WHAT DOES THE CALIFORNIA MEDICAL BOARD CCU UNIT DO?

The Horowitz law office defends doctors against board investigations and challenges to their licenses.  There are many "first contacts" with the disciplinary system but the most common is a reach out from the CCU. 

1. Initial Screening and Intake:

   • The CCU serves as the non-medical branch responsible for the initial screening and intake of all complaints, regardless of their merit.
   • Specific types of complaints, such as those related to sexual misconduct, malpractice judgments, and criminal convictions, are promptly escalated to a higher level.
   • Claims that fall outside the established medical board categories of discipline, often characterized as “wild claims,” are rejected.
   • The CCU receives thousands of complaints annually from various sources, including patients, family members, insurance companies, and other healthcare practitioners.
   • Complaints from insurance companies are meticulously prepared, often by their Special Investigation Units (SIUs), which focus on fraud detection.
   • Patient complaints may stem from inaccurate medical assessments (referred to humorously as “Dr. Google”), personality differences, or billing disputes. The CCU routinely evaluates and filters these complaints.

2. Jurisdictional Assessment:

   • The key criterion for acceptance lies in whether the complaint falls within the Board’s jurisdiction.
   • Common complaints include allegations that the care and treatment provided by a licensee were inappropriate.
   • To assess these complaints, Board staff may request authorization forms, patient medical records, and written summaries from the licensee.
   • When contacting the doctor for a response, the CCU provides a concise summary of the complaint.
   • This interaction often involves a delicate balance, as the CCU aims to share minimal information while the doctor (or their legal representative) seeks a clearer understanding of the allegations.
   • HIPAA considerations come into play during this process.

3. Consultant Review:

   • If the complaint warrants further scrutiny or if a professional medical opinion is necessary, it is forwarded to a medical consultant.
   • The consultant evaluates the complaint, considering all relevant information.
   • Additional data may be requested during this stage.
   • The doctor under scrutiny should be vigilant and prepare a robust defense.
   • In some cases, no violation is found, or there is insufficient evidence to proceed, leading to closure or further review.