless sealed or otherwise confidential, all documents filed in public actions taken against licensees, to include documents filed or introduced into evidence in evidentiary hearings, proceedings on motions or other applications conducted as public hearings, and the transcripts of any such proceedings, are ?government records? available for public inspection, copying or examination. Pursuant to N.J.S.A. 45:9?22, a description of any final board disciplinary action taken within the most recent ten years is included on the New Jersey Health Care Profile maintained by the Division of Consumer Affairs for all licensed physicians. Links to copies of Orders described thereon are also available on the Profile website. See Copies of disciplinary Orders entered by the Board are additionally posted and available for inspection or download on the Board of Medical Examiners' website. See Pursuant to federal law, the Board is required to report to the National Practitioner Data Bank (the certain adverse licensure actions taken against licensees related to professional competence or conduct, generally including the revocation or suspension of a license; reprimand; censure; and/or probation. Additionally, any negative action or finding by the Board that, under New Jersey law, is publicly available information is reportable to the NPDB, to include, without limitation, limitations an scope of pmactice and final adverse actions that occur in conjunction with settlements in which no finding of liability has been made. Additional information regarding the specific actions which the Board is required to report to the National Practitioner Data Bank can be found in the NPDB Guidebook issued by the U.S. Department of Health and Human Services in. April 2015. See - Pursuant to in any case in which the Board refuses to issue, suspends, revokes or otherwise places conditions on a license or permit, the Board is required to notify each licensed health care facility and health maintenance organization with which a licensee is affiliated and every other board licensee in this state with whom he or she is directly associated in private medical practice. In accordance with an agreement with the Federation of State Medical Boards of the United States, a list of all disciplinary orders entered by the Board is provided to the Federation on a basis. From time to time, the Press Office of the Division of Consumer Affairs may issue press releases including information regarding public actions taken by the Board. Nothing herein is intended in any way to limit the Board, the Division of Consumer Affairs or the Attorney General from disclosing any public document.