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What Happens During OPMC Investigation

May 17, 2022 by Norman Spencer

New York medical license defense lawyers of Norman Spencer Law Group PC have successfully represented numerous physicians before the OPMC (Office of Professional Medical Conduct) in disciplinary proceedings for professional misconduct.

When we represent health care professionals and medical professionals matters with the New York State Department of Health’s Office of Professional Medical Conduct – OPMC, we always strive to resolve issues quickly before the situation escalates to possible physician discipline with the physician’s license being suspended for professional misconduct. We would begin legal counsel through the investigatory process of interviews and document reviews. We will then present our position to the OPMC investigator – often convincing the OPMC investigators to terminate the case before it reaches the next level.

What Happens When a Professional or Medical Misconduct Complaint is Filed Against a New York Physician?

The professional medical conduct and disciplinary action process for New York physicians, physician assistants, and licensed health professionals usually begins with a complaint filed with the OPMC. A complaint can include:

  • Negligence of patient care
  • Refusing to provide medical care based on a patient’s race or national origin
  • Performing professional services that were unauthorized, treating patients with a suspended or inactive license
  • Permitting unlicensed persons to treat patients when it requires a medical license.
  • Billing fraud
  • Not updating medical charts or patient charts, etc.

The OPMC will investigate any complaint alleging professional misconduct. Office practice issues, rude behavior from the medical staff, or the physician’s poor “bedside manner” do not fall under their jurisdiction. During OPMC investigations, OPMC investigators may interview the physician and potential witnesses, such as the county medical society, subpoena medical records or patient records, etc.

When the OPMC investigation is concluded and there appears to be sufficient evidence suggesting medical misconduct, the case investigator will refer the investigative report to an investigation committee that consists of two physicians of the special OPMC two-thirds physicians and one non-physician panel. The committee will make a recommendation regarding the next step. For example, they may determine no cause for further professional discipline, and the case will be closed. Alternatively, they may demand an additional investigation, issue an administrative warning to the licensee, or require the licensee to undergo a physical or psychiatric evaluation for mental illness or a similar outcome.

The committee may recommend that formal charges against the licensee be filed. In this case, an administrative hearing will be scheduled. Many physicians or physician assistants seek to settle the case by a Consent Agreement instead of a formal administrative hearing.

Under certain circumstances, when the New York Department of Health determines that a physician is an imminent threat to the health, safety, and welfare of the public, or in the case the licensee has been convicted of a felony, there may be a temporary medical license suspension before the administrative hearing.

When a New York physician is found guilty of professional misconduct, either after a formal hearing or by consent agreement, they will be subject to a variety of potential penalties, including:

  • Revocation of license
  • Full or partial suspension of license with or without conditions
  • Annulment of license
  • A maximum fine of $10,000 for each charge of misconduct
  • Public reprimand
  • Community service
  • A requirement of additional education and training.

 

Can a Physician Appeal the Panel’s Finding?

There are two ways to appeal the hearing outcome. First, there is an administrative avenue where both the physician and the State may appeal the hearing outcome to the Administrative Review Board (ARB). It is the only administrative appellate remedy. The Board consists of three physicians and two laypersons. An Administrative Law Judge oversees the process. Both parties may file legal briefs, and the Board will issue its decision within 45 days after the briefs are filed.

Another avenue is the judicial one. The panel’s hearing findings and/or the ARB’s determination may be appealed by bringing an Article 78 action in the Appellate Division of the New York Superior Court.

What is the Right Way to Respond to an OPMC Investigation?

When you discover that you are the subject of an OPMC investigation, you must consult with an experienced attorney who has handled OPMC actions.

As a licensee, you are obligated to cooperate with OPMC investigations. Failure to cooperate is professional misconduct on its own. Cooperation, however, does not mean forfeiting your rights, and you do have the right to have legal counsel present before discussing the case with the OPMC investigator. You do not have to speak with the investigators.

