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

VA Physician and Health Professional Legal Representation

Veterans Administration (VA) Physician and Employee Legal Representation

The attorneys of The Health Law Firm routinely represent VA physicians, psychologists, nurse practitioners, mental health counselors, social workers, nurses, pharmacists, and other health professionals.

VA Handbook 1100.19, Credentialing and Privileging, requires that the VA hospital to afford you due process of law and fundamental fairness at every step of the process in any clinical privileges action.  This includes:

  1. Timely advance notice of the specific allegations made against you;
  2. The evidence that is to be used against you;
  3. Representation by an attorney for the proceedings;
  4. Advance notice of witnesses and documents that may be used against you;
  5. The opportunity to prepare a defense to the allegations;
  6. The right to cross-examine witnesses;
  7. The right to introduce evidence (documents and witnesses, including expert witnesses) in your defense;
  8. A hearing before a neutral and unbiased hearing panel;  and
  9. Other such rights.

Attorneys who are not familiar with such hearings may be unaware of your rights or how to properly exercise and safeguard them.

Don’t seek legal advice from your colleagues, from your accountant or from an attorney who does not specialize in health law and clinical privileges matters. Also, we don’t recommend shopping around for the cheapest attorney you can find.

Please do not hire a personal injury attorney, a civil litigation attorney, an employment law attorney or any other attorney without health law experience. Your professional life, career and medical license are at stake. You are in the fight of your life. Treat it as such.

If you were diagnosed with a brain tumor, would you attempt to perform your own brain surgery? Would you shop around to find the cheapest neurosurgeon to perform the surgery? Or would you look for the best? Yet, physicians routinely believe they can represent themselves in such matters. In our experience, this simply is not the case.

Far too frequently we are contacted by physicians after the investigation has been completed, after the hearing has been held and after the physician’s clinical privileges have been revoked. Except for an appeal on very narrow grounds, little can be done.

If the VA revokes your clinical privileges, by regulation, this will be reported to the NPDB and to every state in which you have a license. The NPDB report remains on your file for 50 years. Any time in the future you apply for clinical privileges, for a medical license or for medical malpractice insurance, this report will come up and cause you serious problems. It is extremely difficult, if not impossible, to obtain employment or to obtain clinical privileges in any hospital or institution with such an adverse NPDB report in your file. Additionally, any state in which you hold a license will also most likely open an investigation against your medical license based on the adverse NPDB report.

NPDB reports can be mitigated by filing an explanatory rebuttal (as is your right) or by filing a request for a Secretarial Review (appeal) or both. We can do this for you. However, it is easiest and best to prevent a NPDB report from being filed to begin with.

We represent VA health professionals in hearings and proceedings held pursuant to VHA Directive 1100.18, VHA Directive 1100.19, VHA Directive 1100.20, and VHA Directive 1350.

Statements in VA Investigations of Complaints of Adverse Care

Often a VA physician or other health professional will receive correspondence from the VA advising that an investigation regarding adverse care is being conducted and you are requested to provide a written statement about the care. This also frequently happens to those who are no longer VA employees. This matter usually occurs if there has been a Federal Tort Claim filed by a patient or the patient’s next of kin or estate, but may also be prompted by other investigations or inquiries, such as an Inspector General’s investigation or a Congressional inquiry.

It is very important to obtain the relevant documents to review prior to making the statement and to prepare a well-organized, well-written, professional letter back to the VA explaining your involvement in detail. This can help prevent later adverse action against you or and adverse NPDB report being filed against you (see immediately below).

We routinely assist VA physicians and other employees and ex-employees in obtaining records and preparing such statements.

Responding to and Rebutting Proposed NPDB Reports

Often a VA physician or other health professional will receive correspondence from the VA advising that a National Practitioner Data Bank (NPDB) report is being considered against her or him. This also happens frequently to those who are no longer VA employees.  Regardless, you must cooperate.  Otherwise is to risk an adverse NPDB report being filed against you.

This matter usually occurs if there has been a Federal Tort Claim filed by a patient or the patient’s next of kin or estate, and it has been settled, paid, or resulted in a court verdict against the VA. The law and VA regulations require that NPDB reports on the payment be filed naming the individuals involved. However, if your care was not a cause of the patient’s adverse outcome, then you should not be named by the vA in a NPDB report.

It is very important to obtain the relevant documents to review prior to making the statement back to the VA and to prepare a well-organized, well-written, professional letter explaining why your actions were not the cause of the patient’s adverse outcome.  You must do your best to avoid an adverse NPDB report which can damage your career and cause a host of other collateral adverse actions to occur to you.

We routinely assist VA physicians and other employees and ex-employees in obtaining records and preparing such “rebuttal” statements to convince the reviewing VA officials not to make an adverse NPDB report on you.

