Doctors Behaving Badly: Maine welcomes psychiatrist with fraud conviction and drug abuse concerns

If Dr. Reinaldo de los Heros were a cat, he would have run out of lives. But, thanks to accommodating medical boards up and down the East Coast, de los Heros has survived and thrived. Here is a short guide to his fascinating history. You can also track de los Heros on the Doctors Behaving Badly Google map.

First life: De los Heros graduated from the University of Puerto Rico School of Medicine in 1975 and started working in Massachusetts in 1978. He sought and obtained licenses in New Hampshire, Maryland and North Carolina. In 1980, he earned board certification in psychiatry from the American Board of Psychiatry and Neurology.

Second life: In March 1997, he pleaded guilty and was convicted in Massachusetts of Medicaid fraud and felony larceny. According to the charges, he had overbilled Medicaid for a total of $240,681.11.

Third life:  The felony conviction was one too many for the Massachusetts Board of Registration in Medicine. The board revoked his license the same week the guilty plea was announced. De los Heros entered the Massachusetts Physician Health Services program, which treats doctors who have addiction problems or psychological issues.

Fourth life: He had already let his Maryland license lapse in 1978. He held onto his license in New Hampshire, but only barely. In June 1997, the New Hampshire Board of Medicine worked out a settlement agreement with de los Heros in which he surrendered his license.

Fifth life: That left North Carolina as the only place where he could still charge for his services. Soon, even billing became complicated. In September 1997, the U.S. Department of Health and Human Services banned de los Heros from receiving any federal funds, including Medicare, Medicaid, Maternal and Child Health Services Block Grants and Block Grants to States for Social Services programs. It also prevented any business from submitting bills that included work done by de los Heros.

Sixth life: De los Hero could still see patients with private insurance or paying out of pocket in North Carolina. That lasted for nearly two years. The North Carolina Medical Board finally got wind of the felony conviction and the actions taken by Massachusetts and New Hampshire andrevoked his license in February 1999.

Seventh life: After a five-year hiatus, de los Heros resurfaced in Yarmouth, Maine.  He left the Massachusetts Physician Health Services program and signed up with the Maine Medical Association's Committee on Physician Health program in 2004. He had let his board certification in psychiatry lapse in 1997, but this didn't bother the Maine Board of Licensure in Medicine. In July 2006, the board granted him a conditional license. He was told to "restrict his practice to working in a supervised relationship." He also was told to provide regular urine samples to prove he was not taking drugs, and, in a strange twist, the board ordered him to "treat 15% of indigent patients without charge until he becomes an approved provider for Medicare and Mainecare." Hey, if a doctor is considered risky for clients with good insurance, why not relegate him to patients who have fewer options?

Eighth life: Also in 2006, de los Heros managed to win a conditional license in Massachusetts under a probation agreement.

Ninth life: In applying for a full, unrestricted Massachusetts license in 2007, de los Heros left out a few salient details. Boards are always interested in discipline from other states, criminal convictions, federal investigations, anything that might make a state think twice about granting a doctor the privilege to work there. There were many omissions on de los Heros' application, including: the license restrictions placed on him by the Maine medical board, the previous discipline by the North Carolina medical board and an investigation by the U.S. Drug Enforcement Administration (DEA). Given de los Heros' felony convictions for fraud and larceny, this may have been seen as a serious ethical breach and a lack of contrition. The Massachusetts board did not see things this way and merely reprimanded him in November 2007.

Tenth life: De los Heros officially outlived the mythical cat. Barely three years back on the job in Maine, he became the subject of a complaint to the medical board about "competence issues." After investigating, the board determined in July 2009 that de los Heros should undergo a neuropsychiatric evaluation and could continue practicing "only under the supervision of a Board-approved psychiatrist."

Eleventh life. In April 2010, the Maine medical board voted to lift all restrictions on his license and to dismiss the complaint against him. For now, he is a fully licensed psychiatrist in both Maine and Massachusetts, although he continues to operate without board certification in psychiatry.

Final question: Why is the paper trail for de los Heros so hard to find? His case serves as a reminder to both consumers and reporters that it is never enough just to check one medical board for a physician's history.The Maryland Board of Physicians helpfully acknowledges that de los Heros was a physician there for two years, but, if he was the subject of any discipline there, those records are no longer provided because they are beyond the state's 10-year statute of limitations.

The Maine Board of Licensure in Medicine makes it unnecessarily cumbersome to gain access to even the limited information it has on file. The board has taken at least five actions involving de los Heros' license since 2006, but only the documents related to the latest action can be found on the board's website. All of the details about the cases are kept secret.

The Massachusetts board provides no record of de los Heros in its searchable online database, even though its most recent disciplinary action is featured in the board's "List of Disciplinary and Other Public Board Actions."

New Hampshire devotes one sentence to the discipline it gave de los Heros, and good luck trying to find it.

In this case, the North Carolina Medical Board has to be applauded. Although the documents it provides are short on detail, they are the only documents available for disciplinary actions taken against de los Heros in the 1990s. For consumers and for reporters, it should not be so difficult to find a coherent and complete story about a physician who has practiced in five states and been investigated by at least two federal agencies.