Disciplinary Action against
Joseph E. Rich, M.D.

Stephen Barrett, M.D.


The Tennessee Board of Medical Examiners has suspended the license of Joseph E. Rich, M.D. for at least one year beginning in February 2008. Rich, who acquired his Tennessee license in 1995, did business as the Center for Environmental and Integrative Medicine in Knoxville. In 1999, he was disciplined after a finding that in 1997 he had taken a ten-day Canadian vacation, leaving pre-signed prescriptions with an 18-year-old receptionist who filled out at least eleven prescriptions for patients seeking the weight-loss drugs Fenfluromine and Phenterine. He was assessed $1,100, placed on two years' probation, and ordered to have a psychiatric evaluation and be followed by the Tennessee Medical Foundation Impaired Physician Program (TMF). In 2002, the board concluded that Rich had violated the 1999 order by failing to get the psychiatric evaluation or enter the TMF program until late in 2001. The board then ordered him to continue in the TMF program with additional monitoring requirements until 2006.

In 2007, as noted in the document below, the board concluded that Rich had mismanaged and failed to adequately document the care of three patients to whom he administered chelation therapy and 12 patients to whom he administered "detoxification" with methadone. The board concluded that his conduct amounted to "unprofessional, dishonorable or unethical conduct; gross malpractice, or a pattern of continued or repeated malpractice, ignorance, negligence or incompetence in the course of medical practice." The order also said that after his first year of suspension had finished, the board would interview him and decide whether the suspension should be lifted and whether a probationary period is necessary. Rich appealed, and in October 2011, the Tennessee Supreme Court upheld the board's findings of violations but ordered it to review the record and do a better job of articulating the applicable standard of care. As of October 2012, Rich's license remains suspended.

Before moving to Tennessee, Rich had practiced in Kansas and Kentucky In 1988, Rich signed a settlement agreement under which he agreed to leave Kansas and stop practicing in that state. Court documents indicate that he had been diagnosed as having significant emotional problems, had falsified information on his license application, had practiced for several months while his license was not current, and was facing 20 counts of "unnecessary and inappropriate surgery," two counts of failure to diagnose, one count of improper delivery, one count of abandonment, three counts of shoplifting, and one count of submitting false claims for payment of state and federal funds After leaving Kansas, he practiced in Kentucky, where, in 1991, he was summarily suspended from Humana Hospital for failing to properly attend patients who were in labor.


STATE OF TENNESSEE
DEPARTMENT OF HEALTH

IN THE MATTER OF:

JOSEPH EDWARD RICH, M.D.
RESPONDENT

KNOXVILLE, TENNESSEE

TENNESSEE LICENSE NO.: 26657

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BEFORE THE TENNESSEE BOARD
OF MEDICAL EXAMINERS

DOCKET NO. 17.18-073557A

FINAL ORDER

This matter came to be heard before the Tennessee Board of Medical Examiners ("Board") on July 26, 2006, October 6, 2006, January 24, 2007, February 16, 2007, April 26, 2007, June 22, 2007, July 18, 2007, September 19, 2007, September 20, 2007, and December 6, 2007, pursuant to a Notice of Charges issued against the Respondent by the Division of Health Related Boards of the Tennessee Department of Health ("State"). The State was represented by Shiva K. Bozarth, Assistant General Counsel. The Respondent was present on all dates except December 6, 2007, and represented by his counsel of record, Daniel Warlick, of the Davidson County Bar. Presiding over the hearing was Administrative Law Judge, Thomas Stovall, from the Office of the Secretary of State.

Respondent was aware that the hearing in this matter was scheduled to resume on December 6, 2007. Respondent indicated through counsel that he was on vacation and requested a continuance. Respondent's request for a continuance was denied. After consideration of the Notice of Charges, testimony of witnesses, arguments of counsel, and the record as a whole, the Board finds as follows:

I. FINDINGS OF FACT

1. At all times relevant to this matter, Respondent was licensed to practice medicine in Tennessee, License Number 26657, issued August 15, 1995.