VA Facilities from Which We Represent Physicians and Health Professionals

We represent VA physicians, psychologists, nurse practitioners (ARNPs), mental health counselors, social workers, nurses, nurse anesthetists (CRNAs), pharmacists, and other health professionals with problems, from any of the following VA facilities:

ALASKAAnchorage VA Medical Center, Anchorage, Alaska


ALABAMATuscaloosa VA Medical Center Tuscaloosa, Alabama
Birmingham VA Medical Center, Birmingham, Alabama
Central Alabama VA Medical Center, Montgomery, Alabama


ARKANSASEugene J. Towbin Healthcare Center, North Little Rock, Arkansas
John L. McClellan Memorial Veterans’ Hospital, Little Rock, Arkansas


ARIZONACarl T. Hayden VA Medical Center, Phoenix, Arizona
Bob Stump VA Medical Center, Prescott, Arizona
Tucson VA Medical Center, Tuscson, Arizona


CALIFORNIAFresno VA Medical Center, Fresno, California
Martinez VA Medical Center, Martinez, California
Palo Alto VA Medical Center, Palo Alto, California
Tibor Rubin VA Medical Center, Long Beach, California
Jerry L. Pettis Memorial Veterans’ Hospital, Loma Linda, California
Sacramento VA Medical Center, Mather, California
San Francisco VA Medical Center, San Francisco, California
COLORADORocky Mountain Regional VA Medical Center, Aurora, Colorado
Grand Junction VA Medical Center, Grand Junction, Colorado


CONNECTICUTWest Haven VA Medical Center, West Haven, Connecticut


DISTRICT OF COLUMBIAWashington VA Medical Center, Washington, D.C.
DELAWAREWilmington VA Medical Center, Wilmington, Delaware


FLORIDAC.W. Bill Young VA Medical Center, Bay Pines, Florida
Malcom Randall VA Medical Center, Gainesville, Florida
James A. Haley Veterans’ Hospital, Tampa, Florida
Orlando VA Medical Center, Orlando, Florida
Bruce W. Carter VA Medical Center, Miami, Florida


GEORGIACharlie Norwood VA Medical Center, Augusta, Georgia
Joseph Maxwell Cleland Atlanta VA Medical Center, Decatur, Georgia
Carl Vinson VA Medical Center, Dublin, Georgia


HAWAIISpark M. Matsunaga VA Medical Center, Honolulu, Hawaii


IOWADes Moines VA Medical Center, Des Moines, Iowa
Iowa City VA Medical Center, Iowa City, Iowa
IDAHOBoise VA Medical Center, Boise, Idaho


ILLINOISEdward Hines Junior Hospital, Hines, Illinois
Jesse Brown VA Medical Center, Chicago, Illinois
Captain James A. Lovell Federal Health Care Center, North Chicago, Illinois


INDIANAMarion VA Medical Center, Marion, Indiana
Fort Wayne VA Medical Center, Fort Wayne, Indiana


KANSASDwight D. Eisenhower VA Medical Center, Leavenworth, Kansas
Colmery-O’Neil VA Medical Center, Topeka, Kansas
Robert J. Dole VA Medical Center, Wichita, Kansas


KENTUCKYRobley Rex VA Medical Center, Louisville, Kentucky


LOUISIANAAlexandria VA Medical Center, Pineville, Louisiana
Overton Brooks VA Medical Center, Shreveport, Louisiana


MASSACHUSETTSEdith Nourse Rogers Memorial Veterans’ Hospital, Bedford, Massachusetts
Brockton VA Medical Center, Brockton, Massachusetts
Jamaica Plain VA Medical Center, Boston, Massachusetts
West Roxbury VA Medical Center, West Roxbury, Massachusetts
Edward P. Boland VA Medical Center, Leeds, Massachusetts
MARYLANDBaltimore VA Medical Center, Baltimore, Maryland
Perry Point VA Medical Center, Perry Point, Maryland


MAINETogus VA Medical Center, Augusta, Maine
MICHIGANLieutenant Colonel Charles S. Kettles VA Medical Center, Ann Arbor, Michigan
Oscar G. Johnson VA Medical Center, Iron Mountain, Michigan
Aleda E. Lutz VA Medical Center, Saginaw, Michigan
Battle Creek VA Medical Center, Battle Creek, Michigan
John D. Dingell VA Medical Center, Detroit, Michigan


MINNESOTAMinneapolis VA Medical Center, Minneapolis, Minnesota
MISSOURIHarry S. Truman Memorial Veterans’ Hospital, Columbia, Missouri
Kansas City VA Medical Center, Kansas City, Missouri
John J. Pershing VA Medical Center, Poplar Bluff, Missouri
St. Louis VA Medical Center-Jefferson Barracks, St. Louis, Missouri
John J. Cochran Veterans’ Hospital, St. Louis, Missouri
MISSISSIPPIBiloxi VA Medical Center, Biloxi, Mississippi
G.V. (Sonny) Montgomery VA Medical Center, Jackson, Mississippi