It is essential to understand that every word you say and any information you provide will become part of the investigative report comprised by the investigator. It will not matter that you did not say or mean exactly what the report says; and it will be your word against the investigator, and the odds will not be in your favor. Moreover, you may be subject to additional charges based only on your voluntary statements.

When approached by an OPMC investigator, the only correct way to handle the situation is to assure the investigator that you are willing to comply with the investigation and insist on discussing the matter with your attorney first. Your experienced counsel will then contact the OPMC investigator on your behalf, and this will save you from implicating admissions that could make the case more difficult to resolve. Participation in an OPMC interview without prior legal consultation and preparation may be fatal to the outcome of your case and your future ability to practice medicine.

When you are under an OPMC investigation, call our experienced New York OPMC attorneys for immediate consultation!

Filed Under: Blog

What Triggers Medicaid Fraud Investigations In New York?

May 16, 2022 by Norman Spencer

Various Practices That Can Trigger A Medicaid Fraud Investigation For Healthcare Providers and Recipients

Medicaid Services Providers in New York

This article is about what triggers Medicaid fraud investigations for NY healthcare providers and recipients. If you are a Medicaid Services Provider, here are some of the reasons you can be investigated for Medicaid fraud:

If you are a Medicaid Services Provider, here are some of the reasons you can be investigated for Medicaid fraud:

  • Bill Medicaid for services that have never been provided
  • Falsifying patients’ diagnoses to justify tests or other procedures that aren’t medically necessary
  • Misrepresenting medical procedures performed to obtain payment for non-covered services
  • Upcoding: billing for a more costly service than the one performed
  • Unbundling: billing each stage of a procedure as if it were a separate procedure
  • Filing claims for fake services and medical conditions
  • Coverage claims for non-existent illnesses
  • Filing claims for fake and staged car accidents in NY
  • Filing claims for medical care coverage for staged, fraudulent auto accident injuries
  • Illegal kickbacks
  • Illegal fee sharing
  • Billing for services provided by unlicensed personnel in violation of Medicaid rules.

[Read more…] about What Triggers Medicaid Fraud Investigations In New York?

Filed Under: Blog

Speedy Trial Law in New York

March 28, 2021 by Norman Spencer

A defendant who’s been charged in a criminal case is entitled to a speedy trial under the state of New York Criminal Procedure Law Section 30.30. The reasoning is that it’s unfair to have criminal charges pending indefinitely and that defendants have the right to a trial. The statute was created to prevent unreasonable delays.
[Read more…] about Speedy Trial Law in New York

Filed Under: Blog Tagged With: featured

Representing Yourself in Court: Don’t Do It!

March 28, 2021 by Norman Spencer

When you’re charged with a crime, you’ll nearly always have best results by getting a lawyer. The majority of defendants in criminal court receive lawyer representation, particularly when a prison sentence or jail time are possible consequences. It’s hard for people to handle their own criminal cases with competence. No comprehensive statistics exist regarding the number of people who represent themselves, but it’s estimated that more than 99 percent of defendants get a lawyer.

Books Don’t Have Everything

One of the reasons it’s so difficult to self-represent is because of how different reading about law and practicing it are. There are all kinds of books that will explain the different laws and crimes on the record. These laws will have fixed punishments for violations, and they’ll also make courtroom procedures mandated.

Many defendants make the mistake of thinking that these books have everything they need to know. They believe that if they become familiar with the law and crime, they can defend themselves. But unfortunately, criminal law can’t be practiced effectively through just book study. Experienced defense attorneys understand that criminal law is a complicated group of unpredictable systems.

Prosecutors Have More Power Than You Think

One of the things that prosecutors have is a power called “prosecutorial discretion.” This power lets them decide whether criminal charges should be filed, along with the exact charges being filed. This power determines the majority of what occurs in criminal court.

The prosecutor has a great deal of influence over how a case resolves. Each particular prosecutor’s decisions will affect the way the case progresses. Sometimes a person will be accused of one crime. But in other cases, prosecutors will charge a defendant with multiple crimes based on the way their actions can be slanted. Some of these crimes might be minor, while others might be more serious.

