California Medical License Lawyer

Put Years of Experience in Your Corner

 A California Medical License Lawyer has three main responsibilities:

1. Protect our California Physicians from peer review, FPPE, PIPs, summary suspension, adverse credentialing, and privilege related and employment related actions that can adversely affect a medical license.
2. Protect our California Physicians from Medical Board of California investigations and Accusation based proceedings.  This aspect of license protection often arises from “in house” matters such as disruptive physician complaints, internal divisions and nurse complaints, actual peer review, FPPE and other matters.  These escalate and are reportable to the MBC.
3. Represent our physicians in criminal matters whether they arise from the operation of a medical practice and involve Medicare/Medicaid audits, STARK or AKS violations or other professionally related matters.  We also defend unrelated criminal matters that can impact a license such as drunk driving (DUI), drug arrests or domestic violence incidents.  There are strict self reporting rules that are often misunderstood and can be a separate basis for discipline.

“HOT BUTTON” AREAS AFFECTION MEDICAL LICENSES

MEDICAL STAFF & the MEDICAL EXECUTIVE COMMITTEE 

Hospital politics can quickly transform into a threat to your license and career.  All states are governed by federal mandates establishing overview of individual physicians by medical boards and at hospitals by medical staff.  Medical Boards are public entities but medical staff are often mystery black boxes.

The Slippery Slope of Treats to Your License 

Internal investigations can transform medical staff from your partners and colleagues to genuine threats to your entire career.    In a nightmare scenario you receive what appears to be an informal question from a member of medical staff about a complaint raised by a nurse.  You respond quickly and off the cuff.  Two weeks later you learn that several nurses have filed complaints and your off the cuff response is considered dismissive of the nurse(s) concerns.  Suddenly you are defending your medical license because a peer review committee is investigating.  They offer you counseling and you agree to see a “coach”.   Are you safe?    Do you have to report this next time you apply for credentials?  Can this lead to a denial of credentials?  (and if so, is this a reportable denial?)

 All of this can take place in a matters of months.   Nothing in your medical training prepared you for this spider web of accusation and chess like implications.  For physicians caught in the spider webs of hospital or medical group politics, our license defense attorneys understand the mess and can help untangle it.

Who Actually Controls Medical Staff?

Who actually controls the Medical Staff?   Organized medical staff and its management may or may not be truly independent of hospital executive leadership.  The CEO and his/her affiliated management physicians often run the Governing Board so that actual control of a hospital is corporate despite the legal requirements of MD control of medical care. How do you fit in the overall hospital business plan? Are you a physician profit center? Or are you bringing in too many state or federally funded patients and not enough PPO's?   

Is medical staff truly independent from management? Is the governing board (the Board of Directors) independent or are they prestige seekers who hope that by being on the board they will get special treatment for themselves and their families?) Are Joint Commission rules really followed? Are patient needs really the priority? 

Our California Medical Lawyers take a broad view of your situation.  We understand the politics and the people involved in medical licensing, privileging, credentialing and FPPE, PIP and other license threatening proceedings.  Peer review and MEC matters move quickly so our license defense expertise combined with your prompt retention of qualified lawyers can be the difference between resolution and extended conflict.

Partnership Breakups

A medical license is the most vulnerable license in the United States. An employment dispute or a physician partnership dispute inevitably evoke the spectre of a retaliatory license suspension. A partnership breakup should simply be a business issue. However, the medical license is vulnerable to attack by disgruntled business partners and a bad partnership agreement will often encourage attacks on your license by your soon to be former “best friends”.

Our medical license lawyers understand the intricate … intertwined … interrelated webs of employment contracts, social politics, general political trends as they affect the safety and sanctity of your medical license and right to practice.

[We include freedom to exercise independent medical judgment under the term “right to practice” as many of the political developments result in politicians determining how your practice.]

Medical Board and NPDB Reporting - Read Your Contract!

Many physician partnership contracts incentivize termination for cause. These contracts will provide substantial compensation to the departing partner when termination is “at-will” or without cause. The same partnership contract will provide for a different compensation system when termination is “for cause”. 

For cause physician termination is usually orchestrated by an attorney consulted outside the practice or by the practice adminstrator. A carefully executed plan will lead to “for cause termination”. This termination strips the doctor of goodwill, future revenues and other items of inchoate but real value. 

This retaliatory firing triggers a buyout under the for cause provision and will often be for “book value”. Typically “book value” is simply the depreciated value of the equipment onsite. Non-compete clauses complicate the termination process as well. A medical license defense lawyer takes a broad view of your “situational vulnerability” so that we see attacks before they are launched.

Financial Incentive to Attack Your Medical License

A major problem with this for cause firing is that the financial incentive for your former close friends and partners is to find for cause vs. an at-will parting of the ways. These same “for cause” provisions often trigger medical board reporting or at the very least reporting on credentialing applications in the future. To counter these tactics, we often file lawsuits under Labor Code section 1102.6 or Health & Safety Code section 1278.5 to undo the harm caused by a punitive “for cause” firing. 

However, these are after the fact remedies as these punitive actions under these physician employment contracts often trigger medical board reporting (and in extreme cases National Practitioner Data Bank reporting) long before any of the 1102.5 or other employment law remedies provide relief. The best approach is to act before the harm is inflicted.

Be Careful if Your Partnership is Up for Sale

We have seen healthcare practice sales as a trigger for punitive or business driven employment actions. Here is a scenario that confronted one of our doctors. (We sued and won $ 1.7 million dollars)

A partner physician opposed the sale of the practice. The partners in favor of the sale mapped out a campaign to document (meaning invent) physician misconduct. The normal day to day activities of the practice started being written up in a negative manner. Friends became enemies with a smile.  Meetings took place without his knowledge. He was terminated without any cause.  

Any business dispute among partners that involves significant money can trigger the misuse of the employment contract or partnership rules. Beware and contact our physician lawyers early during a potential dispute.  (They have!)

Sham Peer Review Has Broad Protections  

These criticisms are setting up a sham peer review or a termination for cause but they are protected to a large degree from a lawsuit by both Evidence Code section 1157 and the state SLAPP statute.  So there is an incentive in California to complain unfairly and little recourse for the physician victim.

In severe cases we have seen DEA Audits, HIPAA compliance complaints, billing reviews, off label prescription reviews and other outside agency investigations targeted against an individual. 

While the group risks exposure as the partner or employer, an outside investigation often triggers an immediate internal suspension for patient safety. It is a nuclear option but we are seeing it increasingly utilized.

The bottom line is that your California medical license is your Achilles’ heel. It is a point of attraction for attack and your greatest vulnerability. It is the point of attack for personal disputes, marital discord, business disputes unrelated to your medical practice and to professional competitors as well. 

Daniel Horowitz vigorously protects doctors facing sham peer review.  It is a difficult area and Daniel and physician lawyer Mark Ravis are the right choice when you are facing this type of calculated and unwarranted attack on your license.

Don't wait to get help, contact our team today at (925) 291-5388 to schedule an initial consultation with our firm.