California physicians and surgeons are required to follow specific codes of conduct. These include Business and Professions Code laws, Medical Board of California (MBC) regulations, professional ethics, hospital rules, and ideal medical practices. At times, even a simple allegation can trigger an investigation and disciplinary action against these professionals’ licenses. If, as a physician or surgeon, your medical license is at risk, you want to consult an experienced attorney for healthcare license defense as soon as possible.
At Orange County License Attorney, our lawyers not only represent our clients before the MBC, but they also tackle any underlying criminal or civil dispute that may harm a medical license. We represent clients throughout the disciplinary process and can advise them on when to settle and when to seek full exoneration. Do not hesitate to contact us to obtain the quality legal representation you need.
The MBC Role
The MBC is a state government body within the Department of Consumer Affairs (DCA) responsible for issuing licenses to, regulating, and disciplining surgeons, physicians, and specific allied medical professionals across California. The mission of this board is to safeguard healthcare consumers and prevent harm by:
- Ensuring proper licensing, that is, ensuring only qualified professionals are licensed
- Enforcing the Medical Practice Act (MPA) objectively
- Encouraging access to high-quality medical care
- Probing complaints against license holders
- Imposing disciplinary actions against license holders found to have violated the law
- Supporting high standards in medical practice
- Providing public information on licensee records
The MBC also permits the general public to verify a physician’s or surgeon’s license and review their medical history. Also, as the main licensing authority, the MBC has the power to suspend, revoke, or block the application for a surgeon’s or physician’s license in California.
Many licensees wrongly think the MBC is looking out for them, but it’s actually looking out for patients and the public. The MBC won’t support you if you face a complaint for professional misconduct or other violations. Instead, it will be on the complainant’s side, seeking to protect them and ensuring they receive justice. If the board finds the complainant’s allegation against you to be true, it will impose action against your license, which may affect your career.
Only a license defense attorney will fight to protect your interests if you are facing a complaint. That said, you need to contact one as soon as you learn that your license is at risk. Sometimes, patients have unrealistic expectations of medical professionals and wrongly blame them, contingent on outcomes and not the professional’s performance.
Other times, complainants file exaggerated or false allegations against medical professionals. Alternatively, as a surgeon or physician, you can make an honest mistake that should not warrant losing your license. An experienced attorney can help you defend your license before the MBC by presenting appropriate mitigating factors and a solid defense strategy.
Common Violations Alleged Against Physicians and Surgeons
California physicians and surgeons may face complaints from the public, patients, professional and licensing groups, professionally and business-mandated reports, anonymous sources, or government entities. Regardless of where they come from, the MBC must investigate all complaints received, including those that involve the following:
- Boundary violations with patients, such as forbidden relationships and improper conduct
- Practicing without a valid license
- Chemical dependency
- Aiding and abetting unlicensed practice
- Failure to correctly supervise registered nurses or other medical practitioners
- Facing license discipline by a different agency or in a different state
- Failure to comply with mandatory reporting requirements
- Criminal convictions substantially related to the duties, functions, and qualifications of a surgeon or physician
- Negligent or incompetent quality of care
- Prescribing errors, such as overprescribing, misprescribing, prescribing without necessary examination, prescribing to oneself or family members, and prescribing pain medication to people with an addiction.
- Professional misconduct
- Kickbacks or fraudulent billing for medical services
- Inadequately maintaining patient records and charts
- Medical mistakes that lead to patient injury or death
- Non-therapeutic prescribing
- Peer review
- Sexual misconduct or inappropriate touching of patients, even if it is consensual
- Fraud or errors in practice management, recordkeeping, and charting
- Substance abuse (including prescription drugs), addiction, or mental illness that leads to alleged impairment
- Dishonesty or theft
- Medi-Cal, Medicare, or insurance fraud
Note that physicians must report any dispensing of any controlled substance to CURES (Controlled Substance Utilization Review and Evaluation System) within one working day of providing the medication to the patient. Previously, the reporting deadline was seven days after dispensing a controlled substance, but the law has changed. This law also applies to pharmacists and other professionals who legally dispense regulated substances. Failure to report can constitute grounds for disciplinary action.
What Happens When MBC Receives a Complaint?
Once the MBC receives a complaint against you, it will review all the allegations therein as provided by the MPA. Upon receiving a complaint, the board will refer it to the Central Complaint Unit (CCU), whereby a Complaint Unit Analyst will review the details to determine:
- Whether more details are required. If so, the Complaint Unit Analyst will request the information from the complaining party
- If the complaint falls under the MBC’s jurisdiction. If it does not, it will be sent to the appropriate agency.
- If the complaint entails substandard or inappropriate treatment and care provided by you. In that case, the Complaint Unit Analyst will obtain copies of medical records from you for medical consultant review.
- If you have committed only a minor violation. In that case, the board will contact you to advise you of your violation and to bring you into compliance or refer the matter for a citation and fine.
