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

Resources and Documents

Florida State Documents and Information:

Florida Department of Health (DOH) Documents

Healthcare Provider Regulatory Process Enforcement Process Flowchart (click to review)
This flowchart, flow diagram, disciplinary guideline, or algorithm was originally published by the Medical Quality Assurance (MQA) Division of the Florida Department of Health (DOH) in the early 2000s to better explain and illustrate the processing of disciplinary complaints against licensed health professionals in the State of Florida. It does a great job of showing the process. However, it does not contain the information on how long each step of the process can take. Some steps can take months or even years. The chart is a summary of the process that is required by state statutes, including the Florida Administrative Procedure Act (APA), Chapter 120, Florida Statutes. It is a useful guide to locate where your case is in the process.

Florida Emergency Suspension of the License of Alexis Backer Lawler, R.N., January 28, 2026 (click to review)
(Florida Department of Health vs. Alexis Backer Lawler, R.N., D.O.H. Case No. 2026-09960, entered January 28, 2026)
This is an Emergency Suspension Order issued by the Florida Department of Health (DOH) against a registered nurse, immediately suspending the individual’s nursing license due to allegations of unprofessional conduct in retaliation for her exercising her First Amendment right to make statements critical of the present administration on January 22, 2026. The order details findings related to inappropriate and offensive social media activity, including statements that allegedly raised concerns about patient safety, professional judgment, and the nurse’s ability to provide competent care. The document outlines the DOH’s factual findings, legal conclusions, and authority under Florida law to take emergency action to protect public health and safety. It also includes notice of the nurse’s right to judicial review and the initiation of formal disciplinary proceedings.

Florida Agency for Health Care Administration (AHCA)

Grant of Exemption from Disqualification from Employment (click to review)
This document is a sample request sent to the Agency for Health Care Administration (AHCA) for an exemption from disqualification from employment. (2023)

Federal Documents and Information:

Department of Health & Human Services (DHHS)

Sample of a Health Care Subpoena Issued From the Office of Inspector General (OIG) (click to review)
This is an example of a subpoena that the OIG issued while looking into a potential False Claims Act (FCA) case. You need a lawyer if you get one of these.

Office of Inspector General (OIG)

Sample of an Office of Inspector General (OIG) Advisory Opinion, No. 21-18, November 17, 2021 (click to review)

This is a sample of a formal written response, an advisory opinion, from the Office of Inspector General (OIG) regarding whether a proposed business arrangement for the provision of therapy services violates federal fraud and abuse laws, particularly the Anti-Kickback Statute (AKS).

Department of Justice (DOJ)

Sample DOJ Memorandum: Limiting Use of Agency Guidance Documents In Affirmative Civil Enforcement Cases, January 25, 2018 (click to review)

Under the Guidance Policy, the Department may not issue guidance documents that purport to create rights or obligations binding on persons or entities outside the Executive Branch (including state, local, and tribal governments) or to create binding standards by which the Department will determine compliance with existing statutory or regulatory requirements.

Veterans Administration (VA)

Memorandum of Understanding (MOU) Between the DHHS and the VA (click to review)
This is the original Memorandum of Understanding (MOU) or agreement in which the Veterans Administration (VA) originally agreed with the Department of Health and Human Services (DHHS) to participate in reporting matters to the National Practitioners Data Bank (NPDB), as civilian hospitals are required to do.

Department of Defense (DOD)/Defense Health Agency (DHA)

Memorandum of Understanding (MOU) Between the Department of Health and Human Services (DHHS) and the Department of Defense (DOD) (click to review)

This is the original Memorandum of Understanding (MOU) between the Health Resources and Services Administration (HRSA), Department of Health and Human Services (HHS), and the Department of Defense (DOD) that ensures the participation of the DOD in the national reporting system established under Part B of The Health Care Quality Improvement Act of 1986 (the Act). These requirements and procedures have now been incorporated into DHA PM 6025-13, so it is now obsolete.

