In response to a patient complaint, a report of a large malpractice settlement, or a report of a loss of privileges, among other reasons, the Medical Board of California may choose to investigate patient care. Often, to an unsuspecting California physician, the first sign of trouble is receipt of a request for patient records from something called the “Division of Investigation.” The request for patient records usually comes in the mail, but may be served by an investigator. The letter is addressed “Dear Custodian of Records.” With the letter, there should be a certification form for the custodian of records to fill out to certify what, if any, records are being provided, an authorization of release of records form signed by the patient, and a page with a printout of the applicable law.
There can be some confusion because these documents say they come from “Division of Investigation” at the “Health Quality Investigation Unit.” In fact, there is no mention at all of the Medical Board of California in these documents. However, rest assured, it is a Medical Board investigation. This request for records often will eventually lead to further investigation, and, at a later date, questioning of the treating physician by a Medical Board investigator, an expert medical reviewer (physician), and a Deputy Attorney General.
A physician (or other healthcare professional) served with one of these requests has 15 days to produce the records requested. If the records are not produced (or a certification that says the person receiving the request has no records), a civil penalty of $1,000.00 for each day that passes beyond the deadline can be assessed. The rules are contained in Business and Professions Code sections 2225(d) and 2225.5.
A request for patient records is a valuable early warning that a physician disciplinary case may be on the horizon. Months or years later, resulting events can lead to license probation, suspension or revocation, suspension of board certification, loss of Medicare or MediCal privileges, and other consequences. A professional license defense attorney can use this opportunity to prepare the physician to defend their license and privileges in the coming investigation.