The powers and scope of state and federal regulatory agency investigations vary in each case from agency to agency and from state to state. The manner in which the health care practitioner initially responds to the preliminary state inquiries and investigations makes the whole world of difference in how the case against him/her will proceed in the future or if the case an/or inquiry proceeds at all.

Initial investigatory and regulatory actions come in various forms. Some examples are set forth below:

1. A letter of inquiry as to the general nature of the practice and the methods of diagnosis and treatment of the same. Depending on the state in which the practitioner finds him/herself, the regulatory agency may initiate such inquiry on its own, may respond to an anonymous tip form foes of the practice or may act on a specific complaint from a patient. Many health care and dentistry practitioners are under the misapprehension that the agencies cannot initiate such communication unless someone was hurt. That assumption demonstrates a gross misunderstanding of the functions and authority of the regulatory agencies.

2. A letter asking the practitioner to respond to a specific patient complaint or to a specific issue raised by the agency. Usually the patient complaint is attached.

3. A raid at the practitioner’s offices aimed at gathering evidence to prosecute the practitioner criminally and administratively. Usually such raids go hand in hand with accompanying criminal prosecutions.

4. An investigator visiting the practitioner’s office under the guise of observing the nature and extent of the practice.

5. A letter accompanied by a purported proposed “Consent Order”, advising the practitioner of specific violations which the agency perceives that the practitioner committed in the practice of medicine. These type of communications are intended to outright scare the practitioner into signing a consent order under the false pretenses that the officials will allow him/her continue to practice medicine or dentistry unabated. The consent order is then used to find other violations and to ultimately lead to summary license revocation or other disciplinary charges being brought.

6. Conducting house to house interviews of patients based upon names and addresses gathered from the practice records.

7. Random audits of your medical records for unspecified purposes. Many states prohibit

6. Conducting house to house interviews of patients based upon names and addresses gathered from the practice records.

7. Random audits of your medical records for unspecified purposes. Many states prohibit “fishing expeditions” into the practitioner’s records. The practitioner has to be cognizant of these prohibition while responding to the state inquiries.

8. Random and spot audits of your practice structure.

9. Scheduling a “compliance conference” and ordering the practitioner to attend the same under the guise of a chance offered to explain your side of whatever subject the agencies are inquiring into. This preliminary step is usually a mandatory statutory step prescribed in various states as a prerequisite to filing formal charges.

10. Summary suspension of license pending revocation.

The practitioner’s response to the preliminary actions of the state and federal authorities must be commensurate and within the legal frame of the statutory and regulatory requirements governing the authority of the officials and the scope of the inquiry. The scope and purpose of the investigation must be immediately focused and the catchall “fishing expeditions” must be restrained

Many times, simply unaware of the governing law, the investigators and the regulatory attorneys act beyond the powers conferred upon them by the statutes and regulations of their respective states. In their haste and motivation to stamp out alternative, holistic and complementary medicine and dentistry, sometimes the state officials forget or are oblivious to the very same provisions of the law that govern their powers. For example, while some states allow for random wide spread audits a health practitioner’s medical or dental records, others have some severe restrictions on such practices. Many practitioners and attorneys get intimidated by administrative investigators and take the wrong steps at the beginning. Other practitioners may act too combative and in derogation of the provisions of the statutes in their respective states, winding up with additional disciplinary charges against them. A delicate balance must be struck in responding to preliminary actions of regulatory officials. A strong command of the provisions of the law governing the powers and practice of these officials in imperative in responding to the initial action of these officials.

I handled and am handling a variety of responses and aspects to preliminary administrative inquiries and actions throughout the country. While certain actions such as document impoundment raids and summary license suspensions are handled directly in emergency court challenges, the other administrative preliminary inquiries necessitate special analysis and responses so as to minimize the scope of the inquiry/investigation and potential damage to the practitioner and his/her practice. The net effect of the initial response can make the difference between the possible cessation of future proceedings and the dismissal of the investigation altogether on one hand and the continued prosecution of the health car and dentistry practitioner on the other.

My office provides superior legal services in evaluate the regulations and statutes of each state and provide a commensurate response to each official preliminary inquiry designed to minimize the scope of the inquiry and the course of future action.

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