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Dealing With an Investigation by the Office of Professional Medical Conduct (OPMC)
It is possible a physician may be required to appear before the State of New York’s Office of Professional Medical Conduct (OPMC). This is where investigations and prosecutions of every level of professional misconduct takes place. A mistake in this situation could lead to serious consequences.

Professional Misconduct
It is a generic term referring to a long list of various offenses. The list is extensive and consists of more than 29 types of conduct classified as being unprofessional. Should it be determined a physician has violated any of them, this individual could be given professional discipline. There are certain types of professional misconduct that are encountered more often than others.*Being determined to be morally and mentally unfit
*A conviction of a crime in any jurisdiction
*Practicing medicine while under the influence of alcohol or drugs
*Disciplinary action from any state
*Failure to properly supervise staff
*One or more incidence of proven incompetence or negligence
*Permitting unlicensed individual to perform procedures that require them to have a medical license
*Unsatisfactory record keeping
*Fraudulent practices involving billing issues with insurance carriers
*Violations of HIPAA
*Not respecting boundaries with patients
*Making any type of false statements on application for license renewal

Process
The process of a professional misconduct investigation in New York is complicated. There are certain things a person should and should not do if they are the target of an OPMC investigation. The investigative process will begin with an accusation of misconduct being filed. Where the physician is registered or practices will determine where their case will be forwarded. It will be an OPMC regional office located in upstate New York or New York City.

OPMC Investigation
A physician will be notified by telephone or mail that the OPMC has started an investigation on them. It is common for the OPMC investigator to ask to interview the physician or have them provide patient records for review. Physicians know they have an obligation to cooperate with OPMC investigators. This is especially true if it involves a request for documentation. Anyone with a medical license knows they have a duty to cooperate with disciplinary authorities. They do not have an obligation to submit to an interview. New York attorneys will advise their physician clients, in these circumstances, to not speak with an investigator before they get professional legal advice. It’s possible for an OPMC interview to be productive. Many other times, they can be very harmful to a physician.

Interview
During these types of interviews, anything a physician says to an investigator is going to be used against them. It is common for a physician to submit to being interviewed by a OPMC investigator because they believe they have nothing to hide. This could be a huge mistake. The scope of these types of interviews will be significantly much broader than what a physician realizes. In this situation, a physician will likely make statements OPMC investigators will use as new evidence and an opportunity to file more charges.

Hearing
Should a physician’s case go to a hearing, it will be heard before a layperson and two doctors who are all appointed. They will be known as the hearing committee and their function will be that of a judge. An administrative law judge will be at the hearing, but a physician’s guilt or innocence will be determined by the hearing committee. Should the committee determine a physician did commit a misconduct, it is responsible for determining the penalties to be imposed. Penalties in cases of medical discipline in New York involve license revocation, reprimand, license limitation, probation, license annulment as well as suspension. The committee could also determine if a physician will be required to serve community services, pay monetary fines or be required to submit to retraining.

Most OPMC cases with proper legal representation can be resolved prior to a hearing. In many cases, this will involve a consent order. This requires a physician to admit to their wrongdoing. It also enables them to avoid severe penalties. A physician or OPMC can appeal the decision of an Administrative Review Board. The last step is challenging the decision in state court. In this case, the physician will have the burden of proof. The knowledge and experience of an attorney in this situation will always help a physician obtain the best possible result.

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