Tips for Health Providers to Navigate License Disputes

Tips for Health Providers to Navigate License Disputes

  • Contact legal counsel immediately; at times, you will be functioning under specific time frames in which you must act, and report. Responding without assistance from legal counsel may lead to your response revealing too much or too little information. Lawyers with expertise in responding to license complaints can guide you in crafting an optional response that will not lead to further questioning by the government. Failure to no respond at all could lead to other legal actions. Also, not being informed about the law or missing deadlines is not an

 

  • Communications from the State Licensing Board may take different methods: letters, written complaint forms from members of the public, telephone calls, newspaper articles, e-mails, and memos from staff. Communication may be labeled as “informal complaints” and are given a case number by clerical staff on the Intake Team. The licensee or the “respondent” receives a copy of the complaint along with the request for the adequate records and is asked to respond to the

 

  • Do not discuss your legal situation with the media, friends or family, the board, or the complainant. Only discuss with your lawyer and let them speak for and with

 

  • Review with your professional liability insurance policy or agent to see if defending the complaint is covered under your policy, and what your limits are. The coverage may include paying for a lawyer to help

 

  • “Notify your liability carrier and other parties to who you have similar obligations as soon as possible” (Devji I., 2013). Most carriers and many employers and medical service contracts require timely disclosure of any complaint (Devji I., 2013). Failure to notify your liability carrier could affect your insurance coverage and may lead in serious penalties such as fees and violation of your contracts.

 

  • Have your lawyer represent you. Gather all of your documents that involve the case in the complaint to give to your lawyer and make copies for reference. Additionally, depending on the legal situation there are lawyers that specialize in representing these kinds of complaints and licensure proceedings (Devji I., 2013). It is important that you seek help immediately with a lawyer because they will be familiar with the people and procedures of the board, your rights and obligations and can help you determine the limits of your disclosure and reporting obligations (Devji I., 2013).Be complete and forthright in your disclosures and discussions with your lawyer and share both the good information on what you did and the standard of care delivered and on anything that was not perfect or deficient (Devji I., 2013). Communicate with your lawyer in detail so there are no surprises by anything that is

 

  • During the process, investigators can and do seek the advice of the prosecuting attorney assigned and the case advisor. The investigators may conduct undercover operations where they may contact clients or patients. The Department may issue investigative subpoenas under Wis. Stat. § 440.03(4). Administrative search warrants are also available in Pharmacy Examining Board cases, under Wis. Stat. § 961.52, but are very rarely used. Some boards may request their licensees to cooperate with investigations others may not. The Medical Examining Board has authority to order its licensees to submit to physical, mental, and professional competency examinations during the investigative stage, Wis. Stat. § 448.02(3)(a). The investigators do not have traditional law enforcement powers such as arrest, although those assigned to Pharmacy Examining Board cases could be granted such powers under Wis. Stat. § 961.51(1), if that board choses. The Division’s investigators carry with them official photo identification cards, and police-style badges, whenever they go out into the field, and have business cards.

 

  • The decision whether discipline will be pursued or not can occur at any time. A memo is prepared summarizing the file, and the prosecutor is asked for a recommendation. Then the memo and file materials are sent to the case advisor. If the determination is “close the case,” the case is put on the agenda for the next board meeting. These portions of the meetings are conducted in closed session. In most cases, the boards accept these recommendations and vote to “close” the case. In a few cases, more information is requested, or the matter is referred for

 

  • If the licensing board files a formal complaint, the complaint is opened for investigation, but it may not always mean that it will lead to discipline. However, if the cased proceeds to the prosecution stage the file is sent to the prosecuting attorney assigned. In most cases, there will be a discussion between the prosecuting attorney and case advisor of what outcome should be adequate. If an expert witness will be required to establish a prima facie case, the case advisor will be asked for some names of appropriate professionals. This is something that is found to be done in quality of care case in health professions, as well as in business

 

  • After this, an agreement is proposed to the respondent. If you do not agree with the first offer, discuss alternatives with the prosecutor. Nonetheless, if an agreement is reached the board will send a disciplinary order without formal proceedings and 90% of all disciplinary orders are issued.

 

  • You will then receive a form of a Final Decision and Order (settlement reached). It will contain a standard form signed by the respondent and the attorney and the prosecutor, presented to the board’s legal counsel and presented in closed session. Direct regulation cases, signed agreement and order are sent to the Secretary with the file. Once it is accepted, the Final Decision and Order are signed and issued. However, if rejected there will be informal guidance from the board’s chair or legal counsel. Depending on the board, there is an average of 5-10% terms that are rejected the first time. The board or Secretary must accept or reject the final

 

  • Have documentation of the case. Keep in your records the case. Do not change or destroy any paperwork as this could lead to further trouble. Keep a log of the events, including when, how, any witnesses that were present in testimony. Additionally, keep track of any interaction with the complainant, verify that you have a way to prove the interaction and share all this information with your

 

  • Do not initiate contact with the complainant. After the complainant files their complaint with the government work through your lawyer only in responding to the allegations. If the complainant contacts you, direct them to your lawyer for all communications regarding the

 

 

Resources Available

Center for Health & Wellness Law, LLC Phone: 608.579.1267

https://wellnesslaw.com/

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