Articles

We recently concluded a negotiation with a physician and one of the health care insurance companies with which he has done business for years. This issue began, as most do, with a letter from the insurance company stating that they were asking that the doctor provide complete copies of the medical records of more than […]

The Office of Professional Discipline, OPD, is the enforcement arm of the New York State Department of Education and it has jurisdiction over the medical licenses of nurses, physical therapists, massage therapists, acupuncturists, and other non-physician and non-physician assistant licenses. When there is an issue concerning the conduct of one of these professionals, OPD has […]

We represent individuals, including physicians, nurses, and other medical professionals, when they have to litigate against their long term disability insurance companies.  The situation usually starts when the individual has been on disability and then receives a letter from the insurance company stating that for various reasons the person is no longer considered to be “disabled’  as that word is defined in […]

We have been notified by OPMC that an investigation of one of our clients is now completed and the case is now closed, with no further action.  This was a very significant matter and the fact that OPMC has closed it without any findings of wrongdoing by our client is extremely gratifying as the matter was serious and the investigation […]

When a physician decides to settle an issue with the office of professional medical conduct, (OPMC) there is often included in the Terms of the agreement some type of license restriction.  This can be the inability of the physician to prescribe narcotics, the requirement that the physician has a chaperone, the need for a physician […]

When the Office of Professional Medical Conduct, OPMC, investigates a physician, the matter can get to the stage where OPMC offers to “settle” the matter with a Consent Agreement. That means that OPMC will not prosecute the doctor, but the doctor will agree to some level of discipline. Many doctors are more than happy to […]

Over the last few months, there have been numerous articles that discuss the fact that hospitals and doctors are suing their patients for payment of bills arising out of health care that was given. These situations arise in several different ways. Sometimes the patient has a surgical procedure and the surgeon’s bill is covered by […]

We recently were contacted by a physician who was named in a lawsuit along with perhaps 15 other doctors, hospitals, and clinics. This lawsuit is going to take years to come to an end and will cost everyone tens of thousands of dollars whether there is any merit to the claim or not. The physician […]

AN ADDITIONAL UNPLEASANT RESULT FROM SIGNING A CONSENT ORDER WITH THE OFFICE OF PROFESSIONAL MEDICAL CONDUCT (OPMC) I recently was called by a physician who had experienced a very, very unpleasant bit of collateral damage after signing a Consent Order with OPMC.  The Order called for a probationary period and a practice monitor who was […]

It all usually starts with a sudden demand that you, the physician, show up at an emergency meeting with either Human Resources or the chair of the department.  There you are met with a very, very unpleasant discussion about your practice, with the upshot being that you have to resign from the hospital.  The people […]

Be careful if you are a physician doing work for a telemedicine company. We have recently represented physicians in two different cases involving telemedicine, and we think it is important to share the information gathered in those representations. Suffice it to say, this type of medicine can be very dangerous for the individual physician. These […]

All health care givers who work for a facility that is governed by the New York State Justice Center must be very careful when they become the subject of an investigation. The New York State Justice Center is an organization which investigates physicians, nurses, aides and anyone else who works in one of the facilities […]

When you sign a consent order with the OPMC, it is essential that you understand and carry out the commitments in order. I recently was contacted by a physician who, in June of 2018, had signed a Consent Order with the New York State Department of Health, Office of Professional Medical Conduct, (OPMC). That Order […]

Whether you are a physician or another type of health care provider, you are in a business relationship with health insurance companies that cover your patients. This proves to be true for those who are in their network and those that are an out–of–network provider.  Although you welcome the checks that the companies send to […]

Physicians today are at the mercy of health insurers because if you do not have a contract as a “provider” with the insurer then you might very well lose a substantial portion of your income.  I just recently had a case where a major insurer wrote to a surgeon and advised that the contract between […]

SOMETIMES YOU CAN ACTUALLY WIN AN OPMC HEARING AFTER YOU HAVE BEEN CONVICTED OF A CRIME We recently represented a physician who was convicted of a crime, violating a court order involving an Order of Protection, in another state.  Any conviction, any felony or misdemeanor, is, by definition, unprofessional conduct and will result in The […]

BE CAREFUL WHEN YOU GO TO AN INTERVIEW AT THE OFFICE OF PROFESSIONAL DISCIPLINE, OPD, –OTHER PEOPLE MAY HAVE GIVEN STATEMENTS TO PROTECT THEMSELVES AT YOUR CLIENT’S EXPENSE We recently represented a nurse at a Department of Education, OPD interview in a situation where it was claimed that regulations had not been followed when a […]

I just finished a case where a health insurance company, HMO, notified my client, a physician, that it was claiming over-payments to the doctor and that he owed them a very large sum of money.  The notice stated that he had to pay the overcharge within a very short period of time and if he […]

A health care provider recently came to me after entering into a Consent Order with the Office of Professional Conduct, OPMC.  The Order was lengthy and prevented the provider from practicing until certain steps were taken.  One of the steps was to take and pass the certifying exam for Physician Assistants to prove that his […]

Your client has his/her ability to practice medicine restored after a substance abuse rehabilitation, but does the clients board ccertification still exist? I recently represented a physician through a two plus year rehabilitation period and after a Hearing with the New York State Department of Health, The Office of Professional Medical Conduct, OPMC, the ability […]

When a physician has been out of practice for some time due to substance abuse or other circumstances, OPMC will often make the attendance by the physician at a Clinical Competency Assessment program as part of the conditions necessary to permit the physician to return to the practice of medicine.  At the end of the […]

Many times a physician is faced with the option of signing some type of Consent Order with the Office of Professional Medical Conduct, OPMC, to put an end to an investigation.  This is often done to avoid a possibly much worse result if the matter goes to a full blown hearing and the case is […]