2. Respondent's initial license was conditioned upon Respondent's obtaining and maintaining the advocacy of Dr. David Dodd and the Tennessee Medical Foundation and the Respondent was required to obtain the Board's permission before practicing without such advocacy.

3. On June 7, 1999, Respondent's license was disciplined by the Board for:

a) Instructing his eighteen-year-old receptionist to provide prescriptions for Phentermine and Fenfluromine that he had previously signed while he was on vacation;

b) For failure to maintain the advocacy of Dr. David Dodd and the Tennessee Medical Foundation.

4. The June 7, 1999, Order placed the Respondent's license on probation for 2 years with the following conditions:

a) Respondent shall submit a psychiatric evaluation to the Board no later than May 17, 1999;

b) Respondent was required to obtain access to and participation in the Tennessee Medical Foundation Program;

c) Respondent was required to maintain the advocacy of the Tennessee Medical Foundation until such time as the Board approves Respondent’s release from the program;

d) Respondent was obligated to have reports from the Tennessee Medical Foundation submitted to the Board every six months;

e) Respondent was required to appear before the Board on May 18, 1999, for the Board to review his compliance with the Board's requirements.

5. An Agreed Order was ratified by the Board on May 21, 2002, which found that Respondent had violated the conditions of the June 7, 1999, Order as follows:

a) Respondent had not obtained the required psychiatric evaluation until November 2001;

b) Respondent did not "connect with" the Tennessee medical Foundation until December 16, 2001;

c) Respondent did not cause any six-month reports to be issued by the Tennessee Medical Foundation.

6. The May 21, 2002, Order disciplined Respondent's license as follows:

a) Respondent was required to maintain the advocacy of the Tennessee Medical Foundation until December 2006;

b) Respondent was required to have Dr. Roland Gray or his successor with the Tennessee Medical Foundation send a letter to the Board upon Respondent's completion ofthe Tennessee Medical Foundation contract then in effect and state whether the Respondent continued to require partiCipation in the Tennessee Medical Foundation;

c) Respondent was obligated to cause six month reports to be issued by the Tennessee Medical Foundation to the Board beginning October 22, 2002;

d) Respondent was obligated to appear before the Board to discuss his health at its first scheduled meeting following the one-year anniversary date of the May 21, 2002, Order, and appear before the Board once a year thereafter as long as he is obligated to participate in the Tennessee Medical Foundation program.

7. On September 17, 2002, the Board ratified an Amended Agreed Order which modified the May 21, 2002, Agreed Order as follows:

a) Respondent's probation of two years was terminated;

b) Respondent was required to continue weekly psychotherapy sessions as long as he is under the advocacy of the Tennessee Medical Foundation.

8. The Respondent is the founder and director of the Center for Environmental and Integrative Medicine (CEIM), located in or about Knoxville, Tennessee.

a) Posted on the CEIM website, the Respondent claims to be certified by, among others, the American Board of Chelation Therapy and the American Board of Oxidative Medicine, and is a member of the International Bio-Oxidative Medicine Association.

b) Posted on the CEIM website as of January, 6, 2004, the following claim appeared on the "Welcome" screen: "News Flash! The Center for Environmental and Integrative Medicine in Knoxville, Tennessee has been chosen for a five (5) year NIH Chelation study."

c) Posted on the CEIM website as of January, 6, 2004 and again on February 22, 2006, Chelation Therapy via intravenous infusion of EDTA (ethylene diamine tetraacetic acid) and intravenous infusion of Hydrogen Peroxide are among the therapies listed as being available at CEIM.

