Question 1

What do I do if I have received a letter notifying me I am under investigation from my licensing board?

Accepted Answer

Don’t panic.  Most licensing boards are legally required to open an investigation upon receipt of a complaint against a licensee (assuming the Board has jurisdiction). ​ Don’t disregard timelines.  If you’ve received a letter of investigation you will be directed to respond in writing to the letter within a certain period of time and may also be directed to provide documents or other materials at the same time.  Most licensing boards are willing to provide a reasonable extension of time to respond if needed, but don’t let the deadline go by or simply ignore the letter.   Try not to be defensive.  It’s natural to want to defend yourself against allegations made against you, but the licensing board staff member/investigator is simply trying to gather information about the incident.  This is your initial opportunity to provide the licensing board with information regarding the issue in question and to explain your side of things; this is not the time to mount an aggressive defense. ​ Do seek legal assistance as quickly as possible.  While you may feel that you can respond to the letter on your own, legal counsel experienced in administrative licensing matters can help ensure that the response letter sent to the licensing board addresses not only all factual issues involved in the case, but legal issues, as well.

Question 2

The Often-Overlooked Consequences of Licensing Board Actions

Accepted Answer

A formal administrative action initiated by a licensing board against an individual holding a professional license or certificate may result in the imposition of disciplinary action.  Such discipline can range from public reprimands and fines to suspension or revocation of a license/certificate.  If discipline is imposed after a hearing or through a negotiated settlement, it is crucial to be aware of potential ancillary consequences of that discipline.  ​ Reciprocal Actions Reciprocal actions are just one of the potential issues that can arise after a board has imposed discipline against a licensee or certificate holder.  Reciprocal actions are disciplinary actions taken by other boards solely based on the action taken by the initial board.  While laws vary, the great majority of professional licensing boards in almost all states have a provision in their statutes or regulations allowing for discipline to be imposed after another state has imposed discipline against one of their licensees.  These cases are almost impossible to mount a defense against as typically the only thing needed to prove the secondary case is a copy of the filed order imposing discipline from the initial board.   For individuals who hold licenses in multiple states, this can result in a flood of additional disciplinary action, including in some states that will take reciprocal action even if the licensee’s license is lapsed or otherwise inactive.   While reciprocal actions are typically based only on the fact that discipline was taken by another board, it is crucial to mitigate the potential for further action by determining whether there is an affirmative duty to report discipline taken before the license renewal period in another state.  Some states require that a licensee report within a certain time period, sometimes ten to thirty days, any formal disciplinary imposed in another state.  Failure to provide a timely disclosure could result in the other state taking further action for failing to properly disclose.   Finally, while reciprocal actions are most frequently associated with actions taken by an out-of-state licensing board, there can be reciprocal action taken by other boards in-state as well.  For instance, in Nevada, if a healthcare provider was disciplined by their primary licensing board for an issue pertaining to dangerous drugs or controlled substances, they may find themselves facing action against their state-controlled substance or dispensing registrations.   It is vital to understand what the potential consequences may be from another state board when determining the best course of action when faced with pending disciplinary proceedings mitigation that triggers reciprocal actions stemming from the initial action. ​ NPDB The National Practitioner Data Bank (NPDB) is an acronym well known to most physicians.  However, many individuals whose professions require a license issued by a state body are unaware that they may be impacted by the NPDB as well.  The NPDB, in the simplest terms, is a data bank created by federal law which requires certain entities, such as state licensing boards, medical facilities, state Medicaid fraud units, among a myriad of others, to report certain actions to the NDPB.  The regulations governing the NPDB (found at 45 CFR part 60) dictate what entities must report adverse actions and against whom.  Disciplinary action taken against a licensee must, in almost all circumstances, is one of the actions which must be reported to the NPDB by a state licensing entity.  This includes actions taken against physicians, nurses, marriage and family therapists, opticians, audiologists, dentists, and pharmacists, just to name a very few of the professions subject to NPDB reporting. ​ While the NPDB is not accessible to the general public, health plans, professional associations and medical facilities are among those entities which are entitled to query the database for information related to an individual who may be applying for or renewing facility staff privileges, applying for employment (in certain entities), updating credentials with an insurance carrier, or perhaps applying for a license in another state.  Adverse information showing on the NPDB can potentially impact the ability of an individual to obtain credentials or licenses with other entities or maintain those that they may already hold. ​ This is certainly an oversimplification of the NPDB and its potential impacts.  However, individuals who do hold licenses to practice their profession should be aware of the potential for a report to be filed with NPDB should their licensing board taken disciplinary action against them. ​ Professional Associations/Specialty Boards In addition to holding the necessary licenses to practice their profession, many individuals hold additional certifications that may be issued by professional associations or specialty boards.  Such certifications may be issued by entities such as the member boards of the American Board of Medical Specialties, the American Academy of Nurse Practitioners Certification or the National Board for Certified Counselors as examples.  Holding such certifications may be required for employment, to hold credentials at facilities or may be prerequisites to practicing in certain specialty fields within a profession.  These organizations all have their own rules and regulations and generally have a disciplinary policy that allows the organization to initiate disciplinary action, which can include revocation of a certificate, against a member/certificate holder.   For most of these organizations, certain state licensing board actions are grounds for initiating their own disciplinary process which can have far reaching effects on an individual’s ability to practice their profession.  Individuals who hold such certifications should always be aware of whether they are required to report an action taken by a state licensing entity to the certifying organization to avoid additional repercussions. ​ These are only three examples of the unintended consequences of state licensing actions.  Individuals who are facing potential action by their licensing board are strongly encouraged to seek legal counsel familiar with these issues to assist in navigating the additional consequences associated with licensing board actions.

