Thomas Young, V State L & I

CourtCourt of Appeals of Washington
DecidedJuly 12, 2022
Docket55859-9
StatusUnpublished

This text of Thomas Young, V State L & I (Thomas Young, V State L & I) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Thomas Young, V State L & I, (Wash. Ct. App. 2022).

Opinion

Filed Washington State Court of Appeals Division Two

July 12, 2022

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

DIVISION II

THOMAS J. YOUNG, N.D., D.C., No. 55859-9-II

Appellant,

v. UNPUBLISHED OPINION

DEPARTMENT OF LABOR & INDUSTRIES, STATE OF WASHINGTON,

Respondent.

MAXA, J. – Dr. Thomas Young, a naturopathic doctor, appeals the superior court’s

judgment affirming the decision of the Board of Industrial Insurance Appeals (Board) that

affirmed the order of the Department of Labor and Industries (DLI) revoking his authorization to

treat injured workers, suspending him from the DLI provider network, and terminating his

provider network agreement.

In orders issued in August and September 2015, DLI notified Young that it was removing

him from the DLI provider network after (1) learning that Young had surrendered his United

States Drug Enforcement Administration (DEA) registration while under investigation for his

controlled substances prescribing activities, (2) receiving information that the Washington

Department of Health (DOH) had placed Young on probation for prescribing controlled

substances that fell outside the scope of his naturopathic license, and (3) determining that Young

had failed to meet several minimum provider network standards. DLI entered an order denying No. 55859-9-II

Young’s request for reconsideration in January 2016. An industrial appeals judge (IAJ) affirmed

the January 2016 order, and the Board adopted the IAJ’s proposed decision and order as its final

order.

We hold that (1) the superior court did not err in concluding that a January 2015

settlement agreement between DLI and Young to resolve an audit into Young’s billing practices

in which DLI agreed not to conduct retrospective audits was limited to billing and billing audits

and therefore did not prevent DLI from removing Young from its provider network, (2) the

superior court did not err in concluding that Young’s surrender of his DEA registration and DOH

placing Young on probation both were grounds for terminating his provider network agreement,

(3) Young’s numerous challenges to DLI’s, the Board’s, and the superior court’s decisions have

no merit or are not subject to review under RAP 10.3 because Young provides an insufficient

basis for his claims, and (4) the removal of Young from DLI’s provider network was not

unconstitutional.

Accordingly, we affirm the superior court’s judgment affirming the Board’s order

affirming DLI’s January 2016 order.

FACTS

Background

Young is a licensed naturopathic physician and licensed chiropractor who primarily treats

injured workers. Naturopaths can prescribe certain drugs that are not controlled substances but

still require a prescription. If naturopaths would like to be licensed to prescribe certain

controlled substances, they must apply for a DEA registration number. Young applied for a

DEA registration number that limited his prescribing authority to schedule III, IV, and V

controlled substances, which the DEA approved.

2 No. 55859-9-II

In 2012, Young applied and was approved to be included in DLI’s provider network.

When Young signed his provider network agreement, he agreed to provide injured workers with

treatment that complied with Washington law and DLI rules and policies. Young also agreed

that DLI could terminate his provider network agreement if he did not meet the provider network

standards in WAC 296-20-01030 and WAC 296-20-01040, if DLI found a risk of harm to

patients pursuant to WAC XXX-XX-XXXX, or if he violated a material term of the provider network

agreement.

DLI Billing Investigation and Audit

In December 2013, DLI opened an investigation and audit of services billed by Young.

In May 2014, DLI’s Provider Fraud Program issued Young an order and notice regarding the

billing investigation and audit. The May 2014 order explained that based on an investigation and

audit of services billed between July 1, 2012 and November 30, 2013, DLI had found that Young

had (1) billed for and was paid for extended naturopathic office visits without submitting

documentation that supported the level of services billed and (2) failed to provide supporting

documentation to DLI to substantiate the level of services he billed.

The May 2014 order stated that Young had violated RCW 51.48.260, liability of persons

unintentionally obtaining erroneous payments, and WAC 296-20-125, billing procedures. The

order stated as a result, that DLI was terminating Young’s authorization to be paid for services

provided to injured workers and specified an amount that Young owed to DLI. The

accompanying provider audit and investigation report stated that the medical necessity or quality

of care provided to injured workers were not reviewed as part of the audit.

In January 2015, DLI and Young entered into a settlement agreement to resolve the May

2014 order. As part of the settlement agreement, DLI agreed to (1) not revoke Young’s provider

3 No. 55859-9-II

number and to not report Young to the National Practitioner Databank (NPDB) unless he failed

to comply with the terms of the settlement agreement, and (2) “not conduct retrospective audits

of any time period prior to the effective date of this settlement.” 4 Administrative Record (AR)

at 108.

DEA Investigation

At some point, the DEA received notification from the State Naturopathic Board that the

Naturopathic Board was investigating Young for prescriptions written for drugs that he was not

licensed to prescribe as a naturopath. As a result, the DEA reviewed the prescription monitoring

program for Washington and discovered that Young had prescribed 101 prescriptions outside the

scope of his DEA license between February 2012 and January 2014.

In March 2014, DEA investigator Heather Achbach and her colleague visited Young at

his clinic and informed him that they had discovered that he had prescribed controlled substances

that he was not authorized to prescribe. They told Young that they were giving him the

opportunity to voluntarily surrender his DEA registration number in lieu of administrative

proceedings and left him with a copy of DEA’s voluntary surrender of controlled substances

privileges form for his review. Young admitted to writing the 101 prescriptions at issue.

A few days later, Young agreed to sign DEA’s voluntary surrender of controlled

substances privileges form, which stated that he understood that his DEA registration would be

terminated. The DEA categorized Young’s voluntary surrender as a surrender for cause because

there were probable reasons to initiate administrative proceedings to revoke a registration if he

had refused to sign a voluntary surrender.

4 No. 55859-9-II

DOH Investigation

In February 2014, the DOH issued a statement of charges against Young after receiving

complaints from a pharmacist and an advanced registered nurse practitioner about his controlled

substances prescription activities.

In September 2014, the DOH and Young entered into an agreed order regarding the DOH

statement of charges regarding his prescribing activities. Young stipulated to the fact that he had

prescribed a number of controlled substances to 10 patients that went beyond the authorized

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