Y.A. Mosuro, M.D. v. BPOA, State Board of Medicine
609 C.D. 2016
| Pa. Commw. Ct. | Oct 13, 2016Background
- Dr. Yusuf Mosuro, licensed in Pennsylvania since 1998 and residing in Texas, entered into a prescriptive-delegation relationship with an APN who ran a Texas pain clinic; he received flat fees per prescription and saw referral business from the clinic.
- The Texas Medical Board investigated and found Mosuro failed to supervise the APN, allowed non-therapeutic prescribing, and had inadequate documentation; Texas imposed a public reprimand, $10,000 penalty, practice restrictions, exam and CME requirements.
- Pennsylvania’s Board charged Mosuro under Section 41(4) of the Medical Practice Act for having discipline in another state; Mosuro conceded discipline and sought a sanction mirroring Texas or less severe restrictions.
- A hearing examiner recommended a $500 penalty and indefinite suspension; the Board adopted the facts but imposed a public reprimand, $5,000 civil penalty, and indefinite suspension of Mosuro’s PA license, permitting reinstatement only after full compliance and unrestricted restoration of his Texas license.
- Mosuro appealed, arguing the indefinite suspension was an abuse of discretion and violated his constitutional right to pursue his occupation; the Commonwealth Court reviewed for abuse of discretion and affirmed.
Issues
| Issue | Mosuro’s Argument | Board’s Argument | Held |
|---|---|---|---|
| Whether the Board abused its discretion by indefinitely suspending Mosuro’s PA medical license based on out-of-state discipline | Suspension is excessive, does not further public safety, and court should review reasonableness (citing Ake) | Discipline mirrors Texas concerns; suspension protects Commonwealth citizens while Texas monitors remediation | No abuse of discretion; suspension upheld as within Board’s authority to protect public welfare |
| Whether the sanction impermissibly infringes Mosuro’s constitutional right to pursue his occupation | Suspension deprives him of livelihood and may impede his ability to comply with Texas requirements for reinstatement | Board may lawfully condition or suspend licenses to protect public health; issue waived below | No constitutional violation; state may impose restrictions reasonably related to public safety |
| Whether the Board should have mirrored Texas’ restrictions instead of suspending license | Requested mirroring of Texas restrictions and removal upon Texas compliance | Board argued Texas is best positioned to judge remediation and unrestricted return; Pennsylvania needs adequate protection | Board reasonably declined mirroring and chose suspension pending Texas unrestricted restoration |
| Whether penalty amount was arbitrary | Asked for parity with Texas or lesser penalty to reflect mitigation | Board reducedTexas $10,000 penalty to $5,000, viewing full amount unnecessary but warranted significant sanction | Court found penalty and suspension not capricious; within Board discretion |
Key Cases Cited
- Tandon v. State Bd. of Medicine, 705 A.2d 1338 (Pa. Cmwlth. 1997) (states may suspend licenses to protect public health; due process limits apply)
- Slawek v. State Bd. of Med. Educ. & Licensure, 586 A.2d 362 (Pa. 1991) (courts will not substitute their judgment for agency discretion; review limited to bad faith, fraud, or caprice)
- Blair v. Bureau of Prof'l & Occupational Affairs, 72 A.3d 742 (Pa. Cmwlth. 2013) (standard for appellate review of professional-board discipline)
- Ake v. Bureau of Prof'l & Occupational Affairs, 974 A.2d 514 (Pa. Cmwlth. 2009) (court may correct abuses of discretion in degree of penalty; revocation reserved for worst offenders)
- Dent v. West Virginia, 129 U.S. 114 (1889) (states may regulate professions to protect public welfare)
- Barsky v. Bd. of Regents of Univ. of State of New York, 347 U.S. 442 (1954) (states enforce standards of conduct for health-related professions)