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Seven Things To Know When You Receive A Notice Of Investigation From The Department Of Health

Ophthalmologists and Optometrists

The attorneys of The Health Law Firm represent Ophthalmologists and Optometrists in a number of different legal matters. We appear before the Board of Optometry. We represent ophthalmologists and optometrists in disciplinary matters, in credentialing matters, in licensing matters and in defending against malpractice claims and suits.

If you receive a letter from the Department of Health (DOH) notifying you that you are being investigated, this is a very serious matter. Get an attorney who is experienced in such matters.

Here is What You Didn’t Know:

1.  You are not required to make any statement to the investigator, oral or written, and     you should not do so.

2.  You do not have to send the investigator a copy of your resume, and you should not     do so.

3.  You have a Fifth Amendment right to refuse to say or do anything that might incriminate yourself. This applies to administrative investigations.

4.  If you have malpractice insurance (professional liability insurance) it may pay for     your legal defense in an investigation. Use it!

5.  You have the right to obtain a copy of the investigation after it is completed and to file a rebuttal to it.

Other Things About This That You Probably Don’t Know:

1.  You should never agree to voluntarily relinquish your license if any investigation is pending. This will be treated the same as a disciplinary revocation and the consequences will be severe. (see below.)

2.  You should never request an informal hearing. An informal hearing means you are admitting all of the allegations against you are true (pleading guilty), and you are not disputing them.

3.  If disciplinary action is taken against you (including a “voluntary” relinquishment) this will be reported to your national certification board and it will most likely revoke your national certification.

4.  If you have licenses in other states or in other health professions, this will be reported and they will commence investigations and disciplinary actions.

5. It will be reported to the National Practitioner Data Bank (NPDB) and the Office of         the Inspector General (OIG). The OIG will then commence action to exclude you from the Medicare Program. If excluded, it is likely that you will not be able to work in health care or for any government contractor in any capacity.

Our attorneys have been very successful in representing ophthalmologists and optometrists. We may be able to have your case dismissed by the Probable Cause Panel of the Board. If not, we may be able to obtain a favorable result for you in a formal administrative hearing (like a trial) where the government has to prove the case against you, and you are able to defend yourself.

You spent a great deal of time and money to get your professional education and your profession licenses. Don’t give it all up without getting advice from experienced attorneys.

Visit our blog on ophthalmology and optometry law at

Information Regarding Insurance Coverage.

Our recommendation is that every ophthalmologist and optometrist carry professional liability insurance that includes professional license defense coverage (sometimes called disciplinary defense, license defense, administrative hearing coverage or broad coverage). Often this type of insurance coverage is included in most professional liability policies; however, if it is not, it can often be added as a rider to the insurance policy for a slight additional charge. You should be sure that your coverage for professional license defense is at least $25,000, and we recommend that you increase it to $50,000. You should also request and obtain “broad form coverage” that includes coverage of your legal fees for defense of all administrative or governmental proceedings, including Medicare audits, Medicaid audits, EEOC complaints and other types of governmental actions that could be initiated against you.

If you are required to defend yourself at a formal administrative hearing, this is similar to a medical malpractice trial in civil court. Attorney’s fees, court reporter costs, expert witness fees and other costs and fees can rapidly mount up to the point where most ophthalmologists and optometrists could not afford to defend themselves. If you are then required to appeal an adverse outcome, the appeal alone could cost $10,000.

Don’t wait to purchase this type of insurance until there is a complaint filed against you, because then it is too late to purchase it. Complaints can be initiated against you based solely on anonymous calls to the Department of Health Hotline, newspaper reports, prior arrest reports, disgruntled patients, disgruntled insurance companies, competitors or other sources. Once and investigation is initiated, you should obtain legal representation right away. Without insurance, you probably will not be able to afford to hire a competent, experienced health lawyer to defend you. Always go to a board certified health lawyer experienced in representing ophthalmologists and optometrists.

For a chart depicting the Florida Department of Health investigation process, click here.