Certification Boards:

American Board of Internal Medicine (ABIM)

Notice of Potential Disciplinary Sanction From American Board of Internal Medicine (ABIM) (click to review)
This is a sample of the type of letter the ABIM may send out to test takers, whether they are already board certified or not, notifying them of being suspected of cheating, irregular behavior, sharing information from an actual examination, misconduct or other violation of its rules and policies. This is a very serious matter that can lead to drastic adverse actions affecting your job, clinical privileges and career. We routinely assist physicians in preparing and submitting responses, obtaining hearings, or otherwise defending against such accusations.

Private Organizations:

The Joint Commission

Behaviors That Undermine a Culture of Safety (click to review)
(Note: This is a complimentary publication of The Joint Commission, Sentinel Event Alert Issue 40, July 9, 2008. Updated: June 18. 2021)
Published for Joint Commission-accredited organizations and interested health care professionals, Sentinel Event Alert identifies specific types of sentinel events, describes their common underlying causes, and suggests steps to prevent occurrences in the future.

United States Medical Licensing Examination (USMLE) Secretariat & National Board of Medical Examiners (NBME)

USMLE CIR Personal Statement Submission Guidelines, February 2026 (click to review)
This document outlines the submission requirements for a personal statement to the United States Medical Licensing Examination (USMLE) Committee for Individualized Review (CIR). While submission is optional, the guidelines specify that any personal statement must be directly relevant to the allegations, limited to 20 pages, and submitted as a single PDF document by the designated deadline. The document also emphasizes that all materials provided will be reviewed and verified for authenticity by the USMLE. Adhering to these formatting, content, and submission requirements is essential to ensure that the CIR considers the statement during its review process.

USMLE 2026 Bulletin of Information (BOI) (click to review)

(United States Medical Licensing Examination (USMLE), a Joint Program of the Federation of State Medical Boards of the United States, Inc., and National Board of Medical Examiners (NBME), August 7, 2025, 2026 Bulletin of Information)
This document includes information on all aspects of USMLE, such as eligibility requirements, scheduling test dates, testing, and score reporting. You must review and become familiar with the Bulletin before completing your application for USMLE Step 1, Step 2 CK, or Step 3.

Important Updates to United States Medical Licensing (USMLE) Policies and Procedures Regarding Irregular Behavior, September 2025 (click to review)

The United States Medical Licensing Examination® (USMLE®) program has updated its Policies and Procedures regarding irregular behavior. These updates are now in effect as of January 15, 2026, in accordance with the USMLE Bulletin of Information (BOI) requirement. Examinees are encouraged to review these updates to understand what constitutes irregular behavior and how the USMLE works to support exam integrity.

Educational Commission for Foreign Medical Graduates (ECFMG) Statement on Invalidation of the United States Medical Licensing Examination (USMLE) Examination Scores (click to review)

Educational Commission for Foreign Medical Graduates (ECFMG), January 31, 2024, Statement on Invalidation of USMLE® Examination Scores, [Press Release]

Publications By Our Attorneys:

Publications by Lance O. Leider, LL.M., J.D.

HIPAA Fines, Mobile Devices and Risk Assessments: Follow the Steps or Pay the Price
(Note: This article was originally published in Facts & Findings, March/April 2015) by Lance O. Leider, LL.M., J.D.

Publications by Amanda I. Forbes, J.D.

Autism and Access to Healthcare
(Note: This article was originally published in the Mitchell Hamline Law Journal of Public Policy and Practice: Vol. 45: Iss. 1, Article 2. 2024) by Amanda I. Forbes, J.D.

Publications by Michael L. Smith, R.R.T., J.D.

Telehealth in Respiratory Care
(Note: This article was originally published in Advance for Respiratory Care and Sleep Medicine) by Michael L. Smith, R.R.T., J.D.

Healthcare Compliance: An Overview of the Basics for Organizations and Providers
(Note: This article was originally published in Advance for Respiratory Care and Sleep Medicine) by Michael L. Smith, R.R.T., J.D.

$800,000 for Medical Record Dumping