9. In an interview with a Division investigator on February 18, 2004, the Respondent claimed that he had been recently appointed as a researcher for the National Institute of Health (NIH) and stated that the "study" is the "Trial to Access Chelation Therapy (TACT)," which began in March 2003.

a) The Respondent admitted to the aforementioned investigator that he uses in his practice both Chelation and Hydrogen Peroxide therapies as noted above.

b) Although the Respondent did apply to serve as an investigator in the TACT study, his application was rejected and he was not approved for participation in the TACT clinical trial.

10. From approximately August 14, 2003 to approximately March 2, 2004, the Respondent provided medical treatment to M.H.

a) On August 14, 2003, M.H. 's blood pressure was recorded as 164/88.

b) On a diagnostic medical laboratory report dated August 15, 2003, M.H. had a blood Triglyceride level of 232 mg/dl and a blood glucose level of 147 mg/dl, both levels reflected as being high on the report.

c) On a diagnostic medical laboratory report dated August 21, 2003, M.H. had a "post-provocation" urine level with approximately six (6) elements being reflected as beyond the reference range of the report.

d) The report further. states that the "Element reference ranges were developed from a healthy population under non-provoked/non-challenged conditions." The report further stated that "Provocation with challenge substances is expected to raise the urine level of some elements ... "

e) The commentary section of the report states, "This test. .. has not been cleared or approved by the U.S. Food and Drug Administration."

f) On September 2, 2003, the Respondent diagnosed M.H. with the single diagnosis of "Heavy Metal Toxicity." The Respondent then documented the treatment plan to consist of two (2) treatments: chelation and Hydrogen Peroxide.

g) From approximately September 4, 2003 through February 11, 2004, the Respondent provided M.H. with approximately thirteen (13) individual intravenous Hydrogen Peroxide treatments.

h) From approximately September 9, 2003 through March 2, 2004, the Respondent provided M.H. with approximately thirteen (13) individual intravenous Chelation (EDT A) treatments.

i) On March 2, 2004, at the beginning of the Chelation treatment for that day, M.H.'s blood pressure was recorded as 160/98.

j) On a diagnostic medical laboratory report dated February 25, 2004, M.H. had a blood Triglyceride level of 241 mg/dl and a blood glucose level of 297 mg/dl, both levels reflected as being high on the report and an increase in the blood levels of each, as reported on August 15, 2003.

k) On August 14, 2003, M.H. noted on his initial health history, a current medication history, including insulin and oral antihyperglycemic medications, an antihypertensive agent as well as a medication for hyperlipidemia.

l) The Respondent failed to document that any of these medications were prescribed for M.H during the time period referenced above.

m) The Respondent failed to document whether or not he advised M.H. to be treated and/or continue treatment with these medications, and/or by another physician, for the previously diagnosed medical conditions relative to these medications.

n) In an interview with a Division investigator, on March 12, 2003, the Respondent claimed that he always conducts a "pre-chelation" electrocardiogram (EKG) on the patients he treats with Chelation therapy.

o) In accordance with the above referenced medical record, the Respondent Tailed to document conducting and/or interpreting an EKG during the time period referenced above, nor was a copy of an EKG tracing included in the medical record provided.

11. From approximately January 5, 2001 to approximately February 4, 2004, the Respondent provided medical treatment to R.H.

a) On January 5, 2001, R.H. indicated a medical history of Hypertension, epilepsy and high cholesterol. On the same date R.H.'s weight was documented as 295 1/2 pounds.

b) R.H. had a "pre-provocation" urine analysis dated April 17, 2002, the medical laboratory report indicated that no elements tested for were beyond the reference range. The Respondent failed to document whether this test was repeated at a subsequent date or time with differing results.

c) However, on May 14, 2002, the Respondent diagnosed R.H. as having heavy metal toxicity and documented the treatment plan as being Chelation therapy.

d) From approximately May 30, 2002 through approximately December 2, 2003, the Respondent provided R.B. with approximately forty nine (49) individual intravenous Chelation (EDTA) treatments.

e) On March 16, 2003, hair analysis indicated that R.H. had multiple heavy metals present that were beyond the reference range.

