A very brief overview of California Administrative Discipline process.

The moment an inspector from a licensing board (Medical Board, Dental Board, Board of Pharmacy) comes to your healthcare business, it is important to understand and always keep in mind what such visit can lead to. I cannot stress enough how many times we could have better helped our clients if they engaged us earlier in the process (and it would have cost much less too).

What triggers administrative process?

A visit by an inspector usually results in three outcomes:

(1) The best case scenario: the inspector does not find any violations and determines that the facility and provider are in full compliance with the applicable regulations.  In this case, the inspector issues Inspection Report explaining what was reviewed and provider’s compliance.

(2) Not so bad scenario (most common): the inspector finds some minor violations and issues a citation. Citations usually vary from $500 to $5,000 depending on a violation. The provider has a choice of paying or protesting the citation, which usually depends on the amount of the citation and applicable defenses. If you find yourself in this situation and decide to contest, you can request an informal conference with the Board to present any additional evidence or request an administrative hearing, starting the administrative process.

(3) Worst case scenario: After finding serious violations, the Board decides to revoke, suspend, or put your license on probation. No monetary penalties are imposed, however, if you cannot prove compliance, you will be required to pay investigative and legal costs of the Board. About a year after the inspection, a provider receives formal accusations, starting a formal administrative process.

Can you explain how the process works?

After formal accusations were filed, it is time to provide all mitigating and compliance  evidence, as well as present any defenses. After both parties produce evidence, the case is assigned to Office of Administrative Hearings (OAH). Keep in mind, OAH is a part of the executive branch and can only issue a proposed decision, which the Board can adopt or reject. As the result of the hearing, the Board may dismiss the case against a provider, put license on suspension, probation or both, or revoke the license.

Further Information:

If you have received formal accusations or an inspection report, review Board’s disciplinary guidelines, which explain the categories of discipline and likely outcomes. It will also explain the process in more detail.

Board of Pharmacy’ disciplinary guidelines can be found at: http://www.pharmacy.ca.gov/laws_regs/1760_guidelines.pdf

Medical Board’s guidelines: http://www.mbc.ca.gov/Enforcement/disciplinary_guide.pdf

Dental Board’s guidelines: http://www.dbc.ca.gov/formspubs/pub_dgml.pdf

Wishing all of you only “the best case scenarios,”