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Medical License Defense

California Medical License Lawyer

 A California Medical License Lawyer has three main responsibilities:

  1. Protect our California Physicians from peer review, FPPE, summary suspension and adverse credentialing, 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 is often related to the peer review, FPPE and other matters.
  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.

 Our offices are located in Lafayette, California (Contra Costa County).  We represent physicians throughout California.  Our Doctor/Lawyer, Mark Ravis, M.D. is located in Calabasas, California.  We have affiliated offices in Orange County as well.   Daniel Horowitz is also admitted to practice in many of the federal courts.

Nationwide we have existing relationships with physician lawyers in New York, Washington D.C., Pennsylvania, New Jersey, Washington state, Texas and other jurisdictions.   If you need the expertise of Daniel Horowitz and Dr. Mark Ravis, call us whether you are in California or elsewhere in the United States.

“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 Nightmare Scenario (All too common)

  MEC investigations can transform medical staff from your partners and colleagues to genuine threats to your entire career.   While you are deciding whether patient spitting blood has a ruptured esophageal varices, another physician is reviewing your charts because a nurse has complained that you ignored a patient's complaints and were rude when the nurse pointed out that you missed a diagnosis.   Other nurses are submitting complaints to the protected (secret) hospital complaint system and a summary suspension for 7 days is planned.  If you don't apologize it may be increased to a reportable number of suspension days.  And while this is going on, everyone is smiling at you as if nothing is wrong.  

Who Actually Controls Medical Staff?

Who actually controls the Medical Staff?  The Medical Executive Commitee may or may not be truly independent of hospital management.  Management often runs the 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 is Protected & You Are Not

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.

 Physician Defense in California

California Medical License Defense: We provide our physicians during pre-peer review internal communications, peer review investigations, license investigations both prior to and after the filing of an Accusation.  Our focus is job protection and license retention.

Physician Defense Attorneys:

We defend California Physicians in licensing hearings, criminal investigations and against criminal charges, summary suspensions and NPDB filings.

The two areas are closely related as many criminal filings against a physician must be reported to the medical board.    Our California Physician Lawyers have particular expertise in practice related criminal defense and offenses unrelated to practice such as drunk driving (DUI); domestic disputes; domestic restraining orders; domestic violence.

Procedurally, the Medical Board of California controls the licenses of Physicians, Surgeons, Psychiatrists, Physician’s Assistants and Podiatrists.  The Osteopathic Medical Board regulates osteopathic medicine in both licensing and regulation.  The Medical Board and the Osteopathic Board attempt to closely track each other so that inconsistent regulations do not create legal and day to day medical practice conflicts.  

CALIFORNIA APPELLATE REVIEW 

We have experienced appellate lawyers who will appeal adverse determinations by the various licensing boards in California.  In addition to appeals of decisions by the Medical Board of California we can appeal board decisions for many licensing professions including (but not limited to)

  • Decisions by the Dental Board of California; the Veterinary Medical Board of California; the Board of Chiropractic Examiners; the Board of Registered Nursing; the Board of Pharmacy, the California Board of Behavioral Sciences and other regulatory agencies in the State of California.   
  • More Generally all Boards Regulated by the DCA (See DCA List)
  • Osteopathic Medical Board 
  • Board of Chiropractic Examiners (which has the Initiative Act so it has potentially different rules or approaches.

PHYSICIAN  DEFENSE IN CALIFORNIA & NATIONWIDE

Our physician license defense has affiliated expert attorneys in Southern California, Washington State, Pennsylvania, Texas, New York, New Jersey and elsewhere.  If the expertise of our lawyers meet your needs we can practice in many jurisdictions either alone or in partnership with established medical license attorneys with whom we regularly work.  

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Client Testimonials

Our Community-Based Law Group has a National Reputation
    “I'm an Attorney and would highly recommend him to other professionals (and others alike) because he's the very BEST at what he does”
    Dan Horowitz handled my complex business issue with magnanimity, compassion, care, promptness, and utmost professionalism. I'm an Attorney and would highly recommend him to other professionals (and others alike) because he's the very BEST at what he does and has an uncanny knack at finding unique resolutions with unparalleled speed and efficiency. What is quite outatanding is that he treats each client with kindness and compassion as if a family member
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