Pressure from the Community

One important thing is not to underestimate how big a difference your community makes. Every community has unique politics, values, and pressures. Police want to have their crime reports result in a charge. Prosecutors want to have success in their jobs. Judges might want to be re-elected. All of these things combine to work against you in the courtroom.

In some cases, certain crimes may get a great deal of attention. The public might be putting pressure on the prosecutor and judge to harshly prosecute people charged with these crimes. It’s true that the system isn’t supposed to give in to these pressures, but that’s not always the case. A defense lawyer will be familiar with your local environment, so they’ll understand the way pressure might affect the outcome of your case.

Criminal law is a vast world with complicated rules that you don’t know. You need a NYC DWI lawyer to help guide you through the justice system and protect you against those who wish to do you harm.

What Do Attorneys Do?

No matter how educated or smart you may be, the justice system is stacked against you. Everything is working to prove you guilty from the moment of your arrest. It’s almost impossible to represent yourself competently. Defense lawyers are specialists who understand how to approach each criminal case. They can deal with whatever variables arise, explain to you your options, and ensure you make an informed decision going forward. They can also keep you from accidentally incriminating yourself when talking to the police or prosecution.

A criminal lawyer will do a great deal more than pose questions to the court witnesses. They’ll also be responsible for negotiating with prosecutors during every step of the criminal process. They’ll take your needs into account when they help formulate sentencing programs.

Lawyers have gone to school and studied extensively to understand the legal rules in their state. Ideally, your lawyer will have experience representing people in similar situations to your own. They will have a good sense of how a routine case unfolds. If you represent yourself, you may quickly find yourself overwhelmed by things a nyc criminal lawyer wouldn’t flinch at.

If you’ve been accused of a crime, you should get in contact with an experienced criminal lawyer as soon as you can.

Filed Under: Uncategorized

Can I get an old felony expunged?

March 28, 2021 by Norman Spencer

There is a lot of uncertainty around the question of expungement. Can a felony be expunged, and if so, is expungement only for certain types of felonies? Does the conviction have to be old, and if so, how old? 

This article will clear up a lot of myths and misconceptions about expungement and will lay out the basic steps to expunge a criminal conviction.

Can felonies get expunged?

Yes and no. Yes, in certain states certain felonies can be expunged depending on a variety of other factors, but no, not all felonies qualify for expungement. Before discussing which felonies are likely to qualify for expungement and the process for expunging a felony conviction, it’s important to understand what expungement is.

What is expungement?

Expungement is a way of limiting access to your criminal record. Expungement means the record is destroyed.

Generally speaking, the court that grants the expungement will impound the physical file and delete the electronic file from their computers so that it no longer exists. The court will also order that any interested police departments must destroy all records pertaining to that case.

Expungement vs. Sealing a Criminal Record

Having a criminal conviction expunged is different from having a criminal record sealed.

Sealing means the record is kept confidential and typically can only be accessed in limited circumstances relating to law enforcement and sentencing. That said, some states allow employers, like schools and financial institutions, to obtain sealed criminal records in connection with employment-related criminal background checks.

What types of felonies can be expunged?

The type of felonies that can be expunged depends on the state you live in. Not all states allow expungement.

For example, New York does not allow expungement at all. Instead, New York allows certain types of criminal records to be sealed under specific conditions. 

Even though New York law allows for the sealing of criminal records, there is a limit of two criminal convictions that can be sealed, and only one of them can be a felony.

Illinois allows expungement but has very strict requirements. In Illinois, you cannot obtain expungement for any crime that resulted in a conviction. A conviction usually means a finding of guilt resulting in a sentence of jail time, probation, conditional discharge, time served, fines, and also supervisions or qualified probations that have not been completed.

For states like Illinois, that leaves expungement available either in cases where there has been an arrest or charge of a crime without a conviction, or in cases where a conviction was ultimately reversed, vacated, or pardoned.

Conversely, some states have more liberal expungement laws. In fact, California has one of the most lenient expungement laws in the country. If you’ve been convicted of a misdemeanor or certain felonies in California, you’re allowed to petition the court to set aside the conviction and dismiss the case.