Question 3

Defending Your Occupational License, Without Being Defensive"

Accepted Answer

Receiving a notice that you are under investigation by your occupational licensing board is an extremely stressful event.  The initial reaction of many receiving such a notice is to panic that this means the end of their professional career.  The good news is most frequently that is not the case.  Notices of investigation from an occupational licensing board generally request that the recipient respond to the allegations contained in the notice.  While it is of course natural to want to vigorously defend yourself from any allegation, it is critical in responding to a notice of investigation to avoid becoming defensive or overly aggressive in the response.   Crucial facts that a board may need to know about the matter often get lost in overzealous responses.   Except in those circumstances when a board itself initiates an investigative complaint, boards do not pick and choose who to investigate.  For instance, both the governing statutes for the Nevada State Board of Medical Examiners and the Nevada State Board of Nursing provide that those Boards “shall” conduct an investigation when they receive a complaint about a licensee with limited exceptions.  When a board receives a complaint against one of its licensees, it has received only one side, and often only a partial bit of the story.  A response to a notice of investigation is the license holder’s opportunity to provide the board with their side of things, to dispute or clarify allegations that may have been raised.  Implying that the allegations are ridiculous or that the suspected complainant (most times the identity of the complainant is withheld) is vindictive for some reason does not provide the board with the facts.  Context is needed to determine whether the allegations raised in the complaint require more formal disciplinary action or whether the investigation may be closed.   Before responding to a notice of a board investigation, it’s wise to take a step back and think critically about what information the board needs to truly evaluate the matter.  Additionally, it is highly recommended that legal counsel be consulted before submitting any response to a board investigation.  Legal counsel experienced in administrative/licensing matters can help identify potential issues that may need to be addressed proactively and pitfalls to avoid.   Further, legal counsel can respond to alleged violations of statute and regulation which are typically included in the notice of investigation.  Often professional liability policies cover legal costs associated with responding to board matters, with certain restrictions, so it’s good to check your policy to ascertain whether it can help defer all or some legal costs.

Question 4

What do I do after I've responded to the licensing board's letter of investigation?

Accepted Answer

Don’t expect a response immediately.  While most licensing boards attempt to review investigative cases as quickly as possible, many boards engage in some independent investigation regarding the allegations contained in the complaint which may take some time. Also, there may be several cases that must be reviewed prior to your specific investigative matter. 
Upon reviewing the investigative case, most licensing boards (depending on the laws governing the board) will notify you if the matter is being closed or if formal disciplinary action is being initiated in the matter.

Question 5

What happens if my licensing board initiates formal disciplinary action against me?

Accepted Answer

If you have not already retained counsel, do so immediately.  You should not attempt to defend yourself in a formal disciplinary matter.  Every state licensing board has slightly different procedural processes for formal disciplinary matters, but most formal disciplinary complaints are resolved either through a settlement/consent agreement or after a formal hearing is held.  Legal counsel can advise you regarding your options for resolution and the risks and benefits of each option.

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