Court Opinion

ID: 9690018
Source: CourtListenerOpinion
Date Created: 2023-08-24 18:51:45.476977+00
Date Added: 2024-06-11T18:18:53.236384
License: Public Domain

HARRIS, Justice
(dissenting).
In this review of agency action the state board of medical examiners ordered a ninety-day suspension of the medical license of respondent Vincent J. Glowacki. The complaint against Glowacki stems from what the board found to be dishonest billing practices in adding professional service time to hospital and office billing records. The record is clear and undisputed that time overlaps, inappropriately called “anesthesia time,” were entered in order for Glowacki to compensate himself for postoperative care in open-heart surgeries after his “anesthesia time” with patients had ended.
Substantial evidence, indeed overwhelming evidence, supports the board’s finding. The majority nevertheless overturns this administrative determination by way of holding, apparently as a matter of law, that the definition, widely recognized among professional anesthesiologists, is inappropriate. So doing the majority thwarts the medical board’s proper and commendable attempts to protect the public from dishonest billing practices in the medical profession. Moreover the majority holding, because it is in practical effect a de novo review, is a direct affront to the most basic canon of administrative law. Leonard v. Iowa State Bd. of Educ., 471 N.W.2d 815, 816 (Iowa 1991) (“judicial second-guessing of agency wisdom would destroy the fabric of *888administrative law”). The propriety of recognizing this billing policy should remain within the domain of the medical board, and should not be arrogated by this court.
Anesthesia time is a term of art established in the record by testimony and by documents of the American Society of Anesthesiologists, the Physician’s Current Procedural Terminology, and by definitions promulgated by the Health Care Financial Administration, the federal agency that administers medicare and medicaid programs. This testimony and these definitions make it clear that the postoperative care in a recovery room for which Glowacki billed as “anesthesia time” fell outside the recognized definition. Glowacki simply chose to disagree with it, billed in accordance with this disagreement, and altered hospital records to reflect his billing.
Glowacki does not dispute the fact that “anesthesia time” has been defined in accordance with the board’s finding. He admits being aware of it. In filing his claims he nevertheless certified his bills were in accordance with accepted policy. His lame excuse is his view, shared by two of his professional witnesses, that the policy was wrong, that the postoperative treatment should count as “anesthesia time.” The State presented an equally competent anesthesiologist, one whose testimony the board was clearly entitled to accept, who disagreed and thought the recognized definition was correct.
It should be for the board, not for the majority of this court, to settle the definition of “anesthesia time.” In all respect I am astonished that the majority is willing to intrade into what is clearly an administrative matter. And I am dismayed that the majority would do so in a matter where the administrative board is so eminently correct in defending the public interest. I would adopt the following from its decision:
The citizens of this state rely on the accuracy of medical and billing records prepared by their physicians and expert physicians to be truthful and honest in preparing the records. The board concludes that the respondent, who knowingly, not mistakenly, made misleading, deceptive, and untrue statements and committed acts contrary to honesty when he prepared medical and billing records, committed serious violations of statutes and rules related to the practice of medicine that reflect adversely upon his professional conduct.
The trial court was correct in refusing to interfere. I would affirm.
LARSON, J., joins this dissent.