MONTANAFort Harrison VA Medical Clinic, Fort Harrison, Montana


NORTH CAROLINACharles George VA Medical Center, Asheville, North Carolina
Durham VA Medical Center, Durham, North Carolina
Fayetteville VA Medical Center, Fayetteville, North Carolina
W.G. (Bill) Hefner Salisbury VA Medical Center, Salisbury, North Carolina
NORTH DAKOTAFargo VA Medical Center, Fargo, North Dakota


NEBRASKAOmaha VA Medical Center, Omaha, Nebraska


NEW HAMPSHIREManchester VA Medical Center, Manchester, New Hampshire
NEW JERSEYEast Orange VA Medical Center, East Orange, New Jersey
Lyons VA Medical Center, Lyons, New Jersey


NEW MEXICORaymond G. Murphy VA Medical Center, Albuquerque, New Mexico
NEVADANorth Las Vegas VA Medical Center, North Las Vegas, Nevada
Ioannis A. Lougaris VA Medical Center, Reno, Nevada
NEW YORKSamuel S. Stratton VA Medical Center, Albany, New York
Bath VA Medical Center, Bath, New York
Buffalo VA Medical Center, Buffalo, New York
Franklin Delano Roosevelt Hospital, Montrose, New York
Castle Point VA Medical Center, Wappingers Falls, New York
St. Albans VA Medical Center, Queens, New York
Brooklyn VA Medical Center, Brooklyn, New York
Margaret Cochran Corbin VA Campus, New York, New York
Syracuse VA Medical Center, Syracuse, New York
OHIOChillicothe VA Medical Center, Chillicothe, Ohio
Cincinnati VA Medical Center, Cincinnati, Ohio
Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
Dayton VA Medical Center, Dayton, Ohio


OKLAHOMAOklahoma City VA Medical Center, Oklahoma City, Oklahoma


OREGONPortland VA Medical Center, Portland, Oregon
Roseburg VA Medical Center, Roseburg, Oregon


PENNSYLVANIAJames E. Van Zandt VA Medical Center, Altoona, Pennsylvania
Coatesville VA Medical Center, Coatesville, Pennsylvania
Erie VA Medical Center, Erie, Pennsylvania
Lebanon VA Medical Center, Lebanon, Pennsylvania
Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
Pittsburgh VA Medical Center, Pittsburgh, Pennsylvania
H. John Heinz III VA Medical Center, Pittsburgh, Pennsylvania
Wilkes-Barre VA Medical Center, Wilkes-Barre, Pennsylvania


RHODE ISLANDProvidence VA Medical Center, Providence, Rhode Island
SOUTH CAROLINARalph H. Johnson VA Medical Center, Charleston, South Carolina
Wm. Jennings Bryan Dorn VA Medical Center, Columbia, South Carolina


SOUTH DAKOTAFort Meade VA Medical Center, Fort Meade, South Dakota
Hot Springs VA Medical Center, Hot Springs, South Dakota
Royal C. Johnson Veterans’ Memorial Hospital, Sioux Falls, South Dakota
TENNESSEEMemphis VA Medical Center, Memphis, Tennessee
James H. Quillen VA Medical Center, Mountain Home, Tennessee
Nashville VA Medical Center, Nashville, Tennessee
TEXASAudie L. Murphy Memorial Veterans’ Hospital, San Antonio, Texas
Thomas E. Creek VA Medical Center, Amarillo, Texas
George H. O’Brien, Jr., VA Medical Center, Big Spring, Texas
Sam Rayburn Memorial Veterans Center, Bonham, Texas
Garland VA Medical Center, Garland, Texas
Dallas VA Medical Center, Dallas, Texas
Michael E. DeBakey VA Medical Center, Houston, Texas
Kerrville VA Medical Center, Kerrville, Texas
Doris Miller VA Medical Center, Waco, Texas
Olin E. Teague Veteran’s Center, Temple, Texas
UTAHGeorge E. Wahlen VA Medical Center, Salt Lake City, Utah
VIRGINIAHampton VA Medical Center, Hampton, Virginia
Richmond VA Medical Center, Richmond, Virginia
Salem VA Medical Center, Salem, Virginia
VERMONTWhite River Junction VA Medical Center, White River Junction, Vermont


WASHINGTONMann-Grandstaff VA Medical Center, Spokane, Washington
Vancouver VA Medical Center, Vancouver, Washington
Jonathan M. Wainwright Memorial VA Medical Center, Walla Walla, Washington


WISCONSINWilliam S. Middleton Memorial Veterans’ Hospital, Madison, Wisconsin
Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin
Tomah VA Medical Center, Tomah, Wisconsin
WEST VIRGINIABeckley VA Medical Center, Beckley, West Virginia
Louis A. Johnson VA Medical Center, Clarksburg, West Virginia
Hershel “Woody” Williams VA Medical Center, Huntington, West Virginia
Martinsburg VA Medical Center, Martinsburg, West Virginia


WYOMINGCheyenne VA Medical Center, Cheyenne, Wyoming
Sheridan VA Medical Center, Sheridan, Wyoming


PUERTO RICOSan Juan VA Medical Center, San Juan, Puerto Rico