This case study includes a combination of different scenarios and outcomes based on our experiences over the years, and is for demonstrative purposes only. This communication is NOT LEGAL ADVICE, as each case is different and its outcome depends on many factors that are beyond the intended scope of this article.
Case Study: Disciplinary Board Actions: A NJ physician receives a formal Administrative Complaint seeking the revocation/suspension of their professional license for alleged improper prescribing of controlled substances, and other regulatory violations.
Legal Challenges:
• Risk of suspension or revocation of the doctor’s license to practice medicine in NJ, and other states.
• Risk of loss of DEA certification thus taking away the right to prescribe CDS.
• Serious potential for criminal charges related to CDS prescribing that could lead to arrest, conviction, and even a prison sentence.
Important Defense Considerations:
• The physician’s level of adherence with accepted standards of medical practice related to treatment, CDS prescribing and documentation.
• Whether the physician has implemented a robust Compliance Program, specifically including CDS Prescribing Policies and Protocols.
• Complying with the doctor’s statutory duty to cooperate with the Board, while mitigating potential criminal exposure.
Prevention Is Critical:
There are typically, but not always, warning signs to alert a provider that an Administrative Action is forthcoming. These might include, but are not limited to, receipt of a letter of inquiry from the Board, a subpoena for records, or a visit from an investigator allegedly conducting a “routine audit”. It is critical for a provider to engage experienced counsel immediately upon receipt of any communication by their Board. For the most expansive level of protection, a provider must have and adhere to a robust Compliance Program that will avoid improper conduct, and alert of any pitfalls that must be corrected.
Providers Must Have Experienced Healthcare Legal Counsel:
Defending healthcare providers is complex and multifaceted, requiring a strategic approach. Experienced legal representation, the right team of experts, and skillful negotiation are most likely to lead to outcomes that, even where mistakes occur, still carve out a path forward for a licensee to continue to practice and move beyond the mistake.
Doctors, Nurses, Dentists, Chiropractors, Licensed Clinical Social Workers, and other health professionals and providers all practice at the discretion of their governing professional boards and regulatory agencies. Our founding attorney was first a registered nurse who then began her legal career as a NJ Deputy Attorney General assigned to the Professional Boards Prosecution Section, where she gained invaluable experience. Since leaving the Attorney General’s office, Alexandra has effectively represented healthcare professionals before their Boards for close to 20 years. Our firm is well poised to assist providers with licensure applications; to respond to investigative inquiries and demands for information; to defend against disciplinary actions seeking the revocation or suspension of a professional’s license, to advise and represent licensees in matters involving payors and facilities, and to handle healthcare transactions.
Please reach out to us with your questions, and any legal or regulatory needs. We are here for you. [email protected] 908-477-7886
