STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NUMBER: 2015-24593 JOHN S, CLEMENTE, M.D., RESPONDENT. ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through its undersigned counsel, files this Administrative Complaint before the -Board of Medicine against Respondent, John S. Clemente, M.D., and alleges: 1. Petitioner is the state department charged with regulating the practice of medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed physician within the State of Florida, having been issued license number ME 89654. 3. | Respondent’s address of record is 733 Periwinkle Street, Boca Raton, Florida 33486. 4. At all times material to this Complaint, Respondent was Board certified by the American Board of Internal Medicine, with sub- specialty certification in Cardiovascular Disease. 5. On or about June 4, 2015, the State Board of Medical Examiners for the State of New Jersey issued an Interim Consent Order In the Matter of Suspension or Revocation of the License of John S. Clemente, M.D., New Jersey License Number 25MA 52589, that among other terms temporarily suspended Respondent’s New Jersey Medical License. 6. On or about June 10, 2015, the State Board of Medical Examiners for the State of New Jersey issued a Consent Order, In the Matter of Suspension or Revocation of the License of John S. Clemente, M.D., New Jersey License Number 25MA 52589, in which Respondent agreed to voluntarily surrender his license in all jurisdictions with such surrender to be deemed a temporary suspension. 7. Suspension of Respondent’s New Jersey medical license is based upon a Verified Complaint of Respondent's loss of hospital privileges, inspection reports of Respondent's office by contractors for Medicaid and DOH v. John S. Clemente, M.D. Case Number 2015-24593 2 Medicare Services, and police reports. The Verified Complaint alleges that Respondent's personal health indicates that he is incapable of practice in a manner consistent with the public’s health, safety, and welfare. 8. Respondent did not report the actions taken by the State Board of Medical Examiners for the State of New Jersey against his license to the Florida Board of Medicine in writing within thirty days. 9. Respondent did not update his Practitioner Profile with the actions taken by the State Board of Medical Examiners for the State of New Jersey against his license within fifteen days. COUNT I 10. Petitioner re-alleges and incorporates paragraphs one (1) through nine (9) as if fully set forth herein. 11. Section 458.331(1)(b), Florida Statutes. (2014), provides that having a license or the authority to practice medicine revoked, suspended, or otherwise acted against, including the denial of licensure, by the licensing authority of any jurisdiction, including its agencies and subdivisions, is grounds for discipline. DOH v. John S. Clemente, M.D. Case Number 2015-24593 3 12. The State Board of Medical Examiners for the State of New Jersey is the licensing authority for the practice of medicine in the State of New Jersey. 13. On or about June 10, 2015, the State Board of Medical Examiners for the State of New Jersey took action against the Respondent's license by issuance of the Consent Order temporarily suspending the Respondent's license to practice medicine in the State of New Jersey. | 14. Based on the foregoing, Respondent has violated Section 458.331(1)(b), Florida Statutes (2014), by having his license or the authority to practice medicine in the State of New Jersey suspended. COUNT II 15. Petitioner re-alleges and incorporates paragraphs one (1) through nine (9) as if fully set forth herein. 16. Section 458.331(1)(kk), Florida Statutes (2014), provides that failing to report to the Board, in writing, within thirty days, that an action as defined in Section 458.331(1)(b) has been taken against one’s license to practice medicine in another state, territory, or country is grounds for discipline. DOH v. John S. Clemente, M.D, Case Number 2015-24593 4 17. The State Board of Medical Examiners for the State of New Jersey took action as defined in Section 458.331(1)(b) against the Respondent's license by issuance of the Consent Order temporarily suspending the Respondent's license to practice medicine in the State of New Jersey, In the Matter of Suspension or Revocation of the License of John S. Clemente, M.D., New Jersey License Number 25MA 52589. 18. Respondent failed to report the action of the New Jersey Board of Medical Examiners against his license to the Board in writing within thirty days. 19. Based on the foregoing, Respondent violated Section 458.331(1)(kk), Florida Statutes (2014), by failing to report to the Board, in writing, within thirty days, that an action as defined in Section 458.331(1)(b) was taken against Respondent's license to practice medicine in another state. COUNT IIT 20. Petitioner re-alleges and incorporates paragraphs one (1) through nine (9) as if fully set forth herein. DOH v. John S. Clemente, M.D. Case Number 2015-24593 5 21. Pursuant to Section 456.0392(1)(a) the Department of Health shall compile information submitted pursuant to Section 456.039 into a practitioner profile for an applicant submitting information for licensure. 22. Pursuant to Section 456.039(1)(a)8, Florida Statutes (2014), the applicant must provide a description of any final disciplinary action taken within the previous ten years against the applicant by the agency regulating the profession that the applicant is or has been licensed to practice, whether in this state or any other jurisdiction. 23. Pursuant to Section 456.042, Florida Statutes (2014), a practitioner must submit practitioner profile updates of required information within fifteen days after the final activity that renders such information a fact. An updated profile is subject to the same requirements as an original profile. 24. Section 456.072(1)(w), Florida Statutes (2014), provides that failing to comply with the requirements for profiling and credentialing, including, but not limited to, failing to provide initial information, or making misleading, untrue, deceptive, or fraudulent representations on a profile, credentialing, or initial or renewal application is grounds for discipline. DOH v. John S. Clemente, M.D. : Case Number 2015-24593 6 25. On or about the dates set forth above, the State Board of Medical Examiners for the State of New Jersey took action against the Respondent's license In the Matter of Suspension or Revocation of the License of John S. Clemente, M.D., New Jersey License Number 25MA 52589. 26. Respondent failed to comply with the requirements for profiling by failing to provide within fifteen days a description of the action of the State Board of Medical Examiners for the State of New Jersey against Respondent’s license. 27. Based on the foregoihg, Respondent has violated Section 456.072(1)(w), Florida Statutes (2014), by failing to comply with the requirements of profiling. WHEREFORE, the Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: ‘permanent revocation or suspension of Respondent’s license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. DOH v. John S. Clemente, M.D. Case Number 2015-24593 7 SIGNED this 24h day of No Cok / 2016. Celeste Philip, MD, MPH Interim State Surgeon General Ror ol Peter Delia Assistant General Counsel FILED DOH Prosecution Services Unit BEPARTMENT OF HEALTH 4052 Bald Cypress Way, Bin C-65 DEPUTY CLERK Tallahassee, FL 32399-3265 CLERK: Cormglnnnrontty~ Florida Bar #0104207 Telephone (850) 245-4444 DATE 3-30-|b Fax (850) 245-4684 E-mail: peter.delia@fihealth.gov PVD/crv PCP Date: March 25, 2016 PCP Members: Dr. El-Bahri, Dr. Rosenberg, Ms. Goersch DOH v. John S. Clemente, M.D. Case Number 2015-24593 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. A request or petition for an administrative hearing must be in writing and must be received by the Department within 21 days from the day Respondent received the Administrative Complaint, pursuant to Rule 28- 106.111(2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule 28-106.111(4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in the Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Mediation under Section 120.573, Florida Statutes, is not available to resolve this Administrative Complaint. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section 456.072(4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed. DOH v. John S. Clemente, M.D. Case Number 2015-24593 9

Docket for Case No: 16-007618PL