Physician Professional License Defense Attorney
in New York State

Physicians in New York State can face Office of Professional Discipline (OPD) investigations for a variety of reasons. The OPD, operating under the New York State Education Department (NYSED), is responsible for investigating complaints and disciplining licensed professionals, including doctors. Complaints can come from multiple sources, including:

• Patients who claim they received improper care, were overbilled, or experienced unprofessional behavior.
• Colleagues or employees who report ethical violations or workplace misconduct.
• Hospitals and medical boards that flag concerns related to patient safety, documentation errors, or policy violations.
• Insurance companies that detect irregularities in Medicare, Medicaid, or private insurance billing.
• Law enforcement agencies that uncover potential criminal activity involving a physician.

Once a complaint is filed, the OPD will review the allegations and decide whether to open a formal investigation. In many cases, the physician is contacted without knowing the full scope of the complaint, which can make responding difficult. The way a doctor handles this initial phase is critical—even a simple misstatement or poorly worded response can create further complications.

If the OPD decides to move forward with an investigation, they will notify the physician and begin gathering evidence, reviewing patient records, and interviewing witnesses. The process generally includes the following steps:

1. Initial Complaint Review: OPD determines whether the allegations warrant a full investigation.
2. Investigation Phase: The OPD collects evidence, including medical records, billing documents, and witness statements. The physician may be asked to respond.
3. Interview and Settlement Discussions: The physician may be called for an interview, and in some cases, the OPD may offer a settlement or consent agreement.
4. Formal Charges and Hearing: If the case is not resolved, formal charges may be filed, leading to a hearing before the Board of Regents or an administrative panel.
5. Disciplinary Actions: Depending on the outcome, potential penalties can include license suspension, revocation, fines, probation, or mandatory education.

Many New York physicians are caught off guard by OPD investigations, believing that minor allegations will not escalate. However, even a single misstep in responding to an investigator can put a doctor’s license at risk.

For physicians in New York State, an Office of Professional Discipline (OPD) investigation can lead to severe professional and personal consequences. Even if a complaint seems minor, an OPD inquiry can jeopardize a doctor’s medical license, reputation, and ability to practice medicine.

Possible outcomes of an OPD case include:

• License Suspension or Revocation: In serious cases, a physician’s license may be suspended or permanently revoked, preventing them from practicing in New York State or potentially in other states.
• Fines and Civil Penalties: The OPD may impose financial penalties on physicians found guilty of misconduct, adding to the burden of defending a license.
• Probation or Monitoring: Some physicians may receive probationary periods, requiring ongoing supervision, additional training, or frequent reporting to the OPD.
• Damage to Professional Reputation: Even if a doctor retains their license, public disclosure of an OPD actioncan lead to loss of patient trust, hospital privileges, and professional relationships.
• Employment Challenges: Physicians under investigation may face contract termination, difficulty securing new positions, or challenges with credentialing and malpractice insurance.

Many New York doctors do not realize that even an informal interview with OPD investigators can be used against them later in the case. Responding to an inquiry without an attorney experienced in professional license defense can increase the risk of disciplinary action.

Physicians in New York State can face OPD investigations for a wide range of allegations, including:

• Medical Negligence or Substandard Care – Accusations of failing to provide adequate treatment or making critical errors in diagnosis or patient management.
• Billing and Insurance Fraud – Claims related to overbilling, improper coding, or fraudulent Medicare/Medicaid billing practices.
• Substance Use Allegations – Reports of impairment, drug diversion, or failure to meet professional standards due to substance use.
• Boundary Violations – Complaints about inappropriate relationships, harassment, or unprofessional conduct with patients or colleagues.
• Record-Keeping and Documentation Issues – Failure to maintain proper patient records, prescription documentation, or compliance with medical regulations.
• Criminal Charges or Arrests – Physicians facing criminal investigations or arrests, even for non-medical matters, may be subject to OPD disciplinary action.

Because OPD investigations are often complex and multifaceted, a physician may face multiple allegations in a single case. Even if a complaint is unfounded, OPD proceedings can take months or even years to resolve, affecting a doctor’s ability to practice in the meantime.