- Whether an investigation is necessary. In that case, the Complaint Unit Analyst will refer the matter to the board’s Investigation Unit
- Whether the complaint could be mediated at this stage, if appropriate
- If the Complaint Unit Analyst does not find any apparent violation, the board may close the case
If the complaint moves to the investigation stage, the Department of Investigation Health Quality Investigative Unit (HQIU) determines whether you committed a violation. If so, the board can take any of the following actions against you:
- Close the case, but retain it for 12 months if the HQIU cannot confirm a violation
- Close the case but retain it for five years, as it finds the complaint to have merit to a given extent, but there is inadequate evidence to take action against you.
- Refer the matter to the Office of the Attorney General’s Health Quality Enforcement Section to determine whether to initiate disciplinary proceedings.
- Refer the case for criminal, disciplinary, or non-disciplinary action
Minor violations may result in a citation and fine rather than an official Accusation and discipline. But when the investigative unit believes the case against you meets legal standards for disciplinary action, a Deputy Attorney General will initiate an official accusation and schedule a hearing if you plan to contest the charges against you.
Note that if you wish to contest the charges, you must file your response to the Deputy Attorney General’s formal Accusation within 15 days of receiving the notice of Accusation. Your response involves filing a Notice of Defense and Request for Discovery. If you fail to file this notice within the required time, the board may issue a default order leading to the automatic revocation of your medical license.
If you wish to contest the charges, an Administrative Law Judge (ALJ) will hear the case. However, before the hearing, the MBC may propose a stipulated settlement. This is where the board requires you to admit your violation and accept a less severe sanction rather than facing a formal administrative hearing.
A stipulated settlement may be an option for minor violations without a history of disciplinary action, no patient harm, and satisfactory remedial steps. For example, if you used the wrong billing code and an insurer reported the matter to the MBC to pursue restitution, the MBC may require you to take and prevail in an insurance billing code educational course and have a billing monitor for your practice for a specified period. After which, the MBC will drop the formal accusation after you have met these conditions.
If a stipulated settlement is unavailable or fails, your case will proceed to a hearing. At the end of the hearing, the ALJ will have 30 days to draft a proposed decision on what action the board should take against you. The MBC has the discretion to adopt the judge’s decision in full, modify it, or disregard it entirely. Some of the disciplinary actions the board can impose include the following:
- Public reprimand. If your violation is relatively minor and no patient harm occurred, the board can issue you a public letter of reprimand. The letter summarizes the allegations you face, the impropriety of your actions, and any measures you must take to correct your mistakes.
- Probation. The board’s decision to place your license on a probationary period may be a result of a stipulated settlement or an ALJ’s recommendation after an administrative proceeding. When your license is on probation, the board shall impose some probationary conditions as provided by its Disciplinary Guidelines. In this case, the board revokes your license but stays the revocation for a specific period. If you do not adhere to probation, your license can be revoked.
- Suspension. The MBC’s Disciplinary Guidelines define the circumstances under which the board may suspend a professional’s license. When your license is suspended, you cannot refer to yourself as a licensed physician or surgeon, nor can you practice medicine.
- Revocation. This is an outright loss of your license, generally due to an administrative proceeding in a severe case. If your license is revoked, you must wait three years before you seek reinstatement. Revocation, too, goes on public record as the board publishes this disciplinary action on its website.
What To Do If You Receive a Request for Medical Records
As earlier stated, a request for medical records is made when, while reviewing your complaint, the Complaint Unit Analyst discovers that you provided inappropriate or substandard treatment and care. This request is generally sent by mail, though the Complaint Unit Analyst may personally serve it to you. The request letter is usually addressed “Dear Custodian of Records” and authorizes you to release the records with the patient’s signature. The letter should be accompanied by a printout of applicable laws and a certification form for you to certify what records you are providing.
According to California’s Business & Professions Code, you must produce the requested medical records within fifteen days of receiving the request letter. If you fail to comply, you may be subject to a daily fine of $1,000 for each day the records remain unproduced, up to $10,000. Failing to provide the requested records constitutes professional misconduct and can trigger disciplinary action, irrespective of how the underlying investigations turn out.
After the CCU receives the records, a medical consultant reviews them to establish whether you committed a violation. If you did, the CCU would refer the case to the investigation unit for a more comprehensive investigation. From here, the case could be closed or proceed to discipline.
If you receive a request letter for medical records, you must comply. The request could lead to the complaint’s dismissal or formal discipline that could endanger your license. You want to consult a skilled lawyer as quickly as possible.
Contact a Skilled Healthcare Professional License Attorney Near Me
As a physician or surgeon facing disciplinary action, you would like to do anything legally possible to keep a respectful reputation and retain your medical license. Hiring a skilled healthcare professional license defense lawyer can help you do just that. Before you even talk to the MBC about your case or anyone else, you want to obtain legal counsel first. They can help you avoid losing your license.
At Orange County License Attorney, we strive to solve our clients’ cases in ways that save their licenses, protect their reputations, and minimize or eliminate any discipline. We will leverage our unique experience and litigation skills to provide top-tier defense to safeguard your career and livelihood. If your medical license is at risk, call us at (714) 782-6386 for immediate legal intervention.