f) However, repeat hair analysis on January 21, 2004 indicates that the level had increased in approximately fourteen (14) categories.

g) On September 9, 2003, the Respondent advised R.H. to undergo "Oxidative" treatment using Hydrogen Peroxide.

h) From approximately September 9, 2003 through approximately March 2, 2004, the Respondent provided R.B. with approximately six (6) individual intravenous Hydrogen Peroxide treatments.

i) On March 2, 2004, R.H. complained of feeling "tired" and having "pressure" in his chest. R.H.'s weight was recorded as 286.3 pounds, and his blood pressure was recorded as 132/76.

j) The Respondent failed to document measuring R.H.'s heart beats per minute or respirations per minute.

k) An unconfirmed EKG report on this date indicates the presence of an inferior myocardial infarction. The Respondent failed to document a confirmed or alternative interpretation.

l) However, on this date, the Respondent did provide R.H. with an intravenous Hydrogen Peroxide treatment. The treatment was terminated however, after completing approximately two-thirds of the proposed infusion quantity due to pain R.B. was experiencing at the infusion site.

12. From approximately January 7, 2004 to approximately March 9, 2004, the Respondent provided medical treatment to R.S.

a) On the initial progress note, reference is made to a medical history including ADHD, IBS, and depression. The Respondent failed to conduct a physical examination, noting instead "exam deferred." However, a preliminary diagnosis included heavy metal toxicity.

b) On a medical laboratory report dated January 23, 2004, R.S. had a "post-provocative" urine level with approximately three (3) elements reflected as being beyond the reference range.

c) R.S. 's copper level is indicated as 0.l3 mg/24 hours, with the reference range as being between 0.011 and 0.08 mg/24 hours.

d) R.S.'s strontium level is indicated as 0.53mg/24 hours, with the reference range as being between 0.06 and 0.5 mg/24 hours.

e) R.S.'s barium level is indicated as 0.048 mg/24 hours, with the reference range as being less than 0.02 mg/24 hours.

f) The report further states that the "Element reference ranges were developed from a healthy population under non-provoked/non-challenged conditions." The report further stated that "Provocation with challenge substances is expected to raise the urine level of some elements ... "

g) On February 5, 2004, the Respondent diagnosed R.S. as having heavy metal toxicity and decreased oxidative function.

h) From approximately February 12, 2004 through March 9, 2004, the Respondent provided R.S. with approximately six (6) individual intravenous Chelation (EDT A) treatments.

i) On a diagnostic medical laboratory report dated February 12, 2004, R.S. had a blood Triglyceride level of 122 mg/dl and a calcium level of 9.1 mg/dl, both levels being reflected as within the reference range.

j) However, on March 2, 2004, R.S. had a blood Triglyceride level of 233rng/dl and a blood calcium level of 10.5mg/dl, both levels reflected as being high on the laboratory report.

k) The Respondent failed to document that he consulted with or advised R.S. of the changes in these blood levels.

l) The Respondent failed to document that any medical recommendations were made or treatments initiated pursuant to these laboratory reports.

m) On February 24, 2004, the progress note states "severe depression" and "father wants a consult with Dr. Rich today - wants to know what to do for patient about depression. "

n) The Respondent failed to document that he consulted with or advised R.S. nor with R.S.'s father relating to the above progress note.

o) The Respondent failed to document that any medical recommendations were made or treatments initiated pursuant to the above note, until approximately March 9, 2004 when samples of "Tofranil " an antidepressant were provided.

p) However, on this same date, February 24, 2004, the Respondent provided R.S. with an intravenous Chelation (EDT A) treatment.

l3. Respondent did not at any point in time relevant to these facts have any license or certificate that entitled him to provide detoxification treatments using methadone HCL.

