Toeing the line: Startup firm monitors licensed professionals facing sanctions, fines

By Greg Turner / News Business Writer
Monday, October 25, 2004

WESTBOROUGH -- Not everyone knows how to dot their i's and cross their t's, and sometimes it takes much more than a pen or pencil to make the necessary corrections.

When licensed health professionals such as dentists or optometrists run afoul of the rules that regulate their industry, they may face a fine or loss of credentials, or both. When those mistakes are not serious enough to result in major sanctions such as a suspension, government licensing boards may put professionals on probation and require them to hire a monitor to make sure they get their practices in order.

The need for independent monitors to check on and improve the professional in hot water is what prompted the creation of a new company, Affiliated Monitors Inc., earlier this year. The startup was set up by Vincent DiCianni, a former assistant attorney general who, in private practice as an attorney, represented clients before licensing boards for 16 years in Massachusetts.

DiCianni modeled the business after a program in New York called the Independent Private Sector Inspector General. It consists of a group of attorneys, engineers and accountants who provide independent oversight of major public construction projects, particularly in that state's school system. The group checks for overbilling, inadequate paperwork and other errors that could lead to cost overruns or delays in a project.

In Massachusetts, DiCianni sees the business as a way for licensing boards and state agencies to reduce their expenses and case backlogs, while putting the burden of paying for monitoring sanctioned professionals onto the professionals themselves.

"Professionals and businesses facing disciplinary action can continue to practice and avoid costly fines and sanctions," he said. "Because the monitors teach the licensed professionals how to comply with regulations, they are likely to avoid future sanctions. It's also the most economical solution for both the business or professional and the regulatory agency."

But it's not about keeping so-called bad apples on the job or putting the public in danger. Those who are subject to monitoring are more likely to have had problems with billing for health-care services or following state regulations.

"Oftentimes it's because of billing issues or business issues, rather than clinical issues, that they put them on probation," DiCianni said. "The more serious offenders, we have nothing to do with.

"There are so many excellent health-care providers who, because of the complexity of the regulations, because they're so busy trying to care for their patients, the business side of things sometimes suffers, and we're really trying to help them improve that," he said.

Affiliated Monitors, with offices in Westborough and Boston, employs only two full-time and two part-time workers, but it has a "roster" of monitors with experience in various fields at its disposal, DiCianni said.

Those monitors, essentially independent contractors hired by the company, are tapped on an as-needed basis when a contract is reached with a client. The monitors include former state police troopers, educators, former licensing board members and professionals considered experts in their fields.

The company, formed in January, also relies on a policy and advisory board whose members have expertise in the health care, legal and insurance industries.

DiCianni said the firm currently has 10 clients. Its services cost $150 to $700 per hour, depending on the work involved and the skills required of the monitors.

Besides providing monitoring services with the contracts related to probation agreements with licensing boards, the company offers compliance services that help professionals or businesses meet regulations to avoid any disciplinary action. The firm also provides continuing education seminars.

The length of a monitoring contract typically lasts three years, DiCianni said, ending with a final report that gives recommendations for improvements to the licensing board about the licensee.

Affiliated Monitors acts as an independent reviewer of the professional or business, remaining at arm's length from the people it has been hired to scrutinize.

The company's monitors operate under a code of ethics designed to maintain that independence, with checks for conflicts of interest and a requirement that they not develop an informal relationship with the licensee. That means no going out for a cup of coffee and a chat, DiCianni noted.

"Our integrity depends on the integrity of our monitors," he said.

"That goes within our board also," added Albert Burns, a retired trial court judge who sits on Affiliated Monitors' policy and advisory board. "We are there to watch each other, monitor each other.... We're all in this together and no one wants to see it go awry."

The company's marketing has been limited to making presentations before licensing boards to describe its monitoring services and the benefits of using them to save time and money. The firm also attends industry conferences and spreads its message by word of mouth.

"The demand, we think, is going to be significant as more boards, defense attorneys and licensees see the benefit of using an independent monitor," DiCianni said, adding that individuals across the state work as monitors but no other company provides a clearinghouse of independent monitors.

Those licensees who take on the company -- whether under order by a state board or of their own volition -- can expect to see improvements in their compliance with regulations, according to DiCianni.

"Once they buy into the system, they understand how to apply the regulations to their practices. So we think they become better practitioners, better businessmen in the field that they work in because they are now compliant," he said. "And that's a benefit to the public."

For those on probation, it's all about dotting the i's and crossing the t's.

"They don't want to see the board again," DiCianni said. "It's much easier to be compliant than to screw around."

AFFILIATED MONITORS INC.

Founder: Vincent DiCianni
Employees: 2 full time, 2 part time, plus roster of independent contractors
Industry: Service, consulting

Company background: Founded in January and with offices in Westborough and Boston, Affiliated Monitors provides monitoring, compliance services and training to professionals and businesses that are subject to government regulation. Its Web site is www.affiliatedmonitors.com.

(Greg Turner can be reached at gturner@cnc.com or 508-626-3909.)