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How to Prepare for OPMC Investigations: A Legal Perspective

On Behalf of | Aug 20, 2021 | Articles, Blog, Firm News, OPMC Reporter, Publications

In the state of New York, there is an office within the Department of Health that serves to investigate claims of medical misconduct, known as the Office of Professional Medical Conduct or “OPMC.”

While the scope of OPMC’s jurisdiction is not unlimited, they play a heavy hand and are the primary governmental enforcement agency responsible for monitoring physician conduct, addressing complaints against doctors and adjudicating remedial and disciplinary actions that can leave a lasting stain on a physician’s career.

Luckily, there are key steps you can take to ensure legal protection, should you find yourself in the midst of an OPMC investigation. With the help of the right team of healthcare attorneys, you can protect yourself, your practice and your professional reputation.

For this reason, it is imperative that you know how to properly respond in the event an OPMC investigation does occur. For more information on the legal perspective of these events, keep reading below.

What Is an OPMC Investigation?

“OPMC” is the Office of Professional Medical Conduct. This office sits within the New York State Department of Health.

The main purpose of this office is to investigate complaints lodged against medical practitioners who are governed by the Orders of the State Board for Professional Medical Conduct. This includes:

  • Physicians
  • Physician assistants

The board itself is mostly comprised of physicians, with the remaining one-third of personnel made up of physician assistants and laypersons.

What Happens When an OPMC Complaint Is Filed?

An OPMC complaint may be filed by a patient, or from a patient’s family or friends. These issues can also be lodged by hospitals and government sources. Additionally, healthcare facilities must also report internal disciplinary action for misconduct matters.

Examples of qualifying misconduct include:

  • Negligence
  • Incompetence
  • Impairment from alcohol or drugs
  • Refusing to provide care based on race, color, national origin, etc.
  • Ordering excessive tests or treatments
  • Billing fraud
  • Moral Unfitness

These are just a handful of the potential violations that OPMC would investigate. Others might include: failing to maintain or transfer medical records, privacy violations, or sexual harassment or abusive conduct towards a patient.

Once an investigation is launched, physicians are expected to fully cooperate. This includes providing any requested documentation, such as medical records and billing materials. Physicians are also given the right to participate in an informal interview with OPMC representatives, but are not obligated to do so.

From there, the board will make a determination to either dismiss the investigation, or proceed to phase 2 of the process that involves formal charges of misconduct and a multi-step administrative hearing and appeal process. If found guilty, OPMC can impose a variety of disciplinary or remedial actions including:

  • Revocation of medical license
  • Suspension or limitation of medical license
  • Probation
  • Monitoring
  • Censure
  • Reprimand
  • Fines
  • Community service

With such potentially serious consequences on the line, it is imperative every medical professional who may be subject to these rules take these matters seriously, and do what s/he can to minimize risk and outcome. Since the vast bulk of investigations are closed before proceeding to the phase 2 charges, it is strongly recommended that all efforts be taken to “nip the matter in the bud” and try to get the complaint dismissed as soon as possible.

It is extremely important to reiterate that during these interviews—and any other stage of the investigation—physicians are authorized to bring in legal counsel.

What Are OPD Investigations?

Similar to OPMC, OPD is another New York State office that handles these types of investigations. OPD stands for the Office of Professional Discipline and sits within the New York State Department of Education

The Department of Education oversees the licensing process for other (non-medical) professionals practicing in New York. This covers a wide span of professionals, including:

  • Dentists
  • Mental health professionals besides psychiatrists
  • Nurses
  • Pharmacists
  • Veterinarians
  • Athletic trainers
  • Chiropractors

These are just a handful of categories that the New York OPD oversees. As with OPMC cases, OPD inquiries typically begin with a claim that is then investigated.

Like OPMC, an OPD investigation can result in drastic remedial or disciplinary action.

How Can I Prepare for an OPMC or OPD Investigation?

In the event you do find yourself under an OPMC or OPD investigation, one of the most important steps you can take is to secure legal representation. With the help of a trusted team of healthcare lawyers, you can ensure you properly understand all rules and regulations and how they apply to you. Experienced counsel have been down the OPMC/OPD road many times before, and have acquired practical experience in dealing with this very important matter in a professional’s career.

More often than not, physicians fare better during OPMC investigations when they are honest and forthcoming with information. But with that said, it is important to understand your rights under the law throughout the process.

This is where trusted attorneys  in this area of law can help keep compliant with these procedures while avoiding unnecessary instances of self-incrimination.

Turn to the Lawyers at Weiss Zarett Brofman Sonnenklar & Levy, P.C.

With this information, you can gain a greater understanding of OPMC and its investigations. It is imperative that all medical professionals understand this information and the potentially serious consequences on the line.

Should you find yourself on the wrong side of an OPMC investigation, the best thing you can do for yourself and your professional reputation is to immediately seek proper counsel.

With the help of a qualified team of healthcare attorneys that are well-versed in this area of law, you can rest assured that your rights remain protected throughout.

In New York, there is a qualified team of dedicated lawyers standing by to help. Contact an attorney today to learn more, and to ensure you are putting your best foot forward heading into an OPMC investigation.

Mathew J. Levy

David A. Zarett