Even in states that allow it, expungement is only available in very limited situations.

In most states, serious felonies and aggravated crimes, such as murder, manslaughter, armed robbery, rape and other sex crimes, and crimes against minors may never be eligible for expungement. 

On the other hand, a shoplifting felony for grand larceny (i.e., theft over a certain amount, such as $1,000) is an example of an easier felony to expunge. 

In more conservative states, crimes like DUI, reckless driving, or cruelty to animals may never be able to be expunged. As for drug-related felonies, it depends on the classification of the drug crime. A felony conviction for possession of a controlled substance may be easier to expunge than the felony of drug possession with the intent to distribute. 

When can you get a felony expunged?

Again, the time requirements for seeking an expungement varies from state to state. Sometimes a petition to expunge can be filed immediately, and other times there may be a statutory waiting period.

Consider Kentucky, where the law states that an application for expungement cannot be filed sooner than five years after the completion of the person’s sentence or five years after the completion of the person’s probation or parole, whichever occurs later.

Many states require the completion of any supervision or probation, and the payment of all fines or retribution before a person can qualify for expungement. In those cases, the waiting period normally starts from the date of completing supervision, probation or retribution.

In some states, if you were sent to prison, this may automatically disqualify you, but other states may still allow expungement even if you served jail time so long as you can show a lengthy amount of time has passed without new criminal charges and that you are a contributing, law-abiding member of society.

What are the steps to getting a felony expunged?

If you’re looking to get a felony expunged, the very first step you should take is to get copies of your criminal records. You’ll need to review your criminal history to determine whether you can meet your state’s requirements. 

That brings you to the next step, which is researching the expungement laws of your particular state.

If your felony or misdemeanor qualifies for expungement and the timing requirement has been met, the process of expungement formally starts with the filing of a petition or application with the proper criminal court.

Many states also require you to include your criminal record, proof of your completion of probation, supervision and/or retribution, and other paperwork with the petition, all of which will be submitted for a judge’s review and decision.

Most states will require you to send notice of your expungement request to the original law enforcement agencies, the district attorney’s office that handled your case, and the state agency that manages criminal histories for your state.

Most jurisdictions also require that a fee be paid in conjunction with the filing of the petition or application.

What are the benefits of expunging a criminal record?

A significant benefit of expungement is the record of the conviction is destroyed and removed from all files and databases. That means the felony no longer exists and does not have to be disclosed as a criminal arrest or conviction on job applications, loan and other financial documents, or other inquiries.

But maybe the most important benefit to expunging a criminal record is the peace of mind it brings knowing that a negative and unfavorable part of your past can be left in the past and will not haunt you for life. Your slate will have been wiped clean, so to speak. And who wouldn’t want that?

Lauren Blair is a lawyer who writes for the legal counsel and insurance education site, FreeAdvice.com. She has over 25 years of experience in litigation.

Filed Under: Uncategorized

Legal Documents and Licenses Immigrants Need in the U.S.

March 27, 2021 by Norman Spencer

There are a lot of documents and legal papers that immigrants need to keep track of when coming to America, but once they are here, the need for documentation isn’t over. From drivers’ licenses to insurance and work permits, there are plenty of legal documents that immigrants will need to have on hand.

This article will go through various work permits and papers as well as the ins and outs of U.S. car insurance for foreigners. By the end, you will know what legal documents and licenses you need to prioritize getting once you arrive in the U.S.

Get Your Green Card

If you want to live and work permanently in the U.S., you will need to prioritize getting your green card.

First, you will need to find out if you are eligible by looking at the eligibility categories. Then, you will need to file Form I-485 and provide supporting documents and fees (listed in the form). Finally, you have an interview with the U.S. Citizenship and Immigration Services (USCIS).

If your current card expired or is going to expire within six months, you should get it renewed. You can check your case status online at USCIS.gov.