14. Respondent treated patient c.c. from approximately October 16, 2002 until December 21, 2003.

a) Respondent prescribed methadone to c.c. approximately 46 times.

b) Respondent did not obtain copies of any medical records reflecting that C. C. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated C.C. in his clinic's "detoxification program."

15. Respondent treated patient J.B. from approximately June 3, 2003 until January 6, 2004.

a) Respondent prescribed methadone to J.B. approximately 31 times.

b) Respondent did not obtain copies of any medical records reflecting that J.B. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated J.B. in his clinic's "detoxification program."

16. Respondent treated patient A.C. from approximately May 27, 2003 until December 22, 2003.

a) Respondent prescribed methadone to A.C. approximately 10 times.

b) Respondent did not obtain copies of any medical records reflecting that A. C. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated A.C. in his clinic's "detoxification program."

17. Respondent treated patient D.C. from approximately April 14, 2003 until January 6, 2003.

a) Respondent prescribed methadone to D.C. approximately 39 times.

b) Respondent did not obtain copies of any medical records reflecting that D.C. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated D.C. in his clinic's "detoxification program."

18. Respondent treated patient B.L. from approximately December 20, 2002 until January 6, 2004.

a) Respondent prescribed methadone to B.L. approximately 26 times.

b) Respondent did not obtain copies of any medical records reflecting that B.L .. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated B.L. in his clinic's "detoxification program."

19. Respondent treated patient T.D. from approximately April 29, 2003 until February 5, 2003.

a) Respondent prescribed methadone to T.D. approximately 28 times.

b) Respondent did not obtain copies of any medical records reflecting that T.D. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated T.D. in his clinic's "detoxification program."

20. Respondent treated patient Z.D. from approximately April 21, 2003 until November 25, 2003.

a) Respondent prescribed methadone to Z.D. approximately 26 times.

b) Respondent did not obtain copies of any medical records reflecting that Z.D. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated Z.D. in his clinic's "detoxification program."

21. Respondent treated patient G.F. from approximately March 26, 2003 until December 5, 2004.

a) Respondent prescribed methadone to G.F. approximately 37 times.

b) Respondent did not obtain copies of any medical records reflecting that G.F. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated G.F. in his clinic's "detoxification program."

22. Respondent treated patient RH. from approximately January 30, 2003 until January 6, 2004.

a) Respondent prescribed methadone to B.H. approximately 7 times.

b) Respondent did not obtain copies of any medical records reflecting that B.H. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated B.B. in his clinic's "detoxification program."

23. Respondent treated patient B.M. from approximately May 13, 2003 until November 11, 2003. .

a) Respondent prescribed methadone to RM. approximately 23 times.

b) Respondent did not obtain copies of any medical records reflecting that B .M. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated B.M. in his clinic's "detoxification program."

24. Respondent treated patient W.O. from approximately April 1, 2003 until January 5, 2004.

a) Respondent prescribed methadone to W.O. approximately 21 times.

b) Respondent treated W.O. in his clinic's "detoxification program."

25. Respondent treated patient J.S. from approximately May 19, 2003 until September 8, 2003.

a) Respondent prescribed methadone to J.S. approximately 14 times.

b) Respondent did not obtain copies of any medical records reflecting that J .S. was suffering from any illness or injury prior to prescribing methadone.

c) Respondent treated J.S. in his clinic's "detoxification program."

II. CONCLUSIONS OF LAW

26. The facts in Section I of this Order are sufficient to establish violations by the Respondent of the following statutes or rules which are part of the provisions of the Tennessee Medical Examiners Practice Act, (TENN. CODE ANN. § 63-6-101, et seq.) for which disciplinary action before and by the Board of Medical Examiners is authorized.

27. The facts in Section I, paragraphs 10 through 25, supra, constitute grounds for disciplinary action against Respondent's license to practice as a medical doctor in the State of Tennessee pursuant to TENN. CODE ANN. § 63-6-214(b)(1) which prohibits "[u]nprofessional, dishonorable or unethical conduct".

