ALJDEC decisions subject to certification as final

20A-25569-MDX · Arizona Medical Board · 2020-12-21

IN THE OFFICE OF ADMINISTRATIVE HEARINGS

In the Matter of:

Jose Manuel Piscoya, MD

Holder of License No. 25569 For the Practice of Allopathic Medicine in the State of Arizona

No. 20A-25569-MDX

ADMINISTRATIVE LAW JUDGE

DECISION

HEARING: November 13, 2020

APPEARANCES: No one appeared for Jose Manuel Piscoya, M.D.; Carrie H. Smith, Esq. for the Arizona Medical Board

ADMINISTRATIVE LAW JUDGE: Thomas Shedden

FINDINGS OF FACT

The Arizona Medical Board (“Board”) is the duly constituted authority for licensing and regulating the practice of allopathic medicine in the State of Arizona.

On September 29, 2020 the Board issued a Complaint and Notice of Hearing setting this matter for hearing at 9:00 a.m. November 13, 2020.

Through the Complaint the Board alleges that Jose Manuel Piscoya, M.D committed unprofessional conduct because he failed to comply with the Board’s May 17, 2018 Interim Order for Psychosexual Re-Evaluation issued in case MD-17-0083A. The Interim Order is in evidence as Board Exhibit 2.

No representative appeared for Dr. Piscoya at the scheduled hearing-time and the matter was convened in his absence at about 9:17 a.m.

The Board presented the testimony Raquel Rivera, its investigations manager, and Monica Faria, M.D.

Dr. Faria is board certified in general psychiatry and addiction psychiatry. Addiction psychiatry deals with chemical addictions and process addictions, which involve pathological behaviors such as gambling and compulsive sexual behavior.

Dr. Faria interviewed Dr. Piscoya on March 30, 2018 and spoke to him again in April, she reviewed his treatment records, she spoke to the current outpatient program director at one of the facilities in which Dr. Piscoya had received treatment, and she spoke to the therapist who had been treating Dr. Piscoya in December 2018.

Dr. Piscoya holds License No. 25569; in December 2017, he was put under a practice restriction that prohibits him from practicing until he has undergone a neuropsychological evaluation and been found to be safe to practice, which has not happened. Dr. Piscoya’s license was set to expire on May 31, 2019, at which time the investigation in this matter was active. Dr. Piscoya did not renew his license, which was therefore suspended by operation of law.

On December 8, 2017, in case number MD-17-0083A the Board issued “Findings of Fact, Conclusions of Law and Order for Decree of Censure and Probation with Practice Restriction” (the “Decree”), through which it found that Dr. Piscoya had violated Ariz. Rev. Stat. section 32-1401(27)(z)(engaging in sexual conduct with a patient or former patient).

The Decree is in evidence as Board’s Exhibit 1 and provides Findings of Fact detailing the conduct at issue, including information about a prior evaluation and related treatment of Dr. Piscoya.

The terms of the Decree prohibited Dr. Piscoya from practicing medicine until he had undergone a neuropsychological evaluation and been found to be safe to practice, at which time he could apply to the Board for authorization to begin practicing. The Decree requires Dr. Piscoya to comply with the recommendations made as a result of the required evaluation.

Dr. Piscoya was evaluated by H. Daniel Blackwood, Ph. D. on February 14, 2018.

On April 2, 2018, Dr. Piscoya requested the Board’s approval to return to practice. The Board was unwilling to consider that request until it received a report from Dr. Piscoya’s psychiatric evaluation.

Dr. Piscoya contacted Greenburg and Sucher PC, where Dr. Farina then worked, requesting treatment and explaining his need for an evaluation to comply with the Board’s Decree.

Dr. Faria interviewed Dr. Piscoya on March 30, 2018, at which time he provided her with a copy of the Decree and Dr. Blackwood’s evaluation.

Through a letter dated March 30, Dr. Faria provided the Board with her initial opinions and explained that she had received treatment records for review, she was awaiting others, and she had placed a call to a facility that had treated Dr. Piscoya, the purpose of which call was to obtain clarification of his aftercare instructions.

The clarification Dr. Faria sought was regarding Dr. Piscoya’s representation that the treatment facility was aware that he had remained in contact with the patient in case MD-19-0083A and approved of it, which was subsequently proven to be incorrect.

Through a letter dated April 23, 2018, Dr. Faria informed the Board she had completed her review of Dr. Piscoya’s treatment records and spoken to the current outpatient coordinator at one of his treating facilities.

Dr. Faria has had no contact with Dr. Piscoya since the time she prepared the April 23, 2018 letter to the Board.

Dr. Faria’s opinion was that Dr. Piscoya had made progress in his treatment, but she could not conclude that he was safe to practice and she recommended that he undergo a repeat psychosexual evaluation and further intensive inquiry as to whether he could uphold appropriate boundaries and safely practice medicine.

Among Dr. Faria’s concerns were: Dr. Piscoya continued to remain in close contact with the patient at issue in case MD-17-0083A; he did not appear to understand the implications of his actions (i.e. staying in contact with the patient); he was not a reliable historian; and he had contacted Dr. Faria at inappropriate times, raising a concern with regard to boundaries.

During her discussion with the outpatient coordinator, Dr. Faria learned that the facility did not approve of Dr. Piscoya’s remaining contact with the patient and to the contrary, was of the opinion that continued contact would be counter-therapeutic. Dr. Faria wrote that when she raised this point with Dr. Piscoya, his response was “well I wouldn’t have told you if it was going to get me into trouble.”

