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What does the Medical Board CCU (Central Complaint Unit) Do?

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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.