Licensed physical therapists in New York can face myriad legal issues that range from accusations of professional misconduct to federal criminal charges. The healthcare lawyers at Norman Spencer & Associates have not only seen a wide range of issues arise in physical therapy field, but we’ve helped many clients get through them successfully.

Physical therapists have worked hard to earn their degrees and build their reputations, but they can be vulnerable to many legal difficulties that abound in the healthcare industry. These difficulties are often not something physical therapists would ever anticipate they’d have to face. A single error can result to accusations of professional misconduct, which then lead to licensing consequences or even criminal charges. As healthcare lawyers with extensive experience, we’ve helped clients deal with all types of legal issues.

Some of the most common for New York physical therapists include:

• Investigations and prosecutions from the Office of Professional Discipline
• Audits and exclusions from the Office of Medicaid Inspector General
• Investigations from the Medicaid Fraud Control Unit
• Federal criminal investigations relating to no-fault insurance

As licensed professionals, physical therapists are held responsible to the code of professional conduct outlined by law. New York is home to nearly 40 types of conduct that are classified as professional misconduct. Being accused of any one of them can result in disciplinary action by the New York state licensing authority.

Some of the most common misconduct charges we’ve seen physical therapists face include:

• Practicing with incompetence or negligence
• Unlicensed practice, especially when physical therapists perform massage or acupuncture
• Fraudulent practice
• Crime convictions

Investigations from the Office of Professional Discipline (OPD) can be triggered by any number of occurrences. These range from a patient complaint to an anonymous report, with most anonymous reports filed by competitors. Regardless of what the complaint is or where it came from, each one results in an inquiry.

A professional misconduct conviction can lead to license suspension or even revocation, effectively putting a halt to your ability to practice. If your physical therapy practice receives a letter from an OPD investigator, it’s crucial you don’t try to resolve the issue yourself. Even attempting to do so can jeopardize your case. Instead, call the lawyers at Norman Spencer Law Group to discuss your options. Our attorneys have successfully represented hundreds of clients facing the OPD at all stages of disciplinary proceedings. We’ve not only effectively helped clients through their cases, but we’ve also earned the respect of the investigators, prosecutors and clients themselves.

Audits and exclusions by the New York Office of Medicaid Inspector General (OMIG) are other common issues with which we’ve helped many physical therapists. OMIG is responsible for operating the Medicaid program in New York, and the agency has the authority to perform many functions. These include conducting investigations and audits, referring cases for criminal prosecution and litigation, and excluding physical therapists and other practitioners from participating in Medicaid.

Due to the extreme complexity of OMIG cases, we recommend securing professional legal guidance prior to communicating with investigators and auditors. A mishandled audit can end unfavorably for the physical therapist, with penalties that can extend into the range of tens or hundreds of thousands of dollars. Additionally, Medicaid payments can be withheld and the case may be referred by OMIG to the attorney general’s office for possible criminal charges to be filed.

OMIG has the authority to exclude any provider from Medicaid if the office believes the provider’s participation is a danger to the program. Exclusions can occur for practitioners found guilty of professional misconduct or arrested for healthcare-related fraud. Physical therapists excluded from Medicaid often find their career complicated, since they can no longer work in any facility that bills Medicaid. Our healthcare attorneys have handled many such cases, and we can guide physical therapists through this stressful and complex process.

The law firm of Norman Spencer Law Group has helped a number of healthcare professionals through criminal proceedings in federal and state courts. One of the most common issues in this arena is insurance fraud, particularly no-fault insurance fraud cases in federal court. Unfortunately, we know of many New York physical therapists charged with insurance fraud that have ended up with prison terms, the loss of their professional licenses and, by default, the end of their physical therapy careers.

New York’s Medicaid Fraud Control Unit (MFCU) is another agency that aggressively prosecutes physical therapists. As part of the attorney general’s office, MFCU is responsible for investigating and prosecuting Medicaid fraud cases involving New York healthcare professionals in state courts. MFCU cases can arise from a referral by OMIG or another agency.

Physical therapists that are approached by Medicaid Fraud Control Unit investigators, the FBI or other law enforcement agents need to be on guard. It’s best if you don’t discuss anything with these agents. Nor do you need to hand over any documents unless they have a warrant. Instead, ask for their business card and immediately call our office. Also call our office if you’re a New York physical therapist needing legal counsel for other state or federal crimes.