A new troubling trend has recently emerged in the discipline of California health care professionals. The California Department of Health Care Services, or DHCS, has begun to order some health care licensees, such as registered nurses or occupational therapists, suspended from participating in the Medi-Cal program if they are placed on probation by their licensing board, such as the Board of Registered Nursing, due to a criminal conviction. Previously such exclusion actions had been known to be generally brought only when a license had been revoked.
For California health care professionals, accusations against their state license to practice can be costly and time-consuming, with potentially serious consequences to their careers. However, even after a positive result is achieved in a disciplinary case brought by a state agency, doctors and nurses face an additional obstacle to returning to work: the potential of being prohibited from participating in the Medi-Cal program if they are convicted of a crime “substantially related” to the profession.
In past posts, we have previously covered the effects a criminal conviction can have on a state license. Most state agencies have a very broad power to discipline a license for almost any kind of misdemeanor or felony conviction, under statutes that define almost every crime as “substantially related to the qualifications, functions, or duties” of the professional career at issue. Doctors and nurses are no exception: the Medical Board, the Board of Registered Nursing, and the Board of Licensed Vocational Nursing will all aggressively pursue discipline against a licensee who is convicted of a crime.
Almost all health care professionals provide services that are billed to the Medi-Cal program. As such, the Department of Health Care Services considers them “providers of service” within the meaning of Welfare and Institutions Code §14123(a). DHCS has the authority to immediately and indefinitely suspend a provider of service from the Medi-Cal program if the licensee has committed a crime “substantially related” to the practice of his or her profession, regardless of whether or not the licensee has an active license. The consequences to California professionals can be devastating: even if the licensee is placed on probation or merely given a citation as a consequence of their conviction, they could be immediately and indefinitely suspended from participating in Medi-Cal because of the conviction(s) the led to license discipline.
Our firm has strategies to deal with licensees who find themselves on the wrong end of a suspension from the Department of Health Care Services. We also have many years of experience helping licensees deal with the ramifications of criminal convictions. If you are facing license discipline or you have been suspended from participation in the Medi-Cal program, contact an experienced licensing attorney for a professional consultation.