When a complaint is filed, a legal assistant decides whether the matter falls within jurisdiction of the Department. Complaints that are deemed to be within the jurisdiction of the Department and which require investigation are forwarded to the Department’s Bureau of Enforcement and Investigation. Investigators then gather all of the relevant information. This stage can last from several weeks to several months depending on the complexity of the allegations. Once the investigation is complete, the investigation report is provided to the Professional Compliance Office and the prosecuting attorney. A decision is then made about whether to proceed with the matter or whether it should be closed. If the matter goes forward, the prosecuting attorney prepares an Order to Show Cause which is sent to the respondent physician. The physician has 30 days to file a written answer to the Order to Show Cause. Then a hearing is scheduled and the case is heard. If the respondent licensee is unhappy with the outcome of the hearing then the respondent may appeal in a court of law.
This article is intended to be helpful and informative. But even common legal matters can become complex and stressful. A qualified health insurance lawyer can address your particular legal needs, explain the law, and represent you in court. Take the first step now and contact a local health insurance attorney to discuss your specific legal situation.