At the hearing, Dr. Faria confirmed her opinions and provided detailed testimony explaining the bases for her opinions, which included discussion with the therapist who had been treating Dr. Piscoya until December 2019 when Dr. Piscoya “dropped off” and stopped communicating with her office, leading the therapist to drop him.

On May 17, 2018, the Board emailed to Dr. Piscoya at his address of record the Interim Order.

The Interim Order required Dr. Piscoya to register for the evaluation no later than May 31, 2018 and to complete the evaluation by July 17, 2018 (i.e., fourteen and sixty days from the date of issue). Dr. Piscoya did not respond to the Interim Order.

On June 1, 2018, Board staff sent a follow-up email to Dr. Piscoya’s address of record requesting the name of the facility that would be conducting the evaluation. Dr. Piscoya did not respond to that email.

On June 14, 2018, Board staff sent another email to Dr. Piscoya’s address of record that included a copy of the Interim Order and an advisement that if he did not provide the name of the facility by June 18, 2018, the Board would open an investigation. Dr. Piscoya did not respond to that email.

On July 3, 2018, Board staff opened its investigation in this matter based on Dr. Piscoya’s failure to comply with the Interim Order and failure to respond to Board staff’s requests for contact. Notice was provided by email to Dr. Piscoya’s email address of record.

On July 17, 2018, the assigned investigator reported that she had left several messages for Dr. Piscoya via email and telephone and also left multiple messages for staff at the clinic in which he practiced. Dr. Piscoya did not respond to those emails or telephone calls.

On November 25, 2019, the Board issued to Dr. Piscoya a Request for Response providing him with the opportunity to respond to the allegations set out in the Board’s investigative report. Dr. Piscoya did not respond and the matter was referred to the Staff Investigational Review Committee.

On December 19, 2019, SIRC recommended that Dr. Piscoya’s license be revoked, but that he should be given the opportunity chance to surrender his license. The Board Staff provided Dr. Piscoya with a copy of SIRC’s Recommendation and a proposed Consent Order through which he could surrender his license.

On January 29, 2020, Dr. Piscoya contacted the Board’s investigator and reported that he had just received the November 25, 2019 Request for a Response and he would like to provide one. Dr. Piscoya also reported that he had moved out of Arizona and was not practicing medicine in the United States, but was volunteering abroad.

The investigator advised Dr. Piscoya that he could provide a response to the November request, but he never did, and that he should update his contact information with the Board, which he apparently also did not do.

On February 4, 2020, the Board staff sent to Dr. Piscoya an email showing that the deadline by which he was required to respond to the proposed Consent Order had passed, but he was being granted a ten-day extension.

Dr. Piscoya did not file any response to the proposed Consent Order.

Ms. Rivera’s opinion is that Dr. Piscoya is not amenable to regulation as seen by his failure to comply with the Board’s orders and his lack of communication with the Board.

The Board requests that Dr. Piscoya’s license be revoked.

CONCLUSIONS OF LAW

The Board has jurisdiction over Respondent and the subject matter in this case. See Ariz. Rev. Stat. § 32-1401 et seq.

The Board alleges that Dr. Piscoya failed to comply with the Board’s Interim Order dated May 17, 2018, and that his conduct was in violation of Ariz. Rev. Stat. sections 32-1401(27)(s) and (27)(ee).

The Board must prove its allegations by clear and convincing evidence. Ariz. Rev. Stat. § 32-1451.04.

Clear and convincing evidence is “[e]vidence indicating that the thing to be proved is highly probable or reasonably certain.” Black’s Law Dictionary 674 (10th ed. 2014).

Ariz. Rev. Stat. section 32-1401 provides in part:

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27. "Unprofessional conduct" includes the following, whether occurring in this state or elsewhere:

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(s) Violating a formal order, probation, consent agreement or stipulation issued or entered into by the board or its executive director under this chapter.

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(ee) Failing to furnish information in a timely manner to the board or the board's investigators or representatives if legally requested by the board.

Dr. Piscoya received adequate notice that the Interim Order had been issued and that the Complainant and Notice of Hearing had been issued because these were sent to his email address of record. See Ariz. Rev. Stat. § 41-1092.04.

Through the testimony of Dr. Faria and the related exhibits, the Board presented clear and convincing evidence showing that it was justified in ordering Dr. Piscoya to undergo the psychosexual re-evaluation. Because Dr. Piscoya has failed to comply with the Interim Order requiring that evaluation, he has committed unprofessional conduct under Ariz. Rev. Stat. section 32-1401(27)(s).

Because Dr. Piscoya has committed an act of unprofessional conduct, the Board has authority to discipline his license. Ariz. Rev. Stat. § 32-1451(M). This authority exists even though Dr. Piscoya did not renew his license when it was due to expire on May 31, 2019. See Ariz. Rev. Stat. § 32-3202.

Clear and convincing evidence shows that Dr. Piscoya is not amenable to regulation by the Board. Consequently, Dr. Piscoya’s license should be revoked.

RECOMMENDED ORDER

IT IS ORDERED that Jose Manuel Piscoya, M.D.’s License No. 25569 is revoked.

In the event of certification of the Administrative Law Judge Decision by the Director of the Office of Administrative Hearings, the effective date of the Order is five days after the date of that certification.

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-137160-45720000Done this day, December 21, 2020.

/s/ Thomas Shedden

Thomas Shedden

Administrative Law Judge

Transmitted electronically to:

Patricia E. McSorley, Executive Director

Arizona Medical Board

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