28. The facts in Section I, paragraphs 10 through 25, supra, constitute grounds for disciplinary action against Respondent's license to practice as a medical doctor in the State of Tennessee pursuant to TENN. CODE ANN. § 63-6-214(b)(4) which prohibits "[g]ross malpractice, or a pattern of continued or repeated malpractice, ignorance, negligence or incompetence in the course of medical practice".

29. The facts in Section I, paragraphs 10 through 12, supra, constitute grounds for disciplinary action against Respondent's license to practice as a medical doctor in the State of Tennessee pursuant to TENN. CODE A1\TN. § 63-6-214(b)(12) which prohibits "[d]ispensing, prescribing or otherwise distributing any controlled substance or any other drug not in the course of professional practice, or not in good faith to relieve pain and suffering, or not to cure an ailment, physical infirmity, or disease, or in amounts and/or for durations not medically necessary, advisable or justified for a diagnosed condition".

30. The facts in Section I, paragraphs 13 through 25, supra, constitute grounds for disciplinary action against Respondent's license to practice as a medical doctor in the State of Tennessee pursuant to TENN. CODE ANN. § 63-6-214(b)(14) which prohibits "[d]ispensing, prescribing or otherwise distributing any controlled substance or other drug to any person in violation or any law of the state or of the United States".

31. The facts in Section I, paragraphs 13 through 25, supra, constitute grounds for disciplinary action against Respondent's license to· practice as a medical doctor in the State of Tennessee pursuant to TENN. COMP. R. & REGS. 0880-2-.14(6)(c) which states:

If a physician provides medical care for persons with intractable pain, with or without the use of opiate medications, to the extent that those patients become the focus of the physician's practice the physician must be prepared to document specialized medical education in pain management sufficient to bring the physician within the current standard of care in that field which shall include education on the causes, different and recommended modalities for treatment, chemical dependency and the psycho/social aspects of severe, chronic intractable pain.

32. The facts in Section I, paragraphs 13 through 25, supra, constitute grounds for disciplinary action against Respondent's license to practice as a medical doctor in the State of Tennessee pursuant to TENN. COMP. R. & REGS. 0880-2-.l4(6)(e)(3) which states:

Prescribing, ordering, administering, or dispensing dangerous drugs or controlled substances for pain will be considered to be for a legitimate medical purpose if based upon accepted scientific knowledge of the treatment of pain, including intractable pain, not in contravention, of applicable state or federal law, and if prescribed, ordered, administered, or dispensed in compliance with the following guidelines where appropriate. and as is necessary to meet the individual need of the patient:

33. The facts in Section I, paragraphs 13 through 25, supra, constitute grounds for disciplinary action against Respondent's license to practice as a medical doctor in the State of Tennessee pursuant to TENN. COMP. R. & REGs. 0880-2.14(6)(e)(3)(ii) which states:

Pursuant to a written treatment plan tailored for the individual needs of the patient by which treatment progress and success can be evaluated with stated objectives such as pain relief and/or improved physical and psychosocial function. Such a written treatment plan shall consider pertinent medical history and physical examination as well as the need for further testing, consultations, referrals, or use of other treatment modalities;

34. The facts in Section I, paragraphs 13 through 25, supra, constitute grounds for disciplinary action against Respondent's license to practice as a medical doctor in the State of Tennessee pursuant to 21 USCA § 823(g)(I) which states:

Except as provided in paragraph (2), practitioners who dispense narcotic drugs to individuals for maintenance treatment or detoxification treatment shall obtain annually a separate registration for that purpose. The Attorney General shall register an applicant to dispense narcotic drugs to individuals for maintenance treatment or detoxification treatment (or both).

III. POLICY STATEMENT

35. The Tennessee Board of Medical Examiners takes this action in consideration of Respondent's multiple disciplinary violations over a long period, in addition to the lack of regard for previous Board actions which demonstrates a significant failure in his judgment.