Find the Right Tax Documents

While immigration law differentiates between immigrants, nonimmigrants, and undocumented aliens, tax law only differentiates between resident and nonresident aliens. 

Resident aliens are generally taxed the same way that U.S. citizens are. Nonresident aliens have to follow some specific tax rules in the Internal Revenue Code (IRC).

It is extremely important to pay taxes properly so you don’t get convicted of tax fraud. A tax fraud defendant may be deported if they are not a U.S. citizen.

You will also have to report any worldwide income, including income from foreign bank and securities accounts, through the schedule B attachment form.

Non-U.S. citizens should review Publication 519, which helps you determine your filing status. Publication 54 contains special tax rules for resident aliens who work abroad or earn income from a foreign country. If it’s your first year in America, you may have to file taxes for your previous job at home.

Nonresident immigrants are generally taxed on their U.S. source income only and may qualify for tax relief through a tax treaty benefit. Resident aliens do not qualify for this benefit and are taxed on their worldwide income.

The tax documents you will most likely need to file include:

  • 1040-ES Estimated Tax for Individuals
  • 1040-X Amended U.S. Individual Income Tax Return
  • 2350 Application for Extension of Time to File U.S. Income Tax Return
  • 2555 Foreign Earned Income
  • 4868 Application for Automatic Extension of Time to File U.S. Individual Income Tax Return
  • 8822 Change of Address

Though the specifics may vary, so be sure to use Publication 519 to discover your filing status and refer to the IRS website for more information. You can also contact a tax attorney for help.

Prioritize Your Driver’s License

If you drive in the U.S., you will need a valid driver’s license, even if you aren’t a citizen. Fifteen states will allow those who are not citizens to get a drivers’ license, while others require you to have an International Driving Permit (IDP) and a license from your own country. You would have needed to get the IDP and home country license before coming to America.

The states that allow anyone to get a license regardless of whether they are a legal citizen include California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, New Mexico, Nevada, New York, New Jersey, Oregon, Utah, Vermont, and Washington.

Check your state’s requirements to see what you need to bring with you to get a license. Not all of them require proof of residency. You can drive anywhere in the United States if you have a license from one of the states.

Find Proper Auto Insurance Coverage

In addition to a driver’s license, immigrants will also need auto insurance to be legally allowed to drive their own car in the U.S. like citizens do. While getting insurance as a non-citizen can be difficult, it is nonetheless possible if you have your driver’s license or IDP.

Many companies will require a state-issued driver’s license before issuing an insurance policy. Others will charge higher rates to immigrants than they would to citizens.

Currently, Farmers and Progressive both offer auto insurance policies to those with international licenses. There are also some companies like Bristol West and Kemper that will insure foreign drivers. Be sure to compare several quotes to get the best coverage.

Compare at least three companies, and check to make sure that the companies you are seeking quotes from are licensed in the state you will be in. Start with your basic liability insurance needs and go up from there. You can choose to get a temporary auto insurance plan if you are staying for a shorter amount of time.

Learn About Business Licenses

Knowing what you can and can’t do regarding business licenses can be tricky, especially if you happen to be an undocumented immigrant. Many business owners start businesses anyway, and U.S. immigration law does not bar undocumented immigrants from owning a business, though employing an undocumented worker is illegal.

Immigrant investors may be able to get an EB-5 Visa and use the existing visa system to declare their immigration status. If you have a business that is less than a year old and has less than four employees, or if you are moving here to start a business, you will need the E-2 visa.

Business owners need to register their businesses in a specific state. Some states like Delaware have flexible rules for corporate structures and entities and do not require a bank account or local address. Then, they need to fill out a certificate of incorporation.

Certain states like New York have very specific requirements for certain types of businesses, such as pharmacies or barber shops. Look into state-specific requirements for your business type.

You will also need to get an Employer Identification Number for tax purposes and get a business license and bank account. Consider talking to a financial advisor or immigration business advisor for help.

Deborah writes and researches about immigration and insurance for the car insurance comparison site, CarInsuranceComparison.com.

Filed Under: Uncategorized

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