IT IS, THEREFORE, ORDERED, ADJUDGED and DECREED as follows:

36. Respondent's license to practice medicine in the State of Tennessee is hereby SUSPENDED for a period of not less than one year. This suspension shall commence on February l, 2008, subject to the following conditions:

a) Respondent shall obtain an evaluation from the Vanderbilt Comprehensive Assessment Program, for Professionals (VCAP);

b) Respondent shall cause VCAP to forward a copy of their recommendations to the Board:

c) Respondent shall comply with all recommendations of the VCAP assessment;

d) Respondent shall complete a comprehensive course in pain management that shall consist of forty hours of medical training or the equivalent thereof;

e) The course required in paragraph 36(d) must be approved by the Board or its consultant;

f) Respondent shall pay the actual and reasonable costs of the prosecution of the matter incurred by the Office of General Counsel, Department of Health, including all attorney and paralegal time; all costs incurred by the bureau of investigations in connection with the prosecution of the matter; and all costs incurred by administrative law judges, court reporters and witnesses including, but not limited to, travel and lodging during the prosecution of this matter. TENN. CODE ANN. §§ 63-6-214 and 63-1-144, and TENN. COMP. R. & REGS. 0880-2-.12(1)(j);

g) Respondent shall appear before the Board after the completion of the initial year of SUSPENSION for an interview to determine whether his suspension shall be lifted and if any PROBATIONARY period is necessary. If a probationary period is deemed necessary the Board shall determine what if any conditions need to be placed upon Respondent's medical license in Tennessee.

37. Prior to February 1, 2008, Respondent shall ensure that all of his patients have been appropriately transferred to other medical providers and that their medical records are available as required by law and regulation.

38. Any and all costs shall be paid within thirty (30) days from the issuance of the Affidavit of Costs by submitting a certified check. cashier’s check. or money order payable to the State of Tennessee, which shall be mailed or delivered to: Disciplinary Coordinator, Disciplinary Coordinator, The Division of Health Related Boards, Tennessee Department of Health, Office of Investigations, 227 French Landing, Suite 201, Nashville, Tennessee 37243. A notation shall be placed on said check that it is payable for the costs of Joseph Rich, M.D.

This ORDER was approved by a majority of a quorum of the Tennessee Board of Medical Examiners at a public meeting of the Board and signed this 20th day of December, 2007.

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Chairperson
Tennessee Board of Medical Examiners

RECONSIDERATION, ADMINISTRATIVE RELIEF AND JUDICIAL REVIEW

A party may petition the Board for a stay of the Final Order within seven (7) days after the effective date of the Final Order. TENN. CODE ANN. § 4-5-316 (1998).

Within fifteen (15) days after the entry of an initial or final order, a party may file a petition to the Board for reconsideration of the Final Order. If no action is taken within twenty (20) days of filing of the petition with the Board, it is deemed denied. TENN. CODE ANN. § 4-5­317 (Supp. 2002).

Finally, a party may seek judicial review by filing a petition for review in the Chancery Court of Davidson County within sixty (60) days after the effective date of the Final Order. A petition for reconsideration does not act to extend the sixty (60) day period; however, if the petition is granted, then the sixty (60) day period is tolled and a new sixty (60) day period commences from the effective date of the Final Order disposing of the petition. TENN. CODE ANN. § 4-5-322 (Supp. 2002).

Prepared for entry:

______________________________
Shiva K. Bozarth (BPR #22685)
Office of General Counsel
Assistant General Counsel
Suite 210
220 Athens Way
Nashville, Tennessee 37247
(615) 741-1611

CERTIFICATE OF FILING

This Order was received for filing in the Office of the Tennessee Secretary of State, Administrative Procedures Division, and became effective on the 21st day of December, 2007.

______________________________
Thomas Stovall, Director
Administrative Procedures Division


This page was revised on October 6, 2012.

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